Lens-vault analysis and its correlation with other biometric parameters using swept-source OCT

Purpose: To measure lens vault (LV) and to assess its correlation with various ocular parameters in healthy eyes, using for all measurements the same high-resolution swept-source optical coherence tomographer (SS-OCT).Methods: We prospectively recruited 67 Caucasian healthy patients whose mean age was 41.9 ± 12.4 years; only their right eye was included in the study. Data were all recorded with the ANTERION SS-OCT and comprised, for each patient, 5 consecutive measurements of LV, anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber volume (ACV) and spur-to-spur (STS) distance.Results: Mean LV was 0.26 ± 0.23 mm (ranging from -0.24 to 0.78 mm). Data analysis revealed a statistically significant negative correlation between LV and ACD (R=-0.80, p < 0.001), AL (R = -0.36, p = 0.002), and ACV (R = -0.68, p < 0.001), and a positive correlation between LV and LT (R = 0.67, p < 0.001), and age (R = 0.53, p < 0.001). In contrast, no statistically significant correlation was found between LV and WTW (R=-0.17, p = 0.15), CCT (R = 0.11, p = 0.36) or STS (R=-0.10, p = 0.41).Conclusions: Taking into account our findings about intra-parameter correlation levels, we believe that LV should be measured and analyzed together with other ocular parameters in clinical routine practice both for diagnosis and for some refractive surgeries. (AU)

Morphologic and molecular study on the lens anterior capsule in systemic sclerosis / Relato sobre estudo morfológico e molecular da cápsula anterior do cristalino na esclerose sistêmica

ABSTRACT This study aimed to analyze the anterior lens capsule specimens from both eyes of a patient with systemic sclerosis and compare them to the eyes of a control patient. No significant differences between systemic sclerosis and control eyes were observed in the results from the hematoxylin-eosin and picrosirius staining. In the samples obtained from both systemic sclerosis and control eyes, there were expressions of caspase, a molecule expressed in cell death by apoptosis. Heparanase was overexpressed in the systemic sclerosis sample compared to the control sample. Therefore, the anterior lens capsule of the patient with systemic sclerosis is probably affected by the disease since it showed marked expression of heparanase 1.(AU)

RESUMO Analisamos as amostras das cápsulas anteriores do cristalino de uma paciente com esclerose sistêmica e comparamos com as de um paciente controle. Não foram observadas diferenças significativas entre esclerose sistêmica e controle nos resultados da coloração com hematoxilina-eosina e picrosirius. Nas amostras obtidas da esclerose sistêmica e do controle, obtivemos expressão de caspase, uma molécula expressa na morte celular por apoptose. A heparinase foi expressa de forma mais marcante na amostra de esclerose sistêmica quando comparada ao controle. Portanto, a cápsula anterior do cristalino da paciente com esclerose sistêmica provavelmente foi afetada pela doença, uma vez que mostrou expressão aumentada de heparinase 1.(AU)

Comparison of Toric Intraocular Lens Alignment Between Femtosecond Laser-Assisted Capsular Marking and Manual Corneal Marking.

PURPOSE: To compare toric intraocular lens (IOL) alignment between femtosecond laser-assisted capsular marking and manual corneal marking. METHODS: This study prospectively included 72 consecutive eyes (from 72 patients) with cataract and anterior corneal astigmatism of 1.00 diopter (D) or greater that underwent femtosecond laser-assisted cataract surgery with implantation of a toric IOL. These eyes were randomly categorized into two groups based on the IOL alignment method. The femtosecond laser capsular marking group included 36 eyes with capsular markers using the latest femtosecond laser platform. The manual marking group included 36 eyes with manual corneal markers. The preservation of the markers was assessed. Visual acuity and refractive outcomes, as well as deviation from the target axis, were evaluated. RESULTS: In the femtosecond laser capsular marking group, all capsular markers were retained for at least 3 months. In the manual marking group, 22.2% of the corneal markers disappeared within 1 month and all markers disappeared within 3 months. At 1 month postoperatively, the mean magnitudes of refractive astigmatism were -0.41 ± 0.26 and -0.45 ± 0.31 D (P = .81), and the uncorrected distance visual acuities were 0.07 ± 0.06 and 0.07 ± 0.05 logMAR (P = .56) in the femtosecond laser capsular marking and manual marking groups, respectively. The misalignment of the toric IOL within 1 hour postoperatively was 1.5° ± 1.4° in the femtosecond laser capsular marking group and 4.4° ± 2.1° in the manual marking group (P < .01). The deviation from the target axis of implantation was 1.6° ± 1.3° in the femtosecond laser capsular group and 4.8° ± 2.5° in the manual marking group (P < .01) at 1 month postoperatively. CONCLUSIONS: IOL misalignment was significantly lower in the femtosecond laser-assisted capsular marking group than in the manual corneal marking group. In addition, the long-term preservation of the capsular marker is helpful in evaluating the rotation of the toric IOL. [J Refract Surg. 2020;36(8):536-542.].

Micromorphology analysis of the anterior human lens capsule.

PURPOSE: This study aimed to quantify the three-dimensional micromorphology of the surface of the human lens capsule as a function of age. METHODS: Imaging experiments were conducted on whole human lenses received from eight human cadavers (donor age range: 30-88 years). Imaging was performed with an atomic force microscope (AFM) in contact mode in fluid. The porosity and surface roughness were quantified from the height images obtained. A novel approach, based on stereometric and fractal analysis of three-dimensional surfaces developed for use in conjunction with AFM data, was also used to analyze the surface microtexture as a function of age. RESULTS: The AFM images obtained depict a highly ordered fibrous structure at the surface of the lens capsule, although the overall structure visually changes with age. Porosity and roughness were quantified for each image and analyzed as a function of donor age. The interfibrillar spacing revealed an increasing trend with age, although this result was not significant (p = 0.110). The root mean square (RMS) deviation and average deviation significantly decreased with increasing age (p<0.001 for both). The fractal analysis provided quantitative values for 29 amplitude, hybrid, functional, and spatial parameters. All the hybrid parameters decreased with age, although not significantly. Of the functional parameters, the surface bearing index increased significantly with age (p = 0.017) and the summit height exhibited a decreasing trend with age (p = 0.298). Of the spatial parameters, the dominant radial wavelength trend moved toward an increase with age (p = 0.103) and the cross-hatch angle tended toward a decrease with age (p = 0.213). CONCLUSIONS: Significant changes in the three-dimensional surface microtexture of the human lens capsule were found with age, although more experiments on a larger dataset are needed to conclude this with certainty. The analyzed AFM images demonstrate a fractal nature of the surface, which is not considered in classical surface statistical parameters. The surface fractal dimension may be useful in ophthalmology for quantifying human lens architectural changes associated with different disease states to further our understanding of disease evolution.

The occhiolino (occ) mutant Zebrafish, a model for development of the optical function in the biological lens.

BACKGROUND: Zebrafish visual function depends on quality optics. An F3 screen for developmental mutations in the Zebrafish nervous system was conducted in wild-type (wt) AB Zebrafish exposed to 3 mM of N-ethyl-N-nitrosourea (ENU). RESULTS: Mutant offspring, identified in an F3 screen, were characterized by a small pupil, resulting from retinal hypertrophy or hyperplasia and a small lens. Deficits in visual function made feeding difficult after hatching at approximately 5-6 days postfertilization (dpf). Special feeding conditions were necessary for survival of the occhiolino (occ) mutants after 6 dpf. Optokinetic response (OKR) tests measured defects in visual function in the occ mutant, although electroretinograms (ERGs) were normal in the mutant and wt. Consistent with the ERGs, histology found normal retinal structure in the occ mutant and wt Zebrafish. However, lens development was abnormal. Multiphoton imaging of the developmental stages of live embryos confirmed the formation of a secondary mass of lens cells in the developing eye of the mutant Zebrafish at 3-4 dpf, and laminin immunohistochemistry indicated the lens capsule was thin and disorganized in the mutant Zebrafish. CONCLUSIONS: The occ Zebrafish is a novel disease model for visual defects associated with abnormal lens development. Developmental Dynamics 246:915-924, 2017. © 2017 Wiley Periodicals, Inc.

Equatorial wrinkles in the human lens capsule.

Equatorial wrinkles, or crenations, have been previously observed around the equator in coronal images of the human ocular lens. However, wrinkles are typically not apparent when the lens is viewed from saggital directions. In the current paper, the existence and geometry of these wrinkles is shown to be consistent with a mechanical model of the isolated lens, in which the capsule is held in a state of residual tension by a spatially uniform internal pressure. The occurrence of equatorial wrinkles is therefore seen to be a mechanical consequence of the spheroidal shape of the lens capsule and an excess intralenticular pressure. New observations are made, on post mortem lenses, on the geometric arrangement of these equatorial wrinkles. These observations indicate a well-defined pattern in which wrinkles exists along meridional lines in the equatorial regions of the lens. A preliminary 'puncture test' is used to demonstrate that the residual stresses within the capsule in the equatorial region of the lens are broadly consistent with the proposed mechanical model of the lens capsule. It is suggested that the presence of equatorial wrinkles may have an influence on the mechanical performance of the capsule during the accommodation process.

Morphologic Patterns Formed by the Anomalous Fibers Occurring Along the Anterior Capsule of the Crystalline Lens in People With the Long Anterior Zonule Trait.

People with the long anterior zonule (LAZ) trait, which may have prevalence near 2%, have zonular fibers that extend more central than usual along the anterior capsule of the crystalline lens. The anomalous fibers can be observed in vivo with clinical slit lamp biomicroscopy after pharmacologic pupil dilation, and although minimally studied, the LAZ trait may have importance to glaucoma, retinal degeneration, and cataract surgery. To further characterize LAZ morphology, a custom computer program was used to trace LAZ fibers seen on retro-illumination photos acquired during previous study at an academic, urban eye care facility in Chicago, IL. There were 59 African-Americans (54 female; median age = 70 years, 53-91 years) included in the analysis. After initial review of the zonule tracings, we identified three basic LAZ patterns. We called one pattern (47% of right eyes) a "non-segmental LAZ pattern," which was predominated by fibers that could be visually traced to the dilated pupil border where they became obscured by the iris. Another pattern (35% of right eyes), the "segmental LAZ pattern," was predominated by fibers that appeared to terminate abruptly without detectable extension to the pupil border. The third pattern (18% of right eyes), the "mixed LAZ pattern," had a more equivalent mixture of the other two fiber morphologies. Compared to the "non-segmental" group, the "segmental" LAZ eyes had smaller central zonule-free zones (P < 0.0001), and they tended to exhibit fewer LAZ fibers (P = 0.07). These data improve understanding of LAZ clinical anatomy and may be helpful to future investigation. Anat Rec, 300:1336-1347, 2017. © 2017 Wiley Periodicals, Inc.

Ultrasonographic and macroscopic anatomy of the enucleated eyes of the buffalo (Bos bubalis) and the one-humped camel (Camelus dromedarius) of different ages.

The ultrasonographic appearance and measurements of the normal buffalo and camel eye globes were described in 60 buffaloes (Bos bubalis) aged 1 year (28 eyes) and 10 years (32 eyes), and in 51 humped camels (Camelus dromedarius) aged 1 year (26 eyes) and 10 years (24 eyes). Ocular measurements were recorded by A- and B-scan ultrasonographic examination of 40 buffalo eyes (18 young and 22 adult eyes) and 34 camel eyes (14 young and 20 adult eyes) using a KANGH ultrasound scanner equipped with 10 MHz probe. For gross measurements, 20 buffalo and 16 camel eye globes were frozen and dissected and the same measurements were made using fine callipers macroscopically. The aqueous and vitreous humour of the buffalo and camel eyes appeared anechoic. The cornea, anterior and posterior lens capsule and iris appeared hyperechoic. The ocular measurements for the axial length, vitreous chamber depth (VCD), corneal thickness, lens thickness and scleroretinal rim thickness increase with the advance of age in both buffaloes and camels. Except for the anterior chamber depth, VCD and lens thickness, which were larger in adult camels than in adult buffaloes, no other differences between ocular dimensions were observed in both species. The results of this study are valuable for comparative ocular anatomy and will be useful for ultrasonographic evaluation of ocular diseases in buffaloes and camels.

New technique to demonstrate corneal magnification using trypan blue in cataract surgery / Nova técnica para demonstrar a magnificação corneana utilizando azul de tripan na cirurgia de catarata

PURPOSE: To demonstrate the corneal magnification using trypan blue in cataract surgery. METHODS: Eight eyes of eight patients undergoing phacoemulsification with an intraocular lens implantation were enrolled in this study. After staining the anterior capsule with Trypan Blue 0.1 percent and performing the capsulorhexis, the excised anterior capsule was placed on the corneal surface. By observing and measuring the relationship between the border of the excised anterior capsule and the intracameral capsulorhexis opening, the effect of corneal magnification was clearly demonstrated and calculated by linear method. RESULTS: The average magnification of the cornea was 20.88 percent using linear method with an average area magnification of 47.53 percent. CONCLUSION: The capsulorhexis stained by trypan blue is useful to demonstrate the magnification provided by the cornea helping to design an intended opening size.

OBJETIVO: Demonstrar a magnificação corneana utilizando o azul de tripan na cirurgia de catarata. MÉTODOS: Oito olhos de oito pacientes submetidos à facoemulsificação com implante de lente intraocular foram envolvidos neste estudo. Após corar a cápsula anterior do cristalino com azul de tripan 0,1 por cento e realizar a capsulotomia circular contínua, a cápsula excisada foi colocada sobre a superfície corneana. Após observar e aferir a relação entre a borda da cápsula anterior excisada e a abertura da cápsula intracameral, o efeito da magnificação corneana foi claramente demonstrada e calculada através do método linear. RESULTADOS: A média estimada da magnificação corneana foi de 20,88 por cento com uma média de magnificação de área de 47,53 por cento. CONCLUSÃO: A capsulorrexis corada pelo azul de tripan é útil na demonstração da magnificação corneana, auxiliando assim na correta confecção do seu tamanho.

Methyl blue and aniline blue versus patent blue and trypan blue as vital dyes in cataract surgery: capsule staining properties and cytotoxicity to human cultured corneal endothelial cells.

PURPOSE: To evaluate capsule-staining properties and biocompatibility of the triarylmethane dyes methyl blue and aniline blue compared with patent blue and trypan blue on cultured human corneal endothelial cells. SETTING: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany. DESIGN: Experimental study. METHODS: Human corneal endothelial cell cultures were harvested from human donor cells and exposed to various concentrations (0.025 to 5.0 mg/mL) of methyl blue, aniline blue, patent blue, and trypan blue. Cytotoxicity was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide test after 24 hours of incubation. Calcein live cell staining was performed at the same time point. The dyes were also used to stain pig lens capsules in vitro by incubating the lenses for 1 minute with 3 concentrations (0.5, 1.5, and 2.5 mg/mL) of dye, after which the staining properties were evaluated. RESULTS: No significant cytotoxicity was detected for patent blue and methyl blue at any tested concentration. However, aniline blue exerted significant cytotoxicity at concentrations of 1.5 mg/mL or higher and trypan blue at 2.5 mg/mL or higher. Capsule staining of the tested triarylmethane dyes was suitable for performing capsulorhexis, but only at higher concentrations than with trypan blue. CONCLUSIONS: High concentrations and long incubation times of trypan blue and aniline blue showed significant cytotoxicity to human cultured endothelial cells in contrast to patent blue and methyl blue. All tested dyes were able to stain lens capsules sufficiently for capsulorhexis creation. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

[Capsulotomy/capsulectomy in phacosurgery: evolution of development and up-to-date technology (communication 1)].

The review gives information on the anatomy and functions of the lenticular capsule, the evolution of development, and current techniques of capsulotomy (capsulectomy) in the surgery of cataract. It discusses the advantages and disadvantages of anterior continuous curvilinear capsulorhexis, Kloeti radiofrequency bipolar capsulotomy, vitrectorhexis, Fugo plasma blade, and other anterior lenticular capsule opening techniques.

Intracapsular organization of ciliary zonules in monkey eyes.

Ciliary zonules are responsible for changing the curvature of a lens in the dioptric focus of an eye. Present established theory is based on the relaxation of zonular superficial fasciculi affixed to the capsular surface, thereby inducing the change of anterior- and posterior lens curvature causing spontaneous liquid movement of lens material. To achieve precise focusing at any distance, a more active functional organization should exist. The present studies were performed to determine not only the surface attachment but also the intracapsular affix of zonules on monkey eyes. In addition, the development of focusing in newborn and presbyopia is analyzed. Histology was prepared by conventional and molecular immunofluorescence stainings on the compositions of zonules with fibrillin-1 (FBN 1) and lens capsule with collagen IV (COL IV), and in situ hybridization (ISH) analyses on frozen sections. Superficial circumferential attachments of zonule were found radially oriented between ciliary processes and anterior/posterior lens capsules forming a triangular figure. Two functional intralayer integrations were found above them; anterior-posterior crossed fibers over the equator and radial fibers distributed toward the anterior or posterior polar areas. These fibers were bound tightly to the deep layer connective tissues close to the lens epithelium. Fine zonular fibers were aggregated, gradually forming bundles and bifurcated again on the way to the capsule. The lateral striped staining pattern in bundles suggested their elastic nature. Response of α-helixes of collagen IV immunostaining was more positive on α-1,2,4 than α-3,5,6 on anterior- and posterior lens capsules. Newborn eyes revealed not fascicular but fine membranous zonules on the lens surface and small ciliary processes. ISH analysis revealed high synthetic expression of FBN 1 mRNA in cytoplasm of nonpigmented epithelial cells of ciliary processes. The synthetic expression of FBN 1 declined with aging. According to the mechanism of accommodation, active dynamic movement of anterior or posterior capsules play the main role of changing the lens configuration by two intralayer zonular integrations, including anterior-posterior crossed fibers over the equator and radial fibers toward anterior or posterior polar areas acting with coordinated contraction of circular or longitudinal ciliary muscles. The developmental change on focusing is brought about by synthesis of FBN 1 in the newborn eye.

Imaging of the lens capsule with an ultrahigh-resolution spectral optical coherence tomography prototype based on a femtosecond laser.

AIM: To demonstrate the applicability of ultrahigh-speed, ultrahigh-resolution spectral optical coherence tomography (SOCT) to cross-sectional imaging of the capsular bag in vivo. METHODS: The ultrahigh-speed and ultrahigh-resolution SOCT prototype was designed and constructed at Nicolaus Copernicus University (Torun, Poland). To obtain an ultrahigh speed up to 100,000 lines/s a new spectrometer with fast CMOS line-scan camera was built. A femtosecond laser with a central wavelength of 780 nm and Deltalambda=160 nm enabled imaging with an axial resolution of 2.3 microm and lateral resolution of 10 microm in tissue. Lens capsules of two healthy eyes were examined with the aid of the instrument using two- and three-dimensional scanning protocols. RESULTS: The prototype provided ultrahigh-resolution tomograms composed of 8000 A-scans with an acquisition time of 0.16 s. The quality was sufficient to evaluate the capsular bag and to estimate its thickness. It was possible to visualise a separate layer of lens epithelium, to the authors' knowledge the first such visualisation. Three-dimensional data were used to produce lens-capsule thickness maps. CONCLUSIONS: Ultrahigh-resolution, ultrahigh-speed SOCT based on a femtosecond laser allows two- and three-dimensional evaluation of a capsular bag and lens epithelium. The instrument provides new information of scientific and clinical value.

Ability of new vital dyes to stain intraocular membranes and tissues in ocular surgery.

PURPOSE: To evaluate the ability of novel dyes to stain lens capsule (LC), internal limiting membrane (ILM), epiretinal membrane (ERM), and vitreous. DESIGN: Experimental study in animal and human donor eyes. METHODS: Thirteen dyes, methyl violet, crystal violet, eosin Y, sudan black B, methylene blue, toluidine blue, light green, indigo carmine, fast green, congo red, evans blue, brilliant blue, and bromophenol blue, were injected onto the LC and ILM of enucleated porcine eyes. The vitreous was stained with 2 mL of dyes for 1 minute. Six dyes (indigo carmine, evans blue, fast green, light green, bromophenol blue, and brilliant blue) were selected for experiments in human donor eyes and freshly removed ERM. RESULTS: In the porcine eyes, ILM staining with methylene blue, toluidine blue, indigo carmine, evans blue, bromophenol blue, and fast green was moderate, and methyl violet, crystal violet, brilliant blue, or sudan black resulted in strong staining. Methyl violet, crystal violet, sudan black, toluidine blue, and methylene blue caused histologic damage in porcine retinas. Vitreous examination revealed moderate staining with congo red, crystal violet, fast green, eosin Y, methylene blue, toluidine blue, brilliant blue, bromophenol blue, and methyl violet and strong staining with light green and evans blue. ERMs showed strong staining with 0.5% evans blue and moderate staining with 0.5% light green, fast green, brilliant blue, and bromophenol blue. Evaluation of donor eyes disclosed moderate staining with evans blue, light green, and bromophenol blue and strong staining with 0.5% brilliant blue. Moderate or strong staining of the vitreous occurred with most dyes. LC evaluation showed moderate staining with 0.5% evans blue, fast green, and brilliant blue, whereas 0.5% light green produced strong LC staining. CONCLUSIONS: Brilliant blue shows the best ILM staining, whereas bromophenol blue, evans blue, and light green also stain ILM. Most dyes bind well to LC, vitreous, and ERM.

Photothermal effects in connective tissues mediated by laser-activated gold nanorods.

We report a study on the application of laser-activated nanoparticles in the direct welding of connective tissues, which may become a valuable technology in biomedicine. We use colloidal gold nanorods as new near-infrared chromophores to mediate functional photothermal effects in the eye lens capsules. Samples obtained ex vivo from porcine eyes are treated to simulate heterotransplants with 810-nm diode laser radiation in association with a stain of gold nanorods of aspect ratio approximately 4. This stain is applied at the interface between a patch of capsule from a donor eye and the capsule of a recipient eye. Then, by administration of laser pulses of 40 msec and approximately 100-140 J/cm(2), we achieved the local denaturation of the endogenous collagen filaments, which reveals that the treated area reached temperatures above 50 degrees C. The thermal damage is confined within 50-70 mum in a radial distance from the irradiated area.

Constant volume of the human lens and decrease in surface area of the capsular bag during accommodation: an MRI and Scheimpflug study.

PURPOSE: A change in surface area of the capsular bag and a change in volume of the lens can indicate whether a change in the shape of the lens during accommodation is due to the compressibility or the elasticity of the lens material. METHODS: 3D magnetic resonance imaging (MRI) was used to image the complete shape of the lens in a group of five healthy subjects between 18 and 35 years of age. A parametric representation of the cross-sectional shape was fitted to the edges of the lens, which were determined with a Canny edge filter. Based on a partition of the lens into eight parts, the parametric shape makes it possible to calculate the mean cross-sectional area, the volume, and the surface area as a function of accommodation. Corrected Scheimpflug imaging was used to validate the results obtained with MRI. RESULTS: No significant difference in central anterior and posterior radius of curvature and thickness was found between the MRI and Scheimpflug measurements. In accordance with the Helmholtz accommodation theory, a decrease in the anterior and posterior radius of curvature and equatorial diameter and an increase in lens thickness occurred with accommodation. During accommodation, the mean cross-sectional area increased and the surface area decreased. However, no significant change in lens volume was found. CONCLUSIONS: The preservation of lens volume implies that the internal human lens material can be assumed to be incompressible and is undergoing elastic deformation. Furthermore, the change in surface area indicates that the capsular bag also undergoes elastic deformation.