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Biomedical subjects

A Heiligenhaus

Publications and source records attributed to A Heiligenhaus.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Additive retrobulbar anesthesia in surgery of retinal detachment with general anesthesia. Reduced postoperative pain and stress response].

BACKGROUND: It has recently been shown that the pain occurring after retinal detachment surgery can be reduced by combined general and retrobulbar anesthesia. This study investigated the effect of retrobulbar anesthesia on the intra- and postoperative stress response and on postoperative pain, vigilance, nausea and vomiting. PATIENTS AND METHODS: In this prospective randomized study, 45 patients were enrolled where scleral buckling surgery for retinal detachment had been performed under general anesthesia. Bupivacain 0.5% (4 ml) was injected retrobulbarly in group I (n = 15) before surgery (preoperative) and in group II (n = 15) after surgery (postoperative), group III did not receive retrobulbar anesthesia. At different times during and after surgery, blood pressure, cortisol and glucose levels, time in the recovery unit, vigilance score, nausea and vomiting were measured and the pain score was determined. The dosages of intraoperative opioid analgetics and of postoperative pain medication were documented. RESULTS: Retrobulbar anesthesia reduces postoperative pain. Intra- and postoperative endogenous stress responses in groups I and II were reduced and the plasma levels of cortisol and glucose in group I were lower than in group II. In group I, nausea, dosages of intraoperative opioid analgetics and postoperative pain medication were reduced, the vigilance was increased and time in the recovery unit was shortened. CONCLUSIONS: The data show that combined local and general anesthesia has several advantages over general anesthesia alone, especially when the retrobulbar injection is given before retinal detachment surgery.

Aged↗
PubMed2001

Incidence and severity of herpetic stromal keratitis: impaired by the depletion of lymph node macrophages.

HSV-1 induced stromal keratitis (HSK) is an immune-mediated disease. The role of macrophages in this process is still unclear. In this study we investigated the influence of specific macrophage depletion from the spleen and the submandibular lymph nodes by dichloromethylene diphosphonate liposomes (Cl(2)MDP-LIP) on the course of HSV-1 keratitis. BALB/c mice were infected corneally with 10(5)PFU of HSV-1 (KOS). Groups of mice received Cl(2)MDP-LIP 7 and 2 days prior to infection. Cl(2)MDP-LIP were given by various routes: intravenously (i.v.) for macrophage depletion in the spleen; subcutaneously for macrophage depletion in the submandibular regional lymph node (s.c.); or both i.v. and s.c. The development of HSV-1 keratitis was evaluated clinically and histologically. A standard plaque assay from the infected eyes was used to measure virus clearance. Seventy-nine percent of the HSV-1-infected control mice (n = 14) developed severe stromal keratitis by day 14 p.i. The development of stromal keratitis was inhibited by Cl(2)MDP-LIP given s.c. (64%;n = 14;P < 0.05), i.v. and s.c. (50%;n = 14;P < 0.05), but not by i.v. treatment alone (77%;n = 13). After s.c., i.v. and s.c. Cl(2)MDP-LIP injection, histologically the corneal stroma had a decrease in inflammatory cell infiltration by day 14 p.i. compared to the control group, and the DTH response was reduced. The healing of epithelial HSV-1 keratitis and the virus clearance were not affected significantly. These results indicate an important function of macrophages in the course of HSV-1 keratitis. Virus replication in the eye does not appear to be affected by monocytes/macrophages of lymph nodes and spleen. In contrast, the immunopathological process of stromal HSV-keratitis that results in corneal destruction is profoundly accelerated by macrophages in the lymph nodes.

Animals↗
PubMed2001

Improvement of HSV-1 necrotizing keratitis with amniotic membrane transplantation.

PURPOSE: Stromal herpes simplex virus keratitis (HSK) is an immune-mediated disease. Previous studies have indicated that T cells, neutrophils, and macrophages contribute to the tissue damage in HSK. It has been shown that human amniotic membrane promotes epithelial wound healing and has diverse anti-inflammatory effects. In this study, the effect of amniotic membrane transplantation (AMT) on corneal wound healing and on inflammation in mice with necrotizing HSK was examined. METHODS: BALB/c mice were corneally infected with 10(5) plaque-forming units (PFU) of HSV-1 (KOS strain). In 16 mice that exhibited severe ulcerating HSK, the cornea was covered with a preserved human amniotic membrane as a patch. Corneas in 16 infected mice remained uncovered and served as a control. On days 2 and 7 after surgery, the amniotic membrane was removed (eight mice in each group), the HSV-1-infected cornea was evaluated clinically, and the eye was enucleated. Tissue sections were analyzed histologically for epithelialization and cellular infiltration and immunohistochemically with anti-CD3 mAb to T cells, anti-CD11b mAb to both macrophages and neutrophils, or anti-F4/80 mAb to macrophages. RESULTS: Profound regression of corneal inflammation and rapid closure of epithelial defects were observed clinically within 2 days in the amniotic membrane-covered eyes, whereas HSV-1 keratitis and ulceration progressed in all mice in the control group (P < 0.001). Histologically, corneal edema and inflammatory infiltration, and immunohistochemically the number of CD3(+), CD11b(+), and F4/80(+) cells in the cornea were markedly decreased at 2 and 7 days after amniotic membrane application, compared with the uncovered control corneas (P < 0.001). CONCLUSIONS: AMT promotes rapid epithelialization and reduces stromal inflammation and ulceration in HSV-1 keratitis. AMT in mice with HSV necrotizing stromal keratitis appears to be a useful model for investigating the effect and the action mechanism of human amniotic membrane.

Amnion↗
PubMed2000

[Adhesive properties of basal membranes of Bruch's membrane. Immunohistochemical studies of age-dependent changes in adhesive molecules and lipid deposits].

BACKGROUND: In addition to deposition of debris between the plasma and basal membrane of the RPE, different types of early and late AMD-like drusen, choroidal neovascularization and pigment epithelial detachments are characterized by splitting of Bruch's membrane between the basement membrane of the RPE and the inner collagenous layer. Because these layers are normally attached by adhesion molecules, the possible age-related regression of these adhesion molecules in this structure was examined. METHODS: The presence of the adhesion molecules laminin, fibronectin, collagen IV and of lipid deposits was examined in 44 macular specimen (age 4-88 years). RESULTS: Age-related regression of the adhesion molecules laminin, fibronectin and collagen IV was observed in the basement membrane of the RPE and the endothelium cells of the choriocapillaris. This effect correlated with an increase in lipid deposits. CONCLUSION: The regression of adhesion molecules, especially in the basement membrane of the RPE in association with increased lipid deposits in Bruch's membrane, may explain the development of a "cleavage edge" for the splitting of Bruch's membrane between the basement membrane of the RPE and the inner collagenous layer.

Adolescent↗
PubMed2000

Amniotic membrane transplantation for acute chemical or thermal burns.

PURPOSE: To determine whether preserved human amniotic membrane (AM) can be used to treat ocular burns in the acute stage. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Thirteen eyes from 11 patients with acute burns, 10 eyes with chemical burns and 3 with thermal burns of grades II-III (7 eyes) and grade IV (6 eyes), treated at 7 different facilities. METHODS: Patients received amniotic membrane transplantation (AMT) within 2 weeks after the injury. MAIN OUTCOME MEASURES: Integrity of ocular surface epithelium and visual acuity during 9 months of follow-up. RESULTS: Ten patients were male and one patient was female; most were young (38.2 +/- 10.6 years). For a follow-up of 8.8 + 4.7 months, 11 of 13 eyes (84.63%) showed epithelialization within 2 to 5 weeks (23.7 +/- 9.8 days), and final visual acuity improved > or = 6 lines (6 eyes), 4 to 5 lines (2 eyes), and 1 to 3 lines (2 eyes); only one eye experienced a symblepharon. Eyes with burns of grade II to III showed more visual improvement (7.3 +/- 3 lines) than those with burns of grade IV (2.3 +/- 3.0 lines; P < 0.05, unpaired t test). In the group with grade II or III burns, none had limbal stem cell deficiency. All eyes in the group with grade IV burns did experience limbal stem cell deficiency. CONCLUSIONS: Amniotic membrane transplantation is effective in promoting re-epithelialization and reducing inflammation, thus preventing scarring sequelae in the late stage. In mild to moderate burns, AMT alone rapidly restores both corneal and conjunctival surfaces. In severe burns, however, it restores the conjunctival ocular surface without debilitating symblepharon and reduces limbal stromal inflammation, but does not prevent limbal stem cell deficiency, which requires further limbal stem cell transplantation. These results underscore the importance of immediate intervention in the acute stage of eyes with severely damaged ocular surface. Further prospective randomized studies including a control group are required to determine the effectiveness of AMT in acute chemical and thermal burns of the eye.

Acids↗
PubMed2000

[Apoptosis in human non-necrotizing stromal herpes simplex keratitis].

BACKGROUND: Herpes simplex virus (HSV-1) stromal keratitis is an immune-mediated disease. Recently, it has been shown that infection of cells with HSV-1 induces apoptosis. In this study we investigated the presence of apoptotic cell death in keratectomy specimens from patients with HSV-1 stromal keratitis. PATIENTS AND METHODS: Keratectomy specimens from six patients with HSV-1 non-necrotizing stromal keratitis were chosen and compared to healthy corneas. Paraffin sections were analyzed histologically and cryosections were studied by the immunoperoxidase technique for the presence of HSV-1, Fas and FasLigand (FasL) antigens. Apoptosis was assessed by TUNEL assay (TdT-mediated dUTP nick-end labeling). RESULTS: In healthy corneas, Fas was detected in the epithelium, keratocytes and endothelium; FasL was present in the epithelium and endothelium; TUNEL-positive cells were only found in the superficial epithelial cells. In contrast, inflammatory cells and scars were found in all HSV-diseased corneas; HSV-1 antigen was detected in only one specimen. Cells within inflammatory infiltrations and epithelium were apoptotic. Fas was detected in all corneal cell layers and inflammatory cells. FasL was restricted to areas of inflammation. CONCLUSIONS: The data suggest that apoptosis plays a role in the pathogenesis of HSV keratitis. The Fas-FasL system appears to be involved in the induction of apoptosis. Apoptosis could be involved in the depletion of inflammatory cells in the cornea and may limit the extension of viral replication to the eye.

Antigens, Viral, Tumor↗
PubMed2000

Expression of the cell adhesion molecules ICAM-1, VCAM-1 and NCAM in uveal melanoma: a clinicopathological study.

To investigate the relationship between the expression of the cell adhesion molecules intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and neural cell adhesion molecule (NCAM) in uveal melanoma and the metastatic spread in the first 5 years after diagnosis, we performed a hospital-based case-control study with human tissue from 90 patients who underwent enucleation for primary uveal melanoma (iris melanoma excluded). Thirty-five patients developed metastasis within the first 5 years, and 55 patients lived metastasis-free for at least 5 years after enucleation. The paraffin-embedded and formalin-fixed globes were studied by immunohistochemistry with monoclonal antibodies for ICAM-1, VCAM-1 and NCAM. A strong ICAM-1 positivity (more than 75% of the tumor cells stained positive) was detected in 73 tumors (81%). The expression of 75% or less ICAM-1 positive cells in tumors was strongly associated with the development of metastases (odds ratio: 7.5, p = 0.001). Multiple logistic regression models showed that ICAM-1 is an independent risk factor for metastasis even after control for important prognostic markers like extraocular growth, ciliary body involvement, scleral infiltration and cell type. VCAM-1 was expressed in 24 out of 88 tumors (27.3%) and NCAM only in 14 out of 87 tumors (16%). Only spindle cells stained positive with anti-NCAM. NCAM and VCAM-1 expression was not related to metastasis. Our results show that the loss of ICAM-1 expression is associated with an increased risk of metastasis within the first 5 years after diagnosis.

Adult↗
PubMed2000

Macrophage-depletion influences the course of murine HSV-1 keratitis.

PURPOSE: Herpes simplex virus type 1 infection of the cornea induces an immune-mediated disease termed "herpes stromal keratitis" (HSK) that is a major cause of blindness. In this study we investigated the influence of macrophage depletion by Cl(2) MDP encapsulated in liposomes (Cl(2) MDP-LIP) on the course of HSV-1 keratitis. METHODS: The corneas of BALB/c mice were infected with 10(5) PFU of HSV-1 (KOS strain). Mice groups received sub-conjunctival PBS or Cl( 2) MDP-LIP injections 7 and 2 days prior to infection. The eyes were studied clinically, histologically and immunohistochemically with F4/80 antibody at various time points after treatment. Clearance of the virus from the HSV-infected eyes was measured with a standard plaque assay. RESULTS: After subconjunctival Cl(2) MDP-LIP treatment, the HSV-1-induced epithelial keratitis was more severe (P < 0.05). The virus titers were significantly higher after macrophage depletion (day 7, P < 0.005). Stromal keratitis developed in 78.6% of HSV-1 infected PBS treated control mice ( n = 14) by day 14 after infection. By subconjunctival Cl(2) MDP-LIP treatment (n = 14) the incidence of stromal keratitis was reduced to 42.9%, and the keratitis was less severe (P < 0.05). CONCLUSIONS: The data demonstrate an influence of macrophages on the course of HSV-1 keratitis in mice. Macrophage depletion influence the viral replication in the cornea and the immune-mediated process of HSK.

Animals↗
PubMed1999

CD4+ T-cell type 1 and type 2 cytokines in the HSV-1 infected cornea.

PURPOSE: It has been previously shown that CD4+ T-lymphocytes are critical mediators in HSV-1 stromal keratitis (HSK). CD4+ T cell subpopulations (type 1, type 2) can be defined by their capabilities of producing different sets of cytokines. This study was performed to determine the role of type 1 and type 2 cytokines in murine HSK. METHODS: BALB/c mice (n = 20) were inoculated with 10(5) PFU of HSV-1 (KOS strain) and were followed clinically. At various time points post-infection (p.i.), the conjunctival and corneal tissues were analyzed histologically (n = 2 each time point), and immunohistochemically (n = 5 each time point) for the presence of interleukin-1alpha (IL-1alpha), type 1 cytokines (IL-2, interferon-gamma) and a type 2 cytokine (IL-4). The expression of cytokine mRNA was tested in eye samples by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Stromal keratitis clinically progressed after day 9. In 15% of the mice, disease regressed until day 14 p.i. Polymorphonuclear neutrophils, lymphocytes and other mononuclear cells infiltrated the conjunctiva by day 2 and rapidly expanded to the central cornea between days 7 and 14. IL-1alpha, IFN-gamma and IL-2 mRNA were found in the eyes at days 1 and 2 p.i. IL-1alpha protein was detected in the conjunctiva, limbus and corneal epithelium at day 2. The IL-1alpha staining intensities increased with disease progression. This was paralleled by IL-2 and IFN-gamma staining intensities. In contrast, IL-4 mRNA and protein were detected at days 7 through 14 after HSV-1 infection; compared to IL-2 and IFN-gamma, IL-4 staining intensities were lower. CONCLUSIONS: The findings suggest that the lymphocytic infiltrate during the development of HSV-1 keratitis is predominantly composed of type 1 cells expressing IL-2 and IFN-gamma. Type 2 cytokines participate in the late stage of inflammation and might be useful to improve the course of the disease.

Animals↗
PubMed1999

Treatment of HSV-1 stromal keratitis with topical cyclosporin A: a pilot study.

BACKGROUND: In stromal keratitis induced by herpes simplex virus (HSV) the host's immune response contributes to corneal scarring and neovascularization. The purpose of this study was to analyze the efficacy of topically applied cyclosporin A (CsA) in patients with HSV keratitis. METHODS: The authors performed a prospective pilot study in patients with HSV stromal keratitis (n = 18). Eyes were treated with CsA eyedrops and acyclovir ointment. The drugs were tapered off gradually. Visual acuity, slit-lamp appearance, intraocular pressure and corneal sensitivity were evaluated monthly (follow-up 5.2+/-0.28 months, mean +/- SEM. RESULTS: Keratitis resolved with CsA treatment in 10 of 14 patients with non-necrotizing keratitis and in 2 of 4 with necrotizing keratitis. As CsA was used topically, the corticosteroids could be withdrawn in all patients with non-necrotizing keratitis and in 1 of 3 with necrotizing keratitis. Under CsA therapy, persistent or progressive inflammation was noted in 6 of the 18 patients. These 6 patients with keratitis improved only with combined CsA/corticosteroids. Corneal ulcers healed in 4 patients with topical CsA, and corneal neovascularization improved in a further 8. Except for toxic epitheliopathy, no further CsA complications were noted. CONCLUSIONS: The findings in this pilot study suggest that HSV stromal keratitis can be treated successfully with CsA eyedrops, especially in non-necrotizing disease. CsA may be particularly helpful in the presence of steroid glaucoma, herpetic corneal ulcers, and to taper off topical corticosteroids. Additional use of acyclovir may aid in suppressing the recurrence of epithelial HSV keratitis. A randomized study should be performed to evaluate the role of topical CsA in more detail.

Acyclovir↗
PubMed1999

[Laser scanning topography and polarimetry with implantation of intraocular lenses before and after cataract surgery].

BACKGROUND: In the last years, scanning laser measurements were established in glaucoma diagnostics. Techniques of special interest are scanning laser topometry (SLT) for exact measurements of the optic disc and its cup and scanning laser polarimetry (SLP) for precise assessment of the retinal nerve fiber layer thickness. As glaucoma patients often suffer from a cataract, too, and a trabeculectomy additionally favors the advance of lens opacities, in the follow up of glaucoma patients cataract surgery is often necessary. PATIENTS AND METHODS: The influence of cataract surgery in phacotechnique with intraocular lens implantation (31 PMMA-IOLs, Pharmacia/Upjohn, model 811 B, and 25 HEMA/MMA-IOLs, Technomed, Memory Lens) on SLT and SLP was evaluated before and 3 to 4 weeks after cataract surgery in 56 eyes of otherwise healthy patients. Lens opacities were classified according to LOCS III. For SLT, we applied a TopSS, and for SLP a Nerve Fiber Analyzer II and a GDx (LDT, USA). RESULTS: Our results show that SLT and SLP are mostly performable at lens opacities with visual acuity reductions down to 0.16. In SLT, we usually found no big differences in the assessed parameters before and after cataract surgeries with IOL implantation. Standard deviations between three single measurements were mostly smaller postop. In SLP, nerve fiber layer patterns were very similar before and after cataract surgeries with IOL implantation whereas total nerve fiber layer thickness values postoperatively were slightly higher. CONCLUSIONS: Our results indicate that cataract surgeries with IOL-implantation have only mild influence on SLT and SLP. These findings seem to be of clinical interest especially in the follow up of glaucoma patients.

Aged↗
PubMed1998

Ultrasound biomicroscopy in scleritis.

OBJECTIVE: This study aimed to investigate the usefulness of ultrasound biomicroscopy (UBM) for detecting and following up scleritis and episcleritis. DESIGN: The study design was a case series. PARTICIPANTS: Patients with scleral inflammatory diseases (n = 16) were examined. INTERVENTION: Patient-reported problems and slit-lamp and UBM (50-MHz transducer) findings were compared retrospectively for signs of scleral inflammation. MAIN OUTCOME MEASURES: Thickness, reflectivity, and homogeneity of the sclera and episclera were the criteria for discriminating between the different types of scleritis with the UBM technique. RESULTS: Scleral disease was associated with Wegener disease (n = 3), Cogan disease (n = 1), Hashimoto thyroiditis (n = 1), myositis (n = 1), or panuveitis (n = 1). Initial slit-lamp evaluation showed episcleritis (n = 3), diffuse scleritis (n = 9), nodular scleritis (n = 3), or necrotizing scleritis (n = 1). By means of UBM analysis, the diagnosis of episcleritis or scleritis was in agreement with the slit-lamp findings in 2 of 3 and 6 of 13 cases, respectively. In contrast to the slit-lamp diagnosis, UBM studies excluded scleritis in one patient, disclosed necrosis in four patients with scleritis, and detected nodular scleritis patterns in two further patients with diffuse scleritis. The determination of complete remission, improvement, or progression of disease by slit-lamp and UBM evaluation was in agreement in 11 of the 14 patients examined. However, UBM was superior to slit-lamp examination with respect to detecting scleral necrosis, scleral thinning, or the nodular type of scleritis. CONCLUSIONS: The findings indicate that UBM is helpful in rapidly differentiating scleritis from severe episcleritis, detecting the diverse scleritis types with high accuracy, disclosing minimal disease progression, and judging treatment efficacy.

Adult↗
PubMed1998

[Long-term results of autologous conjunctiva-limbus transplantation in pterygium].

BACKGROUND: Conjunctiva-limbus autografting is known as a safe surgical technique for the removal of pterygia, with a low rate of recurrence. However, the long-term effect of this surgical maneuver is not clear. This study now investigates the long-term efficacy of conjunctiva-limbus autografts to prevent pterygium recurrence. METHODS: Conjunctiva-limbus transplants for primary (n = 62) or recurrent (n = 8) pterygia were reevaluated 11 to 83 months after surgery (mean: 44.97 months). Slit-lamp appearance and photomicrographs were studied with respect to the configuration of the transplant and the recurrence of the fibrovascular tissue typical of pterygia. RESULTS: Corneal pterygium recurrence has been observed in 2 cases. Fibrovascular tissue was found at the peripheral transplant-margin in 15 cases, and transplant compression towards the limbal margins were detected in further 7 patients. These conjunctival changes have not been observed during the first postoperative months. CONCLUSIONS: Conjunctiva-limbus autografts in pterygia have excellent efficacy against recurrence within the first few years. The transplant compression and fibrovascular changes within the peripheral conjuctiva seen in this study suggest that recurrencies might, however, develop on the long-term.

Adult↗
PubMed1998

Eosinophil granule proteins expressed in ocular cicatricial pemphigoid.

BACKGROUND: Blister formation and tissue damage in bullous pemphigoid have been attributed to the release of eosinophil granule proteins--namely, to eosinophil derived cationic protein (ECP) and major basic protein (MBP). In the present investigation these eosinophil granule proteins were studied in the conjunctiva of patients with ocular cicatricial pemphigoid (OCP). METHODS: Conjunctival biopsy specimens obtained from patients with subacute (n = 8) or chronic conjunctival disease (n = 13) were analysed histologically and immunohistochemically using antibodies directed against EG1 (stored and secreted ECP), EG2 (secreted ECP), MBP, CD45 (common leucocyte antigen), CD3 (pan T cell marker), and HLA-DR (class II antigen). RESULTS: Subepithelial mononuclear cells, mast cells, and neutrophils were detected in all specimens. The number of mononuclear cells, neutrophils, CD45+ cells, CD3+ cells, and the HLA-DR expression were significantly higher in the subacute than in the chronic disease group. Some eosinophils were found in specimens from five of eight patients with subacute OCP, but in none of the patients with chronic disease. The eosinophil granule proteins (ECP and MBP) were found in the epithelium and substantia propria in patients with subacute conjunctivitis. CONCLUSIONS: Subepithelial cell infiltration in the conjunctiva greatly differs between subacute and chronic ocular cicatricial pemphigoid specimens. The findings suggest that eosinophil granule proteins may participate in tissue damage in acute phase of inflammation in OCP.

Aged↗
PubMed1998

Recombinant tissue plasminogen activator in cases with fibrin formation after cataract surgery: a prospective randomised multicentre study.

AIMS: This study investigated the effect of tissue plasminogen activator (tPA) in patients with severe intracameral fibrin after extracapsular cataract extraction or phacoemulsification with posterior chamber intraocular lens implantation. METHODS: A randomised prospective multicentre study was carried out in 86 patients with intraocular fibrin formation 2-8 days after cataract surgery. While the first group (n = 41) received only anti-inflammatory drugs, a single anterior chamber injection of tPA (10 micrograms) as an additional treatment to the standard was given in the second group (n = 44). On days 1, 2, 14, and 90 after randomisation, the visual acuities, slit lamp findings, and intraocular pressures were documented in standardised protocols. Efficacy of treatment was judged by the rate of fibrinolysis (primary objective), the frequency of synechiae, and central capsular fibrosis (secondary objectives). RESULTS: The incidence and quantity of intraocular fibrin were significantly lower in the patients treated with tPA than in the control group (p < 0.05). The frequencies of synechiae were reduced by tPA injection. The capsule fibrosis noted after 3 months was significantly lower in the tPA group (p = 0.027). No ocular side effects were noted after the tPA injections. CONCLUSIONS: Lysis of postcataract fibrin formation is accelerated and increased by a single intracameral injection of 10 micrograms tPA in addition to standard anti-inflammatory treatment. The findings suggest that the tPA injection reduces posterior capsule fibrosis, which still has to be addressed in larger study populations and with a long term follow up.

Adolescent↗