Efficient extracellular vesicles freeze-dry method for direct formulations preparation and use

Despite the great knowledge achieved in the field of extracellular vesicles (EVs), the short lifetime of EVs liquid formulation still hampers the transfer of EVs technology to clinical applications. In this context, freeze-dried EVs would be advantageous thanks to the enhanced stability of solid formulations. Although some previous attempts have already been reported, the efficiency of EVs lyophilization methodologies used remains insufficient, and the characterization of the resulting EVs is still incomplete. The current work aims to describe an alternative and easy-to-be-applied methodology for EVs lyophilization. The use of sucrose as lyoprotectant at 8.5%wt improved the cryopreservation efficiency. After the subsequent cycles of freeze-drying, properties such as size, morphology, purity, EVs specific markers, biocompatibility and the maintenance of their functionality were confirmed in freeze-dried EVs samples. To sum up, we have designed a methodology for the lyophilization of extracellular vesicles that enables the preservation of the physicochemical properties and functionality of EVs.

Simultaneous bilateral cataract extraction in the UK

AIMS/BACKGROUND

Simultaneous bilateral extracapsular cataract extraction (SBCE) is not routinely performed in the developed world. This study investigated the safety and efficacy of this procedure as performed in the UK.

METHODS

A review of 319 consecutive patients (638 eyes) who underwent SBCE with posterior chamber intraocular lens implantation is presented.

RESULTS

The incidence of intraoperative complications was 7.7%. These included posterior capsule rupture (0.8%) and vitreous loss (0.3%). Postoperative complications were seen in 8.7% of operated eyes and included iris prolapse (0.3%) and raised intraocular pressure (3.0%). Endophthalmitis occurred in one eye (0.15%). There were no major bilateral complications, and, in particular, no cases of bilateral endophthalmitis. Final visual acuities compared favourably with reports for unilateral surgery. Eighty two per cent achieved a final visual acuity of 6/12 or better, and 41% tested 6/6 or better.

CONCLUSION

This study illustrates that SBCE is not associated with an increased incidence of complications and that the visual results are good. Where indicated, and under strict surgical protocol, this procedure is safe.

Extensive visual loss with topical facial steroids

Steroid creams applied topically to the skin are routinely used in the treatment of many dermatoses. Their use on the face in severe atopic eczema is relatively common. We report a series of three patients who whilst using topical facial steroids developed advanced glaucoma. A further two cases of ocular hypertension secondary to topical facial steroids are also described. This is the first series of cases to be reported demonstrating the potentially blinding complications of topical facial steroids. Recommendations are made with regard to screening such patients for glaucoma.

Bilateral homonymous visual field defects as initial manifestation of multiple sclerosis

Symptomatic suprageniculate lesions in multiple sclerosis expressed as a visual field defect are infrequent. The present case developed a bilateral homonymous defect as the initial and unique symptom of the disease. It was confirmed by nuclear magnetic resonance imaging, which disclosed extensive demyelinating areas in both optic nerve radiations. The mode of onset, perimetric findings, and unusual presentation of this condition are briefly discussed.