An intraocular micro light-emitting diode device for endo-illumination during pars plana vitrectomy.

PURPOSE:: Development of a new, fiber-free, single-use endo-illuminator for pars plana vitrectomy as a replacement for fiber-based systems with external light sources. The hand-guided intraocularly placed white micro light-emitting diode is evaluated for its illumination properties and potential photochemical and thermal hazards. METHODS:: A micro light-emitting diode was used to develop a single-use intraocular illumination system. The light-source-on-tip device was implemented in a prototype with 23G trocar compatible outer diameter of 0.6 mm. The experimental testing was performed on porcine eyes. All calculations of possible photochemical and thermal hazards during the application of the intraocular micro light-emitting diode were calculated according to DIN EN ISO 15007-2: 2014. RESULTS:: The endo-illuminator generated a homogeneous and bright illumination of the intraocular space. The color impression was physiologic and natural. Contrary to initial apprehension, the possible risk caused by inserting a light-emitting diode into the intraocular vitreous was much smaller when compared to conventional fiber-based illumination systems. The photochemical and thermal hazards allowed a continuous exposure time to the retina of at least 4.7 h. CONCLUSION:: This first intraocular light source showed that a light-emitting diode can be introduced into the eye. The system can be built as single-use illumination system. This light-source-on-tip light-emitting diode-endo-illumination combines a chandelier wide-angle illumination with an adjustable endo-illuminator.

Ultraviolet A/riboflavin corneal cross-linking for infectious keratitis associated with corneal melts.

PURPOSE: To evaluate the efficacy of ultraviolet-corneal cross-linking (CXL) for treating infectious melting keratitis. METHODS: Five patients with infectious keratitis associated with corneal melting were treated with CXL at the outpatient departments of the Institut für Refraktive und Ophthalmo-Chirurgie and the eye hospital at the University of Zurich. CXL was performed when the infection did not respond to systemic and topical antibiotic therapy. Follow-up after cross-linking ranged from 1 to 9 months. RESULTS: In all cases, the progression of corneal melting was halted after CXL treatment. Emergency keratoplasty was not necessary in any of the 5 cases presented. CONCLUSIONS: CXL is a promising option for treating patients with therapy-refractory infectious keratitis to avoid emergency keratoplasty.

Effect of growth factors on proliferation and expression of growth factor receptors in a human lens epithelial cell line.

PURPOSE: To investigate the effect of basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), insulin-like growth factor 1 (IGF-1), and transforming growth factor beta 2 (TGFbeta2) on proliferation of a human lens epithelial cell line (HLEC-SRA 01/04); the effect of bFGF and TGFbeta2 on proliferation of human lens epithelial cells (HLECs); and the expression of bFGF, EGF, IGF-1, and TGFbeta2 receptors in an HLEC-SRA 01/04 cell line. SETTING: Department of Ophthalmology, University of Ulm, Ulm, Germany. METHODS: Both HLEC and HLEC-SRA 01/04 were treated with 1 to 50 ng/mL bFGF and TGFbeta2) Additionally, HLEC-SRA 01/04 were cultured with EGF and IGF-1 at a concentration of 1 to 50 ng/mL for 48 hours in the presence of [3H]-thymidine. In all experiments, untreated serum-free negative controls were used. (3H)-thymidine incorporation as a direct measure of lens epithelial cell proliferation was assessed by liquid scintillation counting. The expression of bFGF, EGF, IGF-1, and TGFbeta2 receptors in HLEC-SRA 01/04 were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR). Statistical analysis was performed using the 2-sample t test for the means. RESULTS: Proliferation of HLECs was dose dependently induced by bFGF and TGFbeta2, showing maximum effects at 10 ng/mL (P = .0003) and at 50 ng/mL (P < .0001), respectively. Proliferation of HLEC-SRA 01/04 was also induced by bFGF, showing slight but significant effects (P < .03). Additionally, HLEC-SRA 01/04 proliferation was dose-dependently induced by EGF with a maximum effect at 5 ng/mL (P < .01), IGF-1 with a maximum effect at 5 ng/mL (P < .0001), and TGFbeta2 with a maximum effect at 10 ng/mL (P < .0001) compared with the control. The RT-PCR analysis revealed bFGF, EGF, IGF-1, and TGFbeta2 receptor expression in the HLEC-SRA 01/04 cell line. CONCLUSIONS: The data showed that bFGF and TGFbeta2 are strong mitogens for HLEC. The HLEC-SRA 01/04 cell line derived from HLEC reacted to growth factors, with cell proliferation only to a lesser extent. Such quiescence of these cells, when compared with cells in primary culture, cannot be explained by the lack of respective receptors for growth factors. Further investigation of growth factor-induced responses of both cell types will provide new insight into the proliferative processes involved in postoperative secondary cataract formation.

Effect of extracellular matrix on proliferation and differentiation of porcine lens epithelial cells.

BACKGROUND: Proliferation and differentiation of lens epithelial cells (LECs) are important mechanisms of secondary cataract formation. After extracapsular cataract extraction the extracellular matrix (ECM) around the remaining LECs is altered compared with the intact lens. This study investigated the effects of different ECMs on cell proliferation and alpha-smooth muscle actin (alpha-SMA) expression, a marker for myofibroblasts, in cultured porcine LECs. METHODS: Porcine LECs were cultured for 3 days (cell proliferation assay) or 4 days (alpha-SMA expression) on wells and glass cover slips, respectively, coated with laminin, fibronectin, type I collagen or type IV collagen. LECs cultured on uncoated wells or cover slips served as control. Proliferative response was measured by [(3)H]-thymidine incorporation into DNA. alpha-SMA was detected immunocytochemically with a mouse monoclonal antibody, and the relative numbers of alpha-SMA-positive cells were calculated. Statistical analysis was performed using Student's unpaired t-test. RESULTS: Cell proliferation was significantly increased by coating with fibronectin (10,320.5+/-6,073 counts per minute; p<0.0001) (mean +/- SD), type I collagen (12,507.3+/-3,914.2 CPM; p<0.0001) and type IV collagen (9,591.4+/-4,088 CPM; p<0.0001) compared with control (1,876.5+/-998 CPM), whereas coating with laminin had no effect (1,760.8+/-812.6 CPM; p=0.7271). The ratio of alpha-SMA-positive LECs cultured on uncoated cover slips for a period of 4 days was 12.2+/-3.51%. This ratio was significantly increased by coating with fibronectin (24.3+/-4.56%; p=0.0001) and type I collagen (21.2+/-8.48%; p=0.0142). Coating with laminin (9.8+/-3.67%; p=0.1682) and type IV collagen (9.0+/-7.09 %; p=0.2491) slightly decreased alpha-SMA expression, but this effect was not statistically significant. CONCLUSIONS: Fibronectin and type I collagen stimulated both cell proliferation and alpha-SMA expression in cultured porcine LECs. Because fibronectin and type I collagen are not normally present in the adult lens, their possible introduction into the lens capsule after cataract surgery may play a critical role in the development of posterior capsule opacification.