The Effect of Vitrectomy and its Combined Procedures on the Progression of Cataract in Phakic Eyes

PURPOSE: This study was to evaluate the effect of vitrectomy and combined procedures on the progression of cataract in previously vitrectomized eyes. METHODS: The authors reviewed the medical records of 47 patients (48 eyes) who had undergone pars plana vitrectomy followed by cataract surgery and had been followed up for 3 months or longer. The mean follow-up period was 10.5 months. The degree of lens opacity was compared before vitrectomy when the progression of cataract was diagnosed and before cataract surgery using LOCS III. The interval between vitrectomy and cataract surgery was analyzed by age, causative disease, operation procedure, and combined procedure, retrospectively. RESULTS: The degrees of lens opacity at preoperative examination of vitrectomy were 0.31 (Nuclear color/ opalescence) and 0.10 (posterior subcapsular opacity). The mean interval between vitrectomy and the time of diagnosis of development or progression of cataract was 2.1 months, and the degrees of lens opacity at that time were 1.29 and 0.69. The degrees of lens opacity at preoperative examination of cataract surgery were 3.44 and 2.00. The mean interval between vitrectomy and cataract surgery was 11.3 months with a range of 1 to 33 months. The mean intervals in the eyes with gas tamponade (C3F8 or SF6) and silicone oil tamponade were 10.3 and 7.7 months, respectively, but in cases with only vitrectomy was 15.8 months. There was significant difference in each group (P=0.003). CONCLUSIONS: Preoperative visual acuity and internal limiting membrane removal were good prognostic factors in idiopathic macular hole surgery. Functional success group showed constant improvement of visual acuity in postoperative 2 years.

The Effect of Glucose Concentration on Expression of VEGF and HGF in Cultured Human RPE Cells

PURPOSE: To evaluate the expression of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in response to high glucose concentration in human retinal pigement epithelial (RPE) cells. METHODS: After confluent adult human RPE cells (ARPE-19) were cultured in RPMI 1640 media containing three different concentration of glucose (5.5, 11 and 22 mmol/L) for 3, 7 and 14 days, Western blot analysis was performed. Cell pellets were lysed in lysis buffer and cell lysates were centrifused to collect supernatant fractions for quantifying protein concentration. The proteins were subjected to electrophoresis and transferred to nitrocellulose membranes. After the blots were incubated with primary and secondary antibody to VEGF or HGF consecutively, enhanced chemiluminescence and autoradiography were performed. To evaluate the relationship between protein and mRNA expression, RNA from glucose-treated RPE cells was obtained by using RNAzolB. After cDNA was obtained through reverse transcription of RNA, PCR of cDNA was performed by using primers. RESULTS: We found that incubation with different concentrations of glucose increased the protein expression of VEGF and HGF in concentration-dependent manner in RPE. At 14 days, level of VEGF protein expression was higher in 22 mmol/L glucose group than in other two groups (5.5 mmol/L or 11 mmol/L), but no differences of mRNA expression of VEGF were observed in each group. At 3 days, level of HGF protein expression was higher in 22 mmol/L glucose group than in other groups, but mRNA expression of HGF was not detected in all groups. CONCLUSIONS: These results suggest that RPE cells may participate in angiogenesis in progression of diabetic retinopathy through production of VEGF and HGF.

Corneal Endothelial Changes in Patients with Traumatic Hyphema

PURPOSE: In patients with traumatic hyphema, we investigated the changes of corneal endothelium and the associated ocular complications that might attribute to endothelial damage. MATERIALS & METHODS: We reviewed the medical records of 67 patients(67 eyes) who had been admitted and treated for blunt ocular trauma with hyphema between February 1997 and June 2000. One month after injury, endothelial photographs of both eyes of each patient were taken with specular microscope to compare the endothelium of the injured eyes with that of the normal fellow eyes. The endothelial parameters were studied in relationship to various complications to see the relationship between the complications and the endothelial damage. RESULTS: Compared with the fellow uninjured eyes, the injured eyes had a mean decrease in endothelial cell density (ECD) of 5.6% (P=0.015). Nine patients had significant corneal edema with epithelial defect on initial admission, which was defined as corneal impact lesion. In the group with the corneal impact lesion, the mean ECD decrease was 23.1% (P=0.016) and the mean coefficient of variation (COV) increase was 24.8% (P=0.01). With other variables such as the amount of hyphema and the degree of angle recession, statistically significant results could not be obtained. In 20 patients on long-term follow-up examination (mean 36.7 months after the injury), the injured eyes had a mean increase in ECD of 2.5% compared to the result on initial examination. This change was minimal and statistically not significant. CONCLUSION: In patients with traumatic hyphema, this study showed reduced endothelial cell densities in the injured eyes compared to the normal fellow eyes. In particular, statistically significant decrease in ECD was noted to be associated with corneal impact lesion.

Endothelial Function of Cornea Preserved in Korean Corneal Storage Media

PURPOSE: To evaluate the endothelial function of cornea preserved in newly developing korean corneal storage media (CS002, CS003) by estimating the permeability of corneal endothelium and the change of corneal thickness. METHODS: The cornea were divided into six experimental groups - fresh group immediately after enucleation, 4degrees Cmoist chamber group preserved for 24 hours and 48 hours, Optisol & CS002 group for 1, 3, 5, and 7 days, and Likorol & CS003 group for 7, 10, and 14 days after enucleation, and then corneal endothelial permeability(Pac) was measured using carboxyfluorescein solution. Corneal thickness was measured using pachymeter(fine focus adjustment) of the specular microscope. RESULTS: Corneal endothelial Pac (x1 0(- 4) cm/min) was 3.64+/-0.33 in fresh group, 4.79+/-0.28 in 4degrees Cmoist chamber group for 24 hours. Each endothelial Pac of CS002 group at 5 and 7 days was 5.81+/-0.55 and 5.65+/-0.58, which were different with 4degrees Cmoist chamber preservation group for 24 hours(p<0.05) but not different with Optisol groups at same days. Each endothelial Pac of CS003 group at 7, 10, and 14 days was 4.34+/-0.34, 4.66+/-0.59, and 4.66+/-0.27, which were not different from those of Likorol. Each corneal thickness of CS002 and Optisol group at 7days was 417.80+/-19.37 mu m and 421.00+/-19.75mu m, which were resemble increment. Corneal thickness was 426.75+/-22.43mu m in CS003 group and 476.00+/- 40.08mu m in Likorol group at 7days. There was statistical difference between the two group(P<0.05), and this difference was sustained for 14days (P<0.05). CONCLUSION: There was no difference in the effect on corneal endothelial permeability between korean corneal storage media such as CS002 and CS003, and that of previous corneal storage media such as Optisol and Likorol. Corneal thickness of cornea preserved in korean corneal storage media was thinner than that of Likorol.