Outcomes of Ahmed Glaucoma Drainage Implant in Eyes With Glaucoma Secondary to Iridocorneal Endothelial Syndrome.

AIM: To evaluate the success of Ahmed glaucoma valve (AGV) implantation in patients with glaucoma secondary to iridocorneal endothelial (ICE) syndrome. MATERIALS AND METHODS: This retrospective study included 18 eyes of 18 patients with ICE syndrome and glaucoma who had undergone AGV implantation at our institute between January 2008 and April 2019. The primary outcome was the success of AGV, defined as intraocular pressure (IOP) ≥6 and ≤21 mm Hg with or without topical antiglaucoma medication (AGM). Failure was defined as IOP <6 or >21 mm Hg/need for oral AGM/need for additional glaucoma surgery or loss of light perception because of a surgical complication. Corneal clarity and graft survival in these eyes post-AGV were the secondary outcome measure. RESULTS: The median (interquartile range) follow-up was at 20.61 (3.9 to 57) months. Of the 18 eyes, 14 (77.8%) had adequate IOP control with or without AGMs. Postoperatively, the mean (±standard deviation) IOP significantly reduced from 29.7(±10) mm Hg to 16(±3.8) mm Hg and the number of AGMs reduced significantly from a mean of 3.6 (±1) to 1.7 (±0.9). The probability of AGV success was 92.3±7.4%, 66.1±11.0%, and 50.5%±17.3% at 1, 3, and 4 years, respectively. All 4 failures were because of uncontrolled IOP and needed either oral AGM or additional surgery for IOP control. At the last follow-up visit, 16 eyes had clear cornea and 2 eyes had pre-existing corneal scar (eccentric) that persisted after AGV implantation. CONCLUSION: AGV implant was reasonably successful for IOP control in glaucoma secondary to ICE syndrome with a few common but manageable corneal complications.

Cell type-specific adaptation of cellular and nuclear volume in micro-engineered 3D environments.

Bio-functionalized three-dimensional (3D) structures fabricated by direct laser writing (DLW) are structurally and mechanically well-defined and ideal for systematically investigating the influence of three-dimensionality and substrate stiffness on cell behavior. Here, we show that different fibroblast-like and epithelial cell lines maintain normal proliferation rates and form functional cell-matrix contacts in DLW-fabricated 3D scaffolds of different mechanics and geometry. Furthermore, the molecular composition of cell-matrix contacts forming in these 3D micro-environments and under conventional 2D culture conditions is identical, based on the analysis of several marker proteins (paxillin, phospho-paxillin, phospho-focal adhesion kinase, vinculin, ß1-integrin). However, fibroblast-like and epithelial cells differ markedly in the way they adapt their total cell and nuclear volumes in 3D environments. While fibroblast-like cell lines display significantly increased cell and nuclear volumes in 3D substrates compared to 2D substrates, epithelial cells retain similar cell and nuclear volumes in 2D and 3D environments. Despite differential cell volume regulation between fibroblasts and epithelial cells in 3D environments, the nucleus-to-cell (N/C) volume ratios remain constant for all cell types and culture conditions. Thus, changes in cell and nuclear volume during the transition from 2D to 3D environments are strongly cell type-dependent, but independent of scaffold stiffness, while cells maintain the N/C ratio regardless of culture conditions.

Assessment of white matter damage in subacute sclerosing panencephalitis using quantitative diffusion tensor MR imaging.

BACKGROUND AND PURPOSE: Subacute sclerosing panencephalitis (SSPE), a rare progressive degenerative disease, is caused by persistent infection with a defective measles virus. The correlation between the clinical staging and MR imaging is usually poor. The aim of the study was to investigate the role of diffusion tensor imaging (DTI) in the early detection of white matter damage in SSPE in the presence of normal findings on conventional imaging. METHODS: DTI was performed in 21 patients in stage II SSPE and 10 age/sex-matched healthy controls. Fractional anisotropy (FA) and mean diffusivity (MD) values were calculated in the periventricular white matter, corpus callosum, and posterior limb of the internal capsule in patients with normal and abnormal findings on conventional imaging as well as healthy controls. RESULTS: The patients were grouped into those with normal (n = 11) and abnormal (n = 10) findings on conventional imaging for the purpose of quantitative DTI analysis. Abnormal- and normal-appearing white matter on T2-weighted images showed significantly decreased FA values in all the regions compared with those in healthy controls. MD values were significantly increased in the periventricular white matter region of the frontal and parietooccipital lobe in patients with normal as well as abnormal findings on conventional imaging compared with those in healthy controls. CONCLUSION: DTI detects early white matter abnormalities that may have significant therapeutic implication, even in the presence of normal findings on conventional imaging, in patients with SSPE.