1/71. Complete occlusion of the anterior capsular opening after intact capsulorhexis: clinicopathologic correlation.PURPOSE: To report histopathologic findings of capsule contraction syndrome with complete occlusion of the capsulorhexis opening. methods: Case report. In an 81-year-old woman, a complete occlusion of the anterior capsulorhexis opening developed 2 months after phacoemulsification and intraocular lens implantation. We surgically removed the contracted anterior capsule and analyzed the membrane by standard light microscopy and actin immunohistology. RESULTS: light microscopic analysis of the membrane showed fibrous tissue subcapsularly with metaplastic lens epithelial cells. The contracted capsulorhexis opening was filled completely with proliferated actin-positive lens epithelial cells. CONCLUSIONS: Complete occlusion of the capsulorhexis opening can be attributed to excessive shrinkage of the capsule, probably caused by actin filaments found in the residual lens epithelial cells together with weak zonular support, and to the occlusion of the remaining central defect by massive proliferation of metaplastic lens epithelial cells.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/71. Ocular injury caused by an air bag for a driver wearing eyeglasses.BACKGROUND: Although air bags have been shown to reduce the number of fatalities and serious injuries caused by motor vehicle accidents, there have been many reports of air bag-related ocular injuries. We recently treated air bag-related corneal laceration in a patient wearing eyeglasses at the time of a motor accident. CASE: A 38-year-old Japanese man was driving a car at approximately 40 km per hour when he struck a stopped 2-ton truck. He was wearing a three-point lap-shoulder seat belt. At impact, the driver's-side air bag deployed and struck the man on the left side of his face. He was wearing eyeglasses with glass lenses, and the air bag broke the left lens of his eyeglasses, and glass fragments lacerated his cornea. OBSERVATIONS: External examination showed multiple superficial abrasions of the skin and ecchymosis of the left side of his face. Slit-lamp examination of his left eye showed corneal laceration and hyphema. The lens had opacities and was covered with fibrin membrane. Repair of the corneal laceration and phacoemulsification of the lens were performed. Six months later, his best corrected visual acuity was 20/20 in the left eye. CONCLUSIONS: As cars are increasingly equipped with air bags, reports of air bag-related eye injuries have increased. To our knowledge, this is the first reported case of corneal laceration caused by a shattered lens in an air bag-related injury. Ophthalmologists should caution patients about the danger of eye injuries in air bag-equipped cars, and thought should be given to improving the materials for eyeglasses.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
3/71. Demyelinating sensorimotor neuropathy with congenital cataract, mental retardation, and unique, dysplastic perineurial cells within the endoneurium.We report on a 27-year-old Caucasian female with congenital cataract and mental retardation complaining of progressive paresis and atrophy of the lower legs beginning at the age of 16 years followed by atrophy of the thighs and small hand muscles. Motor and sensory conduction velocities (CV) of the upper and lower limbs were reduced (distal peroneal nerve: 21 m/s; median nerve: motor CV: 28 m/s, sensory CV 30 m/s). In the sural nerve biopsy specimens there were unique endoneurial cells immunoreactive for antibodies against the epithelial membrane antigen with multiple surface indentations and projections considered to be dysplastic perineurial cells. To the best of our knowledge these cells have not been reported in any other type of human peripheral neuropathy. The present case with the above clinical and structural findings appears to represent a new, complex, demyelinating type of a sporadic or possibly recessively inherited motor and sensory neuropathy.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
4/71. Incising the thick retrolental fibrovascular tissue with a hooked sclerotome in persistent hyperplastic primary vitreous.A technique for incising thick retrolental fibrovascular tissue and extensive cyclitic membrane is reported in a case of anterior persistent hyperplastic primary vitreous. A membranectomy was performed in a 1-month-old post-lensectomy baby via a limbal approach. A sclerotome tip was hooked to cut through an extremely thick fibrovascular tissue by rotating the sclerotome by its grip. Sutherland microscissors (Grieshaber, switzerland) and a vitrectomy cutter were used for further membranectomy. The baby was followed-up until age 18 months. A total of 3 membranectomy sessions were required because of rapid cyclitic membrane formation, severe centripetal retraction of the membrane on the ciliary processes, and posterior synechia. Thorough membranectomy and cutting the iris edge maintained a clear pupillary area during the 13-month postoperative period. Extremely thick retrolental fibrovascular tissue is a challenging condition that can be dealt with by delicate instrumentation.- - - - - - - - - - ranking = 3.5keywords = membrane (Clic here for more details about this article) |
5/71. rupture of the anterior lens capsule in Alport syndrome.Alport syndrome is an inherited disorder of type IV collagen, a major constituent of basement membranes. Eighty-five percent of cases are transmitted through X-linked dominant inheritance, although autosomal dominant and autosomal recessive inheritance has also been reported. Clinical manifestations of Alport syndrome include progressive glomerulopathy, sensorineural deafness, anterior lenticonus, posterior corneal dystrophy, and abnormal retinal pigmentation. Anterior lenticonus may lead to loss of vision because of progressive myopia or cataract formation. We report 2 cases of unusual cataract formation in adolescent boys who had a rupture of the anterior lens capsule. One rupture was spontaneous, and the other was traumatic.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
6/71. Interlenticular opacification: clinicopathological correlation of a complication of posterior chamber piggyback intraocular lenses.PURPOSE: To present a clinicopathological correlation of 2 pairs of piggyback posterior chamber intraocular lenses (PC IOLs) explanted because of opacification between the lens optics. SETTING: Gayton health Center, Eyesight Associates of Middle georgia, Warner Robins, georgia, and Center for research on Ocular therapeutics and Biodevices, Storm Eye Institute, Medical University of south carolina, Charleston, south carolina, USA. methods: Two pairs of piggyback AcrySof lenses were explanted from 2 patients with significant visual loss related to opacification between the optics. They were submitted for pathological analysis. Gross and histopathological examinations were performed, and photomicroscopy was used to document the results. RESULTS: Gross examination showed accumulation of a membrane-like white material between the lenses. Histopathological examination revealed that the tissue consisted of retained/proliferative lens epithelial cells (bladder cells or pearls) mixed with lens cortical material. CONCLUSION: Piggyback PC IOLs were explanted in 2 cases because of a newly described complication, interlenticular opacification. Three surgical means may help prevent this complication: meticulous cortical cleanup, especially in the equatorial region; creation of a relatively large continuous curvilinear capsulorhexis to sequester retained cells peripheral to the IOL optic within the equatorial fornix; insertion of the posterior IOL in the capsular bag and the anterior IOL in the ciliary sulcus to isolate retained cells from the interlenticular space.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
7/71. Ocular involvement in I-cell disease (mucolipidosis II). light and electron microscopic findings.A 5 1/2 year old boy with I-cell disease (mucolipidosis II) had bilateral corneal haziness, early cortical cataracts and bilateral prominence of his eyes associated with shallow bony orbits. He died of pneumonia at age 5 1/2 years. light and electron microscopic examination of the ocular and orbital tissues revealed an accumulation of acid mucopolysaccharide positive, hyaluronidase resistant material in fibroblasts and histiocytes which had partially replaced Bowman's membrane and the anterior stromal cells of the cornea. Similar material, as well as glycolipid-like substance, was found in the conjunctiva and in the retrobulbar soft tissues.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
8/71. Histopathology and ultrastructure of busulfan-induced cataract.A 49-year-old man with chronic myelogenous leukemia developed dense posterior subcapsular cataracts and punctate cortical opacities after five years of busulfan (Myleran) therapy. We found that the histopathologic appearance of busulfan-induced cataracts is similar to other forms of human and experimental cataracts, regardless of cause. Ultrastructural examination revealed cortical liquefaction with formation of Morgagnian droplets, involving primarily the region from the equator to the posterior subcapsular space. In contrast to previous findings in rats, we observed posterior migration of equatorial nuclei and bladder cell formation. Also present were socalled crystalloid rays and abundant degenerate lens fiber membranes manifested as mutli-layered, irregularly folded configurations resembling myelin figures.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
9/71. vitrectomy for macular edema combined with retinal vein occlusion.This study was performed in order to evaluate the effect of vitrectomy in eyes with retinal vein occlusion associated with macular edema. Twenty-nine years eyes (27 patients) with branch retinal vein occlusion (BRVO), and 14 eyes (13 patients) with central retinal vein occlusion (CRVO) both associated with macular edema underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy and peeling of the posterior hyaloid membrane. Follow-up ranged from 12 to 32 months. macular edema was reduced, and visual improvement was observed (p < 0.0001 in BRVO, p = 0.0257 in CRVO, paired t-test). Visual outcome was better in eyes with better visual acuity before surgery. Early vitrectomy may be recommended for retinal vein occlusion associated with macular edema.- - - - - - - - - - ranking = 0.5keywords = membrane (Clic here for more details about this article) |
10/71. Bilateral anterior lenticonus: Scheimpflug imaging system documentation and ultrastructural confirmation of Alport syndrome in the lens capsule.BACKGROUND: Alport syndrome is a combination of proteinuria, hematuria, and neurosensory high-frequency deafness. Bilateral anterior lenticonus may be a late sign. diagnosis relies on characteristic electron microscopy changes of glomerular basement membranes in renal biopsy specimens. PATIENT: A 38-year-old man was seen for progressive visual acuity loss (20/400 OU; best-corrected visual acuity, 20/60 OD and 20/50 OS). Findings from slitlamp examination included bilateral anterior lenticonus and central posterior subcapsular cataract, documented using a modified Scheimpflug imaging system. Retinal pathology was not present. On detailed questioning, a history of microhematuria and proteinuria since childhood and progressive high-frequency deafness for years were discovered. The family history was negative for nephropathies, deafness, or eye diseases. cataract extraction rehabilitated the patient's vision. RESULTS: Electron microscopy of a fragile capsulorhexis specimen showed typical thinned basal lamina with basement membrane disruptions. CONCLUSIONS: Anterior lenticonus is a rare bilateral progressive developmental anomaly. More than 90% of cases are associated with Alport syndrome. For diagnosis of Alport syndrome, the presence of 3 of 4 criteria is required: family history positive for Alport syndrome, progressive intra-auricular deafness, characteristic eye anomalies, and positive findings from glomerular ultrastructural examination. We believe that ultrastructural proof of anterior lenticonus may also be provided in the lens capsule. Arch Ophthalmol. 2000;118:895-897- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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