Direct regulation of shikimate, early phenylpropanoid, and stilbenoid pathways by Subgroup 2 R2R3-MYBs in grapevine.

The stilbenoid pathway is responsible for the production of resveratrol in grapevine (Vitis vinifera L.). A few transcription factors (TFs) have been identified as regulators of this pathway but the extent of this control has not been deeply studied. Here we show how DNA affinity purification sequencing (DAP-Seq) allows for the genome-wide TF-binding site interrogation in grape. We obtained 5190 and 4443 binding events assigned to 4041 and 3626 genes for MYB14 and MYB15, respectively (approximately 40% of peaks located within −10 kb of transcription start sites). DAP-Seq of MYB14/MYB15 was combined with aggregate gene co-expression networks (GCNs) built from more than 1400 transcriptomic datasets from leaves, fruits, and flowers to narrow down bound genes to a set of high confidence targets. The analysis of MYB14, MYB15, and MYB13, a third uncharacterized member of Subgroup 2 (S2), showed that in addition to the few previously known stilbene synthase (STS) targets, these regulators bind to 30 of 47 STS family genes. Moreover, all three MYBs bind to several PAL, C4H, and 4CL genes, in addition to shikimate pathway genes, the WRKY03 stilbenoid co-regulator and resveratrol-modifying gene candidates among which ROMT2-3 were validated enzymatically. A high proportion of DAP-Seq bound genes were induced in the activated transcriptomes of transient MYB15-overexpressing grapevine leaves, validating our methodological approach for delimiting TF targets. Overall, Subgroup 2 R2R3-MYBs appear to play a key role in binding and directly regulating several primary and secondary metabolic steps leading to an increased flux towards stilbenoid production. The integration of DAP-Seq and reciprocal GCNs offers a rapid framework for gene function characterization using genome-wide approaches in the context of non-model plant species and stands up as a valid first approach for identifying gene regulatory networks of specialized metabolism.

Nozzle tip damage in three generations of intraocular lens injector models: an experimental laboratory study.

PURPOSE: To assess the nozzle tip damage of IOL injectors in three generations from the same manufacturer using the self-developed system-the Heidelberg Score for IOL Injector Damage. SETTING: David J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany DESIGN: Experimental laboratory study METHODS: The nozzle tip damage of three injector models (Emerald, iTec, and Simplicity) was determined using the Heidelberg score for IOL injector damage. Damage to the nozzle tip was examined under a microscope and graded as follows: no damage (score 0), slight scratches (1), deep scratches (2), extensions (3), cracks (4) and bursts (5). The total scores for each injector system were the sum of scores for all injectors in this model. Total scores of the three injector systems were evaluated and compared. The nozzle tip parameters (diameters, tip angles) were also measured in each group. RESULTS: The Emerald system achieved the highest total scores, while the other two systems achieved similar total scores. There was no statistically significant difference in the total scores between the study groups (P > 0.05). The outer cross-sectional diameters were 2.10 and 2.10 mm for Emerald, 1.80 and 1.78 mm for iTec, and 1.78 and 1.80 mm for Simplicity. The thickness of the nozzle tips was 0.13 mm (Emerald), 0.17 mm (iTec) and 0.17 mm (Simplicity). The tip angle for three injector models was 35° (Emerald), 45° (iTec), and 45° (Simplicity). CONCLUSIONS: Although different injector models exhibited varying degrees of damage to the nozzle tip, all injector models generally showed relatively good results. Newer generations of IOL injector models tend to perform better in terms of nozzle tip damage after IOL implantation.

Evaluation of Nozzle Tip Damage in Intraocular Lens Injectors with V-Shaped Notch.

INTRODUCTION: Damage to the nozzle tips of intraocular lens (IOL) injectors has been associated with various adverse events and even IOL surface abnormalities after IOL implantation. In this study, nozzle tip damage of three different injector models with v-notched nozzle tips was systematically evaluated using our self-developed system - the Heidelberg Score for IOL injector damage. METHODS: Nozzle tip damage was categorized into 6 grades: no damage (grade 0), slight scratches (1), deep scratches (2), extensions (3), cracks (4), and bursts (5). Each grade was assigned to a score of 0-5. In each IOL injector group, all IOLs were divided into 2 subgroups based on IOL power: +15 to +21D group and +21 to +26D group. The total scores for each group were the sum of scores for all injectors in this group. Further analysis was performed on the nozzle tip configuration and parameters in each injector model. RESULTS: The median (Q1-Q3) for each injector group in group +15 to +21D was 1.5 (1-2) for Avansee, 4 (3-4) for iSert, and 4 (3-4) for multiSert. A statistically significant difference was found between Avansee and iSert (p < 0.001) as well as between Avansee and multiSert (p < 0.01) in terms of median scores. The median (Q1-Q3) for each injector group in group +21 to +26D was 1.5 (1-2) for Avansee, 4 (4-4) for iSert, and 3 (3-3.75) for multiSert. A statistically significant difference was found between Avansee and iSert in terms of median scores (p < 0.001). The outer cross-sectional diameters were 1.80 and 1.78 mm for Avansee, 1.70 and 1.69 mm for iSert, and 1.69 and 1.68 mm for multiSert. The radii of each notch-based circle were 0.21 mm (Avansee), 0.09 (iSert), and 0.06 (multiSert), respectively. The tip angles for three injector models were 48° (Avansee), 46° (iSert), and 37° (multiSert). CONCLUSIONS: Avansee showed the least nozzle tip damage of all three groups. Compared with our earlier study using preloaded injectors with intact endpieces, all the injector groups with v-notched nozzle tips had more damage to the nozzle tip. It was found that the closer the notch of the nozzle tip was to the letter "V," the more damaged the nozzle tip was after IOL implantation.

Observation of Asymmetric Oxidation Catalysis with B20 Chiral Crystals.

The study of heterogeneous reactions for enantiomeric processes based on inorganic crystals has been resurgent in recent years. However, the question remains how homochirality develops in nature and chemical reactions. Here, the successful growth of B20 group PdGa single crystals with different chiral lattices enabled us to achieve enantioselective recognition of 3,4-dihydroxyphenylalanine (DOPA) based on a new mechanism, namely orbital angular momentum (OAM) polarization. The orbital textures of PdGa crystals indicate large OAM polarization near the Fermi level and carrying opposite signs. A positive or negative magnetization in the [111] direction is expected depending on the chiral lattice of PdGa crystals. Due to this, the adsorption energies of PdGa crystals and DOPA molecules differ depending on how well the O-2p orbital of DOPA pairs with the Pd-4d orbital of PdGa. The results provide one possible explanation for how chirality arises in nature by providing an enantioselective route with pure inorganic crystals.

Oxygen deficiency in Sr2FeO4-x: electrochemical control and impact on magnetic properties.

The oxygen-deficient system Sr2FeO4-x was explored by heating the stoichiometric Fe4+ oxide Sr2FeO4 in well-defined oxygen partial pressures which were controlled electrochemically by solid-state electrolyte coulometry. Samples with x up to about 0.2 were obtained by this route. X-ray diffraction analysis reveals that the K2NiF4-type crystal structure (space group I4/mmm) of the parent compound is retained. The lattice parameter a slightly decreases while the c-parameter increases with increasing x, which is in contrast to the Ruddlesden-Popper system Sr3Fe2O7-x and suggests removal of oxygen atoms from FeO2 lattice planes. The magnetic properties were studied by magnetization, 57Fe Mössbauer, and powder neutron diffraction experiments. The results suggest that extraction of oxygen atoms from the lattice progressively changes the elliptical spiral spin ordering of the parent compound to an inhomogeneous magnetic state with coexistence of long-range ordered regions adopting a circular spin spiral and smaller magnetic clusters.

In-vitro glistening formation in six different foldable hydrophobic intraocular lenses.

BACKGROUND: Glistenings describe small, refractile microvacuoles that may arise within the intraocular lens (IOL) material and reduce the patients' quality of vision. Lenses composed of hydrophobic acrylic material are particularly affected by glistening formation. In this study, we compared the tendency of glistening formation in six different types of hydrophobic acrylic intraocular lenses (IOLs). METHODS: We used a well-established accelerated laboratory method to develop glistenings in the following IOLs: Vivinex XY1 (Hoya), AcrySof SN60WF (Alcon), Tecnis ZCB00 (AMO), Avansee PN6A (Kowa), Aktis SP NS-60YG (Nidek), and CT Lucia 601P (Zeiss). IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h in a water bath. Microvacuole (MV) density and size (Miyata grading) were documented and calculated using an image analysis program. RESULTS: The mean glistening density [MV/mm2] and mean Miyata grading (in brackets) were: Vivinex: 11.6 ± 5.7 (0), SN60WF: 264.4 ± 110.3 (2.6), Tecnis: 6.0 ± 2.8 (0), Avansee: 2.2 ± 0.7 (0), Aktis: 851.4 ± 59.4 (3+) and CT Lucia: 71.0 ± 71.6 (1). CONCLUSIONS: While all tested IOLs showed glistenings with the accelerated laboratory method, the Aktis and SN60WF showed the highest microvacuole density, followed by the CT Lucia. In comparison, the Vivinex, Tecnis, and Avansee IOLs showed far fewer number of glistenings.

Glistening formation in a new hydrophobic acrylic intraocular lens.

BACKGROUND: The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well-established in-vitro laboratory method, we evaluated a new IOL material's resistance to glistening formation. METHODS: An in-vitro stress test for glistening induction was performed on 20 samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm2) was evaluated in five sections of each IOL. The results for each model were compared and rated on a modified Miyata Scale for grading glistening severity. RESULTS: In all cases, glistening number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm2. The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm2. Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero. CONCLUSION: In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. Results from this in-vitro study suggest that glistening numbers will be low in clinical use in the Eyecryl ASHFY600.

Discovery of Elusive K4 O6 , a Compound Stabilized by Configurational Entropy of Polarons.

Synthesis of elusive K4 O6 has disclosed implications of crucial relevance for new solid materials discovery. K4 O6 forms in equilibrium from K2 O2 and KO2 , in an all-solid state, endothermic reaction at elevated temperature, undergoing back reaction upon cooling to ambient conditions. This tells that the compound is stabilized by entropy alone. Analyzing possible entropic contributions reveals that the configurational entropy of "localized" electrons, i.e., of polaronic quasi-particles, provides the essential contribution to the stabilization. We corroborate this assumption by measuring the relevant heats of transformation and tracking the origin of entropy of formation computationally. These findings challenge current experimental and computational approaches towards exploring chemical systems for new materials by searching the potential energy landscape: one would fail in detecting candidates that are crucially stabilized by the configurational entropy of localized polarons.

Effects of ranibizumab (Lucentis®) and bevacizumab (Avastin®) on human corneal endothelial cells.

BACKGROUND: Ingrowth of newly formed blood and lymph vessels (angiogenesis) from the limbus region into the cornea can be treated successfully by subconjunctival application of antiangiogenic agents. Currently, there are several angiogenesis inhibitors from various manufacturers available, such as vascular endothelial growth factor (VEGF) antibodies. The aim of the study was to investigate potential cytotoxic effects of two anti-VEGF agents, ranibizumab (Lucentis®) and bevacizumab (Avastin®) on the human corneal endothelium. METHODS: Human donor corneas, not suitable for corneal transplantation, were organ-cultured in the presence of either ranibizumab (Lucentis®) or bevacizumab (Avastin®) at different concentrations (group 1: 250 µg / ml, group 2: 25 µg / ml, group 3: 2.5 µg / ml) for a period of up to 4 weeks. Microscopic imaging for endothelial cell counting, detection of morphologic alterations of the endothelium, and molecular biology testing (Enzyme-linked Immunosorbent Assay [ELISA]) for metabolic changes was performed. RESULTS: Background-corrected results showed neither a significant lactate dehydrogenase (LDH) change with increasing culturing time nor a significant difference between ranibizumab (Lucentis®) and bevacizumab (Avastin®) treatment. The endothelial cell density revealed also no statistically significant difference between the two treatment groups with ranibizumab (Lucentis®) and bevacizumab (Avastin®) at all concentrations tested in this study. CONCLUSIONS: In this study, the anti-angiogenic agents ranibizumab (Lucentis®) and bevacizumab (Avastin®) demonstrated no cytotoxic effects on the corneal endothelium of human organ-cultured donor corneas over the limited study time period of 4 weeks. However, based on the study design (in-vitro) and the limited follow-up period, no conclusions on potential long-term effects can be drawn.

In vitro optical quality measurements of three intraocular lens models having identical platform.

BACKGROUND: With recent advances in technology and introduction of new intraocular lens (IOL) models, surgeons today have the opportunity to choose from various optical designs, which can influence the postoperative quality of vision. In our laboratory study, we compared the optical quality of three different IOLs that use the identical platform and are produced by the same manufacturer. The study included two diffractive multifocal IOLs, a bifocal and a trifocal one, as well as a monofocal IOL. METHODS: Three IOL models: monofocal CT ASPHINA 409 M, diffractive bifocal AT LISA 809 M, and diffractive trifocal AT LISA Tri 839MP (Carl Zeiss Meditec AG, Germany) were assessed for optical quality by measuring modulation transfer function (MTF) and Strehl Ratio (SR) values at pupil sizes of 3.0 and 4.5 mm on the OptiSpheric® IOL PRO (Trioptics GmbH, Germany). The United States Air Force (USAF) Target images were also recorded to comfirm the optical performance qualitatively. RESULTS: For far focus at 50 lp/mm and 3.0 mm pupil size, MTF value of the monofocal lens (MTF = 0.798) was 1.8-fold and 2.1-fold better than the bifocal (MTF = 0.446) and the trifocal (MTF = 0.382) IOLs, respectively. For near focus, bifocal IOL (MTF = 0.265) was 1.4-fold better than trifocal IOL (MTF = 0.187), while for intermediate focus, the trifocal IOL (MTF = 0.148) was 1.7-fold better than the bifocal IOL (MTF = 0.086). For the same pupil size, total sum of light loss amounted to 5.2% for the monofocal, 16.0% for the bifocal and 6.0% for the trifocal IOL. For a larger pupil, the amount of light loss increased significantly for the multifocal IOLs. CONCLUSIONS: The monofocal IOL performed the best for far, the bifocal IOL for near and the trifocal IOL for intermediate focus. While the monofocal IOL created the least amount of light loss for both pupil sizes, the trifocal IOL created less than half the amount of light loss than the bifocal IOL for small pupil. For large pupil, however, less light scatter was observed for the bifocal than the trifocal IOL.

An ancestral allele of grapevine transcription factor MYB14 promotes plant defence.

Stilbene synthase is a key enzyme for the production of the phytoalexin resveratrol. Some clones of Vitis sylvestris, a wild European grapevine species which is almost extinct, have been shown to accumulate more resveratrol in response to different forms of stress. In the current study, we asked whether the induction of stilbene synthase transcripts in Hoe29, one of the V. sylvestris clones with elevated stilbene inducibility, might result from the elevated induction of the transcription factor MYB14. The MYB14 promoter of Hoe29 and of Ke83 (a second stilbene-inducible genotype) harboured distinct regions and were applied to a promoter-reporter system. We show that stilbene synthase inducibility correlates with differences in the induction of MYB14 transcripts for these two genotypes. Both alleles were induced by UV in a promoter-reporter assay, but only the MYB14 promoter from Hoe29 was induced by flg22, consistent with the stilbene synthase expression of the donor genotypes, where both respond to UV but only Hoe29 is responsive to Plasmopara viticola during defence. We mapped upstream signals and found that a RboH-dependent oxidative burst, calcium influx, a MAPK cascade, and jasmonate activated the MYB14 promoter, whereas salicylic acid was ineffective. Our data suggest that the Hoe29 allele of the MYB14 promoter has potential as a candidate target for resistance breeding.

Synthesis and Characterization of Cs1-xTi2Te2O (x ≈ 0.2): Electron Doping by Te Resulting in a Layered Metal.

Reacting Cs2O1.3, TiTe, TiO2, and Te under inert conditions gives powders of Cs1-xTi2Te2O (x ≈ 0.2). Small single crystals of the same phase were obtained from a CsCl salt melt in closed ampoules. This cesium dititanium ditelluride oxide (P4/mmm, a = 4.0934(3) Å, c = 8.9504(9) Å) is isostructural to CeCr2Si2C and contains layers of face-sharing trans-TiTe4O2 octahedra that are separated by Cs. As Ti occupies only one crystallographic site, its average oxidation state is +2.6, for the Cs deficit x = 0.2. The formally intermediate Ti valence state agrees well with the metallic conductivity and temperature-independent paramagnetic behavior. No superconductivity is observed down to 0.1 K in Cs0.8Ti2Te2O, but the fact that this structure type can accommodate Te2- suggests that electron doping of structurally closely related pnictide oxide superconductors, for example, BaTi2Bi2O, might be possible.

The transcription factor VvWRKY33 is involved in the regulation of grapevine (Vitis vinifera) defense against the oomycete pathogen Plasmopara viticola.

Grapevine (Vitis vinifera ssp. vinifera) is one of the most important fruit species; however, it is highly susceptible to various pathogens, which can cause severe crop losses in viticulture. It has been shown that several WRKY class transcription factors (TFs) are part of the signal transduction cascade, which leads to the activation of plant defense reactions against various pathogens. In the present investigation, a full-length cDNA was isolated from V. vinifera leaf tissue encoding a predicted protein, designated VvWRKY33, which shows the characteristics of group I WRKY protein family. VvWRKY33 induction correlates with the expression of VvPR10.1 (pathogenesis-related 10.1) gene in the leaves of the resistant cultivar 'Regent' after infection with Plasmopara viticola, whereas in the susceptible cultivar 'Lemberger' VvWRKY33 and VvPR10.1 are not induced. Corresponding expression of the TF and VvPR10.1 was even obtained in uninfected ripening berries. In planta, analysis of VvWRKY33 has been performed by ectopic expression of VvWRKY33 in grapevine leaves of greenhouse plants mediated via Agrobacterium tumefaciens transformation. In consequence, VvWRKY33 strongly increases resistance to P. viticola in the susceptible cultivar 'Shiraz' and reduces pathogen sporulation of about 50-70%, indicating a functional role for resistance in grapevine. Complementation of the resistance-deficient Arabidopsis thaliana Columbia-0 (Col-0) mutant line wrky33-1 by constitutive expression of VvWRKY33 restores resistance against Botrytis cinerea to wild-type level and in some complemented mutant lines even exceeds the resistance level of the parental line Col-0. Our results support the involvement of VvWRKY33 in the defense reaction of grapevine against different pathogens.

Na4IrO4 : square-planar coordination of a transition metal in d(5) configuration due to weak on-site coulomb interactions.

Local environments and valence electron counts primarily determine the electronic states and physical properties of transition-metal complexes. For example, square-planar coordination geometries found in transition-metal oxometalates such as cuprates are usually associated with the d(8)  or d(9)  electron configuration. In this work, we address an unusual square-planar single oxoanionic [IrO4 ](4-)  species, as observed in Na4 IrO4 in which Ir(IV) has a d(5)  configuration, and characterize the chemical bonding through experiments and by ab initio calculations. We find that the Ir(IV)  center in ground-state Na4 IrO4 has square-planar coordination geometry because of the weak Coulomb repulsion of the Ir-5d electrons. In contrast, in its 3d counterpart Na4 CoO4 , the Co(IV) center is tetrahedrally coordinated because of strong electron correlation. Na4 IrO4 may thus serve as a simple yet important example to study the ramifications of Hubbard-type Coulomb interactions on local geometries.

Evaluation of Parameters and Nozzle Tip Damage after Clinical Use of Three Hydrophilic Intraocular Lens Injector Models.

Purpose: To assess the nozzle tip damage and the parameters of three different hydrophilic intraocular lens (IOL) injector models. Methods: After routine cataract surgeries at the University Eye Hospital Heidelberg, all the used IOL injectors were collected from the operating room and sent to our laboratory. Nozzle tip damage was assessed under a microscope and graded as follows: no damage (grade 0), slight scratches (1), deep scratches (2), extensions (3), cracks (4), and bursts (5). Each damage grade was assigned a score from 0 to 5, and the total damage score for each injector system was calculated and compared. Nozzle tip parameters (diameters and areas), plunger tip parameters, and tip angles were also measured in each model. Results: The damage scores were (median, Q3-Q1): 1 (1-1) for Accuject, 1 (1-1) for Bluemixs, and 1 (1-1) for RayOne. There was no statistically significant difference in the damage scores between the study groups (P > 0.05). The outer cross-sectional vertical and horizontal diameters were 1.69 and 1.69 mm for Accuject, 1.69 and 1.69 mm for Bluemixs, and 1.70 and 1.71 mm for RayOne. Plunger tip areas were 0.78 mm2 for Accjuect, 0.74 mm2 for Bluemixs, and 0.43 mm2 for RayOne. Plunger tip area/inner cross-sectional area of the nozzle tip (%) was 31.2% for RayOne, 66.7% for Accuject, and 63.8% for Bluemixs. The tip angles for three injector models were 56° (Accuject), 56° (Bluemixs), and 44° (RayOne). Conclusions: All the injector models showed mild to moderate damage to the nozzle tip after IOL implantation, even with smaller diameter tips. RayOne resulted in the lowest ratio between plunger tip area and inner cross-sectional area of the nozzle tip and a better distribution of damage categories than the other two groups. All three injector models had relatively small tip parameters. If smaller incisions are required in certain patients, smaller tip parameters should be considered.

Intraocular lens calcification in a patient with Ehlers-Danlos syndrome.

Introduction: Calcification of hydrophilic intraocular lenses (IOL) is a rare complication following cataract surgery. Secondary calcification is described as due to host factors or changes in the IOL environment and uveitis, proliferative diabetic retinopathy and sequelae of ocular surgery are recognised potentiators. The impact of systemic connective tissue disease on IOL opacification is yet to described. Purpose: To describe the clinical presentation and management of a young patient, with a rare subtype of Ehlers-Danlos syndrome, who presented with secondary IOL calcification 14 years after primary IOL insertion. Observations: Floret-like lesions were observed on the IOL surface. Positive staining for calcification was observed with Alizarin red and von Kossa method on laboratory analysis. Conclusions and importance: Patients with systemic connective tissue disease, such as a subtype of Ehlers-Danlos, may present with secondary IOL calcification many years after primary lens insertion. This poses an additional consideration when implanting IOLs in these patients.Good visual acuity can be achieved with IOL exchange.

Experimental analysis of recommended corneal incision sizes in cataract surgery using 13 intraocular lens injector systems.

Smaller corneal incisions in cataract surgery are linked with a better visual outcome and less frequent postoperative endophthalmitis. The insertion of intraocular lens (IOL) injector systems into the anterior chamber of the eye to implant an IOL is associated with incision enlargement (IE) impeding these positive effects. The aim of this study was to compare manufacturers' recommended incision sizes (IS) of 13 different intraocular lens injector systems in regard of intraoperative IE and postoperative IS. In total, 499 corneal incisions in ex vivo porcine eyes were analyzed. The preoperative ISs depended on the recommended IS of the examined injector system. The IS was measured right before and after IOL injector insertion with an incision gauge set. There was intraoperative IE in 87% of the incisions with a mean IE of 0.26 ± 0.18 mm. IE was often significantly larger in small IS compared to larger IS concerning an injector system (P < 0.05). Five injector systems needed to have a significantly larger IS than the manufacturers' recommended IS with an average difference of 0.3 mm when applying study criteria (P < 0.05). Thus, the present study shows that IS recommendations require to be critically analyzed by ophthalmic surgeons to enable evidence-based practice.

Comparison of a new IOL injector system against 3 standard IOL injector systems with different incision sizes: Miyake-Apple view experimental laboratory study.

PURPOSE: To compare 1 new intraocular lens (IOL) injector system against 3 standard injector systems in porcine eyes. SETTING: David J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany. DESIGN: In vitro laboratory study. METHODS: In 70 porcine eyes, +20.0 diopter IOLs were implanted with the following systems: multiSert, UltraSert, iTec, and RayOne, that is, S1.8 (incision size: 1.8 mm), S2.0 (2.0 mm), S2.2P (2.2 mm, push mode), S2.2S (2.2 mm, screw mode), U2.2 (2.2 mm), iT2.2 (2.2 mm), and R2.0 (2.0 mm). Corneal incision sizes were measured before and after implantation with an incision gauge set. Ease of use was evaluated using a Likert scale. IOL delivery time and performance were determined based on Miyake-Apple view videos. RESULTS: Of the 70 eyes studied, the incision enlargements were 0.36 ± 0.08 mm (S1.8), 0.15 ± 0.07 mm (S2.0), 0.17 ± 0.12 mm (S2.2P), 0.28 ± 0.10 mm (S2.2S), 0.32 ± 0.09 mm (U2.2), 0.30 ± 0.08 mm (iT2.2), and 0.35 ± 0.11 mm (R2.0). Total scores of ease of use were 23.00 (S1.8), 25.00 (S2.0), 29.00 (S2.2P), 26.00 (S2.2S), 26.00 (U2.2), 25.00 (iT2.2), and 24.00 (R2.0). As for the mean delivery time, iT2.2 took the longest time (13.20 ± 3.29 seconds), whereas S2.2S took the shortest time (4.50 ± 0.71 seconds). Optic-haptic adhesion was observed in S1.8 (4, 40%), S2.2P (2, 20%), U2.2 (5, 50%), and iT2.2 (5, 50%). CONCLUSIONS: Injector S, with the appropriate incision size and implantation method, could achieve better results regarding incision enlargement, ease of use, delivery time, and performance than other injector systems. There was an indirect relationship between incision size and inadvertent events.

A laboratory evaluation of nozzle tip damage in four generations of intraocular lens injector systems using a self-developed damage scale.

During intraocular lens (IOL) implantation it is not uncommon for the injector's nozzle-tip to get damaged. However, the damage has not been systematically described or evaluated using an objective scale. In this study we developed our own system-the Heidelberg Score for IOL Injector Damage ("HeiScore"), which was used to grade 60 injectors from four generations of injector models (Monarch III D, AcrySert C, UltraSert, AutonoMe) made by the same manufacturer. (Alcon Laboratories Inc.) HeiScore has six grades of nozzle-tip damage: no damage (which was graded 0); slight scratches (1), deep scratches (2), extensions (3), cracks (4) and bursts (graded number 5). The score for each injector model was the sum of all grades (total number), and we could compare the four injector models. The injectors showed varying damage profiles, from "no damage" to "crack". A tendency of a lower damage score in the newer generations of IOL injectors was noted. However, a statistically significant difference was observed only between Monarch III D and AutonoMe. The "Heidelberg Score for IOL Injector Damage" could efficiently and effectively evaluate the damage to IOL injector systems, which might help manufacturers optimize the positioning of the IOL in the injector during pre-loading.

Intravitreal Application: Physicochemical Properties of Drugs Dissolved in Silicone Oils of Different Density in Comparison to the Porcine Vitreous Body.

Silicone oil endotamponades provide a reservoir for drugs in the eye. Following vitrectomy surgery to treat retinal detachments, extensive diabetic retinopathy or endophthalmitis, they can be used as long-term lipophilic depots. This study aimed to investigate the physicochemical properties of intravitreally applied drugs of different lipophilicity, namely vancomycin, ceftazidime and voriconazole. For this purpose, an in vitro model of the silicone-oil-filled eye compared to porcine vitreous bodies (PVBs) was used. In a glass container, either light or heavy silicone oil or PVB was set into equilibrium with an aqueous fluid. Vancomycin, voriconazole and ceftazidime were added in concentrations commonly applied in clinical practice. The time course of the concentration of the drugs was determined in the hydrophilic phase for up to 24 h. With silicone oil present, the concentrations of vancomycin, voriconazole and ceftazidime were elevated in the aqueous humor when compared to the vitreous body (p < 0.001 for all drugs). With increasing lipophilicity, higher concentrations of the drug dissolved in silicone oil after 24 h (52.7%, 49.1% and 34.3% for vancomycin, ceftazidime and voriconazole, respectively). While no difference between lighter- and heavier-than-water silicone oil was apparent for vancomycin and ceftazidime (p = 0.17 and p = 0.72), voriconazole dissolved significantly better in the heavier-than-water silicone oil (p = 0.002). A higher-than-expected percentage of the glycopeptide vancomycin dissolved in the porcine vitreous body, possibly due to protein binding. In conclusion, silicone oils influence the drug concentration and distribution of intravitreally applied drugs depending on their lipophilicity. The addition of F6H8 used to create heavy silicone oils attenuates these effects for lipophilic drugs. Knowledge of the distribution of these intravitreally applied drugs is crucial to ensure the desired anti-infectious effect.