RESUMO
PURPOSE: To study the molecular characteristics of lens epithelial cells from patients with senile cataract by cDNA microarray technique. METHODS: Lens epithelial cells adhering to anterior capsules taken during cataract surgery collected from 108 patients, aged 56-92 years (senile cataract group), were pooled. Pooled epithelial cells of normal, noncataractous lenses from one patient with ocular trauma, one patient with lens subluxation, and 25 cadaveric eyes, all under the age of 55 years, served as a control. Total RNA was extracted by conventional methods from the two groups of cells, and a fluorescent probe was prepared for each group. The probes were hybridized on 9700 known human cDNA clones. Hybridized clones were analysed using a scanning laser and the results were processed by GEMTools (Incyte Genomics) software. RESULTS: A total of 1827 clones hybridized with the two probes. Of these, 400 showed differences of more than two-fold in gene expression between the two probes. Relative to controls, gene expression in the senile cataract lenses was upregulated in 318 clones and downregulated in 82. Three genes-filensin, inwardly rectifying potassium channel (IRPC), and pigment epithelium-derived factor (PEDF) were strongly downregulated (by 41.3-, 6.8-, and 5.9-fold, respectively) in senile cataract. CONCLUSIONS: Cataractogenesis is associated with numerous changes in the genetic profile of the lens epithelial cells. Since filensin, IRPC, and PEDF genes are known to have important roles in the physiology and morphology of the transparent lens, substantial downregulation of their expression might contribute to the formation of senile cataract.
Assuntos
Envelhecimento/genética , Catarata/genética , Proteínas do Olho/genética , Regulação da Expressão Gênica/genética , Cristalino , Idoso , Idoso de 80 Anos ou mais , Sondas de DNA/genética , DNA Complementar/genética , Regulação para Baixo/genética , Células Epiteliais , Humanos , Proteínas de Filamentos Intermediários/genética , Cristalino/patologia , Pessoa de Meia-Idade , Fatores de Crescimento Neural/genética , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Canais de Potássio Corretores do Fluxo de Internalização/genética , RNA/análise , RNA Mensageiro/análise , Serpinas/genéticaRESUMO
PURPOSE: To report a case in which cataract surgery was performed under local anesthesia, with continuous positive airway pressure-assisted ventilation. METHODS: A 40-year-old woman with myotonic dystrophy and severe orthopnea, who could not lie supine because of severe orthopnea, and who was a high-risk candidate for general anesthesia, underwent cataract surgery with continuous positive airway pressure ventilation by face mask. RESULTS: The patient underwent uneventful phacoemulsification and intraocular lens implantation in her left eye, while under continuous positive airway pressure ventilation. CONCLUSION: Selected patients who are unable to lie supine for ocular surgery because of severe orthopnea, and who are at risk for systemic complications under general anesthesia, may be evaluated for continuous positive airway pressure-assisted surgery.
Assuntos
Ventilação de Alta Frequência , Implante de Lente Intraocular , Facoemulsificação/métodos , Adulto , Anestesia Local , Dispneia/complicações , Feminino , Humanos , Distrofia Miotônica/complicaçõesRESUMO
PURPOSE: To assess the safety and efficacy of topical anesthesia using lidocaine gel in cataract surgery. SETTING: Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel. METHODS: One hundred cataract procedures (48 manual extracapsular cataract extraction [ECCE] and 52 phacoemulsification) were performed using lidocaine 2% gel as the sole anesthetic agent. The gel was applied 3 to 5 times prior to surgery. Intraoperative and postoperative data were recorded, and patients were asked to grade the pain on a scale of 0 (no pain) to 10 (unbearable pain). RESULTS: Sixty-two percent of patients having manual ECCE and 74% having phacoemulsification reported no pain during surgery (score 0). The mean pain score in the manual ECCE group was 0.99 +/- 1.64 (SD); 3 patients required an additional intracameral lidocaine injection. The mean score in the phacoemulsification group was 0.72 +/- 1.47; no patient required additional anesthesia. CONCLUSIONS: Topical application using lidocaine 2% gel is safe and highly effective, especially in clear corneal phacoemulsification. The gel also provides prolonged lubrication, further facilitating surgery.