Unilateral lifebuoy cataract: A case report.

RATIONALE: Lifebuoy cataract is a rare congenital condition characterized by lens thinning. Due to its rarity, detailed treatment reports and standardized surgical approaches are limited. This study aims to enhance the current body of knowledge by presenting comprehensive case reports and describing surgical techniques for the treatment of lifebuoy cataracts. PATIENT CONCERNS: A 14-year-old boy was diagnosed with a congenital cataract in his right eye at the age of 9, which was left untreated. The patient visited our hospital due to progressive visual impairment. DIAGNOSES: The visual acuity of the right eye was counting fingers at 30 cm. The uncorrected visual acuity of the left eye was 20/100, whereas the best corrected visual acuity was 20/20. The intraocular pressures were 18 mm Hg (left eye) and 20 mm Hg (right eye). Slit-lamp microscopy revealed central calcification of the lens capsule in the right eye and slightly opaque cortical tissue in the periphery, with no observable lens nucleus. Anterior segment optical coherence tomography (CASIA2, TOMEY, Nagoya, Japan) of the right eye showed fused anterior and posterior capsules and an absence of the lens nucleus, leading to a diagnosis of lifebuoy cataract. INTERVENTIONS: Cataract surgery was performed on the right eye. Following a 2.4-mm sclerocorneal incision and trypan blue staining, continuous curvilinear capsulorrhexis was performed around the central opacity. The surrounding cortex was removed using irrigation and aspiration, while a viscoelastic agent was injected between the central calcified membrane and the posterior capsule. The membranous tissue was carefully peeled away and removed using forceps. Despite residual posterior capsular opacification, posterior capsulotomy was not performed due to concerns about vitreous prolapse. The intraocular lens was fixed within the capsule. Ten days post-surgery, the remaining posterior capsular opacification was treated with neodymium-doped yttrium aluminum garnet laser capsulotomy. OUTCOMES: The uncorrected visual acuity and best corrected visual acuity of the right eye improved to 20/100 and 20/50, respectively. LESSONS: This case report demonstrates a successful surgical approach for a lifebuoy cataract, highlighting its unique morphology and the need for careful, specialized techniques. These findings aim to guide ophthalmologists in managing this rare condition, potentially improving patient care.

Clinical Features of Syphilis Patients with Ocular Symptoms as the Initial Manifestation.

Purpose: This study aimed to investigate the clinical features of patients with syphilis having ocular symptoms as the initial manifestation. Patients and Methods: Eleven patients diagnosed with ocular syphilis at Dokkyo Medical University Hospital and Jichi Medical University Hospital between November 2018 and April 2022 were studied retrospectively. Results: Six patients were diagnosed with secondary, three were latent, and one was tertiary stage syphilis. Ten out of 11 patients underwent cerebrospinal fluid analysis, and 1 refused. Nine out of 10 patients tested positive, of which 4 presented with neurological symptoms and the others were asymptomatic. Nine out of 11 patients tested negative for human immunodeficiency virus. Antiluetic therapy was administered to 10 out of 11 patients, which improved or maintained visual acuity at -0.1 logMAR in 9 patients. One patient achieved the best-corrected visual acuity -0.1 logMAR in one eye, whereas the other showed no improvement due to severe chorioretinal degeneration. Conclusion: Ocular syphilis presents with various clinical findings and has no significant ocular manifestations without acute syphilitic posterior placoid chorioretinitis. Patients diagnosed with syphilis based on ocular symptoms should undergo cerebrospinal fluid analysis.

Developmental factors of fibrous opacification in the atopic cataract lens capsule.

AIM: We investigated the developmental factors of fibrous opacification in the atopic cataract lens capsule. METHOD: We examined the expression of transforming growth factor (TGF)-ß signals (phosphorylated Smad2/3 and Smad7) and plasminogen activator inhibitor (PAI)-1 in atopic cataract lenses by immunohistochemistry. The PAI-1 concentration in aqueous humor was also measured. RESULTS: Lens epithelial cells of the atopic cataract lens capsule showed positive immunohistochemical staining for phosphorylated Smad2/3 and Smad7. Lens epithelial cells of the age-related cataract lens capsule were positive for phosphorylated Smad2/3, but negative for Smad7 by immunohistochemistry. All cells were negative for PAI-1. However, high concentrations of PAI-1 were detected in the aqueous humor of atopic cataract patients. CONCLUSION: We suggest that TGF-ß and PAI-1 contribute to fibrous opacification in the atopic cataract lens capsule.

Generation of large-amplitude coherent-state superposition via ancilla-assisted photon subtraction.

We propose and demonstrate a novel method to generate a large-amplitude coherent-state superposition (CSS) via ancilla-assisted photon subtraction. The ancillary mode induces quantum interference of indistinguishable processes in an extended space, widening the controllability of quantum superposition at the conditional output. We demonstrate this by a simple time-separated two-photon subtraction from continuous wave squeezed light. We observe the largest CSS of traveling light ever reported without correcting any imperfections, which will enable various quantum information applications with CSS states.

Microsatellite polymorphisms of the MICA gene among Japanese patients with Behçet's disease.

BACKGROUND: Behçet's disease (BD) is a multisystemic inflammatory disease of unknown origin. Because some researchers have recently suggested a primary association of BD with the A6 allele of the human major histocompatibility complex class I chain-related A (MICA) gene, we investigated microsatellite polymorphisms of the MICA gene in subjects with and without BD. METHODS: This was a case-control study of 23 Japanese patients with BD and 23 Japanese volunteers without BD who were compared for MICA microsatellite polymorphisms using the polymerase chain reaction (PCR). We also analysed associations between 5 MICA alleles and the clinical features of patients. RESULTS: There was no significant difference between case patients and control subjects in phenotype frequencies. The MICA-A6 allele showed the strongest positive correlation with the human leukocyte antigen allele HLA-B51. Allele A5 showed a strong positive correlation with age at onset and a strong negative correlation with iridocyclitis and HLA-B51. A4 showed a strong negative correlation with ocular lesions and HLA-B51. Patients with the MICA-A6 allele had significantly higher HLA positivity than patients without the allele. INTERPRETATION: While the MICA-A6 allele had no significant association with BD, it showed a strong association with HLA-B51. This finding suggests that an association between MICA-A6 and BD may be a secondary phenomenon related to HLA-B51. As several associations with MICA alleles and clinical features have been found, further investigation is expected to elucidate the biological mechanism of action of the MICA protein relative to disease onset.