Comparison of diclofenac and fluorometholone in preventing cystoid macular edema after small incision cataract surgery: a multicentered prospective trial.

Purpose: To compare a nonsteroidal topical solution (0.1% diclofenac) to a steroidal topical solution (0.1% fluorometholone) in preventing cystoid macular edema (CME) and disruption of the blood-aqueous barrier.

Application of a newly developed, highly sensitive camera and a 3-dimensional high-definition television system in experimental ophthalmic surgeries.

Objective: To apply a new television system, which displays highly sensitive, high-quality 3-dimensional (3-D) images, in performing experimental ophthalmic surgeries.

Methods: By combining a high-gain avalanche rushing-amorphous photoconductor (HARP) camera, recently developed in Japan, which has 600 times greater sensitivity than conventional television cameras, and a single-camera, 3-D high-definition television system, which displays high-quality 3-D images, we performed cataract/intraocular lens surgeries and pars plana vitrectomies under various illumination intensities in pig cadaver eyes.

Results: Cataract/intraocular lens surgeries were performed using 7.

Blood-retinal barrier and autofluorescence of the posterior polar retina in long-standing pseudophakia.

Purpose: To study the physiological state of the retina in long-standing pseudophakic eyes using blood-retinal barrier (BRB) disruption and autofluorescence as parameters.

Setting: Miyake Eye Hospital, Nagoya, Japan.

Method: This retrospective, case-controlled study sought to determine whether ultraviolet (UV)-light-filtering and blue-light-filtering intraocular lenses (IOLs) had different outcomes in severity of BRB disruption and autofluorescence of the posterior polar retina than clear (untreated) IOLs.

Capsular block syndrome with external blockage of the capsular opening by a ciliary sulcus fixated posterior chamber lens.

Purpose: To report capsular block syndrome with external blockage of the capsular opening by a posterior chamber lens fixated in the ciliary sulcus.

Method: Case report.

Results: In an 89-year-old man who had undergone cataract surgery, a posterior chamber lens was accidentally fixated in the ciliary sulcus after continuous curvilinear capsulohhexis and phacoemulsification/aspiration.

Latanoprost accelerates disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema in early postoperative pseudophakias.

Objective: To study the effect of latanoprost, a prostaglandin analog, on the blood-aqueous barrier and angiographic cystoid macular edema (CME) formation in early postoperative pseudophakias.

Patients And Methods: Included in the study were eyes with ocular hypertension, normal-tension glaucoma, or primary open-angle glaucoma undergoing surgery for cataract. The study consisted of a randomized double-masked trial for latanoprost and an open-label controlled trial for determining the effects of diclofenac sodium or fluorometholone eyedrop use on latanoprost or its placebo.

New classification of capsular block syndrome.

Purpose: To propose a new classification of capsular block syndrome (CBS) to improve understanding of the etiology and provide effective treatment.

Setting: Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, and Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan.

Methods: Three groups of eyes with CBS were reviewed: eyes originally reported and diagnosed as having CBS; eyes experiencing CBS after hydrodissection and luxation of the lens nucleus; and eyes with CBS accompanying liquefied aftercataract or capsulorhexis-related lacteocrumenasia.

[Preventive effects of diclofenac ophthalmic solution on post-cataract-surgical cystoid macular edema].

Using eyes undergoing phacoemulsification followed by implantation of a foldable acrylic intraocular lens (IOL) designed for small-incision cataract surgery, a multi-center study was performed to compare a non-steroidal ophthalmic solution (0.1% diclofenac) to a steroidal ophthalmic solution (0.1% fluorometholone) in preventing cystoid macular edema (CME) and inducing disruption of the blood-aqueous barrier determined by laser flare cellmetry.

Liquefied aftercataract: a complication of continuous curvilinear capsulorhexis and intraocular lens implantation in the lens capsule.

Purpose: To describe a new type of aftercataract that contains a liquefied, milky white substance between the lens optic and the posterior lens capsule.

Method: We reviewed the medical records of 41 patients identified as having this type of aftercataract.

Results: All 41 eyes (41 patients) underwent uneventful phacoemulsification after continuous curvilinear capsulorhexis and implantation of a posterior chamber intraocular lens made from polymethylmethacrylate.

Dislocation of the lens nucleus into the vitreous cavity after standard hydrodissection.

Purpose: Having encountered dislocation of the lens nucleus into the vitreous cavity immediately after continuous tear capsulorhexis and hydrodissection of the nucleus, we examined common features of eyes with this complication.

Methods: We reviewed consecutive cases of cataract extraction.

Results: The complication occurred in four of 10,126 eyes.

Correlation between intraocular lens hydrophilicity and anterior capsule opacification and aqueous flare.

Purpose: To study the correlation between a basic parameter of intraocular lens biocompatibility, hydrophilicity, and two clinical parameters, postoperative inflammation and anterior capsule opacification.

Setting: Miyake Eye Hospital, Nagoya, Japan.

Methods: Three combinations of IOLs that were identical in shape but had distinct contact angles of water were used in this prospective double-masked study: (1) experimental comparison of collagen type IV and poly(methyl methacrylate) (PMMA) IOLs in rabbit eyes; (2) clinical comparison of heparin-surface-modified and PMMA IOLs; (3) clinical comparison of three foldable IOLs, silicone, acrylic, and memory.

[Corneal autofluorescence in eyes with branch retinal vein occlusion].

Basic studies have suggested that corneal autofluorescence, originating from flavoprotein and pyridine nucleotides, is caused by metabolically impaired corneal mitochondrial respiration. In this study, we used corneal autofluorescence as a parameter for evaluating the pathology at the corneal cell level in eyes with branch retinal vein occlusion. Unilateral branch retinal vein occlusion cases with durations of 2 months to 7 years since the onset and age-matched normal eyes were used for the study.

Blood-aqueous barrier in eyes with retinal vein occlusion.

Purpose: The purpose of this study is to examine the changes of blood-aqueous barrier function in cases of central or branch retinal vein occlusion.

Methods: In addition to fluorophotometry of the aqueous humor and posterior vitreous, the authors used a method that quantifies protein in the aqueous (aqueous flare) by measuring the intensity of scattered laser light.

Results: Aqueous and posterior vitreous fluorescein concentrations and aqueous flare were significantly higher than in unaffected fellow eyes or eyes of visually normal age-matched controls both in central and branch retinal vein occlusions.

Anterior lens capsulotomy using the holmium YAG laser in pig cadaver eyes.

Anterior lens capsulotomy was performed on pig cadaver eyes using the evaporation and coagulation functions of the holmium YAG laser. Laser energy ranging from 50 to 80 mJ was delivered to the lens-capsule surface by a 26-gauge fiber-optic quartz needle probe. In eight of 10 eyes, a tear-free, 4.

Active transport system of prostaglandins: clinical implications and considerations.

We hypothesize that two factors are essential in the development of epinephrine-induced cystoid macular edema (CME): (1) the stimulation of prostaglandin synthesis by some tissues, presumably the anterior uvea by epinephrine; (2) the dysfunction of the active transport (Bito's pump) which is responsible for the removal of prostaglandins from intraocular fluids. We conducted several experimental studies to confirm these hypotheses. The results strongly suggest that epinephrine maculopathy is induced by a mechanism involving prostaglandins or, possibly, other related eicosanoids and not simply by epinephrine itself, as has been postulated.

Increased aqueous flare as a result of a therapeutic dose of mannitol in humans.

To evaluate the effects of mannitol on aqueous flare (aqueous protein concentration), we administered an intravenous clinical therapeutic dose to normal young adults (average age 20.1 years), to normal older adults (average age 61.5 years), and also to patients with diabetes mellitus, systemic hypertension, or pseudoexfoliation syndrome who were about to undergo intraocular surgery (average age 66.

Staining of zonules during posterior chamber lens implantation in a cadaver eye model.

A cadaver eye model was used to study the effects of extracapsular lens removal and implantation on the zonules and capsule. Five staining solutions were instilled in the posterior and anterior chambers of human cadaver eyes and washed out three to five minutes later. Gomori's chrom hematoxylin-eosin most clearly revealed the zonules.

Inflammatory mediators in postoperative aphakic and pseudophakic baboon eyes.

We measured prostaglandin E2 and leukotriene B4 in the aqueous humor of baboon eyes, 1 or 8 days after phacoemulsification, with or without posterior chamber lens implantation. We also evaluated the effects of steroid eye drops and cyclooxygenase inhibitor eye drops on the synthesis of these mediators of inflammation. Eyes that had undergone phacoemulsification showed significant elevation of prostaglandin E2 at both postoperative periods compared with normal, phakic control eyes.

Biphasic fluorescence decay in kinetic vitreous fluorophotometry.

Eyes of 15 normal subjects and 24 diabetic patients underwent kinetic vitreous fluorophotometry at five, six, eight, ten, 24, and 48 hours after intravenous administration of sodium fluorescein 10 mg/kg. Exponential decay constants (Kv) were calculated for the period between five and 24 hours (Kv1) and for that between 24 and 48 hours (Kv2). In normal subjects and diabetic patients with background retinopathy, Kv1 was larger than Kv2, indicating biphasic fluorescence decay.

Pupillary fibrin membrane. A frequent early complication after posterior chamber lens implantation in Japan.

The incidence of pupillary fibrin membrane formation, a relatively frequent complication of cataract surgery in Japan even for experienced surgeons, was noted in 2038 consecutive cases of senile cataract removal and primary posterior chamber intraocular lens (PC IOL) implantation. The overall incidence was 4.4%.

Corneal endothelial changes in pseudoexfoliation syndrome.

Using specular microscopy and computer-assisted morphometry, we studied 27 eyes with pseudoexfoliation syndrome, 17 apparently normal fellow eyes, and 15 eyes of matched normal subjects with no ocular disease other than senile cataract. Endothelium of the eyes with pseudoexfoliation syndrome showed significantly lower cell density than did the endothelium from control eyes. Endothelium of both eyes of patients with unilateral pseudoexfoliation syndrome showed significant morphologic changes in cell size (polymegethism) and shape variability (pleomorphism); these changes were essentially the same in overtly affected and apparently normal fellow eyes.

In vitro inhibition of lens epithelial cell growth by continuous wave Nd:YAG laser.

Bovine lens epithelial cells were suspended in MEM medium and subjected to continuous wave, low power, pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation. The temperature of each suspension was maintained at 36 degrees C. Laser applications ranged from 1 to 10 watts and from 100 to 2000 seconds, but the total dose to each of the epithelial cell suspension was 2000 J.

Hypotheses on the role of prostaglandins in the pathogenesis of epinephrine maculopathy and aphakic cystoid macular edema.

This article presents hypotheses regarding pathogenesis of epinephrine maculopathy. According to these hypotheses, two points are the most essential in the development of epinephrine-induced CME: one is the stimulation of PG synthesis by some tissues, presumably, the anterior uvea by the applied epinephrine, the other is the dysfunction, in some aphakic eyes, of the active transport system (Bito's pump) which is responsible for the removal of PGs from intraocular fluids. To test these hypotheses, the authors and their group conducted several experimental studies.

Fluorophotometric evaluation of the blood-ocular barrier function following cataract surgery and intraocular lens implantation.

Ocular fluorophotometry is a sensitive method for quantitative, in vivo evaluation of the blood-ocular barrier function. This paper reviews studies that have used this technique to evaluate the effects of devices or techniques used in cataract and implant surgery.

Synthesis of prostaglandin E in rabbit eyes with topically applied epinephrine.

Using radioimmunoassay techniques, we measured the amounts of prostaglandin E (PGE) in the aqueous humor and vitreous body of 22 phakic and ten aphakic rabbit eyes. Either epinephrine and placebo, epinephrine and indomethacin, indomethacin and placebo, or placebo and placebo were administered topically for 5 months. Treatment of aphakic eyes was initiated 1 month after intracapsular lens extraction.

Long-term effects of topically applied epinephrine on the blood-ocular barrier in humans.

Epinephrine (1.25%) was applied topically twice daily to both eyes of 22 patients with glaucoma or ocular hypertension. Half of these patients received topical indomethacin (0.