Ptosis induced by topical steroid eye drops: Two cases reports

RATIONALE

Ptosis is a rare complication of periocular steroid use. Studies report that local injections of steroids produce ptosis. We describe the first 2 cases of ptosis because of long-term treatment with topical steroid eye drops.

PATIENT CONCERNS

Two cases admitted to our hospital because of ptosis of their right eye after long-term treatment with topical steroid eye drops. Both of them had uncontrolled Posner-Schlossman syndrome.

DIAGNOSIS

Two cases were diagnosed as steroid-related ptosis.

INTERVENTIONS

Regulatory anti-inflammation therapy was prescribed for case 1, and after inflammation control, phacoemulsification was done for her. Six months after steroid withdrawal, the levator resection of the right eye was performed. Case 2 refused our advice of steroid reduction and ptosis surgery.

OUTCOMES

After surgery, case 1 retained a symmetrical appearance during a 1-year follow-up. In the surgery, we found thin levator muscles and slack levator palpebrae superioris aponeurosis (LPSA) in the affected eye. Postoperative transmission electron microscopy revealed typical signs of apoptosis in levator muscle cells.

LESSONS

We suggest topical application of steroids induces levator muscle apoptosis and LPSA weakness, and results in ptosis.

Identification of seven novel ZNF469 mutations in keratoconus patients in a Han Chinese population

PURPOSE

To test for the potential presence of novel mutations in the zinc finger protein (ZNF469) gene in patients with sporadic keratoconus (KC) from a Han Chinese population.

METHODS

Fifty-three patients with primary KC, 30 patients with high myopia (HM), and 100 unrelated population-matched healthy controls without any ocular or systemic disorders, all of Han Chinese ethnicity, were recruited. Blood samples were donated, and genomic DNA was isolated from peripheral blood leukocytes. Sequence variations in ZNF469 were initially identified in patients with KC with next-generation sequencing and subsequently confirmed using Sanger sequencing. Sequence variants identified in patients with KC were subsequently screened in 30 patients with HM and 100 healthy control subjects. Other genes that were reported to be related to KC were also screened in the patients with KC who carried the mutations in ZNF469. The Sorting Intolerant Form Tolerant (SIFT) program was used to predict the effect of amino acid substitution on the ZNF469 protein.

RESULTS

Sixteen sequence variants in the coding regions of ZNF469 were identified in this Chinese KC cohort. After five known single nucleotide polymorphisms (SNPs), one false-positive result, and three mutations that were also detected in the results of the whole-exome sequencing (WES) data performed in 220 Han Chinese individuals without ocular abnormalities were removed, seven novel mutations in ZNF469 (c.2059G>A, c.2137C>A, c.3466G>A, c.3749C>T, c.4300G>A, c.4684G>A, and c.7262G>A) that were predicted to be potentially damaging were identified. The patient with KC with the c.3466G>A mutation was also shown to carry one dedicator of cytokinesis 9 (DOCK9) mutation (c.1940C>T). None of the mutations were detected in the patients with HM or the healthy controls. All of the seven mutations in the patients with KC were heterozygote.

CONCLUSIONS

The results suggested for the first time that ZNF469 has a pathogenic role in Chinese patients with KC and have widened the mutation spectrum of KC in the Han Chinese population.

Identification and Functional Analysis of a Novel MIP Gene Mutation Associated with Congenital Cataract in a Chinese Family

Congenital cataracts are major cause of visual impairment and blindness in children and previous studies have shown about 1/3 of non-syndromic congenital cataracts are inherited. Major intrinsic protein of the lens (MIP), also known as AQP0, plays a critical role in transparency and development of the lens. To date, more than 10 mutations in MIP have been linked to hereditary cataracts in humans. In this study, we investigated the genetic and functional defects underlying a four-generation Chinese family affected with congenital progressive cortical punctate cataract. Mutation screening of the candidate genes revealed a missense mutation at position 448 (c.448G>C) of MIP, which resulted in the substitution of a conserved aspartic acid with histidine at codon 150 (p.D150H). By linkage and haplotype analysis, we obtained positive multipoint logarithm of odds (LOD) scores at microsatellite markers D12S1632 (Z_max = 1.804 at α = 1.000) and D12S1691 (Z_max = 1.806 at α = 1.000), which flanked the candidate locus. The prediction results of PolyPhen-2 and SIFT indicated that the p.D150H mutation was likely to damage to the structure and function of AQP0. The wild type and p.D150H mutant AQP0 were expressed in HeLa cells separately and the immunofluorescence results showed that the WT-AQP0 distributed at the plasma membrane and in cytoplasm, while AQP0-D150H failed to reach the plasma membrane and was mainly retained in the Golgi apparatus. Moreover, protein levels of AQP0-D150H were significantly lower than those of wide type AQP0 in membrane-enriched lysates when the HEK-293T cells were transfected with the same amount of wild type and mutant plasmids individually. Taken together, our data suggest the p.D150H mutation is a novel disease-causing mutation in MIP, which leads to congenital progressive cortical punctate cataract by impairing the trafficking mechanism of AQP0.

The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006-2011

AIMS

To estimate the cumulative incidence of postoperative endophthalmitis, identify risk factors and determine clinical outcomes in China.

METHODS

Medical records were reviewed for all patients with acute-onset endophthalmitis after cataract surgery from January 2006 to December 2011 at eight eye centres of tertiary care hospitals in China.

RESULTS

Sixty-six cases of presumed endophthalmitis occurred after 201 757 cataract surgeries, yielding a cumulative incidence of 0.033% (95% CI 0.025 to 0.041). Logistic regression analysis revealed that the risk of endophthalmitis increased with intraoperative communication with vitreous (multivariate OR 9.96; 95% CI 4.54 to 21.84; p<0.001). After a median follow-up of 153 days, best-corrected visual acuity in the affected eye was more than 20/70 in 29/65 (44.6%) patients, and more than 20/40 in 20/65 (30.8%). A predictor of good visual acuity was baseline acuity of counting fingers or better (OR 6.25; 95% CI 2.13 to 18.33). Of 64 cases, 25 (39.1%) were culture positive. Coagulase-negative Staphylococcus and Pseudomonas species were the most common organisms isolated, accounting for 72.0% of the culture-positive cases (18/25). Two eye centres that used a combination of a high concentration vancomycin (1 mg/0.1 mL intracameral vancomycin injection or 100 µg/mL vancomycin in irrigating solution) and tobramycin as infection prophylaxis achieved a lower incidence of endophthalmitis than other centres (p<0.001).

CONCLUSIONS

The incidence of acute postoperative endophthalmitis after cataract surgery in tertiary care hospitals of China was 0.033%. Intraoperative communication with vitreous was a major risk factor for developing endophthalmitis. Prophylactic use of a high-concentration vancomycin and tobramycin may play a positive role in the prevention of postoperative endophthalmitis after cataract surgery.

A recurrent PAX6 mutation is associated with aniridia and congenital progressive cataract in a Chinese family

PURPOSE

Aniridia is phenotyically and genetically heterogeneous. This study is to summarize the phenotypes and identify the genetic defect responsible for aniridia and congenital progressive cataract in a three generation Chinese family.

METHODS

A detailed family history and clinical data from patients were collected by ophthalmologic examination, including visual acuity, slit-lamp examination, tonometer, keratometry, corneal topography, optical coherence tomography, and ultrasonic A/B scan. All exons and flanking intronic sequences of the paired box 6 (PAX6) gene were amplified by polymerase chain reaction (PCR) and screened for mutation by direct DNA sequencing. Structure and function of the mutant PAX6 were analyzed by bioinformatics analysis.

RESULTS

All the six patients shared common manifestations of complete aniridia, congenital cataract and thickened cornea, and broad phenotypic variability was observed in nystagmus, ptosis, strabismus, glaucoma, corneal pannus, corneal curvature, corneal vascularization, cataract subtype, ectopia lentis, axial length, and optic disc anomalies. Sequencing of the candidate gene detected a heterozygous c.307C>T transition in the coding region of PAX6, resulting in the substitution of a highly conserved arginine codon for a termination codon (p.R103X). The p.P103X mutation co-segregated with the affected individuals in the family. The change was supposed to cause structural and functional changes based on computational analysis.

CONCLUSIONS

We identified a recurrent PAX6 c.307C>T mutation in an aniridia and congenital progressive cataract family, and summarized the variable phenotypes among the patients, which expanded the phenotypic spectrum of aniridia in a different ethnic background.

A novel GJA3 mutation associated with congenital nuclear pulverulent and posterior polar cataract in a Chinese family

Congenital cataract (CC) is the leading cause of visual disability in children. To date, mutations in many genes have been linked to CC. In a four-generation Chinese family with congenital nuclear pulverulent and posterior polar cataracts, we detected a heterozygous c.5G>A transition in the second exon of GJA3, resulting in the substitution of a highly conserved glycine with aspartic acid (p.G2D) at the N-terminus of the connexin46 (Cx46) protein. Wild type (wt) and mutant Cx46 plasmids were transfected into HeLa cells to examine the molecular basis of cataract formation. Unlike wt Cx46, Cx46G2D mutant formed gap junction plaques inefficiently, changed hemichannel permeability, and caused apoptosis. These results suggest that the glycine residue at the second position of the N-terminus is important for gap junction plaque formation and hemichannel function.

Closure of a persistent cyclodialysis cleft using the haptics of a normal-sized intraocular lens

A 50-year-old man suffering from hypotony in the right eye caused by a traumatic cyclodialysis and complicated by a choroidal detachment and cataract was treated in our clinic. After an unsuccessful direct cyclopexy, phacoemulsification was performed and a normal-sized single-piece polymethyl methacrylate posterior chamber intraocular lens (PMMA PCIOL) was inserted into the ciliary sulcus, with the haptic rotated toward the cyclodialysis cleft. Postoperatively, the corrected visual acuity improved to 20/20, and the intraocular pressure returned to normal. Ultrasound biomicroscopy showed the closure of the cleft. Phacoemulsification with a normal-sized PMMA PCIOL inserted into the ciliary sulcus is a safe, effective and technically simple surgical treatment for small cyclodialysis induced hypotony complicated by cataract. Internal compression of the cleft by the haptic of a normal sized IOL along with postoperative inflammation led to scarring and closure of the cleft.

The TGFBI R555W mutation induces a new granular corneal dystrophy type I phenotype

PURPOSE

To report the clinical and molecular features of a distinct form of transforming growth factor-β-induced (TGFBI) gene-linked corneal dystrophy exhibiting a new granular corneal dystrophy type I (CDGG1) phenotype.

METHODS

A complete ophthalmologic examination was performed in all individuals of a Chinese family in which autosomal dominant transmission of the disease had been observed. DNA was obtained from the peripheral blood leukocytes of each participating subject. Genetic analyses included keratin 3 (KRT3), keratin 12 (KRT12), and TGFBI polymerase chain reaction (PCR) amplification and automated nucleotide sequencing of exons from the genomic DNA.

RESULTS

The corneal phenotype in this pedigree was characterized by multiple bilateral dot-like, circular opacities at different corneal depths, with some of the affected individuals only having opacities in the epithelium, which is different from the typical CDGG1 phenotype. TGFBI analysis revealed a heterozygous point mutation at exon 12 (c.1663C>T) in all of the affected individuals, predicting a p.R555W missense mutation.

CONCLUSIONS

The phenotype which resulted from the TGFBI R555W mutation in this family is distinct from that observed in the typical case of CDGG1. We propose this disorder should be classified as a new phenotype of CDGG1, and this finding demonstrates the importance of gene diagnosis in the corneal dystrophies.

Characterization of a novel mutation in the CRYBB2 gene associated with autosomal dominant congenital posterior subcapsular cataract in a Chinese family

PURPOSE

To identify the underlying genetic defect in four generations of a Chinese family affected with bilateral congenital posterior subcapsular cataracts.

METHODS

Clinical data from patients in the family were recorded by slit-lamp photography. Genomic DNA samples were extracted from peripheral blood of the pedigree members. Mutation screening was performed in the candidate gene by bidirectional sequencing of the amplified products. The mutation was verified by restriction fragment length polymorphism (RFLP) analysis.

RESULTS

The congenital cataract phenotype of the pedigree was identified as posterior subcapsular by slit-lamp photography. Sequencing of the candidate genes detected a heterozygous c.5C→T change in the coding region of the βB2-crystallin gene (CRYBB2), resulting in the substitution of a highly conserved alanine to valine (p. A2V). All nine family members affected with cataracts were positive for this change, but it was not observed in any of the unaffected members of the family. The transition resulted in the loss of a HaeIII restriction site in the affected members of the pedigree, which was present in the unaffected family members and in all of the 100 unrelated individuals tested.

CONCLUSIONS

This study has identified a novel CRYBB2 gene mutation, resulting in the amino substitution p. A2V in a Chinese family with posterior subcapsular congenital cataracts. This mutation is probably the causative lesion for the observed phenotype in this family.

A Chinese family with progressive childhood cataracts and IVS3+1G>A CRYBA3/A1 mutations

PURPOSE

To characterize the disease-causing mutations in a Chinese family with progressive childhood cataracts.

METHODS

Family history and clinical data were recorded. Direct gene sequencing together with multi-point linkage analysis using microsatellite markers flanking the gene was applied to identify the disease-causing mutation.

RESULTS

Lens examination in the affected members revealed childhood cataracts along with progressive developing fetal nuclear lactescent cataracts with 'Y' sutural opacities, and also progressive developing peripheral cortical opacities. Direct gene sequencing showed a G>A transition at the donor splice site of intron 3 (IVS3+1 G>A) of the βA1/A3-crystallin gene (CRYBA3/A1) in this Chinese autosomal dominant childhood cataract family, and the maximum heterogeneity logarithm of odds (HLOD) score obtained by multi-point analysis was detected at marker locus D17S1800 (HLOD=3.005; α=1.000).

CONCLUSIONS

To our knowledge, this is the first report of a phenotype of progressive nuclear and cortical cataracts related to the CRYBA3/A1 mutation IVS3+1 G>A. This finding expands the spectrum of cataract phenotypes caused by the IVS3+1 G>A mutation of CRYBA3/A1, confirms the phenotypic heterogeneity of this mutation and suggests the mechanism that influences the cataractogenesis in different ethnic backgrounds.

A novel mutation in the major intrinsic protein (MIP) associated with autosomal dominant congenital cataracts in a Chinese family

PURPOSE

To detect the underlying genetic defect in a Chinese family affected with bilateral congenital cataracts.

METHODS

A detailed family history and clinical data were recorded. Mutation screening was performed in the nuclear cataract-related gene by bidirectional sequencing of the amplified products. The mutation was verified by denaturing high-performance liquid chromatography (DHPLC).

RESULTS

Two cataract phenotypes were observed within this family: one eye exhibited Y-suture and nuclear pulverulent opacification of the lens, while the others exhibited complete opacification in the fetal nuclear region. Sequencing of the candidate genes detected a heterozygous c.319G>A change in the coding region of the major intrinsic protein (MIP), resulting in the substitution of a highly conserved Valine by Isoleucine (p.V107I).The mutation was confirmed by DHPLC.

CONCLUSIONS

This study has identified a novel MIP mutation, p.V107I in a Chinese family with congenital cataracts. To the best of our knowledge, this is the first reported case of cataracts caused by a mutation in the second extracellular loop domain of MIP.

Identification of a novel splice-site mutation in MIP in a Chinese congenital cataract family

PURPOSE

To map the locus and identify the gene causing autosomal dominant congenital cataract (ADCC) with "snail-like" phenotype in a large Chinese family.

METHODS

Clinical and ophthalmologic examinations were conducted on family members and documented by slit lamp photography. Linkage analysis was performed with an initial 41 microsatellite markers, then 3 additional markers flanking the major intrinsic protein (MIP) gene. Mutations were screened by DNA sequencing and verified by restriction fragment length polymorphism (RFLP) analysis.

RESULTS

Significant two-point LOD scores were obtained at 5 markers flanking MIP with the highest 3.08 (theta=0.00) at marker D12S1632. Mutation screening of MIP identified a heterozygous G>A transition at the acceptor splice site of intron 3 (IVS3 -1 G>A), abolishing a BstSF I restriction site in one allele of all the affected individuals.

CONCLUSIONS

We identified a novel splice-site mutation (IVS3 -1 G>A in MIP) in a Chinese ADCC family. To our knowledge, this is the first report on an acceptor splice-site mutation in human genes associated with ADCC.

A nonsense mutation in CRYGC associated with autosomal dominant congenital nuclear cataract in a Chinese family

PURPOSE

To identify the genetic defect associated with autosomal dominant congenital nuclear cataract in a Chinese family.

METHODS

Family history and phenotypic data were recorded, and the phenotypes were documented by slit lamp photography. The genomic DNA was extracted from peripheral blood leukocytes. All the exons and flanking intronic sequences of CRYGC and CRYGD were amplified by polymerase chain reaction (PCR) and screened for mutation by direct DNA sequencing. Structural models of the wild type and mutant gammaC-crystallin were generated and analyzed by SWISS-MODEL.

RESULTS

Sequencing of the coding regions of CRYGC and CRYGD showed the presence of a heterozygous C>A transversion at c.327 of the coding sequence in exon 3 of CRYGC (c.327C>A), which results in the substitution of a wild type cysteine to a nonsense codon (C109X). One and a half Greek key motifs at the COOH-terminus were found to be absent in the structural model of the mutant truncated gammaC-crystallin.

CONCLUSIONS

A novel nonsense mutation in CRYGC was detected in a Chinese family with consistent autosomal dominant congenital nuclear cataract, providing clear evidence of a relationship between the genotype and the corresponding cataract phenotype.

Novel FBN1 mutations associated with predominant ectopia lentis and marfanoid habitus in Chinese patients

PURPOSE

To identify mutations in the fibrillin-1 gene (FBN1) and provide further information about genotype-phenotype correlations in Chinese patients with predominant ectopia lentis (EL) and marfanoid habitus.

METHODS

Patients from seven Chinese families underwent complete physical, ophthalmic, and cardiovascular examination. Genomic DNA was extracted from leukocytes of peripheral blood from the patients. The 65 exons and flanking intronic sequences of FBN1 were amplified by polymerase chain reaction (PCR) and screened for mutation by direct DNA sequencing.

RESULTS

Three novel mutations, c.203G>T in exon 2, c.502T>C in exon 5, and c.2096G>C in exon 16 as well as four known mutations, c.364C>T in exon 4, c.1633C>T in exon 13, c.1879C>T in exon 15, and c.4588C>T in exon37, were identified in FBN1.

CONCLUSIONS

We identified three novel mutations and four known mutations in FBN1 and found cysteine substitution highly related to EL. These results expand the mutation spectrum in FBN1 and enrich our knowledge of genotype-phenotype correlations due to FBN1 mutations. To our knowledge, this is the first report of cysteine residue loss in the unique NH2-terminal domain of fibrillin-1.

Progressive polymorphic congenital cataract caused by a CRYBB2 mutation in a Chinese family

PURPOSE

To report and identify the genetic defect that causes progressive polymorphic congenital cataracts affecting a large five generation Chinese family.

METHODS

Family history and phenotypic data were recorded, and the phenotypes were documented by slit lamp photography. Genetic linkage analysis was performed on the known genetic loci for autosomal dominant congenital cataract (ADCC) with 41 short tandem repeat polymorphic markers. Mutations were screened by DNA sequencing and restriction fragment length analysis (RFLP).

RESULTS

A significant two point LOD score was generated at marker D22S420, D22S539 and D22S315 for 22q11.2. The highest observed LOD score was 6.26 (theta=0.00) with marker D22S315. Mutation screening of the CRYBB2 gene in this family revealed an C-->T transition at position 475 (Q155X) of the cDNA sequence, creating a novel SpeI restriction site that cosegregated with affected members of the pedigree, but was not present in unaffected members or any of the 100 unrelated individuals tested.

CONCLUSIONS

Our finding expands the spectrum of cataract phenotypes caused by the Q155X mutation of CRYBB2, confirms the phenotypic heterogeneity of this mutation and suggests the mechanism that influences the congenital cataract formation in different ethnic backgrounds.

Special fasciculiform cataract caused by a mutation in the gammaD-crystallin gene

PURPOSE

To identify ultrastructure changes and genetic defects associated with a special fasciculiform autosomal dominant congenital cataract (ADCC) affecting a large Chinese family.

METHODS

Members of the Chinese family affected by this special fasciculiform ADCC were studied. Clinical examinations, light and transmission electron microscopy of the removed lens tissue, linkage analyses using polymorphisms of microsatellite markers, and mutational analyses of candidate genes by direct sequencing were performed.

RESULTS

The thirteen affected individuals in the family showed no variability between one another. The lens fiber cells showed focal degeneration, dense globular intracellular deposits, and an enlarged intercellular space. This ADCC was associated with a locus on chromosome 2q33-35 (maximum lod score [Zmax]=3.34; theta=0.05). Mutational analyses of the candidate genes (gamma-crystallin; CRYG), identified a C->A heterozygous transversion at nucleotide position 70 in the gammaD-crystallin gene (CRYGD) exon2, which co-segregated with the presence of ADCCs and was not observed in 100 unrelated controls.

CONCLUSIONS

This study identified ultrastructure changes and genetic defects associated with a special fasciculiform ADCC affecting a large Chinese family. It appeared to be caused by a missense mutation in the CRYGD gene, further supporting the notion that alterations to CRYG play an important factor in human cataract formation.

Caspase-3 and its inhibitor Ac-DEVD-CHO in rat lens epithelial cell apoptosis induced by hydrogen in vitro

OBJECTIVE

To investigate the role of caspase-3 and its inhibitor Ac-DEVD-CHO in rat lens epithelial cell apoptosis induced by hydrogen peroxide (H(2)O(2)) in vitro.

METHODS

Rat lenses were incubated in modified Eagle's medium containing 2 mmol/L H(2)O(2) to induce apoptosis in vitro. Apoptosis in lens epithelial cells was assessed by transmission electron microscopy and annexin V-propidium iodide (PI) double staining flow cytometry after 12, 24 and 48 h of incubation. The activity of caspase-3 was analyzed by western blotting.

RESULTS

Observations under transmission electron microscopy revealed that 2 mmol/L H(2)O(2) could effectively induce lens epithelial cell apoptosis in vitro. Caspase-3 activity increased during cell apoptosis and the peak measurement occurred at 24 h after treatment with H(2)O(2). Cell apoptosis was blocked by caspase-3 inhibitor Ac-DEVD-CHO.

CONCLUSIONS

The activation of caspase-3 plays an important role in executing apoptosis in H(2)O(2)-treated lens epithelial cells and in the formation of cataract. The caspase-3 inhibitor Ac-DEVD-CHO may effectively prevent lens epithelial cell apoptosis caused by oxidative injury.

[Influence of low molecular weight heparin on proliferation of bovine lens epithelial cells on the surface of intraocular lens]

OBJECTIVE

To investigate the anti-proliferation effect of low molecular weight heparin (LMWH) on bovine lens epithelial cells (BLEC) on the surface of polymethylmethacrylate (PMMA) intraocular lens (IOL).

METHODS

BLECs were incubated in vitro on the surface of PMMA IOLs. The cultural media contained LMWH (1 x 10(5) U/L) or normal heparin (1 x 10(5) U/L) or none of them (control). Cells were counted by flow cytometry.

RESULTS

The heparin or LMWH treated BLECs on the surface of PMMA IOLs showed immature appearance, while the BLECs in the control group showed a tendency of fibrosis. The numbers of BLECs (per ml) in the digested solution from the surface of IOLs were 878.2 +/- 107.8 (control), 545.5 +/- 58.2 (heparin) and 407.8 +/- 36.6 (LMWH). The comparisons among the three groups showed significant differences (P < 0.001).

CONCLUSION

Low molecular weight heparin inhibits proliferation of lens epithelial cells on the surface of intraocular lens, which could be used as a potential drug to prevent the occurrence of postoperative capsular opacification after IOL implantation.

[The expression of calpain II in rat lens epithelial cells of hydrogen peroxide-induced cataract]

OBJECTIVE

To study the expression and role of calpain II in rat lens epithelial cells (LECs) of hydrogen peroxide (H(2)O(2))-induced cataract.

METHODS

Rat lenses were cultured in vitro and cataract was induced by 2 mM H(2)O(2). The lenses were observed under microscope. Simultaneously, photographs and picture analyses were done in order to detect the variation of the opacity. The expression of calpain II in rat LECs was detected with immunohistochemical method and compared with a control group.

RESULTS

When the lenses were cultured in 2 mM H(2)O(2) for 3 hours (h), the expression of calpain II in rat LECs was increased obviously. There was significant difference between H(2)O(2)-induced and the control group (P = 0.006). After 6 h, vesicles appeared at the equator of the lenses. There was a significant difference between the result of picture analysis of H(2)O(2)-induced and control group (P = 0.013). So the expression of calpain II in rat LECs of H(2)O(2)-induced cataract was increased before cataract occurred. After induced with H(2)O(2) for 24 h, the opacity of lenses and the expression of LECs were both increased as compared with that at 6 h (P = 0.000, 0.000).

CONCLUSION

H(2)O(2) can enhance the expression of calpain II in rat LECs which may play a role in the mechanism of oxidative stress-induced cataract.

Phacofragmentation without perfluorocarbon liquid for dislocated crystalline lenses or lens fragments after phacoemulsification

PURPOSE

To evaluate the clinical outcome of vitrectomy with phacofragmentation without perfluorocarbon liquid (PFCL) in the management of dislocation of the crystalline lens, caused by trauma, hereditary disorders, or hypermature cataracts, and lens fragments due to phacoemulsification.

METHODS

A prospective study was conducted to evaluate 30 eyes of 29 patients who had undergone standard pars plana vitrectomy with phacofragmentation without PFCL in the vitreous cavity, for the removal of dislocated crystalline lenses or lens fragments, from January 1998 to July 2000. All cases were followed for more than six months.

RESULTS

Final best corrected visual acuity of 0.5 or better increased from 0% preoperatively to 36.7% postoperatively, and 0.2 or better rose to 76.7%. The mean IOP was significant reduced, from 26.35 mmHg to 12.75 mmHg. No intraoperative complications occurred. Although two eyes (6.7%) developed retinal detachment, one (3.3%) had cystoid macular edema (CME) and one (3.3%) had a transient intraocular pressure increase (to 25 mmHg) postoperatively, all others had a favorable outcome.

CONCLUSIONS

Standard pars plana vitrectomy with phacofragmentation without PFCL in the vitreous cavity is a safe, simple, and effective method for removing a dislocated crystalline lens or lens fragments, with good visual outcome.

Expression and effect of basic fibroblast growth factor on human cataract lens epithelial cells

OBJECTIVE

To detect the expression of basic fibroblast growth factor (bFGF) in human ocular tissues, and to assess the effect of bFGF on the proliferation of human cataract lens epithelial cells (LECs) and its correlation with age.

METHODS

Enucleated eyes were subjected to immunostaining for bFGF protein. Human cataract LECs were cultured in vitro, and treated with bFGF for 48 hr. Proliferation was estimated by the positive area ratio of proliferating cell nuclear antigen (PCNA) in immunohistochemistry.

RESULTS

bFGF protein was found in various human ocular tissues. bFGF stimulated human cataract LEC proliferation, and there was an age-related decrease in responsiveness of human cataract LECs to bFGF (P < 0.05).

CONCLUSION

bFGF might play an important role in the proliferation of residual human cataract LECs after cataract surgery.

[The comparison of two methods to predict the post-operative visual acuity of cataractous patients]

OBJECTIVE

To study the accurate methods to predict the post-operative visual acuity of cataractous patients with different degrees of opaque lenses.

METHODS

Visual electrophysiological methods and retinometer were used to evaluate the visual function after phacoemulsification and intraocular lens implantation in 152 cases (152 eyes). The regressive analyses between the post-operative best corrected visual acuity (BCVA) and each of the following results: the pre-operative flash electroretinogram (F-ERG), flash visual evoked potentials (F-VEP) and potential visual acuity (PVA) were performed, respectively.

RESULTS

More obvious linear-relationship was shown between PVA and BCVA (r = 0.654) than that between the combination of b wave's amplitude of F-ERG with wave's amplitude of F-VEP and BCVA (r = 0.528) in the patients with partial opaque lenses. Obvious linear-relationship between the combination of the F-ERG with F-VEP values and BCVA (r = 0.487) and no obvious relationship between the potential visual acuity and BCVA (r = 0.049) were shown in the patients with near complete/complete opaque lenses.

CONCLUSION

Both visual electrophysiological and retinometric detection, especially the latter one, can predict the post-operative visual acuity of the patients with partial opaque lenses accurately. Visual electrophysiological detection can predict the post-operative visual acuity of cataractous patients with near complete/complete opaque lenses accurately but retinometric detection can not.

[The age-related effect of basic fibroblast growth factor on the proliferation of lens epithelial cells]

OBJECTIVE

To detect the age-related effect of basic fibroblast growth factor (bFGF) on the proliferation of human lens epithelial cells (HLECs) in patients with cataract and discuss the mechanism.

METHODS

Human lens anterior capsules with attached HLECs were cultured in vitro, treated with 10 microg/L bFGF for 48hr, and then the positive area ratio of proliferating cell nuclear antigen (PCNA) in immunohistochemistry was estimated. Immunohistochemical analysis of bFGF receptor was also carried out.

RESULTS

The bFGF could enhance the HLEC proliferation in patients with cataract at various ages. The enhancement of the proliferation and the expression of bFGF receptor protein were negatively correlated to the age of the patients with cataract (P < 0.01).

CONCLUSIONS

The basic fibroblast growth factor might play an important role in the formation of posterior capsular opacity (PCO) after cataract surgery. With the decrease in the patient's age, the enhancement of HLEC proliferation is increased, indicating that the fact is related to the high incidence of PCO in children.