[Epi-LASIK with a 1000 hertz excimer laser]. / EpiLASIK mit einem 1000 Hertz Excimer-Laser.

PURPOSE: The aim of this study was to evaluate the safety, stability and efficacy of Epi-LASIK with a 1000 hertz excimer laser system. METHODS: 40 eyes of 23 patients underwent an Epi-LASIK procedure using the Gebauer EpiLift and the WaveLight Concept System 1000. Preoperatively as well as 1 month, and 3 months postoperatively, a complete ophthalmic examination, including objective and subjective refraction (UCVA, BCVA) and topography, was performed. RESULTS: The mean preoperative spherical equivalent (SE) was -4.07 D (SD ± 1.89 D). 1 month after surgery, the spherical equivalent was + 0.01 D (SD ± 0.33 D), and 3 months after surgery -0.06 D (SD ± 0.28 D). 3 months after the Epi-LASIK procedure, 90 % of the patients were within ± 0.5 D of the intended correction, and 97.5 % were within ± 1.0 D of the intended correction. The astigmatism was reduced from -0.77 D (SD ± 0.68 D) to -0.24 D (SD ± 0.29 D) 3 months after surgery. 34 of the 40 eyes had a clear cornea 3 months after surgery, and 6 of the 40 eyes presented with haze grade 0.5. CONCLUSIONS: In our pilot series of 40 eyes, the use of the 1000 hertz excimer laser did not reveal any specific clinical side effects potentially associated with the use of a high repetition rate. These first results with Epi-LASIK and the WaveLight Concept System 1000 are very promising.

Neurobeachin: A protein kinase A-anchoring, beige/Chediak-higashi protein homolog implicated in neuronal membrane traffic.

We describe the identification and initial characterization of neurobeachin, a neuron-specific multidomain protein of 327 kDa with a high-affinity binding site (K(d), 10 nm) for the type II regulatory subunit of protein kinase A (PKA RII). Neurobeachin is peripherally associated with pleomorphic tubulovesicular endomembranes near the trans sides of Golgi stacks and throughout the cell body and cell processes. It is also found in a subpopulation of synapses, where it is concentrated at the postsynaptic plasma membrane. In live cells, perinuclear neurobeachin is dispersed by brefeldin A (BFA) within 1 min, and in permeabilized cells a recruitment of neurobeachin from cytosol to Golgi-near membranes is stimulated by GTPgammaS and prevented by brefeldin A. Spots of neurobeachin recruitment are close to but distinct from recruitment sites of COP-I, AP-1, and AP-3 coat proteins involved in vesicle budding. These observations indicate that neurobeachin binding to membranes close to the trans-Golgi requires an ADP-ribosylation factor-like GTPase, possibly in association with a novel type of protein coat. A neurobeachin isoform that does not bind RII, beige-like protein (BGL), is expressed in many tissues. Neurobeachin, BGL, and approximately 10 other mammalian gene products share a characteristic C-terminal BEACH-WD40 sequence module, which is also present in gene products of invertebrates, plants, protozoans, and yeasts, thus defining a new protein family. The prototype member of this family of BEACH domain proteins, lysosomal trafficking regulator (LYST), is deficient in genetic defects of protein sorting in lysosome biogenesis (the beige mouse and Chediak-Higashi syndrome). Neurobeachin's subcellular localization, its coat protein-like membrane recruitment, and its sequence similarity to LYST suggest an involvement in neuronal post-Golgi membrane traffic, one of its functions being to recruit protein kinase A to the membranes with which it associates.

[Experimental results of erbium:YAG laser vitrectomy]. / Experimentelle Ergebnisse zur Erbium:YAG-Laservitrektomie.

BACKGROUND: Vitrectomy performed by conventional guillotine devices includes the risk of mechanical damage to retina as well as other ocular structures. The present study aims to investigate the efficacy of the Er:YAG laser for vitreous liquefaction. MATERIALS AND METHODS: Vitreous liquefaction by means of Er:YAG laser pulses was performed using a special handpiece. The output of an Er:YAG laser operating at 2.94 microns was coupled into a ZrF optical fibre (length 2 m) which ended inside a cavity located at the quartz tip (diameter 320 microns) of the handpiece where tissue ablation took place. The viscosity of the liquefied vitreous was determined by rotation viscosimetry and compared to liquefied vitreous obtained by mechanical vitrectomy. In addition, the aspiration flow (ml/min) was correlated to the repetition/cutting rate of the laser and the cutter. The temperature rise at the handpiece was recorded with a micro thermocouple. RESULTS: The cutting threshold was determined to 5 mJ +/- 3 mJ at a pulse duration of 200 microseconds. The viscosity of the vitreous liquefied with the Er:YAG laser was 31 +/- 10 mPa s which is similar to the results of mechanical vitrectomy (42 +/- 19 mPa s) but significant less than that of normal vitreous (880 +/- 280 mPa s). The aspiration of the laser handpiece in dependence to the repetition rate increases linear up to 2.6 ml/min at 30 Hz. The temperature increase at the handpiece was < 1 K under vitrectomy conditions (aspiration and irrigation) with an averaged laser power of 0.3 W (10 mJ at 30 Hz). CONCLUSIONS: The decreased vacuum forces used by the laser vitrectomy system may result in less mechanical stress to the retina as well as intravitreal structures which may be attached to it. An Er:YAG laser vitrectomy system may offer the potential of fewer complications during vitrectomy.