Morphologic and molecular study on the lens anterior capsule in systemic sclerosis / Relato sobre estudo morfológico e molecular da cápsula anterior do cristalino na esclerose sistêmica

ABSTRACT This study aimed to analyze the anterior lens capsule specimens from both eyes of a patient with systemic sclerosis and compare them to the eyes of a control patient. No significant differences between systemic sclerosis and control eyes were observed in the results from the hematoxylin-eosin and picrosirius staining. In the samples obtained from both systemic sclerosis and control eyes, there were expressions of caspase, a molecule expressed in cell death by apoptosis. Heparanase was overexpressed in the systemic sclerosis sample compared to the control sample. Therefore, the anterior lens capsule of the patient with systemic sclerosis is probably affected by the disease since it showed marked expression of heparanase 1.(AU)

RESUMO Analisamos as amostras das cápsulas anteriores do cristalino de uma paciente com esclerose sistêmica e comparamos com as de um paciente controle. Não foram observadas diferenças significativas entre esclerose sistêmica e controle nos resultados da coloração com hematoxilina-eosina e picrosirius. Nas amostras obtidas da esclerose sistêmica e do controle, obtivemos expressão de caspase, uma molécula expressa na morte celular por apoptose. A heparinase foi expressa de forma mais marcante na amostra de esclerose sistêmica quando comparada ao controle. Portanto, a cápsula anterior do cristalino da paciente com esclerose sistêmica provavelmente foi afetada pela doença, uma vez que mostrou expressão aumentada de heparinase 1.(AU)

Ocular findings in Fabry disease in Colombian patients / Manifestaciones oculares de la enfermedad de Fabry en pacientes colombianos

ABSTRACT Fabry disease is a rare X-linked disorder caused by an alpha-galactosidase enzyme deficiency, which leads to a progressive lysosomal glycosphingolipids accumulation, mainly globotriaosylceramide, in multiple organism tissues including the eye. This case series describes the first ophthalmological Colombian report of Fabry disease highlighting the importance of ocular signs as markers of the disease, useful in diagnosis and treatment to avoid long-term complications that lead to a morbi-mortality increment. We describe five cases of Fabry disease from Bogotá, Colombia, including a complete clinical history, ophthalmologic, optometric examination, and photographs. We found that all patients had refractive defects and that in all cases corneal verticillata pattern was found. Four patients presented with posterior capsule lens brown-beige deposits and four patients had conjunctival and retinal tortuous vessels. A complete ophthalmologic examination is important for prompt diagnosis, which is key to starting a multidisciplinary treatment and reducing morbi-mortality.

RESUMEN La enfermedad de Fabry es un raro trastorno ligado al cromosoma X causado por deficiencia de la enzima alfa-galactosidasa y la consiguiente y progresiva acumulación lisosómica de glucoesfingolípidos, especialmente la globotriaosilceramida, en múltiples tejidos del organismo, incluido el ojo. En este reporte se presenta la primera serie de casos de manifestaciones oculares de la enfermedad de Fabry en Colombia, resaltando la importancia de los signos oculares como ayuda para el diagnóstico temprano. Se presentan cinco casos de la enfermedad en Bogotá y se da cuenta de las historias clínicas y los exámenes oftalmológicos y de optometría, y se incluyen fotografías. En todos los pacientes se hallaron errores de refracción y se evidenció el patrón de córnea verticillata. Cuatro pacientes presentaban depósitos de color café y castaño claro en la cápsula posterior del cristalino, y cuatro tenían tortuosidad vascular conjuntival y retiniana. El examen oftalmológico completo es importante para hacer un diagnóstico oportuno con el fin de iniciar el tratamiento multidisciplinario y reducir la morbimortalidad.

Inhibition effects of sulforaphane-induced autophagy flux to cell proliferation on ex vivo human capsular bags / 中华实验眼科杂志

Background Sulforaphane (SFN) is an effective chemopreventive agent and can regulate the biological molecular mechanisms to inhibit the overgrowth of cells.Autophagy is a biological process of maintaining cellular internal environment.Understanding the affection of SFN to biological behavior of human lens epithelial cells (LECs) and the association of SFN with autophagy is helpful for the prevention and target treatment of posterior capsule opacification (PCO).Objective This study was to investigate the eradication effeccts of SFN on residual lens cell population in vitro posterior capsule opacification (PCO) model and evaluate the mechanism of SFN-induced cell death.Methods In vitro human capsular bag models were generated from fresh donor eyes by phacoemulsification and were cultured in EMEM containing 2％ fetal bovine serum (FBS).Different concentrations of SFN (0,1,10 and 100 μ mol) were added in the medium for 30 days respectively according to grouping,and the growth of LECs was observed by optical microscope and immunofluorescence technique.FHL124,a human LEC line,was cultured with EMEM containing 5％ FBS and divided into 0,1,10,30 and 100 μmol SFN groups.Lactate dehydrogenase (LDH) release rate in the medium was detected to evaluate cell damage/death.The migration of the cells on capsular bags was assessed by scratch test.The ultrastructure and number of autophagosomes were examined under the transmission electron microscope.The expression of LC3 in the cells were detected using Western blot in the presence or absence of autophagy inhibitors.Results The cell coverage rates on the capsular bags were significantly lower in the 10 and 100 μ mol/L SFN groups than those in the 0 and 1 μmol/L SFN groups,with a statistically significant difference among the groups (F =48.57,P ＜ 0.01).Immunofluorescence showed that the density of F-actin-and Vimentin-positive cells was evidently decreased in the 10 and 100 μmol/L SFN groups compared with 0 and 1 μ mol/L SFN groups.The releasing levels of LDH (absorbancy) were 0.19± 0.03,0.39±0.06,0.56±0.07,0.68±0.08 and 0.89±0.09 in the 0,1,10,30 and 100 μ mol/L SFN groups,respectively,and the releasing level of LDH was gradually increased in the 10 and 100 μ mol/L SFN groups in comparison with the 1 μmol/LSFN group (all at P＜0.01).With the increase of SFN concentration,the reduction rate of scratched area decreased with the increase of SFN concentration,and the decrease of scratch area was significantly lower than that of adjacent low mass concentration group and the differences were statistically significant (P＜0.05).The relative expressions of LC3-Ⅱ protein were 0.423±0.003,14.543±0.024,0.668±0.024 and 0.576±0.056 in the blank control group,SFN group,SFN + 3-MA group and 3-MA group,respectively,and the relative expressions of LC3-Ⅱ protein were significantly lower in the SFN+3-MA group and 3-MA group than those in the SFN group (all at P＜0.01).The number of autophagosomes was 4.07±0.32,4.13±0.34,9.21 ±0.53 and 21.02± 1.34 in the blank control group,and 1,10,100 μmol/L SFN groups,and the number of autophagosomes in the 10 and 100 μ mol/L SFN groups was significantly higher than that in the blank control group and 1 μmol/L SFN group (all at P＜0.01).Conclusions SFN mediates LECs death by promoting autophagy in ex vivo capsular bags,and SFN may be a novel agent of potential chemopreventive and target treatment for PCO.

Wnt3a-induced extracellular matrix production and gel contraction in human lens epithelial cells / 中华实验眼科杂志

Background Excessive production,deposition and contraction of extracellular matrix (ECM) of human lens endothelial cells (LECs) is one of main causes to posterior capsular opacification (PCO).Researches indicated that Wnt3a protein was involved in production of ECM and fibrosis in epithelial cells,but its effect on LECs is still unclear.Objective This study aimed to elucidate the roles of Wnt3a in production of ECM and gel contraction of LECs.Methods Lipofectamine-mediated transient transfection technique was used to introduce cDNA of Wnt3a gene and pcDNA3-HA vector into the LEC cell line SRA01/04 to act as Wnt3a transfection group and control group respectively.After 48 h of transfection,Western blot was used to detect the expression of Wnt3a,main components of ECM Col-Ⅰ,Col-Ⅳ and integrin β1.Immunofluorescence was used to detect the expression and distrubition of α-SMA and F-actin;collagen contraction was observed by mingling SRA01/04 cells with Col-Ⅰ.Results After 48 hours of transfection using lipofectamine 2000,the expressions of wnt3a protein in SRA01/04 cells was 0.703 ±0.105 in the wnt3a transfected group,and that in the control group was 0.290 ± 0.066,showing a significant difference between the two groups (t =5.782,P＜0.01).Western blot assay showed that the expression levels of Col-Ⅰ and Integrin β1 was 0.697±0.021 and 0.875±0.055 in the Wnt3a transfected group,and which was significantly higher than 0.370±0.020 and 0.580±0.030 in the control group (t =19.600,8.156,both P＜0.01).The expression level of Col Ⅳ in the Wnt3a transfected group was higher than that of the control group (0.430±0.020 vs 0.383 ±0.031),but the difference was not significant (t =2.514,P＞0.05).Immunofluorescence assay revealed that F-actin and α-SMA were weakly expressed in the cell membrane primarily in the control group,while they were strongly expressed in the cell membrane,cytoplasma in the Wnt3a transfected group.Tewnty-four hours after addtion of Col-Ⅰ,the gel contraction area ratio appeared to be more obvious in comparison with the 8 hours (64.1％ ±2.3％ vs 98.9％ ± 1.0％),and gel contraction area ratio was lower in the Wnt3a transfected group than that in the control group (64.1％ ± 2.3％ vs 93.9％ ± 3.1％).Conclusions The overexpression of Wnt3a activates the production of ECM,and the remodeling of celluar skeleton and cellular contraction.

The influence of size and shape of Nd:YAG capsulotomy on visual acuity and refraction / A influência do tamanho e forma da capsulotomia por laser de Nd:YAG sobre a acuidade visual e refração

ABSTRACTPurpose:To evaluate the influence of size and shape of neodymium:yttrium aluminum- Garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction.Methods:We retrospectively evaluated 85 eyes of 67 patients treated with Nd:YAG laser posterior capsulotomy for posterior capsule opacification (PCO). The mean age of included patients was 57.57 ± 9.26 (mean ± standard deviation, 38-75 years). The mean interval between surgery and Nd:YAG laser capsulotomy was 26.09 ± 7.08 (10-38) months. Patients were divided into four groups according to the shape and size of capsulotomy. Groups comprised patients with cruciate shape capsulotomies with openings of less than or equal to 3.5 mm (Group 1) or greater (Group 2) and patients with circular shape capsulotomies with openings of less than or equal to 3.5 mm (Group 3) or greater (Group 4).Results:The mean number and energy of laser firings were significantly higher in Group 4 (p=0.00), and significantly lower in Group 1 (p=0.00), compared with that in other groups. Pre-procedural and post-procedural mean spherical equivalent (SE) values were significantly higher in Group 1 (p=0.026 and p=0.011, respectively). No statistical difference in best-corrected visual acuities (BCVA) or intraocular pressures (IOP) were observed between groups before (p=0.44 and p=0.452, respectively) or after capsulotomy (p=0.108 and p=0.125, respectively). A significantly higher number of patients in Group 4 (p=0.001), and a significantly lower number of patients in Group 1 (p=0.001), reported floating bodies compared with that in other groups. No significant changes in SE or intraocular pressure were observed after capsulotomy in any group (p=0.074 and p=0.856, respectively). Best-corrected visual acuity was significantly improved following capsulotomy in all groups (p<0.01).Conclusion:Cruciate shape capsulotomy with an opening of 3.5 mm or less provides the greatest improvement in visual function with minimal complications.

RESUMOObjetivo:Avaliar a influência do tamanho e forma da capsulotomia a laser de Neodímio: Ítrio-Alumínio-Granada (Nd:YAG) na acuidade visual e refração.Métodos:Oitenta e cinco olhos de 67 pacientes, com opacificação de cápsula posterior (PCO), que tinham sido submetidos a capsulotomia por laser de Nd:YAG, foram avaliadas retrospectivamente. A idade foi 57,57 ± 9,26 (média ± desvio padrão), variação 38-75 anos. O intervalo médio entre a cirurgia e a capsulotomia a laser de Nd:YAG foi 26,09 ± 7,08 (variação 10-38) meses. Os pacientes foram divididos em 4 grupos de acordo com a forma e o tamanho da capsulotomia. O grupo 1 incluiu pacientes com forma cruzada e tamanho igual ou menor do que 3,5 mm de abertura capsulotomia, Grupo 2, forma cruzada e tamanho maior do que 3,5 mm, Grupo 3, forma circular e tamanho igual ou menor do que 3,5 mm e Grupo 4, forma circular e tamanho superior a 3,5 mm.Resultados:A quantidade média de energia utilizada e tiros aplicadas foram significativamente maiores no Grupo 4 (p=0,00) e significativamente menores no grupo 1 (p=0,00). O equivalente esférico (SE), antes e após o procedimento, foi significativamente mais elevado no Grupo 1 (p=0,026, p=0,011). Não houve diferença estatística entre os grupos em relação à acuidade visual melhor corrigida (BCVA) e pressão intraocular (IOP) antes do procedimento (p=0,44, p=0,452) e após o procedimento (p=0,108, p=0,125). O número de pacientes com sintomas de moscas volantes foi significativamente maior no grupo 4 (P=0,001) e significativamente inferior no grupo 1 (p=0,001). SE e IOP após o procedimento não foram estatisticamente diferentes daqueles antes do procedimento (p=0,074, p=0,856, respectivamente) em todos os grupos. BCVA após o procedimento foi significativamente melhor do que antes do procedimento (p=0,00) em todos os grupos.Conclusões:Em conclusão, para complicações mínimas e máximas funções visuais, o tamanho ótimo capsulotomia deve ser igual a ou menor do que 3,5 mm e deve ser em forma cruzada.

Effect of drug-sustained capsular tension ring on proliferation of lens epithelial cells in vitro / 中国医师杂志

Objective Our study was performed to design a drug-sustained capsular tension ring (CTR) to evaluate its potentiality on prevention of PCO in the swine capsular bag model in vitro.Methods Following the continuous capsule curvilinear capsulorhexis ( CCCC),Phacomulsification with capsular tension ring implantation was pedormed.CTR-supported swine capsular bag models were prepared and divided into two groups,group CTR ( n =13 ) implanted with the original CTR without any modification and group CTR-PLGA-MG132 ( n =13) implanted with the CTR covered with PLGA and MG132.The CTRsupported capsular bags were cultured in vitro for up to 3 weeks.The area of lens epithelial cells (LEC) coverage over the posterior capsule surface was quantified every day under microscope.The capsules were treated for histological examination.The change of fibronectin was assessed by ELISA assay kit.Results After 2 ～ 3 days,outgrowth of LEC across the posterior capsule was observed,and the posterior capsule was totally covered by a confluent monolayer of cell after (9.06 ± 1.61 ) days in group CTR.Capsular wrinkles became increasingly apparent as time progressed.An increase in capsular thickness was also observed.In contrast,there was less LEC deposition in group CTR-PLGA-MG132.Histological examination showed LEC layers were closely arranged on the posterior capsular surface in group CTR.In group CTR-PLGA-MG132,there was comparatively looser cell arrangement.Compared with group CTR,the mean fibronectin level of posterior capsule by week 3 in group CTR-PLGA-MG132 was 25.14 μg/ml and 106.09 μg/ml respectively.Statistical analysis showed a significant difference ( P ＜ 0.01 ).Conclusions LEC migration,proliferation,and synthesis of EMT markers were inhibited in Group CTR-PLGA-MG132,compared with Group CTR.Drug-sustained capsular tension rings can effectively inhibit the migration,proliferation of LEC and the change of EMT ( epithelial-to-mesenchymal transition) in swine capsular bag models.Drug-sustained capsular tension rings might be a potential therapy to prevent the posterior capsular opacification in the future.

Pressão intraocular antes e após a facoemulsificação em olhos normais / Intraocular pressure before and after phacoemulsification in normal eyes

OBJETIVO: Avaliar comparativamente a pressão intraocular (PIO) antes e após 1 dia, 3 dias, 1 semana, 1 mês, 3 meses, 6 meses e 1 ano, em olhos normais submetidos à facoemulsificação. MÉTODOS: Análise retrospectiva da pressão intraocular (medida pelo tonômetro de aplanação de Goldmann) de 221 olhos normais de 133 pacientes submetidos à facoemulsificação sem intercorrências. A PIO foi avaliada antes e após a facoemulsificação (1dia, 3 dias, 1 semana, 1 mês, 3 meses, 6 meses e 1 ano), e os valores encontrados nestes períodos foram submetidos a uma análise comparativa. RESULTADOS: A PIO média foi de 16,06±2,69 mmHg no pré-operatório; 18,76±5,96 mmHg após 1 dia; 14,82±4,08 mmHg após 3 dias; 14,03±3,06 mmHg após 1 semana; 13,88±3,26 mmHg após 1 mês; 12,74±2,45 mmHg após 3 meses; 12,74±2,01 mmHg após 6 meses; e 13,24±2,77 mmHg após 1 ano. A PIO aumentou 18,9 por cento após 1 dia; diminuiu 6,9 por cento após 3 dias; 12,3 por cento após 1 semana; 12,5 por cento após 1 mês; 19,3 por cento após 3 meses; 20,1 por cento após 6 meses; e 19,9 por cento após 1 ano. CONCLUSÃO: A cirurgia de facoemulsificação sem intercorrências leva a uma redução significativa da PIO em olhos normais. A diminuição da PIO é mais acentuada naqueles pacientes que apresentam PIO mais alta no pré-operatório.

PURPOSE: To assess intraocular pressure (IOP) before and after 1 day, 3 days, 1 week, 1 month, 3 months, 6 months and 1 year in normal eyes submitted to a phacoemulsification. METHODS: Intraocular pressure retrospective analyses (measured by Goldmann applanation tonometer) of 221 normal eyes of 133 patients submitted to an uneventful phacoemulsification. The IOP was evaluated before and after phacoemulsification ( 1day, 3 days, 1 week, 1 month, 3 months, 6 months and 1 year), and these values were submitted to a comparative analyses. RESULTS: The mean preoperative IOP of 16,06±2,69 mmHg rose postoperatively to 18,76±5,96 mmHg at 1 day; dropped to 14,82±4,08 mmHg at 3 days; 14,03±3,06 mmHg at 1 week; 13,88±3,26 mmHg at 1 month; 12,74±2,45 mmHg at 3 months; 12,74±2,01 mmHg at 6 months; and 13,24±2,77 mmHg at 1 year. The IOP rise was 18,9 percent at 1 day; fall of 6,9 percent at 3 days; 12,3 percent at 1 week; 12,5 percent at 1 month; 19,3 percent at 3 months; 20,1 percent at 6 months; and 19,9 percent at 1 year. CONCLUSION: In normal eyes, uneventful phacoemulsification reduced IOP. The greatest IOP decreases were in patients with a higher preoperative IOP.

Fixação iriana de lentes de câmara posterior para o tratamento da afacia / Iris fixation of posterior chamber intraocular lenses for the treatment of aphakia

OBJETIVO: avaliar os resultados de uma série de casos de fixação iriana de lentes intra-oculares de câmara posterior para correção de afacia, realizados no setor de catarata da disciplina de Oftalmologia da Faculdade de Medicina do ABC e compará-los a literatura existente. MÉTODOS: estudo prospectivo de oito pacientes afácicos, que apresentavam ausência de suporte capsular adequado e foram submetidos à cirurgia para implante secundário de LIO de câmara posterior com fixação iriana seguindo a técnica modificada de McCannel. RESULTADOS: sete dos oito pacientes (87,5 por cento) que não tiveram complicações cirúrgicas obtiveram melhora na acuidade visual corrigida. Um paciente (12,5 por cento) apresentou complicação intra-operatória, evoluindo com ceratopatia bolhosa do pseudofácico. Um paciente (12,5 por cento) apresentou glaucoma secundário à dispersão pigmentar. CONCLUSÃO: em nosso estudo a técnica de fixação iriana de câmara posterior se mostrou eficaz e segura para o tratamento da afacia, em concordância com os dados da literatura.

PURPOSE: evaluate the results of a case series of iris-sutured posterior chamber IOLs for the correction of aphakia in the cataract sector of the department of Ophthalmology of the ABC School of Medicine and compare them with the existing data. METHODS: prospective study of eight patients who underwent foldable IOL implantation using modified McCannel iris suture fixation for aphakia in the absence of capsule support. RESULTS: seven of eight patients (87,5 percent) without surgical complications improved their best corrected visual acuity. One patient (12,5 percent) with surgical complication developed pseudophakic bullous keratopathy. One patient (12,5 percent) developed secondary glaucoma caused by dispersion syndrome. CONCLUSION: in our study the iris-sutured posterior chamber IOLs prove to be safe and effective in the treatment of aphakia, in accordance with existing data.

Eficácia de hipotensores oculares tópicos após capsulotomia posterior / Efficacy of topic ocular hipotensive agents after posterior capsulotomy

OBJETIVO: Analisar e comparar os efeitos dos agentes hipotensores tópicos, sobre a pressão intra-ocular (PIO), após capsulotomia posterior com laser Nd:YAG em olhos pseudofácicos de indivíduos não-portadores de glaucoma. MÉTODOS: Cento e quarenta e cinco olhos pseudofácicos foram submetidos à capsulotomia por laser Nd:YAG. Antes da capsulotomia, foram instilados hipotensores: apraclonidina 1 por cento (n=21), brimonidina 0,2 por cento (n=20), dorzolamida 2 por cento (n=23), latanoprosta 0,005 por cento (n=20), pilocarpina 2 por cento (n=20) e timolol 0,50 por cento (n=20). Grupo controle (n=21) recebeu placebo. A PIO foi medida de forma mascarada, 1 hora antes da capsulotomia, 1 e 2 horas após o procedimento. Caso a pressão estivesse maior que 20 mmHg, seria medida após 4 e 24 horas. A capsulotomia foi executada com lente de Abraham, anestesia tópica e com YAG laser. A PIO foi medida com tonômetro de aplanação de Goldmann. Seria considerado hipertensão ocular se o aumento da pressão intra-ocular estivesse acima de 4 mmHg quando comparada aos valores do período de pré-procedimento a laser. A energia média empregada foi de 2,1 ± 1 mJ. RESULTADOS: A PIO pré-procedimento não diferiu estatisticamente entre os grupos. A PIO média de 1h (11,9 ± 3,8) e 2 horas (11,5 ± 3,0) do grupo tratado foi estatisticamente significante inferior à do grupo controle (12,6 ± 2,8) (p=0,001). Para as demais medidas não foram observadas diferenças significantes. Após 2 horas, houve aumento porcentual médio ( por cento) de PIO de 8,7 ± 19,1 por cento (13,5 ± 3,2 mmHg) no grupo controle e de 1,2 ± 26,3 por cento (12,5 ± 3,6 mmHg) no grupo pilocarpina. Para os demais grupos, às 2 horas, observou-se redução porcentual de PIO, nos grupos tratados com apraclonidina de -24,7 ± 15,5 por cento (9,8 ± 2,6 mmHg), brimonidina de -8,9 ± 15,5 por cento (10,1 ± 1,7 mmHg), dorzolamida de -6,9 ± 20,3 por cento (12,1 ± 2,8 mmHg), latanoprosta de -0,4 ± 25,9 por cento (12,1 ± 2,9 mmHg)...

PURPOSE: To analyze and compare the effects on intraocular pressure (IOP) of several topic hypotensive agents after posterior capsulotomy with Nd:YAG laser in non glaucoma patients. METHODS: 145 pseudophakic eyes underwent to Nd:YAG laser posterior capsulotomy. Before capsulotomy. 21 were treated with apraclonidine, 20 with brimonidine, 23 with dorzolamide, 20 with latanoprost, 20 with pilocarpine, and 20 with timolol. Controls (21 eyes) received placebo. IOP measurements (Goldmann applanation tonometry) were taken under masked conditions 1 hour before procedure and after 1 and 2 hours. If postoperative PIO was above 20 mmHg its measurements were extended to 4 and 24 hours. Capsulotomy was performed with Abraham lens, under topic anesthetic, using Nd:YAG laser. Ocular hypertension would be considered if the IOP had suffered an increase of 4 mmHg above the initial. Mean total energy used was 2.1 ± 1 mJ. RESULTS: The preoperative IOP did not differ statistically among groups. Mean IOPs of treated eyes 1h (11.9 ± 3.8) and 2h (11.5 ± 3.0) were statistically lower than IOP compared with control group (12,6 ± 2,8) (p=0.001). There were no statistically significant differences for the other measurements. Control and pilocarpine had a percentual IOP increase after 2 hours of 8.7 ± 19.1 percent (13.5 ± 3.2 mmHg) and 1.2 ± 26.3 percent (12.5 ± 3.6 mmHg) respectively. Mean percentual postoperative IOP reduction was detected in the apraclonidine group -24.7 ± 15.5 percent (9.8 ± 2.6 mmHg), in the brimonidine group -8.9 ± 15.5 percent (10.1 ± 1.7 mmHg), in the dorzolamide group -6.9 ± 20.3 percent (12.1 ± 2.8 mmHg), in the latanoprost group -0.4 ± 25.9 percent (12.1 ± 2.9 mmHg) and in timolol group -16.2 ± 14.1 percent (10.3 ± 1.7 mmHg). These differences were statistically significant (p=0.001). There was no significant difference between frequencies of hypertension (p=0.148). CONCLUSION: Apraclonidine caused higher hypotensive effect after capsulotomy...

Exfoliação capsular verdadeira: relato de dois casos / True capsular exfoliation: report of two cases

Relatamos dois casos de exfoliação verdadeira da cápsula, acontecendo em pacientes idosos sem história de exposição prolongada a altas temperaturas ou passado de inflamação intra-ocular. Os aspectos biomicroscópicos, anátomo-patológicos e possíveis implicações cirúrgicas são comentados.

We report two cases of true capsular exfoliation occurring in elderly patients with no known history of prolonged heat exposure or intraocular inflammation. The biomicroscopic aspects, histopathologic findings and possible surgical implications are discussed.