The Tibia Plafond Horizontal Orientation Angle for Frontal Alignment Evaluation of the Distal Lower Extremity.

PURPOSE OF THE STUDY Osteotomies around the knee are an established technique for treating knee osteoarthritis and other knee conditions by redistributing the body's weight and force within and around the knee joint. The aim of this study was to determine if the Tibia Plafond Horizontal Orientation Angle (TPHA) is a reliable measure for describing ankle alignment of the distal tibia in the coronal plane. MATERIALS AND METHODS This retrospective study included patients who underwent supracondylar rotational osteotomies for correction of femoral torsion. All patients had standing radiographs taken preoperatively and postoperatively with both knees pointed forward. Five variables, including Mechanical Lateral Distal Tibia Angle (mLDTA), Mechanical Malleolar Angle (mMA), Malleolar Horizontal Orientation Angle (MHA), Tibia Plafond Horizontal Orientation Angle (TPHA), and Tibio Talar Tilt Angle (TTTA), were collected. The preoperative and postoperative measurements were compared to each other using the Wilcoxon signed rank test. RESULTS A total of 146 patients were included in the study, with a mean age of 51.47 ± 11.87 years. There were 92 (63.0%) males and 54 (37.0%) females. MHA decreased from 14.0° ± 5.32° preoperatively to 10.59° ± 3.93° (p < 0.001) postoperatively, and TPHA decreased from 4.88° ± 4.07° preoperatively to 3.82 ± 3.10° (p = 0.013) postoperatively. The change in TPHA was significantly correlated with the change in MHA (r = 0.185, CI 0.023 - 0.337; p = 0.025). No differences were found between the measurements of mLDTA, mMA, and mMA pre- and postoperatively. DISCUSSION The orientation of the ankle should be taken into consideration during preoperative planning of osteotomies and should be measured in cases of postoperative ankle pain. CONCLUSIONS The TPHA is a reliable measure for describing ankle alignment of the distal tibia in the frontal plane. Key words: osteotomy, ankle, realignment, coronal alignment, preoperative planning.

Single-stage total hip arthroplasty after failed fixation of proximal femoral fractures: an increased risk for periprosthetic joint infections?

BACKGROUND: Higher complication rates have been reported for total hip arthroplasty (THA) after osteosynthesis of proximal femur fractures (PFF). This study evaluated the infection risk for conversion of internal fixation of PFF to THA by a single-staged procedure in the absence of clear infection signs. METHODS: Patients undergoing a one-staged conversion to THA (2013-2018) after prior internal fixation of the proximal femur were included. Preoperative diagnostics with laboratory results, hip aspirations as well as intraoperative microbiology and sonication were assessed. Postoperative complications were recorded as well as patient demographics, duration between initial and conversion to THA, explanted osteosynthesis and implanted THA. RESULTS: Fifty-eight patients (24 male/34 female, 62.8 ± 14.5 years) were included with a mean time of 3.8 ± 7.5 years between internal fixation and conversion to THA (45 cementless, 3 cemented, 3 hybrid and 7 hybrid inverse THAs). Preoperative mean blood level CRP was 8.36 ± 14 mg/l (reference value < 5 mg/l) and leukocyte count was 7.11 ± 1.84^3/µl (4.5-10.000^3/µl). Fifty patients had intraoperative microbiological diagnostics, with either swabs in 86.2% and/or sonication in 29.3%. Positive microbiological results were recorded in 10% (5 of 50 patients), with pathogens identified being mainly Staphylococcus. Complications after conversion occurred in 9.6% including a postoperative low-grade infection rate of 5.8% after a mean of 2.5 years. CONCLUSION: This study found a positive microbiological test result in 10% of a one-stage conversion of PFF fixation to THA. Moreover, we found a high infection rate (5.8%) for early postoperative periprosthetic joint infection. Interestingly, CRP has not been proven to be an adequate parameter for low-grade infections or occult colonized implants. Therefore, we recommend a comprehensive pre- and intraoperative diagnostic including hip aspiration, swabs and sonication when considering one-staged revision.

Sporting activity is reduced following medial reefing performed for patellar dislocation : A retrospective case series of 144 patients with a minimum follow-up of 24 months.

BACKGROUND: Patellar dislocation is common in young and active patients. The purpose of this study was to determine sporting activity following the medial reefing of patellar dislocation. METHODS: One hundred forty-four patients with objective patellar dislocation were treated between 2004 and 2013. Three groups were analyzed retrospectively with a minimum follow-up of 24 months: (1) primary dislocation that was treated with medial reefing without a recurrent dislocation until the day of follow-up (n = 74), (2) primary dislocation that was initially treated with medial reefing but with a recurrent dislocation until the day of follow-up (n = 44), and (3) medial reefing after failed conservative treatment (n = 26). Sporting activity was assessed using a widely-used sporting activity questionnaire and the Tegner score prior to the injury and at the follow-up (58.7 ± 22.6 months after the injury). Clinical outcomes were assessed using IKDC and Kujala score. RESULTS: The Kujala score was 94.7 ± 9.3 for Group 1, 84.1 ± 16.6 for Group 2 and 93.4 ± 9.7 for Group 3. IKDC at the time of follow-up was 97.2 ± 9.3 for Group 1, 86.1 ± 14.6 for Group 2 and 95.1 ± 11.1 for Group 3. 91.9% of Group 1 and 92.3% of Group 3 were active in sports prior to their injuries and at the time of the follow-up. In Group 2, sporting activity reduced from 81.8 to 75.0%. In all groups, a shift from high performance to recreational sports was found. CONCLUSIONS: Despite good clinical results, sporting activity was reduced following patellar dislocation treated with medial reefing. Also, a shift from engagement in high- to low-impact sports among the participants was noted.

[Combined posterior and anterior cruciate ligament reconstruction : Arthroscopic treatment with the GraftLink® system]. / Kombinierte Rekonstruktion des hinteren und vorderen Kreuzbandes : Arthroskopische Versorgung mit dem GraftLink®-System.

OBJECTIVE: Simultaneous arthroscopic reconstruction of the anterior and/or posterior cruciate ligament (ACL/PCL) using the GraftLink® system (Arthrex) to obtain stable treatment and good functional results. The transplant is protected by the safety belt like biomechanical GraftLink® principle, which is used to secure the intraoperatively obtained stability in the long term. INDICATIONS: ACL, PCL, or combined cruciate ligament rupture, especially multiligament injuries. Revision ACL and PCL reconstruction. CONTRAINDICATIONS: Preoperative fixed posterior tibial subluxation. Reduced range of motion (ROM) with an extension lag (extension/flexion 0­0-120° preoperatively required). Complex regional pain syndrome. High-grade atrophy of the quadriceps femoris muscle and osseous deformities. SURGICAL TECHNIQUE: Supine position with mobile leg and possible flexion of at least 120° allowing antegrade femoral bone tunnel replacement. Retrograde tunnel placement (e. g. using a retrocutter) is recommended in case of less than 120° knee flexion. Thigh tourniquet. Staging arthroscopy. Cruciate ligament reconstruction is realized by anatomic tunnel placement for the ACL/PCL using the GraftLink®. Recommended sequence of reconstruction: 1. tibial PCL tunnel, 2. femoral ACL tunnel, 3. femoral PCL tunnel, 4. tibial ACL tunnel. Hybrid fixation is recommended. Portals: High anteromedial, high anterolateral, posteromedial, posterolateral, small subvastus incision. POSTOPERATIVE MANAGEMENT: Combined cruciate ligament replacement: Gradual load and ROM increase in the PCL track. After postoperative week 5, increasing load up to full weight bearing, with extension/flexion 0­0-90° after week 7. Down training of the PCL track after week 13. Contact and competitive sports after 1 year. RESULTS: The GraftLink® system allows restoration of knee joint stability with good functional results. The procedure is especially suitable for complex situations like after knee dislocation with ACL and PCL reconstruction in 1 or 2 steps.

Obesity causes poorer clinical results and higher re-tear rates in rotator cuff repair.

BACKGROUND: The purpose of this retrospective study was to report on the functional outcome after both open and arthroscopic rotator cuff (RC) repair in normal weight, pre-obese and obese patients. It was hypothesized that obesity is a negative prognostic factor for clinical outcome and failure for the RC repair. METHODS: One hundred and forty-six patients who underwent either open or arthroscopic rotator cuff repair between 2006 and 2010 were included in this study. Seventy-five patients (56.7 ± 10.1 years of age) after open RC repair and 71 patients (59.0 ± 9.1 years of age) treated arthroscopically were available for evaluation. In both groups a double-row reconstruction was performed. Patients were divided in three groups according to their body-mass index. The mean follow-up was at 43 ± 16 (minimum 24) months. At follow-up, the clinical outcome was assessed by the DASH and Constant score. An ultrasound of both shoulders was performed in all patients. RESULTS: The mean BMI was 28.3 ± 5.3 in the arthroscopic group and 27.7 ± 4.3 in the open group. Overall, in both groups similar clinical results were noted [Constant-Murley score 78.3 ± 18.2 arthroscopic vs. 77.0 ± 21.8 for open surgery; DASH 12.7 ± 18.2 arthroscopic vs. 15.6 ± 21.6 for open surgery (p = 0.81)]. Both the failure rate and the clinical outcome were significantly worse for obese patients (BMI > 30, p = 0.007). The failure rate was 15.8% for the normal-weight patients, 8.2% in the pre-obese group and in the obese group 28.6%. The RC repair failure occurred in 11 cases in both groups after arthroscopic or open treatment (15.0%). CONCLUSIONS: Both the arthroscopic and the open approach showed equivalent clinical results and failure rates. Obesity (BMI > 30) causes less favorable results in the Constant and DASH scores and showed higher re-tear rates.

No change in patellar height following open wedge high tibial osteotomy using a novel femur-referenced measurement method.

BACKGROUND: Open wedge high tibial osteotomy (HTO) can influence the tibial slope and thereby the landmarks of currently used patellar height indices. The purpose of this retrospective study was to compare and validate a new femur-referenced patella height measurement method to currently used patellar height indices in a cohort of HTO patients. METHODS: Patellar height (Caton-Deschamps, Blackburne-Peel and Insall-Salvati Indices and our newly developed Femoral Patellar Height Index) as well as tibial slope were analysed. Full-weight-bearing long-leg anteroposterior radiographs as well as anteroposterior and lateral radiographs of the knee in 0° of extension were used. Radiographs were performed preoperatively, and at six weeks, three, six, 12 and 18months postoperatively. Measurements were recorded twice by two observers. The second observation was performed after a delay of three months. RESULTS: A total of 99 patients with a mean age of 46.2±8years were included. A statistically significant pre- to postoperative increase in tibial slope was found in all methods. Patellar height decreased according to Caton-Deschamps and Blackburne-Peel Indices. The Insall-Salvati Index as well as the novel Femoral Patellar Height Index remained unchanged. Intra-rater (interclass correlation coefficient (ICC) 0.914-0.998) and inter-rater (ICC 0.955-0.989) reliability were highest in the new index. CONCLUSION: Detected changes of patellar height following open wedge HTO depend on the method used. Tibial slope increases following surgery. Our new index with a femoral reference for measuring patellar height was validated and good to excellent intra- and inter-rater reliability were demonstrated. Following HTO, the Femoral Patellar Height Index can be recommended as a standardized method to measure patellar height.

[Return to sport after surgical treatment of a posterior cruciate ligament injury : A retrospective study of 60 patients]. / Rückkehr in den Sport nach operativer Versorgung einer hinteren Kreuzbandverletzung : Eine retrospektive Untersuchung von 60 Patienten.

BACKGROUND: Injuries of the posterior cruciate ligament (PCL) lead to an initial reduction of sporting activity. However, in previous studies, return to sport after operative treatment of PCL injuries has been analysed insufficiently. The aim of this study was (1) to determine the rate of return to sport in physically active patients, (2) to analyse possible changes in sporting activities and (3) to examine the influence of the severity of the initial injury. PATIENTS AND METHODS: Within a retrospective clinical and radiological follow-up at least 24 months after surgery (80.3 ± 28.2 months), 60 patients (44.8 ± 12.1 years) with surgically treated isolated or combined PCL injuries were included in the study. Pre-accidental and post-operative sporting activities were queried and compared in a standardised questionnaire. Possible differences with respect to the initial injury severity (Cooper classification) were examined. RESULTS: The return-to-sport rate of the physically active patients was 87.0 %. 17.6 % of patients with a combined PCL injury and 4.8 % of patients with isolated PCL injury were not able to return to sport. Significant reductions in the frequency of exercise (p = 0.0087), the duration of exercise (p = 0.0003) and the amount of regularly performed sports (p < 0.0001) were found. A change from high-impact sports to low-impact sports was noted. CONCLUSION: Patients with operatively treated PCL injuries can return to sport. However, for competitive athletes an injury to the PCL can lead to the end of their career. A reduction of sporting activities and a change from high-impact sports to low-impact sports can be expected. A persisting inability to return to sporting activities in patients with isolated PCL injuries cannot be assumed.

[Treatment strategy for posttraumatic complex deformity. After bilateral femoral shaft fractures]. / Behandlungsstrategie bei posttraumatischer Komplexdeformität. Nach Femurschaftfraktur beidseits.

A case of complex posttraumatic deformity after bilateral femoral shaft fractures is reported. Different possibilities for correction in cases of valgus malalignment combined with internal rotation deformity as well as shortening combined with external rotation deformity are presented. Oblique osteotomy and a motorized femoral extension nail were used.

Light scattering in normal and cataractous lenses of farmed Atlantic salmon (Salmo salar): a slit lamp and Scheimpflug photographic study.

To investigate normal light scattering and cataract formation, the anterior eye segments of farmed Atlantic salmon (Salmo salar) reared in fresh water and sea water were documented in vivo for the first time with a Topcon SL-45 Scheimpflug camera. A total of 40 fish from the fresh-water-rearing period, obtained from 2 groups of identical age but showing a different growth rate, and 24 fish from the sea-water-rearing period, sampled from 2 groups with identical age but being fed different food brands, were included in this study. The fish were anaesthetized before examination. Due to the naturally wide pupil, no mydriatic compound was applied. All fish were removed from the water for photography, which was performed for each eye in 0 degrees = vertical slit position. Images were recorded on Kodak Tmax 400 black-and-white film. Microdensitometric image analysis of all negatives was performed using a Joyce-Loebl online microdensitometer. In spite of the virtual absence of an anterior chamber gap between cornea and lens and very little light scattering in the normal fish lens, a small number of distinct layers could be reproducibly identified in the lens. While there was little abnormal light scattering which could point to cataract development in young fish from the fresh water period, the evaluation of the lenses from the 2 sea water groups showed the presence of specific forms of cataract especially in the cortical and supranuclear layers. There were significant differences between the groups fed different food brands at the sea water site. In conclusion, Scheimpflug photography proved to be applicable to eye research in fish in vivo. It is suggested that this method should be employed for reproducible documentation as an extension to slit lamp monitoring in experimental research to reveal causative factors for cataracts in farmed fish.

Comparison of various calpain inhibitors in reduction of light scattering, protein precipitation and nuclear cataract in vitro.

PURPOSE: To compare effects of calpain inhibitors on in vitro light-scattering in rat lens soluble protein and calcium-ionophore (A23187)-induced cataract formation in cultured rat lenses. METHODS: Rat lens soluble protein was hydrolyzed for 24 hours by activation of endogenous lens calpain. Ten calpain inhibitors were tested in this model at 10 and 25 microM concentration. As an index of protein precipitation, light scattering was measured daily at 405 nm for 8 days. Lens proteins were analyzed by isoelectric-focussing. Subsequently, rat lenses were cultured for 5 days with 10 microM A23187. Calpain inhibitors (SJA6017, MDL28170, AK295 and PD150606), which inhibited light-scattering were tested at 100 microM concentration in this model. Cataract evaluation, isoelectric-focussing and calcium determinations were performed. RESULTS: At 25 microM concentration AK295, SJA6017, E-64, PD-150606 and MDL28170 produced greater than 25% inhibition of light-scattering. Isoelectric-focussing revealed that addition of Ca(2+) produced characteristic crystallin proteolysis and aggregation patterns. AK295, SJA6017, MDL28170 and E64c prevented these changes. Lenses cultured in A23187 exhibited nuclear cataract, elevated calcium and proteolysis and aggregation of crystallins. Co-culture with SJA6017, MDL28170 and E64c reduced A23187-induced nuclear opacities, proteolysis and aggregation of crystallins without affecting increased total calcium. CONCLUSIONS: Endogenous calpain-activation model and A23187-induced cataract model can be used sequentially to screen calpain inhibitors for potential anti-cataract activity. Proteolytic changes in lens cortex after exposure to A23187 are also due to calpain activation. AK295, SJA6017 and MDL28170 possess efficacy against calcium-induced models of rodent cataracts. Use of calpain inhibitors represents a promising approach to cataract therapy.

Higher glycation of beta L- and beta S-crystallins in the anterior lens cortex and maximum glycation of gamma-crystallins in the bovine lens nucleus, demonstrated by frozen sectioning, isoelectric focusing and lectin staining.

The aim of the current study was to demonstrate glycation of beta L-, beta S- and gamma-crystallins in the young bovine lens. To establish which of the crystallins are glycated and where they are located in the lens, we carried out microsectioning of the lens, followed by isoelectric focusing (IEF). Four bovine lenses of 1.183 +/- 0.070 years were frozen-sectioned into equator and 11 layers. Water-soluble crystallins were separated by IEF and stained: (1) with Coomassie brilliant blue for proteins; (2) with the lectin concanavalin A, followed by horseradish peroxidase and diaminobenzidine, for glycated proteins. Experiments were performed with crystallins and proteins in native form, in the absence of denaturants. The crystallins were separated by IEF into alpha-crystallins of high molecular weight (HM), alpha L-, beta H-, beta L-, beta S- and gamma-crystallins. In the lectin staining experiments, only HM, beta L-, beta S- and gamma-crystallins were positive, whereas the alpha L- and beta H-crystallins were negative. Contrary to the glycated gamma-crystallins in the lens nucleus, the beta S- and beta L-crystallins were predominantly glycated in the anterior cortex and to a somewhat lower extent also in the posterior cortical regions. The degree of glycation (total densitometric readings of lectin-stained bands/Coomassie-blue-stained bands) is as follows: total gamma-crystallins 2.44, beta S-crystallins 0.77 and beta L-crystallins 0.28. Though glycation in the bovine lens is very low, lectin staining is sufficiently sensitive to detect the various glycated crystallins. The degree of glycation of gamma-crystallins was 3 times higher than that of beta S-crystallins and 9 times higher than that of beta L-crystallins.

The glycation of bovine lens betaL-, betaS- and gamma-crystallins demonstrated by isoelectric focusing and lectin staining.

The aim of the current study is to detect glycation of betaL-, betaS- and gamma-crystallins in the young bovine lens. To determine which of the crystallins are glycated, we have made isoelectric focusing of the water-soluble crystallins of four bovine lenses of 1. 183+/-0.070 years. Samples are stained: (1) with Coomassie Brilliant Blue for proteins; (2) with the lectin Concanavalin-A, followed by horse-radish peroxidase (HRP) and diaminobenzidine (DAB). Experiments are performed with crystallins in native form, in absence of denaturants. The crystallins are separated by isoelectric focusing into: alpha-crystallins of high-molecular weight (HM)-, alphaL-, betaH-, betaL-, betaS- and gamma-crystallins. In the lectin staining experiments only HM-, beta L-, betaS- and gamma-crystallins are positive, whereas the alphaL- and betaH-crystallins do not stain. Though glycation in the bovine lens is very low, lectin staining is sufficiently sensitive to detect the various glycated crystallins.

Detection of glycated fetal human lens crystallins by concanavalin-A and aldehyde staining.

The binding of the lectin Concanavalin-A (Con-A) to crystallins was investigated. For this purpose, human fetal and juvenile lens crystallins were isofocused and specifically stained brown for glycoproteins by the lectin Con-A, and purple by the periodic acid Schiff's reagent (PAS). In reference experiments protein bands were stained with Coomassie Blue for proteins. Since Con-A is a protein with glucose-specific receptors, the following crystallins, glycated with this sugar, were visualized after isoelectric focusing: HM-, beta L-, beta S- and gamma-crystallins, but not alpha L- and beta H-crystallins. Glycation increased significantly with fetal age. The crystallins themselves could also function as sugar receptors, because it was shown that they possessed also receptors for glucose, like Con-A. This crystallin receptor staining revealed beta L-, beta S-, gamma- but hardly HM-crystallins. The PAS, Con-A and receptor stainings gave in principle identical results. The glycoproteins Con-A, horseradish peroxidase and lentil lectins were used as positive controls.

Staining of free sulfhydryl groups of proteins after separation by isoelectric focusing of Bio-Rad standards and lens crystallins.

In this study, we propose a new staining method for free sulfhydryl groups of proteins after having separated native samples by thin-layer isoelectric focusing (IEF) in absence of detergents. A comparison was made between proteins stained purple for free sulfhydryl groups (SH) and proteins stained blue by Coomassie blue (CB). A stainability factor, F = %SH/%CB, was calculated for each protein. The Bio-Rad IEF standards containing seven marker proteins for pH scale determination were stained purple, in the same way as they were designed for CB staining. To prove the validity of the currently proposed staining method for a defined protein system such as the eye lens crystallins, these proteins were also stained after IEF as described above. The factor F was calculated for all alpha-, beta-, and gamma-crystallin components that stained in both methods. We discovered that alpha-crystallins contained comparatively high amounts of free SH groups, while some beta- and gamma-crystallin components also contained considerable amounts of free SH groups. The SH staining procedure with 2,2'-dihydroxy-6,6'-dinaphthyl disulfide applied after IEF appeared to be useful, specific, and reproducible.

Water-insoluble high-molecular-weight and alpha-crystallins as the source of the Scheimpflug light scattering pattern in the rat lens.

Lenses of 14-week-old rats were separated into 10 layers or fractions by a frozen-sectioning technique. The biochemical characteristics of these layers were assigned to corresponding parts of the densitometric reading obtained from the Scheimpflug negative, which enables a correlation of light scattering values recorded in vivo to protein patterns in the same area. Calculated as percentage of lens dry weight, all water-soluble crystallins show minima and the water-insoluble crystallins show maxima in the lens nucleus. This demonstrates that the nucleus contains the bulk of the water-insoluble high-molecular-weight and alpha-crystallins, being the source for the Scheimpflug light scattering pattern.

Crystallin profiles of calf and bovine lens microsections, stained for free sulfhydryl groups and proteins.

Calf and bovine lenses of 0.98 and 8.40 years old were separated mechanically into lens equator and inner cylinder. The inner cylinder was cut into 10 to 11 sections by a microsectioning device. These sections were investigated on the protein profiles of water-soluble crystallins, stained for proteins by Coomassie Blue (CB). These crystallins were also specifically stained purple for free sulfhydryl groups (SH). It appeared that all crystallins that were stained blue for proteins were also stained purple for sulfhydryl groups. This means that all crystallins contain free sulfhydryl groups. Going from anterior and posterior cortex to the nucleus of the lens, there was an appreciable increase of the percent of gamma-crystallins, whereas especially in the older lenses a decrease of gamma-crystallins could be observed in the lens equator and the anterior and posterior cortices. A stainability factor F = %SH/%CB was calculated for all crystallins. HM-, alpha- and beta s-crystallins exhibit high values of factor F. For the bovine lens, factor F of HM-crystallin displayed a maximum in the nucleus, whereas this factor decreased for gamma-crystallins towards the nucleus. This microsectioning technique allows for determining age-related differences between the sections obtained. This may lead to a comprehensive understanding of age-related changes within one lens, including cataractous changes.

Water-soluble and insoluble crystallins of the developing human fetal lens, analyzed by agarose/polyacrylamide thin-layer isoelectric focusing.

Eight human fetal lenses, selected on basis of normality, of a gestational age of 119 to 231 days were analyzed by thin-layer isoelectric focusing (IEF) in agarose/polyacrylamide gels. This method was adapted for the separation of lens crystallins into HM-, alpha-, beta- and gamma-crystallins. It is especially suitable for analysis under non-denaturing conditions of high-molecular-weight crystallins and of insoluble crystallins (WI) solubilized in formamide. The latter could be separated into HM-, alpha- and gamma-crystallins. During fetal development, a considerable increase of gamma-crystallin proportion was observed due to new synthesis. This increase was balanced by a decrease of alpha-crystallin proportion.

Correlation of Scheimpflug photography of the anterior eye segment with biochemical analysis of the lens. Application of a frozen-sectioning technique to investigate differences in protein distribution of single lens layers.

Normal and cataractous lenses were separated mechanically into lens equator and inner cylinder and the latter then sectioned in a freezing microtome. Fractions with 120-140 sections each were collected representing single lens layers, and the content of water-soluble and insoluble proteins was determined. Protein profiles for each lens layer were obtained by means of isoelectric focusing in special agarose gels. Using this microsectioning technique, it was possible to demonstrate differences in the protein distribution in single layers of both normal and cataractous human lenses. Comparison of the protein profiles of the normal lens and the lenses of different cataract morphology used in this study demonstrates the potential usefulness of this methodology for future research with cataract lenses.