Morphological aspects of human lens capsules. A comparative LM, SEM and TEM examination

Lens capsules of patients of advanced age, obtained after extracapsular cataract surgery, were carefully prepared for a combined LM, TEM and SEM investigation, after preliminary washing and mounting onto a holder in a buffer solution. After pre-fixation with GA, samples were postfixed for LM/TEM and OsO4/K4Fe)CN)6 and stained with toluidine-blue/basic fuchsin for LM and with uranyl acetate/lead citrate for TEM; for SEM the GA-pre-fixed samples were post-fixed by the Tannin Arginine-OsO4 non-coating technique. At LM-level discrimination between healthy and degenerating cells was possible after toluidine staining. At SEM-level protrusion of the cell nucleus and fibrillation and blebbing of the cell membrane as the result of capsular degeneration could be observed with the TAO-method. At TEM-level protrusion of the cell nucleus, degeneration of the cytoplasm, ballooning of the mitochondria, the presence of microfilaments and the occurrence of vacuoles were visible as the result of capsular degeneration on cataract formation.

Cell-ingrowth in a silicone plombe. Interactions between biomaterial and scleral tissue after 8 years in situ: a SEM and TEM investigation

A male patients (42 years) who had been treated for retinal detachment by the implantation of a silicone plombe into the sclera, returned to the clinic 8 years after implantation because of inflammation of the tissue and partial protrusion from the sclera. After removal of the plombe this was processed for TEM and SEM and examination of the plombe material after 8 years in situ could be carried out in order to get information about the cell-biomaterial interface. A large proportion of the silicone pores was filled with cellular material, including macrophages, giant cells and erythrocytes thus indicating a foreign body granuloma. The external surface of the pores showed a granular osmiophilic dense amorphous layer including extracellular debris. Engulfing of silicone particles by macrophages and the evidence of long-term tissue response suggest partial biodegradation of the silicone and certainly not complete inertness as was formerly claimed.

Amount and surface structure of albumin adsorbed to solid substrata with different wettabilities in a parallel plate flow cell

In this article we studied the adsorption of serum albumin to substrata with a broad range of wettabilities from solutions with protein concentrations between 0.03 and 3.00 mg.mL-1 in a parallel-plate flow cell. Wall shear rates were varied between 20 and 2000 s-1. The amount of albumin adsorbed in a stationary state was always highest on PTFE, the most hydrophobic material employed and decreased with increasing wettability of the substrata. Increasing stationary amounts of adsorbed albumin were observed with increasing wall shear rates at the lowest protein concentration. Inverse observations were made at the highest protein concentration. Transmission electron micrographs of replicas from the albumin-coated substrata showed that proteins were mostly adsorbed in islandlike structures on the hydrophobic substrata. The tendency to form islandlike structures was shear rate- and concentration-dependent and disappeared gradually going to more hydrophilic substrata. On glass, the most hydrophilic material employed, a homogeneous, well distributed, fine knotted, reticulated structure was found. In conclusion, this study demonstrates that both the amount of adsorbed albumin as well as the surface structure of the adsorbed proteins are regulated by the substratum wettability. This observation may well account for the fact that substratum properties can be transferred by an adsorbed protein film to the interface with adhering cells or microorganisms.

The Gonioseton, a surgical treatment for chronic glaucoma

A new and simple technique for glaucoma filtering surgery is presented. It is based on the introduction of a stainless steel microspiral or gonioseton into a goniopuncture by way of an ab interno procedure, minimising surgical trauma to the filtration area. Preliminary results are presented.

Morphology of donor lens-capsule material studied by SEM

The lens capsule of a 70-year-old male donor with a cataractous lens was carefully prepared for SEM by first washing the capsule with buffer solution to remove lens-fibres and subsequently attaching it to silicon rubber. During the fixation and drying stages of the preparation procedure the capsule stayed attached to the rubber substratum. In the equatorial zone germinating cells were found with knob-shaped microvilli, closely connected to lens-fibres. Large units of pathological capsule epithelial cells were found, only slightly inter connected by a few pseudopodia. In addition, single pathological epithelial cells with pseudopodia, arranged on top of the cell in a rosette-like configuration, were found at certain locations. Both types are probably related to the original lens-cataract.

Secondary cataract material collected with a glass cannula. A SEM study

Secondary cataract material from three patients, collected with a glass cannula approx. 18, 24 and 30 months respectively after operation, was prepared for SEM examination. For the soft samples this was done by filtration through a millipore filter followed by fixation and drying. The more solid material was suspended in a fixation solution, followed by centrifuging, suspension in 70% ethanol and drying on a specimen-holder. The short residence samples (18 months) showed mainly erythrocytes, some (inflammatory) cells and degenerated lens-fibre material. Most of the more solid material, which was collected more than 20 months after operation, showed fragments of (regenerated) capsule epithelium and pieces of solid lens-fibre material with fragments of capsule epithelium attached.

Reaction of the rabbit corneal endothelium to nylon sutures. A SEM study

Nylon and stainless steel sutures separately placed deeply into rabbit corneas by splitting the stroma for a few millimeters, without closing sutures, remained in the cornea for two, four and six weeks respectively. In contrast to the stainless steel sutures an extensive tissue reaction could be observed clinically around the nylon sutures within a few days and was still present after 4-6 weeks. On the endothelial side, covering of the nylon with fibroblast cells took place very slowly, this in contrast with stainless steel. Irritation of the tissue and an oedematous appearance of the endothelium around the nylon suture was the result. At first a kind of collagen network, often mixed with inflammatory cells, was deposited on the nylon material before fibroblast cells could grow in. Covering of the stainless steel started quite soon after implantation, without preliminary deposition of collagen material. The reason for this phenomenon must be sought in the high free surface energy of the stainless steel, which attracts cells, in contrast to nylon which has a very low free surface energy.

Remineralization of human dentine in vitro

In this paper the in vitro remineralization of human dentine with 0, 0.5, 2 and 10 ppm F in the remineralization solution is presented and analyzed by microradiography. Furthermore, the remineralization data of human and bovine dentine are quantitatively compared. The main results of this paper are: (1) the efficacy of human (and bovine) remineralization is about proportional to the square root of the F level in the remineralizing solution, and (2) the amount of mineral effectively deposited in the dentine is most likely controlled by the diffusion of fluoride into the tissue. This study shows furthermore that although numerical differences exist in the remineralization of human and bovine dentine, the general remineralization behaviour is quite similar. The presence of F- in the parts per million range is essential for the remineralization efficacy in vitro and also for the 'overremineralization' of the outer dentine surface.

Prosthetic microvenous grafting into the femoral vein of the rat; considerations concerning the anastomotic technique

The sequential thrombotic events which occur after implantation of microvenous prostheses prepared from a polyurethane-based material (I.D. 1 mm, length 5 mm, n = 36) into the rat femoral vein by means of the conventional end-to-end suture technique were evaluated by direct inspection and by scanning electron microscopy during the first 24 postoperative hours. Thrombus formation started at the anastomotic sites on the exposed collagenous vessel wall tissue and increased with increasing postoperative time intervals, leading to complete occlusion of the prostheses after 30 minutes of implantation. As a result of these findings, 8 more microvenous prosthetic implantations were performed with the sleeve anastomotic technique and evaluated after 24 hours. Six of these prostheses were patent with only minimal exposure of collagenous tissue at the anastomotic sites and subsequently minimal thrombus accumulation. Two prostheses left in situ and evaluated after 3 weeks were then still patent and completely endothelialised. Based upon the present study, we recommend the sleeve anastomotic technique for implanting synthetic microvenous prostheses because this technique prevents extensive exposure of collagenous vessel wall tissue at the anastomoses, thus leading to less thrombus accumulation and subsequently to a higher patency rate.

Keratoconus morphology and cell dystrophy: a SEM study

The SEM-pictures represent a keratoconus in a 59-year-old patient with a Descemet rupture, which had led to a so-called Kammerwassereinbruch, where the failure of the endothelial structure has become manifest in the epithelium. In the Descemet-rupture the onset of stromal pathology is observable, while outside the rupture severe degradation of endothelial cells is seen. This is manifested as cell-membrane perforation, loss of cell contents and oedema formation in general. On the epithelial side the pathology is expressed as cell-membrane degradation and the presence of very irregularly shaped, sometimes swollen and in other cases shrunken, epithelial cells, in particular in the areas of the surface depressions. The topographical correspondence of these pathological phenomena on the endothelial and the epithelial sides is stressed.

Lens-capsule material of human and animal origin, studied by SEM

Lens-capsule material from healthy and cataractous human lenses and from rabbits was collected with specially designed forceps. Subsequently the capsule fragments were fastened, after short pre-fixation, onto a rubber substrate with small stainless steel tacks, to prevent rolling-up of the fragments during the fixation and drying procedure for the SEM. Finally the capsule fragments were studied by SEM. Marked morphological changes, e.g., irregular swelling (like blebs) of the nuclei, formation of deep grooves at the cell borders and complete loss of epithelial cells, were found in the lens capsules obtained from certain cataractous lenses. Differences in capsule thickness were found in pathological capsule material. The imprints (attachment-lines) of the lens-fibres on the epithelial cells were often difficult to visualize.

Air-injection of the corneal stroma: a SEM study

The corneal stroma is supposed to be a homogeneous structure both from an optical and an anatomical point of view. Intrastromal injection of glutaraldehyde as a fixative causes local swelling and opacification of the corneal tissue. Local injections of small volumes of air superficially and more deeply into the corneal stroma produce similar swellings and formation of opaque areas. SEM investigation of these areas shows the existence of stromal canals, partly pre-existing, partly caused by the internal 'explosions' due to the air-injection. This suggests an anatomically non-homogeneous, although optically homogeneous, cornea.

Comparison of the reaction of the cornea to nylon and stainless steel sutures: an animal study

In 11 rabbits a comparison was made between the reactions of the cornea to nylon and to stainless steel sutures, macroscopically and by means of scanning electron-microscopy (SEM). Macroscopically, the wounds sutured with steel thread showed much less reaction than the wounds sutured with nylon. Vascularization was never encountered in the wounds sutured with steel thread. SEM examination also showed clear differences, which became noticeable within a short time. Both on the suture and round the opening in the cornea extensive deposits of material are seen within a short time (1 week) in the case of nylon, in the case of stainless steel this reaction is much less marked. A few weeks later deposits also appear on the steel thread, but these have a different composition and contain no material suggestive of an inflammatory reaction.

A transmission electron microscopy study of the adsorption patterns of early developing artificial pellicles on human enamel

Adsorption patterns of pellicles formed in a flow cell system under a moderate shear rate of 21 s-1, were studied with a replica technique. Characteristic features of the bare enamel surface disappeared within seconds after exposure to reconstituted saliva, indicating the adsorption of a homogeneous film. After that, three to four distinct homogeneous films were adsorbed on top of each other within 10 s and an uneven, knotted structure developed with stalky projections on the outer surface. This heterogeneous adsorption pattern determined the structure of the pellicle surface for at least 2 h.

Dentine caries in vivo. Combined scanning electron microscopic and microradiographic investigation

Dentine subjected to an in vivo demineralization challenge by plaque looses substantial amounts of mineral and is expected to change its ultrastructure. Results are presented of a combined microradiography and scanning electron microscopy (SEM) study on in vivo demineralized human dentine. The tissue was first demineralized in vivo under plaque for 3 weeks and subsequently analyzed by microradiography and SEM. In 6 participants dentine was positioned in a full prosthesis just under M2 in such a way that the outer surface of the tissue was 1.5 mm lower than the surface of the prosthesis; plaque accumulation takes place in the recessed area. A special technique allows SEM observations (at a given distance from the outer surface) on broken thin sections of demineralized dentine with a mineral content determined by microradiography. The results show that the ultrastructure of the dentine changes during severe demineralization. The main ultrastructural features are, however, still largely intact, even if half of the mineral originally present has been lost. In dentine with a mineral content of about 25 vol%, the dentinal tubules are enlarged by about 30%. In vivo demineralized dentine looses mineral in substantial amounts both from intertubular and from peritubular regions.

Remineralization of bovine dentine in vitro. The influence of the F content in solution on mineral distribution

In this paper remineralization of bovine dentine is reported. After demineralization of the dentine in an acidic gel system creating lesions of about 180 microns depth, the tissue was remineralized in a 1.5 mM Ca and 0.9 mM phosphate containing solution at pH 7 and 37 degrees C for 8 or 21 days. The F content in the remineralization solution was 0.02, 2, or 10 ppm as NaF. Samples were analyzed by means of microradiography and scanning electron microscopy. The results show that remineralization (without F added in solution) causes a decrease in mineral loss and in lesion depth. With 2 or 10 ppm in solution, however, a substantial mineral accumulation in the lesion, but particularly on the original dentine surface, was observed. During 3 weeks of remineralization, mineral accumulations of 67 and 70 vol% of mineral for 2 and 10 ppm F in solution, respectively, were found near the original outer surface, with the sound dentine mineral value being 48 vol%. The combined microradiography and scanning electron microscopy data show that the mineral accumulated is for a major part deposited on the dentine tissue and partly inside. The latter deposition occurred both inside the tubules as well as in the intertubular areas. Inside the tubules dense precipitates were observed. Because several differences exist between bovine and human dentine, an extrapolation to the human in vivo situation is speculative. The results indicate that the presence of fluoride in the parts per million range is important for dentine remineralization efficacy and that the outer surface area in dentine can be 'overremineralized'.

Glass-metal keratoprosthesis: light and electron microscopical evaluation of experimental surgery on rabbit eyes

A keratoprosthesis (KP) is the last and only surgical resort to regain some visual acuity in eyes with severely damaged corneae. Corneal blindness represents an important percentage of the blind in the economically poor countries. Commercially available KP's, e.g. those made of PMMA, which are difficult to sterilize and vulnerable to surface damage, are too expensive in these countries. To overcome these disadvantages, we developed a new KP, made of a glass core melted into a platinum cylinder with flange. They were implanted unilaterally in eyes of ten Hollander rabbits intralamellarly. They were fixated by two stainless steel traction threads passed around the whole eyeball. We investigated this type of KP in the rabbit cornea, its acceptance by stroma, epi- and endothelium, and its hydro-mechanical dynamics in situ. No signs of infection or extrusion were observed. No epithelial downgrowth, nor adverse tissue reaction could be detected. LM and SEM showed endothelialization of the newly formed stroma around the central column of the KP. We conclude that this type of KP (although optically still to be optimized) has been accepted by the rabbit cornea and a clinical trial on cornea-blind patients is justified.

Soemmering's ring, an aspect of secondary cataract: a morphological description by SEM

A Soemmering's ring attached to a patient's I.O.L. was removed and processed for SEM-examination. The enveloping structure of the Soemmering's ring was clearly of capsular origin, adherent along a single line and forming an envelope around the inner material. The envelope had a membranous character. The contents of the ring varied from the outside to the centre. Close to the capsule envelope a more or less amorphous material was found. Most of the contents of the ring was made up of lens-fibre material. Sometimes clear lens fibres were visible with densely packed lens-fibre proteins, sometimes with clusters of recrystallized proteins, rod-shaped or spherical, surrounded by what appeared to be amorphous material. The recrystallized and the amorphous lens-fibre material are similar to material found in cataractous lenses.

Stainless steel as suturing material in human- and rabbit corneas: a SEM-study

Stainless steel wire, dia. 50 microns, was used as suturing material in rabbit corneas for periods of 1.5, 3 and 7 months respectively, in order to test its inertness and acceptance by the corneal tissue. One clinical case of stainless steel wire used for fixation of an I.O.L.-implantation, after a 5-year residence in the eye, is reported as well. After 1.5 months' residence, the suture margins were well covered with tissue containing irregularly shaped endothelial cells, some fibroblastic-type cells and various kinds of collagenous fibre material. The buckled surface was partly covered with a very thin membrane of collagenous material, strands of collagenous fibres and a few fibroblastic-type cells. After 3 months' residence the buckle was almost completely covered with an endothelial cell layer. The individual cells had a somewhat irregular hexagonal shape. At a few local sites closure was still progressing, with filopodia and other collagenous matter generated by neighbouring cells on top of previously deposited Descemet's membrane. After 7 months' residence, the buckle was completely covered with normal endothelium. The fixation suture in the human case showed perfect acceptance by the corneal tissue.

Some aspects of cataract morphology: a SEM-study

Two lenses from patients of very advanced age with senile cataracts were processed for SEM, fractured equatorially, sputtered with Au and examined by SEM. In the cross-fracture various areas could be observed. Although the overall structure of the lens-fibres appeared to be intact, higher magnifications showed that the len-fibre material had changed into a brittle structure, with either a granular appearance or a fibrillar character. At other places clearly recrystallization of lens-fibre proteins had taken place, with the formation of finger-like substructures, sometimes organized into plate-like structures or running parallel to each other in a kind of undulating pattern. Between the various areas of chemically changed lens-fibre material certain 'canal-like' areas were found with cellular structures, the so-called 'waterclefts' or 'Wasserspalten'. Structures which, together with the chemical change in the lens proteins, account for the dramatic change in light dispersion.

A model to investigate xerostomia-related dental caries

The aim of this study was to develop an in vivo model in which onset, progression, and prevention of xerostomia-related dental caries can be studied. The progress of the caries process was investigated on ground and polished human enamel blocks placed in the lower denture of 7 edentulous subjects suffering from xerostomia. During a period of 6 weeks the samples were analyzed at weekly intervals by means of scanning optical monitoring, scanning longitudinal microradiography, scanning electron microscopy, and hardness measurements. Although the indentation length increased significantly within 2 weeks, no demineralization could be yet observed with scanning optical monitoring, longitudinal microradiography, and electron microscopy in most samples. Starting from the 3rd week a progressive demineralization could be observed by all methods. The mineral loss (hydroxyapatite) in the 3rd week was 0.0126 kg.m-2 (median) which increased to 0.0761 kg.m-2 after 6 weeks. Scanning electron microscopy showed a destruction which resembled that of natural xerostomia-related dental caries. From this study it may be concluded that the in vivo model developed is suitable for studying onset, progression, and prevention of xerostomia-related dental caries.

Fungal growth on soft contact lenses: a SEM-study

Three soft contact lenses of the HEMA type, discarded because of irritation of the cornea, were processed for and subsequently examined with the SEM, A large portion of the convex surface was covered with globular deposits of fungal spores. Cross-fractures of lenses showed penetration of the fungi into the matrix material of the lenses. The concave surface of the contact lenses showed at two points imprints of the epithelial cells of the cornea in the deposited material on that side of the lenses.

A morphological description of human cataractous lenses by SEM

Human cataractous lenses from patients of advanced age (101 & 85 year) were investigated by SEM. Various aspects of the cataract morphology could be observed. Even when the overall shape of the lens fibres had remained unchanged (although the typical ball and socket interconnections were barely visible) the homogeneous fibre content had changed into fibrillar and/or granular material, or the lens fibres had been (partly) hollowed out. Where there was shrinkage of the originally hexagonally-shaped lens fibres to a more or less rounded form with a wrinkled surface, the contents had changed into granular material with low density. Both granular and fibrillar material could account for a substantial increase in light scattering, resulting in a considerable decrease in vision through the lens.