Anterior capsule contraction with foldable silicone intraocular lenses.

PURPOSE: To examine the causes signs, and symptoms of anterior capsule contraction syndrome and the response to neodymium YAG (Nd:YAG) anterior capsulotomy. SETTING: Madigan Army Medical Center, Tacoma, Washington, USA. METHODS: This retrospective review comprised 70 cases of phacoemulsification with foldable plate-haptic silicone intraocular lens (IOL) implantation. Patients who developed anterior capsule contraction postoperatively, defined as the anterior capsule being visible through an undilated pupil, had a radial anterior capsulotomy with an Nd:YAG laser. Variables analyzed were visual acuity, subjective complaints, associated inflammation, and IOL decentration. RESULTS: Ten eyes of 9 patients (14%) developed anterior capsule contraction and had Nd:YAG laser radial anterior capsulotomy. Three of 9 patients reported decreased visual acuity and glare. Two other patients had chronic anterior chamber inflammation unresponsive to steroids after surgery that resolved after Nd:YAG anterior capsulotomy. Intraocular lens decentration was observed in 3 patients before the Nd:YAG capsulotomy. Posterior lens dislocation occurred in 1 patient after capsulotomy and required surgical lens exchange. CONCLUSION: One-piece foldable silicone IOLs may not provide enough peripheral capsule expansion.

A prospective study of ocular hypertension and glaucoma after pediatric cataract surgery.

BACKGROUND: Late-onset glaucoma can occur after pediatric cataract surgery. However, no large prospective study of the prevalence of ocular hypertension and glaucoma after pediatric cataract surgery has been performed. METHODS: A prospective glaucoma evaluation was offered to all eligible subjects at least 5 years after automated lensectomy and vitrectomy for pediatric cataracts. RESULTS: Sixty-two (58%) of 107 eligible subjects received a glaucoma evaluation. One (4.5%) of 22 patients with bilateral cataracts had glaucoma, and a much higher percentage (45%) had ocular hypertension. Five (12.5%) of 40 patients with unilateral cataracts had glaucoma, and an additional 32.5% had ocular hypertension. For patients with monocular cataracts, the age and corneal diameter at the time of cataract surgery were related to the subsequent development of ocular hypertension or glaucoma. The majority of subjects were able to cooperate with a comprehensive glaucoma examination that included cycloplegic refraction, determination of intraocular pressure, examination of the optic nerve, and fundus photography, without requiring sedation. CONCLUSIONS: There is a high prevalence of ocular hypertension after pediatric cataract surgery. Children who are 5 years of age and older usually are able to cooperate with a glaucoma evaluation. The natural history of ocular hypertension after pediatric cataract surgery will be determined with longitudinal studies in the future.

Reactivity of horse liver alcohol dehydrogenase with 3-methylcyclohexanols.

The specificity of horse liver alcohol dehydrogenase for cyclohexanol and its 3-methyl derivatives was investigated by stopped-flow and initial velocity kinetic studies. The (1S,3S)-3-methylcyclohexanol was 7 times more reactive (V/Km) than cyclohexanol, whereas the (1R,3R)-3-methylcyclohexanol was at least 1000 times less reactive than its enantiomer. Computer simulation of the transient reaction of NAD+ and the cyclohexanols catalyzed by the enzyme suggests that the rate of transfer of hydrogen from the alcohol to NAD+ is increased with the 1S,3S isomer. Modeling of the three-dimensional structure of the ternary complex of the enzyme suggests that the 1S,3S isomer should only bind in a productive, reactive mode, whereas the 1R,3R isomer would bind predominantly in a nonproductive, inhibitory mode.