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)

Morphologic and molecular study on the lens anterior capsule in systemic sclerosis.

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.

Femtosecond Laser-assisted Cataract Surgery in Patients With Marfan Syndrome and Subluxated Lens.

PURPOSE: To report femtosecond laser-assisted cataract surgeries in patients with Marfan syndrome with mild, moderate, and severe lens subluxation. METHODS: Case reports. RESULTS: Two patients with Marfan syndrome underwent femtosecond laser-assisted cataract surgery (Alcon LenSx Lasers Inc., Aliso Viejo, CA). One patient had a mild lens subluxation in one eye and a moderate lens subluxation in the fellow eye. The other patient had a severe lens subluxation in one eye. In all eyes, the laser was able to perform a circular and free-floating anterior capsulotomy and lens fragmentation. In two of the eyes it was also helpful in decreasing corneal astigmatism by making corneal intrastromal relaxing incisions. There were no postoperative complications. CONCLUSIONS: Femtosecond laser-assisted cataract surgery is an effective approach for cataract surgery in patients with Marfan syndrome with mild, moderate, and even severe lens subluxation, with the benefits of causing minimal further zonular damage and being able to treat corneal astigmatism with relaxing incisions.

Visual outcomes of eyes implanted with a toric multifocal intraocular lens.

PURPOSE: To investigate the predictability, efficacy, and safety of a ReSTOR multifocal intraocular lens (IOL) (Alcon Laboratories, Inc., Fort Worth, TX). METHODS: This retrospective, noncomparative case study included 70 eyes of 44 patients implanted with a ReSTOR toric multifocal IOL (Alcon Laboratories, Inc., Fort Worth, TX). Patients were examined preoperatively and approximately 3 months postoperatively. Uncorrected and distance-corrected distance and near visual acuities were measured. Refractive and topographic astigmatism were recorded. Improvement, number of lines gained and lost, and correlation of attempted and achieved astigmatic correction values were also investigated as measurements of efficacy, safety, and predictability. RESULTS: Mean follow-up time was 2.3 ± 1.2 months. Postoperative values of uncorrected distance and near visual acuity were 0.02 ± 0.05 logMAR (20/21 ± 20/22 Snellen) and 0.01 ± 0.04 logMAR (20/20 ± 20/22 Snellen), respectively. Statistical analyses revealed a significant improvement when comparing preoperative and postoperative values of manifest refraction spherical equivalent (P < .0001), uncorrected distance visual acuity (P < .0001), and astigmatism (P < .0001); 95.7% of eyes were 20/25 or better and 100% of eyes were 20/30 or better. At the last follow-up visit, none of the examined eyes had lost any lines. One hundred percent of the eyes remained unchanged or improved after surgery. Mean postoperative manifest refraction spherical equivalent was -0.06 ± 0.27 at the last follow-up visit. The residual manifest astigmatism was 0.22 ± 0.21. There was a highly significant correlation between preoperative attempted topographic astigmatism and postoperative achieved refractive astigmatism. CONCLUSIONS: The study provides clinical evidence that the new toric multifocal IOL seems to be predictable, safe, and effective, providing satisfactory visual acuity for far and near and correcting astigmatism.

Permanent blue discoloration of a hydrogel intraocular lens by intraoperative trypan blue.

A 79-year-old white man had cataract surgery in the right eye with implantation of an Acqua intraocular lens (IOL) (Mediphacos). Trypan blue 0.1% was used during surgery to stain the anterior capsule and enhance the contrast during capsulorhexis. Seven days after surgery, the patient presented with "dark and double" vision (monocular diplopia). The IOL was decentered superiorly and appeared dark blue. The lens was explanted 2 months after surgery and sent for gross and microscopic analyses in a dry state and after hydration. The same analyses were performed on 2 unused lenses of the same design that had been immersed in diluted trypan blue solutions (0.01% and 0.001%). On the explanted lens, the dark blue staining was denser in the optic, especially in its periphery. The blue discoloration could not be removed after 24 hours of lens immersion in a balanced salt solution at 37 degrees C. Permanent staining of the unused lenses was also obtained after immersion in the trypan blue solutions.

Amiloidose localizada da córnea: relato de 2 casos / Localized corneal amyloidosis: study of 2 cases

Os autores apresentaram dois casos clinicamente distintos, com diagnóstico histopatológico de amiloidose corneana localizada, sem que padräo familiar e patologias oculares ou sistêmicas associadas pudessem ser identificadas. De acordo com a literatura, os autores fazem o diagnóstico de amiloidose corneana secundária, na qual a provável patologia causal näo foi identificada, mas näo descartam a possibilidade de amiloidose primária localizada da córnea, patologia esta extremamente rara