Comparison of the germination rates of Metarhizium spp. conidia from Japan at high and low temperatures.

UNLABELLED: The knowledge of the growth characteristics of entomopathogenic fungi at different temperatures is very important for understanding their ecology and field efficacy as biological control agents. However, the relationships between their DNA-based phylogenetic tree classifications and growth characteristics at different temperatures have not been adequately investigated. In this study, we compared the phylogenetic relationships between Metarhizium anisopliae sensu lato and M. flavoviride isolates obtained from soils in various environments in Japan and the germination rates of their conidia on agar medium in hot and cold conditions. The results showed that the 89 Japanese isolates belonged to the clade of eight species, according to the molecular phylogenetic analysis. The germination rates of isolates belonging to the M. brunneum and M. flavoviride var. pemphigi clades were higher at lower temperatures (9·7-11·0°C) and lower at higher temperatures (34·3-35·2°C) compared with the other six species. The isolates of these two species originated from different geographical regions in Japan, despite their uniform germination characteristics. This study detected the clear interspecific differences in the in vitro germination characteristics of the Japanese isolates of Metarhizium spp. at two different temperature regimes. SIGNIFICANCE AND IMPACT OF THE STUDY: The relationships between the growth characteristics and phylogenetic placements have not been adequately investigated in species of the entomopathogenic fungus Metarhizium. This study determined the relationships between the germination rates in hot and cold conditions and the phylogenetic placements of 89 Japanese soil isolates of Metarhizium spp. Fourteen isolates each of M. brunneum and M. flavoviride var. pemphigi, identified by molecular phylogenetic analysis, showed relatively high germination rates at lower temperatures and low germination rates at higher temperatures compared with isolates, which were identified as six other species. This study detected a strong relationship between the phylogenetic placements of Japanese Metarhizium spp. isolates and their in vitro germination characteristics.

Confirmation of the presence of lens epithelial cells in the anterior chamber after phacoemulsification.

AIMS: To detect the presence of lens epithelial cells in the anterior chamber of the eye at the end of phacoemulsification. METHODS: A prospective observational study was carried out on 50 patients undergoing phacoemulsification. Fluid from the anterior chamber was collected from these patients at the end of phacoemulsification. Thirty samples were processed for detection of viability using calcein AM-propidium iodide. Remaining samples were processed for immunofluorescence detection of alphaA-crystallin and vimentin. The nonparametric Mann-Whitney U test was applied. RESULTS: The presence of lens epithelial cells was confirmed in 27 of the first 30 samples. The total number of cells observed in these 27 samples were 64.70 +/- 58.49. Within these 27 samples, 35.5% were live cells and 64.5% were dead. The cells were present as single cell or in groups. Twenty three percentage samples were also positive for nucleated lens fibres. In the remaining 20 samples, 89% cells were confirmed to be lens epithelial cells. CONCLUSIONS: We show for the first time, the presence of cells in the fluid of the anterior chamber at the end of phacoemulsification. The cells were positive for alphaA-crystallin and vimentin, thereby suggesting that they were lens epithelial cells.

[Influence of intraocular lens material and design on the development of posterior capsule opacification]. / Einfluss von Intraokularlinsenmaterial und -design auf die Nachstarentwicklung.

Based on the literature of 1999-2005, we attempted to clarify the influence of material and design of an intraocular lens (IOL) on the development of posterior capsule opacification (PCO) and identify the future problems to be solved. The sharp edge design of an IOL has significantly reduced PCO in recent years. Histopathological studies showed that a sharp capsular bend was formed at the sharp posterior optic edge, and the migration of lens epithelial cells was obviously inhibited at the site. Experimental and clinical studies suggest that the sharper the edge is, the sharper the capsular bend, and the greater the preventive effect, regardless of IOL material. The sharp capsule bend appears to represent a physical hindrance, which may induce contact inhibition of cell movement. How material participates in the preventive effect should be clarified in a future study. Thus, at the moment, the formation of capsular bend at the posterior optic edge appears to be the decisive criterion to evaluate the influence of IOL material and design on the development of PCO. Optimization of design and material of an IOL, which facilitates capsular bend formation as sharply and quickly as possible, may reduce PCO to a clinically negligible level.

Capsular bending ring to prevent posterior capsule opacification: 2 year follow-up.

PURPOSE: To evaluate the preventive effect of a capsular bending ring on anterior and posterior capsule (PCO) opacification in a 2 year clinical study. SETTING: Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. METHODS: This study comprised 60 patients with senile cataract (35 women, 25 men) with a mean age of 69 years. An open poly(methyl methacrylate) capsular bending ring with a truncated edge profile designed to create a sharp bend in the equatorial capsule was implanted in 1 eye of patients with a hydroxyethyl methacrylate intraocular lens (IOL). The contralateral eye, which acted as a control, received an IOL but no ring. Patients were examined 6 months (n = 52), 1 year (n = 48), and 2 years (n = 42) postoperatively. Anterior capsule opacification was determined by slitlamp evaluation. Anterior capsule shrinkage (area within the capsulorhexis) and PCO were evaluated and scored using a computer software package for image analysis. Posterior capsule opacification was also measured by the rate of neodymium:YAG (Nd:YAG) capsulotomies. RESULTS: Anterior capsule opacification and shrinkage were significantly less in eyes with the ring. The mean PCO score was 0.235 +/- 0.215 (SD), 0.287 +/- 0.200, and 0.398 +/- 0.248 with the ring and 0.530 +/- 0.190, 0.670 +/- 0.225, and 1.111 +/- 0.298 without the ring at 6 months, 1 year, and 2 years, respectively (P <.01 at each follow-up). An Nd:YAG laser capsulotomy was performed in 4 eyes with and 17 eyes without the ring after 2 years (P <.01). CONCLUSIONS: The capsular bending ring significantly reduced anterior capsule fibrosis and shrinkage as well as PCO. The ring may be useful in patients who are at high risk of developing eye complications from capsule opacification that require Nd:YAG laser capsulotomy, in those expected to have vitreoretinal surgery and photocoagulation, and in cases of pediatric cataract.

Effect of round-edged acrylic intraocular lenses on preventing posterior capsule opacification.

PURPOSE: To clarify the extent to which the adhesiveness of an acrylic material influences the formation of posterior capsule opacification (PCO). SETTING: Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. METHODS: Two types of AcrySof(R) intraocular lenses (IOLs) were prepared: round edged and tumbled. The AcrySof with round edges was implanted in 1 eye in a group of 4 rabbits and the tumbled IOL, in 1 eye in a group of 5 rabbits. In both groups, the contralateral eye received a conventional AcrySof with sharp optic edges. A histopathological examination was performed 3 weeks after surgery. RESULTS: With the round-edged AcrySof IOL, no capsular bend formed at the optic edge and abundant lens epithelial cells (LECs) migrated posteriorly. With the sharp-edged AcrySof lens, a sharp capsular bend formed and LEC migration was significantly inhibited. In eyes with a tumbled IOL, a capsular bend was created, but it was less marked than that created by the sharp-edged lens and there was slightly more LEC migration posteriorly. CONCLUSIONS: The AcrySof IOL lost its preventive effect on PCO when the optic was rounded. The effect of the AcrySof lens in preventing PCO is mainly a result of its rectangular, sharp-edged optic design. The acrylic material may play a complementary role by helping create a sharp capsular bend. Capsular bend formation is the key to the PCO preventive effect of an IOL.

Inhibition of lens epithelial cells by Fas-specific antibody activating Fas-Fas ligand system.

PURPOSE: To detect cell specific apoptosis factors, Fas and Fas ligand, and the common intracellular apoptosis modulators, interleukin-1 beta converting enzyme (ICE)-like protease (caspase 1), Bcl-2, Bcl-xL and Bax in lens epithelial cells (LEC) of human cataracts. To study the effects of Fas-stimulating monoclonal antibody on inhibition of LEC proliferation. METHODS: Reverse-transcriptase-polymerase chain reaction (RT-PCR) was used to detect Fas, Fas ligand, caspase 1, Bcl-2, Bcl-xL and Bax, after cDNA was synthesized from the total RNA isolated from human cataractous LEC obtained by capsulotomy during cataract surgery. Fas-stimulating monoclonal antibody was added at the concentrations of 10, 30, 100, 300 and 1000 ng/ml to the incubation medium of human cataractous LEC; and the specimens were incubated for 24 h at 37 degrees C with 5% CO(2) circulation and 100% humidity. The specimens were then stained with Hoechst 33342, and the number of apoptotic cells was counted. RESULTS: Fas, caspase 1, Bcl-2, Bcl-xL and Bax mRNA were detected by RT-PCR. Fas ligand mRNA was not detected by RT-PCR. At each concentration, Fas-stimulating monoclonal antibody significantly inhibited LEC proliferation. CONCLUSIONS: Human cataractous LEC expressed mRNA of Fas and various modulators of apoptosis pathways. Fas-stimulating monoclonal antibody may have the potential to prevent posterior capsule opacification after cataract surgery by inhibiting LEC proliferation.

Preventing lens epithelial cell migration using intraocular lenses with sharp rectangular edges.

PURPOSE: To compare the preventive effect on posterior capsule opacification (PCO) of an acrylic intraocular lens (IOL) and a silicone IOL, both with sharp rectangular optic edges. SETTING: Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. METHODS: After phacoemulsification, an acrylic IOL (AcrySof(R)) was implanted in 1 eye and a silicone IOL (CeeOn 911) in the contralateral eye of 7 rabbits, one of which was omitted from evaluation. RESULTS: The Miyake-Apple view and histopathological findings 3 weeks after surgery revealed that the lens capsule wrapped tightly around the optic edges, conforming to a distinctly sharp bend, with both IOL types in 5 rabbits. Migrating lens epithelial cells (LECs) were inhibited at the site. The AcrySof IOL had a better capsular bend effect in the histological sections, but there was no apparent difference in PCO development between the 2 IOLs. CONCLUSIONS: The CeeOn 911 silicone IOL, with sharp rectangular optic edges, showed an effect on preventing PCO that was similar to that of the AcrySof IOL. When a discontinuous capsular bend is created by an IOL with sharp optic edges, the bend may induce contact inhibition of migrating LECs regardless of the lens' material composition.

Expression of transforming growth factor (TGF)-alpha, TGF-beta(2) and interleukin 8 messenger RNA in postsurgical and cultured lens epithelial cells obtained from patients with senile cataracts.

BACKGROUND: Testing our hypothesis that residual lens epithelial cells (LEC) participate in the pseudophakic inflammation by producing cytokines, prostaglandins (PG) or both, we detected interleukin-1 (IL-1), IL-6, b-FGF and PGE(2) in the incubation medium of cultured LEC. This paper describes our subsequent work on the expression of TGF-alpha, TGF-beta(2), IL-4 and IL-8 mRNA in postsurgical and cultured LEC. METHODS: The anterior lens capsule with attached LEC was obtained by anterior capsulotomy during cataract surgery and cultured. Specimens in serum-free medium immediately after surgery or those in serum-added medium after 2 weeks of culture were used. Reverse transcriptase-polymerase chain reaction (PCR) and electrophoresis were used to detect mRNA coding for TGF-alpha, TGF-beta(2), IL-4 and IL-8 in human cataract LEC. RESULTS: Electrophoresis of the PCR products showed that appropriately sized amplification products were specific for TGF-alpha and TGF-beta(2) in the specimens immediately after surgery and after culturing, and IL-8 in the cultured LEC. IL-4 was not detected in either group of specimens. CONCLUSIONS: Human cataract LEC synthesize TGF-alpha and TGF-beta(2) mRNA in situ and after culturing, and the cultured LEC also synthesize IL-8 mRNA. These cytokines may be synthesized by LEC in vitro and play an important role in an autocrine or paracrine manner in the proliferative process of LEC after cataract surgery, which can cause inflammation and aftercataract.

Preventing posterior capsule opacification by creating a discontinuous sharp bend in the capsule.

PURPOSE: To clarify which factor--intraocular lens (IOL) design or material--contributes most to the inhibition of migrating lens epithelial cells (LECs). SETTING: Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. METHODS: After phacoemulsification, an acrylic IOL with sharp optic edges was implanted in 1 eye and a poly(methyl methacrylate) (PMMA) IOL with an optic design similar to that of the acrylic IOL in the contralateral eye of 4 rabbits. RESULTS: The Miyake view and histopathological findings 3 weeks after surgery revealed that the lens capsule wrapped tightly around the optic edges, conforming to a distinctly sharp rectangular bend there with both IOL types in all rabbits. The migrating-LECs were inhibited at the site, and a massive Soemmering's ring cataract was formed. CONCLUSIONS: The discontinuous sharp capsule bend created by the sharp optic edges in both IOL types appeared to induce contact inhibition of the migrating LECs. The preventive effect of an acrylic IOL on posterior capsule opacification may be design dependent.

Posterior capsule opacification. Part 1: Experimental investigations.

Posterior capsule opacification (PCO) is the most frequent complication associated with decreased vision after cataract surgery. Previous methods of preventing PCO have not proven to be practical, effective, and safe for routine clinical procedure, but some novel concepts and methods have recently been developed. This 2-part review looks at clinical and experimental investigations of PCO, focusing on developments since 1992. Clinical aspects will be presented in a later issue. This paper addresses (1) in vitro models for PCO research; (2) pathophysiology and molecular biology of lens epithelial cells (LECs); (3) prevention of PCO. Of special interest are methods of culturing human LECs obtained by capsulotomy during cataract surgery, including those obtained with an intact capsular bag, to provide an in vitro model for investigating the pathophysiology of LECs; the effect of a sharp bend in the lens capsule that induces contact inhibition of migrating LECs; more specific inhibition of migrating LECs using an immunotoxin, b-FGF-saporin, or EDTA and RGD-peptides.

Capsule-bending ring for the prevention of capsular opacification: a preliminary report.

BACKGROUND AND OBJECTIVE: To report the preliminary results of a study on the preventive effect of the capsule-bending ring on anterior and posterior capsule opacification (ACO and PCO, respectively). PATIENTS AND METHODS: The ring is an open, band-shaped, circular polymethylmethacrylate (PMMA) ring measuring 11 mm in diameter with pre-tension (13 mm in diameter when the ring is open), 0.2 mm in thickness, and 0.7 mm in width. To retain sharp edges, the ring is not polished. The sharp edges should create a sharp, discontinuous capsular bend in the fornix, which induces contact inhibition of migrating lens epithelial cells after cataract surgery. This capsule-bending ring is inserted into the capsular fornix following phacoemulsification, prior to the implantation of an intraocular lens (IOL). In a multicenter trial, 100 patients were scheduled to undergo phacoemulsification and IOL implantation in both eyes within 1 month. The procedure was performed with the ring in 1 eye and without the ring in the other eye of each patient. RESULTS: The anterior capsule was prevented from coming into contact with the IOL, and ACO was significantly reduced in the eyes with the ring, rendering the capsular opening larger 3 months after surgery. PCO was obviously reduced on slit-lamp examination in the follow-up period up to 6 months, but needs to be evaluated during a longer period. CONCLUSION: This band-shaped, sharp-edged capsule-bending ring may be useful for cases that need good fundus visualization for photocoagulation or expected vitreoretinal surgery and for the prevention of PCO.

Accommodation amplitude after lens refilling with injectable silicone by sealing the capsule with a plug in primates.

OBJECTIVE: To restore accommodation in primate eyes by refilling the lens capsule with injectable silicone compounds. MATERIALS AND METHODS: Eight eyes of 8 monkeys (Macaca fascicularis) were treated by the lens refilling procedure. To prevent leakage of the injected liquid silicone before it polymerized in the capsule in vivo, a silicone plug for sealing the capsular opening was developed. After endocapsular phacoemulsification following an upper minicircular capsulorhexis, the plug was introduced into the capsulorhexis opening. A silicone mixture was injected into the capsular bag through the delivery tube of the plug. Automated refractometry was performed 1 week and 3 months after surgery. Accommodation amplitude was determined as the difference between the refractions before and 1 hour after topical application of 4% pilocarpine chloride. RESULTS: Five of 8 eyes could be refilled. In 4 of 5 eyes, refraction could be measured. Accommodation amplitude ranged from 1.0 to 4.5 diopters, with a mean of 2.3 +/- 1.3 diopters (8.0 +/- 2.0 preoperative values). At 3-month examination, thick posterior capsule opacification precluded refractometry in all eyes. CONCLUSIONS: The lens refilling procedure with the use of a silicone plug for sealing the capsular opening was feasible in primate eyes. The accommodation amplitude attained was a small fraction of the value before surgery. This may result from the loss of so-called intracapsular accommodation, ie, active participation of lens fiber cells in accommodation. However, since the obtained accommodation may be sufficient for near vision after cataract surgery, this lens refilling procedure warrants further study. Elucidation of the mechanism of intracapsular accommodation may also be necessary.

Inhibition of migrating lens epithelial cells at the capsular bend created by the rectangular optic edge of a posterior chamber intraocular lens.

BACKGROUND AND OBJECTIVE: To study the mechanism of the reportedly low incidence of posterior capsule opacification (PCO) in eyes treated with a posterior chamber intraocular lens (PC IOL). MATERIALS AND METHODS: Various IOL designs, including the PC IOL, were studied using scanning electron microscopy. Rabbit lens capsules were studied histopathologically 2, 3, and 4 weeks after implantation of a PC IOL in one eye and a biconvex polymethylmethacrylate (PMMA) IOL in the contralateral eye as a control. RESULTS: The optic edge of the PC IOL was sharp and rectangular, whereas that of the biconvex PMMA or silicone IOLs from various manufacturers had been smoothed and rounded by polishing. PCO was significantly reduced in the eye with a PC IOL in all rabbits. The lens capsule wrapped tightly around the optic edge of the PC IOL so that it conformed to the same shape and thereby created a distinct rectangular bend in the capsule or a rectangle between the optic edge and the posterior capsule. Migrating lens epithelial cells (LECs) were obviously inhibited at that site. CONCLUSIONS: A discontinuous capsular bend or rectangle created by the sharp, square optic edge of the PC IOL may have induced contact inhibition to migrating LECs and reduced PCO. How, whether, and to what extent this design-dependent effect is influenced by features of the IOL material needs to be clarified by comparison with results achieved with an IOL made from the same material in a different design and vice versa.

Lens refilling with injectable silicone in rabbit eyes.

PURPOSE: To evaluate the technique of refilling the lens capsule with injectable silicone and assess the postoperative findings. SETTING: Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. METHODS: The lens capsules in the eyes of 16 rabbits weighing 1.5 to 2.0 kg were refilled with 0.2 mL of silicone polymer (about 66% bag volume) after endocapsular phacoemulsification through an upper minicircular capsulorhexis 1.5 to 1.8 mm in diameter. The capsule opening was sealed with a silicone plug to prevent leakage of the injected silicone. Main outcome measures were surgical success rate, inflammation, endothelial cell loss, refractive change after pilocarpine 4% instillation, and capsule opacification. RESULTS: The lens capsule could be refilled in 10 eyes. The failures were caused by capsule rupture during phacoemulsification (n = 3) and profuse leakage of the injected silicone. Silicone that leaked minimally during surgery was easily washed away. Silicone that leaked and polymerized in the anterior chamber postoperatively (n = 3) was easily removed by surgery the following day. Mean endothelial cell loss was 10.2% 1 month after surgery. Aqueous flare intensity was significantly lower on days 2 and 4 than after conventional intraocular lens implantation in a control group. The respective mean preoperative and postoperative refractions were 0.7 diopters (D) +/- 1.0 (SD) and 19.1 +/- 1.0 D and the mean change (difference between the refractions before and after topical application of pilocarpine 4%), -0.4 +/- 0.6 and 1.1 +/- 0.4 D (P < .01). Posterior capsule opacification (PCO) was noted after 3 weeks in all eyes. CONCLUSIONS: Lens capsule refilling and capsular plug use to prevent silicone leakage was shown to be feasible and avoided complications caused by leakage. Refractive changes suggest that the procedure could yield accommodation in primates> Although neodymium: YAG laser capsulotomy did not cause herniation of the injected silicone, PCO prevention is an essential issue in lens refilling because the capsulotomy may annul the attained accommodation.

Capsular bag distention syndrome noted 5 years after intraocular lens implantation.

PURPOSE: To describe a case of capsular bag distention syndrome with opaque contents noted 5 years after intraocular lens implantation. METHODS: A 66-year-old man underwent phacoemulsification after circular capsulorhexis and intraocular lens implantation in the left eye. Five years later, the posterior capsule was vaulted far posteriorly, the capsular opening was apparently sealed by the lens optic, and the bag contents were slightly opacified. Two years later, the contents of the hyperdistended capsular bag showed intensified opacity, causing definite blurred vision. RESULTS: The opacified medium was emptied from the capsular bag posteriorly into the vitreous after Nd:YAG laser capsulotomy, and the distended capsule was restored. CONCLUSIONS: Our findings suggest that the contents were collagens produced by residual lens epithelial cells or necrotic and/or apoptotic autolyzed lens epithelial cells.

The inhibition of lens epithelial cell migration by a discontinuous capsular bend created by a band-shaped circular loop or a capsule-bending ring.

BACKGROUND AND OBJECTIVE: This study investigated the inhibitory effect of a discontinuous capsular bend created by an intraocular lens (IOL) with a band-shaped loop or a capsule tension ring on migrating lens epithelial cells (LECs). MATERIALS AND METHODS: To create a sharp bend in the capsule, the round form (shown on cross section) of the open-circular loop of a polymethylmethacrylate IOL was changed to a band-like shape, 1.0 mm wide and 0.2 mm thick. A capsule tension ring of the same shape (on cross section) with a 14-mm diameter was also made. After cataract surgery, this IOL or ring was implanted into the capsular bag in 5 rabbit eyes. The same IOL with an unmodified haptic or conventional capsule tension ring was implanted in the contralateral eye as a control. After 8 weeks, Miyake view and histopathologic examinations were performed. RESULTS: LECs accumulated at the equatorial corner outside the haptic or ring, showing the inhibition of LEC migration. In the control eyes, LECs accumulated inside the haptic or ring, forming a Soemmering's ring cataract, thus showing markedly less inhibition of LEC migration on macroscopic and microscopic observations. CONCLUSIONS: A discontinuous bend in the capsule significantly inhibited LEC migration in rabbit eyes. The creation of a capsular bend through the appropriate design of the IOL-haptic or capsule tension ring might significantly decrease the incidence of posterior capsule opacification for humans.

Inhibition of migrating lens epithelial cells by blocking the adhesion molecule integrin: a preliminary report.

PURPOSE: To evaluate the preventive effect of blocking integrins by sustained release of RGD peptide (arginine-glycin-aspartic acid sequence) or a combination of RGD peptide and ethylenediaminotetraacetic acid (EDTA) on lens epithelial cell (LEC) migration. SETTING: Nishi Eye Hospital, Jinshikai Medical Foundation, Osaka, Japan. METHOD: A polylactic-glycolic acid disk containing 4% RGD or a combination of 23% EDTA and 10% RGD was implanted in the capsular bag in five rabbit eyes following standard cataract surgery. The release rate in vitro was 4.4 microg/h for RGD peptide alone and 7.8 and 7.6 microg/h for combined EDTA and RGD peptide, respectively. The contralateral eye received a disk without agents as a control. RESULTS: After 1 month, a slight inhibition of LEC migration onto the posterior capsule was observed histopathologically in eyes receiving RGD peptide. A significant inhibition was observed in eyes with combined EDTA and RGD. CONCLUSIONS: Application of RGD peptide and EDTA and RGD peptide may inhibit LEC migration by inhibiting the integrins expressed on the LECs. Blocking adhesion molecules expressed on LECs may reduce posterior capsule opacification.

Controlling the capsular shape in lens refilling.

OBJECTIVES: To investigate control of the capsular shape by determining the ability of the lens capsule to mold injected silicone and to evaluate the relationship among the volume of silicone injected, refraction, and the amplitude of accommodation. METHODS: After endocapsular phacoemulsification following an upper, minicircular capsulorhexis, the lens capsule of a pig eye was refilled with a silicone mixture that polymerizes in vitro in 2 hours. The minicircular capsulorhexis opening was sealed by a small silicone plug to prevent leakage. The anterior capsule curvature and refraction of the lens were measured by a Scheimpflug camera and lensometer, respectively, with and without zonular tension. Zonular tension was created using a ciliary ring sutured to the ciliary bodies and expanded. RESULTS: The mean (+/- SD) anterior curvature of the lenses without zonular tension was 6.50 +/- 0.07 mm after 17 hours and 6.54 +/- 0.04 mm after 42 hours; with zonular tension it was 7.01 +/- 0.11 mm and 7.23 +/- 0.24 mm, respectively. The curvature became flatter when zonular tension was applied or steeper when zonular tension was abolished momentarily during measurements after 17 hours, but after 42 hours the curvature was unaffected by the application or removal of zonular pressure. The mean (+/- SD) amplitude of accommodation (the difference between refraction without zonular tension and that with it) was 3.2 +/- 0.5 diopters (D), 6.1 +/- 1.8 D, 4.8 +/- 0.8 D, and 2.8 +/- 1.3 D, when the lens was refilled with a silicone volume corresponding to 45%, 55%, 75%, and 95%, respectively, of the mean normal lens volume. CONCLUSIONS: The lens capsule possesses some ability to mold the injected silicone during its polymerization. When the eye is atropinized, the lens capsule may conform to its nonaccommodated state. Accommodation could be obtained by various degrees of refilling. Moderate refilling yields a greater amplitude of accommodation than does more complete refilling. Using a silicone plug to seal the capsular opening facilitates lens refilling with excellent reproducibility and seems to be useful in research.

Detection of cell adhesion molecules in lens epithelial cells of human cataracts.

PURPOSE: To detect the expression of cell adhesion molecules (CAMs), including beta integrins, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1, leukocyte-endothelial cell adhesion molecule-2, E-cadherin, and CD44, in cultured lens epithelial cells (LECs) of human cataracts. To show that LECs attach to cells or extracellular matrix components by the detected adhesion molecules. METHODS: A circular section of the anterior capsule with attached LECs obtained by anterior capsulotomy during cataract surgery was cultured in a well of an eight-chamber slide. The LEC immediately after surgery and the cell outgrowth beyond the capsular margin at 2 weeks of culture were observed after the culture was stained immunohistochemically. Functional assays of LEC growth on collagen- or laminin-coated plates were performed in the presence and absence of the antibody blocking the detected adhesion molecules. RESULTS: beta 1 integrin, ICAM-1, and CD44 were detected in both the original specimens and the cultured cells. When the antihuman anti-beta 1 integrin monoclonal antibody (mAb), anti-ICAM-1 mAb, or anti-CD44 mAb was added at 10 micrograms/ml to the incubation medium, LEC migration and proliferation were inhibited significantly on the collagen- or laminin-coated plates. When the mAb blocking these three CAMs were added each at 1 microgram/ml, LEC proliferation also were inhibited. CONCLUSIONS: beta 1 integrin, ICAM-1 and CD44 are all involved in LEC attachment and growth on collagen and laminin in vitro. It can be assumed that these CAMs are involved in adhesion of LECs to extracellular matrix components of the lens capsule. Understanding the characteristics of the adhesion molecules in LEC may lead to the development of a new approach to inhibit secondary cataract formation.

Capsule opacification after refilling the capsule with an inflatable endocapsular balloon.

PURPOSE: To describe the features of capsule opacification in rabbits and cynomolgus monkeys after the capsules were refilled with an inflatable endocapsular balloon. SETTING: Nishi Eye Hospital, Jinshikai Medical Foundation, Osaka, Japan. METHOD: Capsule opacification was evaluated by slitlamp examination, Miyake view, and histopathological examination in 15 eyes of 15 rabbits and 16 eyes of 13 primates from 4 to 32 months after the lens capsule had been refilled. RESULTS: The incidence of capsule opacification was 94%. In the eyes that did not have lens epithelial cell (LEC) removal, a monolayer of LECs was seen on the posterior capsule when the lens capsule was tautly refilled, whereas a thick layer was seen when the lens capsule was moderately or poorly refilled. In the eyes that had LEC removal, the opacification was generally less marked regardless of the amount of refilling. In two rabbit capsules that were refilled moderately or tautly and had LEC removal, the capsule remained clear. Neodymium:YAG capsulotomy in two eyes did not cause herniation of the injected silicone. CONCLUSIONS: Filling the capsule tautly and removing the LECs effectively reduced capsule opacification but could not completely inhibit LEC migration. This suggests the need for more efficient and thorough LEC removal or even a pharmaceutical approach to prevent capsule opacification after lens refilling.