scholarly journals Opacification of hydrophilic intraocular lenses associated with vitrectomy and injection of intraocular gas

2018 ◽  
Vol 3 (1) ◽  
pp. e000157 ◽  
Author(s):  
Arie L Marcovich ◽  
Tamer Tandogan ◽  
Mor Bareket ◽  
Eva Eting ◽  
Ifat Kaplan-Ashiri ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Gas Injection ◽  
Intraocular Lenses ◽  
Calcium Deposition ◽  
Alizarin Red ◽  
Iol Implantation ◽  
X Ray ◽  
Intraocular Gas ◽  
Pars Plana ◽  
Intravitreal Gas

ObjectiveTo report 11 cases of intraocular lens (IOL) opacification after pars plana vitrectomy (PPV) involving intravitreal gas injection.Methods and analysisEleven cases of hydrophilic IOLs that opacified following PPV with intravitreal gas injection are described. Eight IOLs were explanted and analysed by light microscopy and scanning electron microscopy. Staining with alizarin red and von Kossa stains, as well as energy dispersive X-ray spectroscopy (EDX) were performed. Three IOLs were not explanted. The surgeons attached the clinical data.ResultsThe IOLs were hydrophilic acrylic produced by six manufacturers. Six patients underwent primarily phacoemulsification with IOL implantation. PPV with intravitreal gas injection was performed 3 months–6 years afterwards. The other five patients underwent combined phacoemulsification with IOL implantation and PPV with intravitreal gas injection. IOL opacification was recorded 1 month –6 years after PPV. In eight patients, the IOLs were explanted 1 month–9 years after opacification was noticed. In three patients, the opacified IOL was not explanted. IOLs had opacified mainly anteriorly at the pupillary entrance or capsulorhexis opening. Light microscopy demonstrated granular surface deposits on the IOLs that stained positive for calcium by alizarin red and von Kossa stains. EDX analysis of the deposits detected calcium and phosphorus.ConclusionsHydrophilic acrylic IOLs can opacify due to calcium deposition after PPV and intravitreal gas injection and may require IOL explantation. A hydrophobic IOL may be preferred when a simultaneous phacoemulsification and vitrectomy with intravitreal gas is performed.

Visually Significant Opacification of Hydrophilic Acrylic Intraocular Lenses – A Clinico-Pathological Analysis

2003 ◽  
Vol 13 (2) ◽  
pp. 147-150 ◽  
Author(s):  
V.K.Y. Yong ◽  
P.A. Netto ◽  
W.-J. Heng ◽  
E.-Y. Yap ◽  
H.-M. Lee ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Intraocular Lenses ◽  
Iol Implantation ◽  
X Ray ◽  
Pathological Analysis ◽  
Transmission Electron ◽  
Sem Study ◽  
Hydrophilic Acrylic Intraocular Lens ◽  
Initial Implantation ◽  
Scanning Electron

Purpose To describe the clinic-pathological analysis of the visually significant opacification of the Cirrus International Hydroflex™ foldable hydrophilic acrylic intraocular lens (IOL) (model SC600-2, Medical Developmental Research Inc., Clearwater, Florida) and to highlight that this IOL is the same model as the Acryflex™ SC600-2 IOL, by the same manufacturer. Methods Retrospective review of five eyes of four patients with opacification of their Cirrus International Hydroflex™ foldable hydrophilic acrylic IOLs (model SC600-2) after uncomplicated phacoemulsification and IOL implantation. Two IOLs were explanted from two patients 14 to 24 months after initial implantation. Each explanted lens was divided into equal halves, one half for scanning electron microscopy (SEM) study and the other half for transmission electron microscopy (TEM) examination. SEM and TEM samples were also subjected to energy dispersive X-ray analysis (EDX). Results The IOL opacification was detected 14 to 24 months after uncomplicated phacoemulsification and IOL implantation. EDX analysis showed that the crystals contained calcium and phosphorus, presumably calcium phosphate. Conclusions The Cirrus Inter national Hydroflex™ foldable hydrophilic acr ylic IOL (model SC600-2) is associated with opacification, that appeared worse centrally than peripherally. This is the same model as the Acryflex™ SC600-2 IOL, made by the same manufacturer. The opacification consists of calcium and phosphate.

Calcification of hydrophilic acrylic intraocular lenses following secondary surgical procedures in the anterior and posterior segments

2019 ◽  
pp. bjophthalmol-2018-313385 ◽  
Author(s):  
Kieren Darcy ◽  
Andrew Apel ◽  
Mark Donaldson ◽  
Robert McDonald ◽  
John Males ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hydrophobic Surface ◽  
Intraocular Lenses ◽  
Case Review ◽  
Retrospective Case ◽  
South Wales ◽  
Intraocular Gas ◽  
Pars Plana ◽  
Common Risk Factors ◽  
Lens Surface

AimsTo report 15 cases of intraocular lens (IOL) calcification following intraocular surgery and to identify common risk factors.MethodsA retrospective case review of patients with IOL calcification reported from the Royal Victorian Eye and Ear Hospital, Melbourne, Australia, and six surgeons in private practice in the Australian states of Victoria, New South Wales and Queensland.Results15 cases of IOL calcification were identified. Eight cases were in hydrophilic acrylic IOLs and seven in hydrophilic acrylic IOLs with hydrophobic surface properties. Five cases occurred following intraocular injection of gas during endothelial keratoplasties. Two cases occurred following pars plana vitrectomy where gas was used. The remaining eight cases did not involve the injection of any intraocular gas; six cases were following trabeculectomy surgery, and two cases were after insertion of a ‘piggyback’ sulcus IOL. In each case, the calcification had a characteristic pattern, being centrally placed in the pupillary zone, mainly affecting the anterior lens surface.ConclusionThe aetiology of IOL calcification is not fully understood, although there are known risk factors such as using hydrophilic acrylic materials and the use of intraocular gas. Surgical consideration of a patient’s ocular comorbidities before IOL implantation is an important tool to mitigate some of this risk.

scholarly journals The Bubble Eye Sign: Understanding the Radiological Imaging of Gas inside the Orbit

2021 ◽  
Author(s):  
Sunny C. L. Au ◽  
Callie K. L. Ko
Keyword(s):  
Orbital Fracture ◽  
X Ray ◽  
Orbital Emphysema ◽  
Intraocular Gas ◽  
Intravitreal Gas ◽  
Attending Physician ◽  
Scleral Shell ◽  
Unnecessary Radiation ◽  
Tomography Scan ◽  
Tamponade Effect

AbstractGas, appears as radiolucent on X-ray, is normally absent in the orbit. However, intraocular surgeries occasionally utilize retained intraocular gas for tamponade effect. Intravitreal gas persists after retinal surgery, being confounded by the scleral shell of the operated eye, outlines the shape of the eyeball, and gives the characteristic bubble appearance on skull X-ray. This is different from orbital emphysema caused by orbital fracture when gas is located outside the globe but confined by the orbit, giving a crescent or concave shape over the superior orbit usually. Falls is common after intraocular retinal surgeries due to change of usual stereopsis, prolonged prone posturing, and other systemic comorbidities. By identifying the “Bubble Eye sign” described, attending physician should alert the presence of intravitreal gas, most commonly iatrogenic. Further ophthalmological history taking and examinations are thus indicated, instead of exposing patients to unnecessary radiation under computed tomography scan for orbital fracture investigation.

scholarly journals Microscopic Characteristics of Late Intraocular Lens Opacifications

2020 ◽  
Author(s):  
Piotr Kanclerz ◽  
Timur Mert Yildirim ◽  
Ramin Khoramnia
Keyword(s):  
Intraocular Lens ◽  
Room Temperature ◽  
English Language ◽  
Critical Issue ◽  
Intraocular Lenses ◽  
Alizarin Red ◽  
Younger Patients ◽  
X Ray ◽  
International Laboratory ◽  
Hydrophobic Acrylic

Context.— The increases in overall life expectancy and in lens surgeries performed on younger patients have resulted in a significant increase in the anticipated duration of artificial intraocular lenses (IOLs) in the eye. Thus, the physicochemical properties of the IOL become a critical issue, and several types of postoperative IOL opacifications have been reported. Objective.— To describe the microscopic characteristics of opacified IOLs. Glistenings and subsurface nanoglistenings are fluid-related phenomena developing mainly in hydrophobic acrylic IOLs and are associated with aqueous influx into the IOL matrix. Calcification presents in hydrophilic acrylic or silicone IOLs as deposits of hydroxyapatite or other phases of calcium. Snowflake degeneration is less common, and it manifests in older polymethyl methacrylate IOLs. Data Sources.— PubMed and ScienceDirect databases were searched for the following keywords: intraocular lens, IOL, cataract surgery, phacoemulsification, opacification, glistening, subsurface nanoglistenings, calcification, snowflake degeneration. English-language articles published up to October 15, 2019 were included in the study. The manuscript contains mainly a literature review; however, it was supplemented with original investigations from the David J. Apple International Laboratory for Ocular Pathology Conclusions.— Glistenings and subsurface nanoglistenings should be evaluated in hydrated state and at room temperature; they manifest as microvacuoles sized from 1.0 to greater than 25.0 μm and less than 200 nm, respectively. Calcification deposits are situated on or underneath the surface of the IOL and can be stained with a 1% alizarin red solution or with the von Kossa method. Snowflake degeneration manifests as “particles” or “crystals,” causing whitish IOL discoloration. Scanning electron microscopy or energy dispersive X-ray spectroscopy may improve the diagnostic accuracy.

scholarly journals Computational fluid dynamics (CFD) simulation analysis on retinal gas cover rates using computational eye models

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Gozawa ◽  
Yoshihiro Takamura ◽  
Tomoe Aoki ◽  
Kentaro Iwasaki ◽  
Masaru Inatani
Keyword(s):  
Cfd Simulation ◽  
Simulation Analysis ◽  
Fluid Dynamic ◽  
Fluid Analysis ◽  
Intraocular Gas ◽  
Pars Plana ◽  
Computational Fluid Dynamics Cfd ◽  
Multiple Breaks ◽  
Gas Volume ◽  
Wall Wettability

AbstractWe investigated the change in the retinal gas cover rates due to intraocular gas volume and positions using computational eye models and demonstrated the appropriate position after pars plana vitrectomy (PPV) with gas tamponade for rhegmatogenous retinal detachments (RRDs). Computational fluid dynamic (CFD) software was used to calculate the retinal wall wettability of a computational pseudophakic eye models using fluid analysis. The model utilized different gas volumes from 10 to 90%, in increments of 10% to the vitreous cavity in the supine, sitting, lateral, prone with closed eyes, and prone positions. Then, the gas cover rates of the retina were measured in each quadrant. When breaks are limited to the inferior retina anterior to the equator or multiple breaks are observed in two or more quadrants anterior to the equator, supine position maintained 100% gas cover rates in all breaks for the longest duration compared with other positions. When breaks are limited to either superior, nasal, or temporal retina, sitting, lower temporal, and lower nasal position were maintained at 100% gas cover rates for the longest duration, respectively. Our results may contribute to better surgical outcomes of RRDs and a reduction in the duration of the postoperative prone position.

Putting Molecules in the Picture: Using Correlated Light Microscopy and Soft X-Ray Tomography to Study Cells

2019 ◽  
pp. 1-32
Author(s):  
Axel Ekman ◽  
Jian-Hua Chen ◽  
Venera Weinhardt ◽  
Myan Do ◽  
Gerry McDermott ◽  
...  
Keyword(s):  
Light Microscopy ◽  
X Ray

scholarly journals Revisiting the source of wilt symptoms: X-ray microcomputed tomography provides direct evidence that Ralstonia biomass clogs xylem vessels

2021 ◽  
Author(s):  
Brian Ingel ◽  
Denise Caldwell ◽  
Fiona Duong ◽  
Dilworth Y. Parkinson ◽  
Katherine A. McCulloh ◽  
...  
Keyword(s):  
Stomatal Conductance ◽  
Light Microscopy ◽  
Bacterial Wilt ◽  
Xylem Sap ◽  
Physiological Mechanism ◽  
Bacterial Biomass ◽  
Microcomputed Tomography ◽  
Wilt Disease ◽  
X Ray ◽  
Bacterial Wilt Disease

AbstractPlant pathogenic Ralstonia cause wilt diseases by colonizing xylem vessels and disrupting water transport. Due to the abundance of Ralstonia cells in vessels, the dogma is that bacterial biomass clogs vessels and reduces the flow of xylem sap. However, the physiological mechanism of xylem disruption during bacterial wilt disease is untested. Using a tomato and Ralstonia pseudosolanacearum GMI1000 model, we visualized and quantified the spatiotemporal dynamics of xylem disruption during bacterial wilt disease. First, we measured stomatal conductance of leaflets on mock-inoculated and wilt-symptomatic plants. Wilted leaflets had reduced stomatal conductance, as did turgid leaflets located on the same petiole as wilted leaflets. Next, we used X-ray microcomputed tomography (X-ray microCT) and light microscopy to differentiate between mechanisms of xylem disruption: blockage by bacterial biomass, blockage by vascular tyloses, or sap displacement by gas embolisms. We imaged stems on plants with intact roots and leaves to quantify embolized vessels. Embolized vessels were rare, but there was a slight trend of increased vessel embolisms in infected plants with low bacterial population sizes. To test the hypothesis that vessels are clogged during bacterial wilt, we imaged excised stems after allowing the sap to evaporate during a brief dehydration. Most xylem vessels in mock-infected plants emptied their contents after excision, but non-conductive clogged vessels were abundant in infected plants by 2 days post infection. At wilt onset when bacterial populations exceeded 5×108 cfu/g stem tissue, approximately half of the xylem vessels were clogged with electron-dense bacterial biomass. We found no evidence of tyloses in the X-ray microCT reconstructions or light microscopy on the preserved stems. Bacterial blockage of vessels appears to be the principal cause of vascular disruption during Ralstonia wilt.

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