Decoding task specific and task general functional architectures of the brain.

Functional magnetic resonance imaging (fMRI) is used to capture complex and dynamic interactions between brain regions while performing tasks. Task related alterations in the brain have been classified as task specific and task general, depending on whether they are particular to a task or common across multiple tasks. Using recent attempts in interpreting deep learning models, we propose an approach to determine both task specific and task general architectures of the functional brain. We demonstrate our methods with a reference-based decoder on deep learning classifiers trained on 12,500 rest and task fMRI samples from the Human Connectome Project (HCP). The decoded task general and task specific motor and language architectures were validated with findings from previous studies. We found that unlike intersubject variability that is characteristic of functional pathology of neurological diseases, a small set of connections are sufficient to delineate the rest and task states. The nodes and connections in the task general architecture could serve as potential disease biomarkers as alterations in task general brain modulations are known to be implicated in several neuropsychiatric disorders.

Correction: A knowledge, attitude, and practice survey on mediation among clinicians in a tertiary-care hospital in Singapore.

[This corrects the article DOI: 10.1371/journal.pone.0199885.].

A knowledge, attitude, and practice survey on mediation among clinicians in a tertiary-care hospital in Singapore.

Healthcare delivery is a highly complex, deeply personal and costly endeavour that involves multiple specialties and services. There is an imbalance in knowledge between the healthcare provider and consumer that may contribute to doubts and uncertainty over treatment and outcomes. It is unsurprising that conflict and dispute can develop between healthcare providers and patients and their next-of-kin. The use of mediation in the healthcare setting has recently been promoted in many developed countries, including Singapore. We administered a detailed 32-item survey in a large tertiary-care teaching hospital to improve our understanding of the knowledge, attitude and practice of dispute resolution among clinicians to pave the way for better strategies to improve the adoption of mediation in healthcare setting. Ninety-seven respondents had an average of 62% (SD: 12%) knowledge score. The most common misconceptions held by the respondents about mediation were: (1) mediation was about fact-finding, (2) mediation is limited to only certain types of dispute, (3) mediation proceeds by both parties giving their account of the dispute, then a third party decides a settlement, (4) the average time it takes to resolve a dispute through mediation, (5) the cost of mediation, (5) the venue of mediation, (6) the person determining the outcome of mediation, (7) confidentiality of mediation. In general, the respondents were positive about the use of mediation as a dispute resolution tool. When asked to indicate the relative importance of different outcomes of dispute resolution, financial compensation and waiver of hospital bill attracted mixed responses while understanding facts of dispute, assurance that the same error would not recur, and offering corrective treatment were rated as being important. By contrast, seeking an apology from the complainant was considered neutral to somewhat important and the respondents were least concerned with the publicity of the dispute. Direct negotiation with the complainant was considered the most time- and cost-efficient means of resolving a dispute while the opposite was true for litigation. Mediation was considered the approach where the clinicians are most likely to achieve their desired outcome while litigation was considered least likely to produce a favourable outcome. Approximately half of the respondents reported having personal experience or known of a colleague who had been involved in a medico-legal dispute. A quarter of these cases were resolved by direct negotiations with the complainant while lawyers, the judge and mediation, resolved approximately 15% each, respectively. The knowledge base of the clinicians in this study about mediation was moderate and probably reflected the general lack of direct experience in the resolution of a dispute or training in mediation. This further corroborated with the general response that the uptake of mediation in the healthcare setting is currently poor in Singapore due to the lack of awareness and perceived lack of avenue among the surveyed clinicians. Any further work to be done with clinicians may be in the direction of (1) increasing general understanding of mediation, (2) increasing awareness of avenues for mediation, and (3) becoming better aware of when to propose mediation.

Evaluation of the Sorbent Properties of Single- and Multiwalled Carbon Nanotubes for Volatile Organic Compounds through Thermal Desorption-Gas Chromatography/Mass Spectrometry.

Carbon nanotubes (CNTs) possess well-defined structural and chemical characteristics coupled with a large surface area that makes them ideal as sorbent materials for applications where adsorption processes are required. The adsorption properties of carboxylated derivatives of multiwalled carbon nanotubes (COOH-MWCNT) and singlewalled carbon nanotubes (COOH-SWCNT), together with their nonfunctionalized counterparts (MWCNT and SWCNT) for 48 common atmospheric volatile organic compounds (VOCs) were determined using thermal desorption-gas chromatography/mass spectrometry (TD-GCMS). The CNTs exhibited similar recoveries for many of the VOCs compared to the standard sorbent materials, Carbopack X and Tenax TA. However, VOCs with electron donor-acceptor (EDA) properties such as carbonyls, alkenes, and alcohols exhibited poorer recoveries on all CNTs compared to Carbopack X and Tenax TA. The poor recoveries of VOCs from the CNTs has important implications for the long term use and storage of CNTs, because it demonstrates that they will become progressively more contaminated with common atmospheric VOCs, therefore potentially affecting their surface-based properties.

Surgical smartphone applications across different platforms: their evolution, uses, and users.

INTRODUCTION: There are a vast array of smartphone applications that could benefit both surgeons and their patients. To review and identify all relevant surgical smartphone applications available for the Apple iPhone iOS and Google Android platform based on their user group and subspecialty for which they were designed. METHOD: Both the literature using PubMed and Google Scholar were searched using the following terms: application$, smartphone$, app$, app*, surgery, surgical, surg*, general surgery, general surg*, bariatric$, urology and plastic surgery, ortho*, orthop(a)edic, cardiac surgery, cardiothoracic, neurosurgery, and ophthalmology. RESULTS: The search yielded 38 articles of which 23 were eligible. Each of the key specialties was searched in the Apple iTunes App Store for iPhone iOS and the Google Play Android application store. In total, there were 621 surgical applications for Apple iPhone iOS and 97 identified on Android's Google Play. There has been a 9-fold increase in the number of surgical applications available for the Apple iPhone iOS from 2009 to 2012. Of these applications there were 126 dedicated to plastic surgery, 79 to orthopedics, 41 to neurosurgical, 180 to general surgery, 36 to cardiac surgery, 121 to ophthalmology, and 44 to urology. There was a wide range of applications ranging from simple flashcards to be used for revision to virtual surgery applications that provided surgical exposure and familiarization with common operative procedures. CONCLUSIONS: Despite the plethora of surgical applications available for smartphones, there is no taxonomy for medical applications. Only 12% were affiliated with an academic institution or association, which highlights the need for greater regulation of surgical applications.

Controlled release of bone morphogenetic protein 2 and dexamethasone loaded in core-shell PLLACL-collagen fibers for use in bone tissue engineering.

Electrospun nanofibers mimic the native extracellular matrix of bone and have generated considerable interest in bone tissue regeneration. The aim of this study was to fabricate novel poly(l-lactide-co-caprolactone) (PLLACL), PLLACL/collagen nanofibers blended with bone morphogenetic protein 2 (BMP2) and dexamethasone (DEX) for controlled release during bone tissue engineering (BTE). The morphology, surface hydrophilicity, and mechanical properties of the PLLACL/collagen nanofibrous mats were analyzed by scanning electron microscopy and water contact angle and mechanical stability determination. The performance of the scaffolds was investigated in terms of the viability and morphology of human mesenchymal stromal cells (hMSC) on the nanofibrous mats. BMP2 and DEX were successfully incorporated into PLLACL/collagen nanofibers by means of blending or coaxial electrospinning and the PLLACL/collagen blended fibers proved useful for hMSC culture. Release of the two growth factors from PLLACL/collagen nanofibrous mats in vitro was investigated by UV spectrophotometry. The release profiles for core-shell nanofibers showed more controlled release of the growth factors compared with the blended electrospun fibers. The experimental results show that controlled release of BMP2 and DEX can induce hMSC to differentiate into osteogenic cells for bone tissue engineering. The results imply that PLLACL/collagen nanofibers encapsulating two drugs and/or proteins have great potential in bone tissue engineering.

Combined treatment with bevacizumab and 5-fluorouracil attenuates the postoperative scarring response after experimental glaucoma filtration surgery.

PURPOSE: This study evaluated the use of combined bevacizumab with 5-fluorouracil (5-FU) on postoperative scarring and bleb survival after experimental glaucoma filtration surgery in comparison to the agents alone. METHODS: Filtration surgery was performed on 26 female New Zealand White rabbits. The rabbits were allocated to one of four treatments: 5-FU combined with bevacizumab, 5-FU alone, bevacizumab alone, or phosphate buffered saline (PBS). The subconjunctival injections were administered immediate postoperatively and weekly for 3 weeks. Clinical assessment and bleb photography were performed. Histologic staining determined the presence of subconjunctvial fibrosis and mRNA expression of collagen I and fibronectin in the tissue was quantified. RESULTS: Bevacizumab in combination with 5-FU resulted in a greater antifibrotic effect compared with monotherapy with 5-FU or bevacizumab alone, as evidenced by the attenuation in fibronectin and mature collagen I expression and deposition (P < 0.05). In addition, this was associated with a 100% bleb survival at day 28 in the combined treatment group compared with monotherapy (50% bevacizumab [P < 0.05] and 25% 5-FU [P < 0.001]). Conjunctival vascularity significantly reduced with bevacizumab treatment both alone and in combination with 5-FU. CONCLUSIONS: The results provide compelling evidence that combined bevacizumab and 5-FU offers superior antifibrotic effect over monotherapy in a model of glaucoma filtration surgery, while prolonging bleb survival at the same time. A synergistic effect is suggested to be present.

Nasolabial fold angle measurement using anterior segment optical coherence tomography in normal subjects.

PURPOSE: The human nasolabial fold angle (NFA) has been measured using MRI and photogrammetry and has been shown to decrease with age. The authors aimed to evaluate a novel method using optical coherence tomography to measure the NFA. METHODS: In this cross-sectional observational series, the authors used anterior segment optical coherence tomography (ASOCT) to image the NFA of both cheeks of 126 subjects aged 21 to 79 years. A dental vinylpolysiloxane custom-designed mould was used as a chin rest. The mean of 3 scans on each side was calculated and analysis of variance, multiple comparisons, and multiple linear regression were carried out using SPSS 11.0. RESULTS: Sixty-one subject (48.4%) were men and 65 (51.6%) were women. Mean age was 50.6 +/- 16.8 years (range, 21-79 years). The ASOCT successfully imaged the NFA in all subjects. Mean right and left NFA were 144.4 degrees +/- 17.1 degrees and 145.4 degrees +/- 17.7 degrees. The NFA were dissimilar between the 6 age categories by decade (p < 0.001). Age was the significant predictor of NFA, accounting for 55% of NFA variation. Every year accounted for a decrease of 0.78 degrees (p < 0.001) and 0.80 degrees (p < 0.001) for the right and left cheeks, respectively. Male sex resulted in an increase in NFA of 5.4 degrees (p = 0.007) and 4.0 degrees (p = 0.06) in the right and left cheeks, respectively. CONCLUSIONS: The NFA decreases with age and increases with male sex and can be measured with ASOCT accurately and easily.

Salzmann nodular degeneration after laser in situ keratomileusis.

PURPOSE: To report a case of Salzmann nodular degeneration after laser in situ keratomileusis (LASIK). METHODS: Case report. RESULTS: A 36-year-old woman with no significant medical history underwent routine myopic LASIK in both eyes and 3 months later developed Salzmann nodular degeneration at the inferotemporal and inferonasal flap edges of the left eye only. The visually inconsequential nodules, which did not respond to topical steroids, slowly increased in size and remained 4 years post-LASIK. CONCLUSION: Salzmann nodular degeneration is a rare complication of LASIK.

High-definition optical coherence tomography imaging of the iridocorneal angle of the eye.

OBJECTIVE: To assess the ability of high-definition optical coherence tomography (HD-OCT) to image the anterior chamber angle. METHODS: Forty-five consecutive subjects with phakic eyes underwent gonioscopy and anterior chamber angle imaging with HD-OCT adapted with a 60-diopter aspheric lens mounted over the imaging aperture. The patients' fixation was directed to the side using an external fixation light, and scans were taken of the temporal and nasal quadrants. The visibility of angle structures was assessed and the diagnosis of angle closure using HD-OCT was compared with that of gonioscopy. RESULTS: The majority of subjects were Chinese (91.1%) and female (62.2%). Cross-sectional HD-OCT allowed in vivo visualization of the scleral spur in 71 of 90 quadrants (78.9%) and the termination of the Descemet membrane (Schwalbe line) in 84 of 90 quadrants (93.3%). It was possible to image the trabecular meshwork in 56 quadrants (62.2%). Angle closure was observed in 17 eyes with gonioscopy and 12 eyes with HD-OCT (P = .12, McNemar test). The 2 modalities showed good agreement for angle closure diagnosis by quadrant (kappa = 0.65). CONCLUSION: The adapted HD-OCT provided magnified views of the anterior chamber angle and allowed visualization of the Schwalbe line and trabecular meshwork in most eyes.

Diabetic retinopathy in diabetics referred to a tertiary centre from a nationwide screening programme.

INTRODUCTION: The aim of the study was to describe the prevalence and risk factors for diabetic retinopathy in a multi-ethnic diabetic patient cohort referred for retinal evaluation from a nationwide diabetic retinopathy screening programme in Singapore. MATERIALS AND METHODS: Seven hundred and forty-two patients, aged 21 to 95, referred for suspected diabetic retinopathy on annual one-field non-mydriatic 45 degree retinal photographs (Topcon TRC-NW6, Topcon Corporation, Tokyo, Japan) from primary care to the Singapore National Eye Centre diabetic retinopathy clinic were included. The photographs had been interpreted by 24 trained family physicians accredited every 2 years with a training programme. Patients underwent a standardised interview and examination. Fundi were examined with indirect ophthalmoscopy by 2 examiners. Presence and severity of diabetic retinopathy was graded into none, mild, moderate, severe, very severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Macular oedema and clinically significant macular oedema were also graded. RESULTS: Ninety-nine per cent of patients were type 2 diabetics. The prevalence of diabetic retinopathy was 38.1%, visionthreatening retinopathy was 11.8% and macular oedema was 6.9%. There were no racial differences. Significant predictors of any retinopathy were longer duration of diabetes, lower body mass index, being on treatment for hypertension, hypercholesterolaemia and use of diabetic medication. Predictors for vision-threatening retinopathy were younger age, longer duration of diabetes and lower body mass index. CONCLUSIONS: The use of one-field non-mydriatic 45 degree photography as a screening tool for diabetic retinopathy resulted in a cohort of which 38.1% had diabetic retinopathy. Risk factors for diabetic retinopathy of this cohort are also presented.

Molecular analysis of CHX10 and MFRP in Chinese subjects with primary angle closure glaucoma and short axial length eyes.

PURPOSE: The genetic basis of primary angle closure glaucoma (PACG) has yet to be elucidated. Ocular characteristics related to PACG such as short hyperopic eyes with shallow anterior chambers suggest the involvement of genes that regulate ocular size. CHX10, a retinal homeobox gene associated with microphthalmia, and MFRP, the membrane-type frizzled-related protein gene underlying recessive nanophthalmos, represent good candidate genes for PACG due to the association with small eyes. To investigate the possible involvement of CHX10 and MFRP in PACG, we sequenced both genes in PACG patients with small ocular dimensions. METHODS: One hundred and eight Chinese patients with axial lengths measuring 22.50 mm or less were selected for analysis. Ninety-three age- and ethnically-matched control subjects were also screened. Genomic DNA was extracted from leukocytes of peripheral blood samples, and the exons of CHX10 and MFRP were amplified by polymerase chain reaction (PCR) and subjected to bidirectional sequencing and analysis. RESULTS: All study patients were Chinese with a mean age of 66.2+/-9.1 years (range 46-86). There were 77 females (71.3%). Forty-nine out of the one hundred and eight subjects had previous symptomatic PACG, and 59 had asymptomatic PACG. The mean axial length was 21.90+/-0.50 mm (range 19.98-22.50 mm). We identified a possible disease-causing variant in CHX10 (c.728G>A) resulting in Gly243Asp substitution in one patient. This variant was not found in 215 normal controls. Several CHX10 and MFRP polymorphisms were also identified. CONCLUSIONS: Our results do not support a significant role for CHX10 or MFRP mutations in PACG.

Association analysis of CFH, C2, BF, and HTRA1 gene polymorphisms in Chinese patients with polypoidal choroidal vasculopathy.

PURPOSE: Polypoidal choroidal vasculopathy (PCV) is a major cause of serosanguinous maculopathy in Chinese patients with age-related macular degeneration (AMD). Variants in the CFH and HTRA1/LOC387715 genes are strongly associated with AMD in Caucasians and Chinese. Variants in the C2 and BF genes have been found to confer a significantly reduced risk of AMD. This study was undertaken to determine whether these associations occur in Chinese patients with PCV. METHODS: Patients of Chinese ethnicity with clinically and angiographically diagnosed PCV and normal control subjects were recruited from the Singapore National Eye Centre. Five single-nucleotide polymorphisms (SNPs) in the CFH gene, two each within the C2 and BF genes and two variants located in the LOC387715 and HTRA1 genes, were screened in all patients and control subjects. RESULTS: Seventy-two patients with PCV and 93 normal control subjects were studied. A significant association was noted with CFH variants rs3753394 and rs800292 among the PCV cases (P = 0.0015 and P = 0.0045, respectively). Individuals homozygous for the TT genotype of rs3753394 had a significantly higher risk (P = 0.0076) of PCV (OR = 4.29; 95% CI: 1.47-12.50) than those carrying a single copy of the T allele (P = 0.3210; OR = 1.69; 95% CI: 0.60-4.78), after adjustment for such risk factors as age and sex. The genotype frequencies of rs11200638 and rs10490924 in HTRA1 and LOC387715, respectively, were also found to be significantly different between patients with PCV and normal control subjects (P = 0.00032 and P = 0.003, respectively). The AA genotype of rs11200638 and TT genotype of rs10490924 conferred a 4.9-fold (95% CI: 1.85-12.95) and 4.89-fold (95% CI: 1.85-12.90) increased risk of PCV, respectively, after adjustment for age and sex. The Y402H variant of CFH (rs1061170) and the BF and C2 variants were not significantly different in patients and normal control subjects. CONCLUSIONS: The SNPs rs3753394 and rs800292 of CFH and rs11200638 of HTRA1 are significantly associated with the risk of PCV in Chinese patients.

Lack of association between the rs2664538 polymorphism in the MMP-9 gene and primary angle closure glaucoma in Singaporean subjects.

PURPOSE: A recent study identified the single nucleotide polymorphism (SNP) rs2664538 within the MMP-9 gene with risk for acute primary angle closure glaucoma (PACG). The aim of this study was to confirm this association in Singaporean Chinese subjects with both acute and chronic PACG. METHODS: This was an observational cross-sectional study. Genomic DNA was extracted from leukocytes of peripheral blood and genotypes were determined by polymerase chain reaction and direct sequencing. The association of the SNP with PACG was evaluated using chi tests. RESULTS: A total of 217 subjects with PACG (consisting of 85 acute and 132 chronic PACG), and 83 normal control Chinese subjects were studied. There was no significant difference in the rs2664538 SNP allele frequencies for acute or chronic PACG subjects compared with controls. CONCLUSIONS: This study did not find an association between the rs2664538 polymorphism within the MMP-9 gene and PACG in this sample of Chinese subjects.

Lack of association between interleukin-1 gene cluster polymorphisms and glaucoma in Chinese subjects.

PURPOSE: A recent study identified single nucleotide polymorphisms (SNPs) within the IL-1 gene cluster at chromosomal locus 2q13 that were associated with reduced risk for primary open-angle glaucoma (POAG) in whites. The purpose of this study was to investigate the association between IL-1 SNPs and glaucoma in Chinese patients with either POAG or primary-angle closure glaucoma (PACG). METHODS: Patients with POAG with a mean IOP without treatment that was consistently <21 mm Hg on diurnal testing were classified as having normal-tension glaucoma (NTG) and those with higher IOP were classified as having high-tension glaucoma (HTG). Subjects with PACG had at least 180 degrees of angle closure on gonioscopy. Genotypes were determined by polymerase chain reaction and restriction digest enzymes at the following loci: IL1A (-889C/T), IL1B (+3953C/T), and IL1B (-511C/T). The association of individual SNPs with glaucoma was evaluated by using chi(2) testing. Haplotype analysis was performed with the PHASE program, with haplotype frequency estimated for combined cases and controls, assuming Hardy-Weinberg equilibrium (HWE) of haplotypes. RESULTS: Of the Chinese subjects studies, 194 had POAG (94 NTG and 100 HTG), 125 had PACG, and 79 were normal control subjects. There was no significant difference in IL-1 SNP or allele frequencies for in subjects with POAG or PACG compared with control subjects, or between NTG and HTG. None of the common haplotypes showed any significant difference between the HTG, NTG, PACG, and normal control subjects. CONCLUSIONS: This study did not find an association between IL-1 gene cluster polymorphisms and glaucoma in this sample of Chinese subjects.

Lens opacity, thickness, and position in subjects with acute primary angle closure.

PURPOSE: To compare lens thickness (LT), lens position (LP), relative lens position (RLP), and degree and type of lens opacity between affected and fellow eyes of subjects with acute primary angle closure (APAC) to identify any differences in lens characteristics that may be contributory to the acute episode. In addition, axial length (AL) and anterior chamber depth (ACD) measurements were evaluated. METHODS: Seventy-three study subjects with unilateral APAC were treated with sequential laser iridotomy (LI) in both eyes. Two weeks after LI, ACD, LT, and AL measurements were made in both eyes using ultrasound pachymetry. LP was defined as ACD+1/2LT and RLP as LP/AL. The Lens Opacity Classification III (LOCS III) System was used for grading lens opacity. RESULTS: The subjects were 90% Chinese and 63% female. Mean age was 61.0+/-10.9 years. Significant differences between the affected and fellow eyes were found in the ACD (2.11+/-0.35 vs 2.18+/-0.23; P=0.02) and LP (4.61+/-0.47 vs 4.75+/-0.29; P=0.02). Cortical opacity was greater in fellow eyes (0.32+/-0.72 vs 0.53+/-0.95; P=0.02). There was no difference in LT, RLP, or degree of lens opacity in the nuclear and posterior subcapsular regions. CONCLUSIONS: Compared with fellow eyes, APAC-affected eyes have shallower ACD, more anterior LP, and less cortical opacity. These differences may be contributory to APAC.

Peripapillary retinal nerve fiber layer thickness variations with myopia.

PURPOSE: To determine the relationship between peripapillary retinal nerve fiber layer (RNFL) thickness and myopia using optical coherence tomography (OCT). DESIGN: Prospective observational case series. METHODS: One hundred thirty-two young males with myopia (spherical equivalent [SE], -0.50 to -14.25 diopters) underwent ophthalmic examination of one randomly selected eye. Optical coherence tomography (OCT-1, version 4.1) was performed by a single operator using circular scans concentric with the optic disc with scan diameters of 3.40 mm, 4.50 mm, and 1.75 x vertical disc diameter (VDD). For each scan diameter, mean peripapillary RNFL thickness was calculated. Statistical analysis comprised repeated-measurements analysis and Pearson correlation. RESULTS: Mean peripapillary RNFL thickness did not correlate with SE for the 3.40-mm (r = -0.11, P = 0.22), 4.50-mm (r = -0.103, P = 0.24), or 1.75xVDD (r = -0.08, P = 0.36) OCT scan diameters. Neither did mean peripapillary RNFL thickness correlate with axial length for the 3.40-mm (r = -0.04, P = 0.62), 4.50-mm (r = 0.03, P=0.75), or 1.75xVDD (r = -0.02, P = 0.78) scan diameters. Mean peripapillary RNFL thicknesses for the 3.40-mm, 4.50-mm, and 1.75xVDD scans were 101.1+/-8.2 microm (95% confidence interval [CI], 99.4-102.8), 78.9+/-8.2 microm (95% CI, 77.5-80.3), and 97.5+/-10.9 microm (95% CI, 95.6-99.4), respectively. CONCLUSIONS: Mean peripapillary RNFL thickness did not vary with myopic SE or axial length for any OCT scan diameter investigated. Retinal NFL thickness measurements may be a useful parameter to assess and monitor glaucoma damage in myopic subjects.

Surgical management of late dislocated lens capsular bag with intraocular lens and endocapsular tension ring.

A case of late spontaneous dislocation of the lens capsular bag (CB) with foldable acrylic intraocular lens (IOL) and endocapsular tension ring (CTR) and its surgical management is reported in a 52-year-old man. The dislocation occurred 2 years 3 months after phacoemulsification cataract surgery in which a CTR was used for zonular instability. A 3-port pars plana vitrectomy was performed. Because it was not possible to grasp the IOL-CTR-CB complex, perfluorocarbon liquid was used to attempt to float it up. This was unsuccessful, so a scleral indenter was used to apply external pressure on the sclera to tilt the IOL-CTR-CB complex into a position where it could be grasped with a forceps and removed through a corneal section. A scleral-fixated IOL was placed, and the patient achieved a best corrected visual acuity of 6/9. The procedure was safe and effective without intraocular complications.