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PubMed · 11787748

Retinal detachment.

A S Banker·W R Freeman
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Abstract

RD is a serious and well-known complication after cataract surgery, developing in 1% to 3% of all patients undergoing cataract extraction. High myopia, disruption of the posterior capsule intraoperatively or postoperatively by Nd: YAG laser, and vitreous loss increases the risk for RD. Retinal evaluation with detailed indirect ophthalmoscopy with scleral indentation and prophylactic treatment to all lesions that contribute to retinal tear and RD is strongly advocated before cataract surgery and Nd: YAG laser capsulotomy. Intraoperative vitreous loss should be managed meticulously, and these patients should be examined more frequently in the postoperative period. During phacoemulsification, no attempts should be made to retrieve the dislocated nuclear fragments without proper vitrectomy. It is best advised that a vitreoretinal surgeon handles the complication. Early recognition and prompt treatment following the detachment can result in good visual recovery.

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Cataract ExtractionHumansMyopiaRetinal DetachmentRisk FactorsJournal ArticleReview

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A S Banker, W R Freeman. 2001. Retinal detachment.. https://doi.org/10.1016/s0896-1549(05)70268-6

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PubMed2003

Immunohistochemical and molecular genetic evidence for type IV collagen alpha5 chain abnormality in the anterior lenticonus associated with Alport syndrome.

OBJECTIVE: To present evidence for a type IV collagen alpha5 chain (alpha5[IV]) abnormality in the anterior lens capsule of a patient with anterior lenticonus associated with Alport syndrome. METHODS: The anterior lens capsule obtained from a 54-year-old man with anterior lenticonus associated with Alport syndrome was examined ultrastructurally and stained immunohistochemically for the alpha chains of type IV collagen, alpha1(IV) to alpha6(IV). A search was also made for a mutation in the COL4A5 complementary DNA encoding the alpha5(IV) chain by reverse transcription-polymerase chain reaction of illegitimate transcripts. RESULTS: The anterior lens capsule of the patient was much thinner than that of normal subjects and lacked the alpha3(IV) to alpha6(IV) chains immunohistochemically, while control specimens stained positively for all of the alpha(IV) chains. The patient had a C-to-T transition at nucleotide 5231 causing a nonsense mutation, R1677X, in the COL4A5 complementary DNA. CONCLUSION: Our findings demonstrated that normal anterior lens capsules express all of the alpha(IV) chains and that a patient with anterior lenticonus associated with Alport syndrome had a mutation in the COL4A5 gene resulting in the lack of immunoreactivity to alpha3(IV) to alpha6(IV) chains in the anterior lens capsule. Clinical Relevance This study showed abnormal composition of alpha(IV) chains in the anterior lens capsule of a patient with anterior lenticonus caused by a nonsense mutation in the COL4A5 gene. Further investigation of the phenotype-genotype relationship will provide a better understanding of the molecular pathogenesis of anterior lenticonus.

Cataract Extraction↗