| We describe a patient with Chandler's syndrome variant of the iridocorneal endothelial syndrome in whom ectopic Descemet's membrane was found intraoperatively on the anterior surface of the lens. Initially, the membrane was confused with the anterior lens capsule during extracapsular cataract extraction, leading to the performance of a pseudocapsulorrhexis. Electron microscopy disclosed that the epilenticular membrane was composed of multiple layers of abnormal basement membrane consistent with the iridocorneal endothelial syndrome. ( info) |
2/143. Capsular block syndrome with external blockage of the capsular opening by a ciliary sulcus fixated posterior chamber lens. PURPOSE: To report capsular block syndrome with external blockage of the capsular opening by a posterior chamber lens fixated in the ciliary sulcus. METHOD: Case report. RESULTS: In an 89-year-old man who had undergone cataract surgery, a posterior chamber lens was accidentally fixated in the ciliary sulcus after continuous curvilinear capsulohhexis and phacoemulsification/aspiration. The next day, capsular block syndrome was noted along the posterior chamber lens optic, which was blocking the capsular opening from the outside. CONCLUSION: In all previously reported eyes with capsular block syndrome, the posterior chamber lens had been placed inside the lens capsule to block the continuous curvilinear capsulorhexis opening from the inside. ( info) |
3/143. Interpseudophakos Elschnig pearls associated with late hyperopic shift: a complication of piggyback posterior chamber intraocular lens implantation. We report 3 cases of bilateral piggyback lens implantation in which late hyperopic shift occurred associated with Elschnig pearl formation in the peripheral interface between the 2 lenses. ( info) |
| AIMS: Examination of the expression of the mutated allele of myotonic dystrophy protein kinase gene and lens epithelial cell changes in patients with myotonic dystrophy. methods: Six eyes from three patients with myotonic dystrophy underwent cataract surgery. The lens epithelium was photographed to examine the morphological changes. mRNAs were extracted to determine myotonic dystrophy protein kinase gene expression in the lens epithelium and peripheral blood. Age matched lens epithelial cells from senile cataracts were used as controls. RESULTS: All eyes showed iridescent or posterior subcapsular lens opacity. The expression of the myotonic dystrophy protein kinase gene with trinucleotide repeat expansion was evaluated by reverse transcriptase polymerase chain reaction, Southern blotting, and sequence analysis. Lens epithelial cell densities were extremely reduced in the patients compared with the control group. CONCLUSION: To the authors' knowledge, this is the first report to describe the relation between lens epithelial cell changes and mutated gene expression in patients with myotonic dystrophy. The gene may be mitotically unstable in the lens epithelial cells; it may influence cell density and lens epithelial function, and it may lead to the development of typical subcapsular lens opacity. ( info) |
5/143. True exfoliation of the lens capsule. True exfoliation or lamellar delamination of the lens capsule is a rare disorder in which the lens capsule is thickened and the superficial portion of the lens capsule splits from the deeper layer and extends into the anterior chamber. The pathogenesis of this disorder is not clear, but intense infrared radiation has been thought to be the main causative factor. We describe a patient with a history of heat exposure who had a cataract and was found to have bilateral delamination of the anterior lens capsule. Findings from light microscopy and scanning and transmission electron microscopy demonstrated a lamellar separation of the anterior portion of the lens capsule, confirming the diagnosis of true exfoliation. ( info) |
6/143. Loss of iridolenticular contact in eyes with exfoliation syndrome may protect against glaucoma. PURPOSE: To provide evidence for the hypothesis that dynamic iridolenticular contact predisposes to the development of glaucoma in exfoliation syndrome (XFS). methods: We present four patients with bilateral XFS and unilateral exfoliation glaucoma (XFG) whose normotensive eyes had suffered traumatic loss of dynamic iridolenticular contact. RESULTS: All 4 patients had bilateral XFS and developed XFG only in the untraumatized eyes. One patient had loss of iridolenticular contact in the traumatized eye, two had a nonreactive pupil, and one had had intracapsular cataract extraction at age 28. CONCLUSIONS: Loss of dynamic iridolenticular contact may help to protect against development of glaucoma in eyes with XFS. ( info) |
7/143. Combined secondary capsulorhexis and vitreous surgery in a case of anterior capsule contraction and vitreous hemorrhage. A 59-year-old woman with diabetic vitreous hemorrhage and contracted anterior capsule opening received secondary capsulorhexis and trans pars plana vitrectomy in a single operation. The combined surgery was successful. In addition, the anterior capsule opening was enlarged by the procedure and no further vitreous hemorrhage occurred during the 6 month follow-up period in both eyes. When anterior capsule opening reduction is encountered in patients requiring vitreoretinal surgery, combining secondary capsulorhexis and vitreoretinal surgery together in a single operation maybe provide a good treatment alternative. ( info) |
8/143. ciliary body detachment caused by capsule contraction. A 74-year-old woman developed capsule contraction associated with hypotony and choroidal effusion 18 months after uneventful phacoemulsification with 3-piece poly(methyl methacrylate) intraocular lens implantation. Ultrasound biomicroscopy revealed ciliary body detachment and stretched zonules. A radial neodymium: YAG anterior capsulotomy was performed, resulting in the resolution of the ciliary body detachment and choroidal effusion as well as in normal intraocular pressure over 4 days. ( info) |
9/143. neodymium: YAG laser parabolic anterior capsulotomy in extreme capsule contraction syndrome. We report a technique of neodymium: YAG laser parabolic anterior capsulotomy in an extreme case of capsule contraction syndrome with complete occlusion of the central opening and intraocular lens (IOL) displacement. This technique achieves both optical and mechanical benefits of a clear visual axis and possible prevention of further IOL decentration. ( info) |
10/143. Intralenticular candida species abscess in a premature infant. PURPOSE: To report the clinical and histopathologic findings of a premature infant with severe retinopathy of prematurity complicated by the development of an intralenticular fungal abscess. methods: Case report and literature review. RESULTS: A markedly premature infant developed candida septicemia at 29 weeks postconception. Over the ensuing 10 weeks, cataract and intraocular inflammation developed sequentially in each eye, as did progressive retinopathy of prematurity with tractional retinal detachment. Pars plana vitrectomy and lensectomy revealed intralenticular candida species abscess. CONCLUSION: Progressive cataract and intraocular inflammation in a low birth weight infant may be caused by endogenous intraocular infection secondary to systemic candidiasis. Cataract secondary to retinopathy of prematurity is rare. ( info) |