Rapid bilateral anterior capsule contraction following high myopic cataract surgeries:a case report

We describe a rapid anterior capsule contraction following phacoemulsifiction and intraocular lens(IOL) implantation in an old woman with high myopia. The patient with high myopia complicated with cataract received phacoemulcification and IOL implantation bilaterally .The best-corrected visual acuity (BCVA) improved from 0.1 to 0.4 in the right eye and 0.5 in the left eye 1 week after surgeries.5 weeks after surgery of the right eye and 4 weeks after surgery of the left eye, the patient complained blurred vision in the right eye. BCVA of the right eye was 0.06 and that of the left was 0.1. Slit-lamp examination revealed anterior capsule contraction in both eyes and a fully closed capsulorhexis opening in the right eye. The IOLs were centered but almost completely enclosed, with numerous linear fibrous folds radiating from the hick central fibrosis. We surgically excised the central part of the anterior capsule of the eyes with microscissors, resulting again in BCVA of 0.4 and 0.5 in the right and left eyes respectively. Anterior capsule contraction might appear much earlier than three months after phacoemulsification and IOL implantation surgery in case of high myopia complicated with cataract. Patients with high myopia receive cataract and IOL surgery should be monitored carefully for the rapid development of anterior capsule contraction.

Evaluation of the safety of anterior capsule staining with trypan blue under air: a retrospective analysis

AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery.METHODS: The current study involved a retrospective analysis of the medical records of 86 patients with vitreous hemorrhage, who underwent pars plana vitrectomy and cataract surgery.The patients were classified into two groups.The trypan blue group(n=45) comprised patients who underwent anterior capsule staining with 0.03% trypan blue under an air bubble.The control group(n=41) comprised of patients who underwent intracameral illuminator-assisted capsulorhexis.The status of endothelial cell density(ECD) in both the groups was analyzed.RESULTS: The trypan blue group displayed significant decline in ECD at 1 mo(7.91% loss, P<0.001) and 3 mo(9.65% loss, P<0.001) after the surgery, whereas no significant changes were observed in the control group.Moreover, the number of patients who did not display a postoperative decline in ECD was significantly higher in the control group(43.9%;18 patients) than in the trypan blue group(17.1%;7 patients, P=0.004).CONCLUSION: Anterior capsule staining with trypan blue under the air bubble would not be as safe as the intracameral illuminator.The ECD loss might be attributed to the air bubble rather than to the deleterious effects of 0.03% trypan blue.Further studies are required to clarify this.

Experimental Study on the Effectiveness and Safety of Gardenia Blue Pigment on Anterior Capsule Staining

Objective: To explore the effect of gardenia blue pigment on the anterior capsule staining and its safety performance. Methods: In this study, New Zealand white rabbits were used as the research object to test the effect of gardenia blue pigment on the anterior capsule staining and anterior segment toxicity. In this study, gardenia blue stains of different concentrations (5%, 4%, 3%, 2%, 1%, 0.5%) were prepared to stain the anterior capsule of rabbit crystals, and the effect of the stain was observed to determine the optimal concentration of the stain. Twenty-seven healthy New Zealand white rabbits without eye disease were randomly divided into three groups: gardenia blue staining group;bio-blue positive drug group;physiological saline group. The intraocular pressure, anterior chamber inflammation, corneal endothelial injury, and anterior chamber angle pathological changes were measured in 1D, 7D, and 14D. Results: The results of this study showed that the effect of gardenia blue pigment on the anterior capsule of the lens was the best when the concentration of blue pigment was 2%. There was no change in intraocular pressure in the anterior chamber for a short period of time. There is no damage to the corneal endothelium. Conclusion: The results of this study show that the effect of gardenia blue pigment on the anterior capsule is best when the concentration of blue pigment is 2%, and the stain has no obvious toxic and side effects on the anterior segment of the eye.

Anterior and posterior capsule densitometry levels after femtosecond laser-assisted cataract surgery

AIM： To analyze and compare five different variables over one year follow-up（1 wk, 1, 3, 6 and 12 mo）： anterior capsule（AC）, and posterior capsule（PC） area densitometry values, AC and PC linear densitometry values, and AC opening area reduction ratio after femtosecond laserassisted cataract surgery. METHODS： This was a prospective comparative study. Seventy-one patients underwent femtosecond laser-assisted cataract surgery on single eye between June 2014 and December 2015. A 5.0 mm diameter laser assisted anterior capsulotomy was performed on all eyes. In every postsurgery evaluation, AC opacificaction（ACO） and PC opacification（PCO） density levels were provided by Oculus Pentacam·HR using area and linear densitometry methods. Digital images were captured with a slit-lamp Topcon photographic camera and IMAGEnet· 5 software. The AC opening area on the digital images was measured using the Sketchandcalc area calculator and converted to reduction ratio levels.RESULTS： Using Pearson correlation coefficient（PCC）, we found no correlation（r=-0.091, P=0.46） in the twelfth month assessment between the evolution of ACO area densitometry values and PCO area densitometry values considered as independent variables. We found no correlation, using PCC（r=-0.096, P=0.43） between the evolution of ACO linear densitometry values and PCO linear densitometry values, in the twelfth month visit, working both as independent variables. AC linear densitometry levels and AC area densitometry levels continued to grow strongly from sixth to twelfth months. Analysis of the values of AC opening area reduction ratio（1 wk, 1, 3, 6, 12 mo） revealed statistically significant differences between the values of successive examinations but the magnitude of the change decreased. In the final period of monitoring between six and twelve months the magnitude of change was low.CONCLUSION： Our results show strong increases of Scheimpflug ACO densitometry values from the sixth to the twelfth month while capsulorhexis area reduction ratio levels displayed a considerable decrease. We found no correlation between ACO area and linear densitometry values and PCO area and linear densitometry values, in the twelfth month examination, working as independent variables.

Upregulation of histone H3 caused by CRYAA may contribute to the development of age-related cataract

Objective:Age-relate cataract(ARC)is a disease of the eyes with no effective drugs to prevent or treat patients.The aim of the present study is to determine whether histone H3,αA-crystallin(CRYAA),β-galactosidase(GLB1),and p53 are involved in the pathogenesis of ARC.Methods:A total of 99 anterior lens capsules(ALCs)of patients with ARC of various nuclear grades,ultraviolet models of ALCs,and two human lens epithelial cell lines(FHL-124 and SRA01/04)were used,and the expression of histone H3,CRYAA,GLB1,and p53 were detected by immunoblotting and reverse transcription and real time-quantitative polymerase chain reaction.The association between CRYAA with histone H3,GLB1,and p53 was assessed in FHL-124 and SRA01/04 cells following CRYAA overexpression.Results:Histone H3 and p53 in ALCs of patients with ARC were up-regulated in a grade-dependent manner,and the expression of CRYAA showed a positive association with histone H3,p53,and GLB1.In UV models of ALCs and human lens epithelial cell lines,the expression levels of histone H3,cell apoptosis factors(Bax/Bcl-2,cleaved caspase-3),and inflammation factors(interleukin-6,tumor necrosis factor-α)were all up-regulated.Furthermore,transfection of CRYAA in FHL-124 cells induced overexpression of histone H3.Conclusion:CRYAA-mediated upregulation of histone H3 may be involved in the pathogenesis of ARC.p53 may also have a role in ARC development,but not via the CRYAA-histone H3 axis.The results of the present study may assist in improving our understanding of the pathogenesis of ARC and in identifying potential targets for treatment.