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A novel approach for the fixation of enucleated eyes during microsurgical procedures using common household plumbing accessories.

The authors describe a novel approach for the fixation of enucleated eyes during microsurgical procedures using common household plumbing accessories. The device consists of a ring adaptor with 4 round-ended screws placed horizontally at its sides and a plastic hose connector. The enucleated globe is secured in the center of the ring adaptor by gently tightening the screws. The hose connector supports the posterior pole of the globe and is secured onto a styrofoam board that provides a platform for resting the surgeon's hands. The device proved very satisfactory to residents during the teaching of cataract surgery and trabeculectomy on porcine eyes. Our globe fixation device is simple, inexpensive, effective, and readily available. It may be especially useful in developing countries.

Equipment Design↗

Cytodiagnostic clues to primary retinoblastoma based on cytologic and histologic correlates of 39 enucleated eyes.

In 39 cases undergoing ocular enucleation, cytologic characteristics of primary intraocular retinoblastomas were examined in relation to histologic findings. Retinoblastoma cells occurred singly or in clusters within the associated necrotic debris. Calcific deposits were present in both cytologic and histologic specimens. Portions of capillaries with perivascular tumor infiltrates were identified as pseudorosettes. Wright rosettes were occasionally seen in poorly differentiated retinoblastomas. Flexner-Wintersteiner rosettes were uncommon; however, "mirror ball-like" clusters in cytologic materials correlated well with the rosettes and were a diagnostic clue. Cytomorphologically, the tumor cells could be divided into two types that reflected their histologic grading of differentiation. These findings are cytodiagnostic clues to the presence of retinoblastomas and can be helpful in the cytologic diagnosis.

Child↗

Changes in lactate dehydrogenase activity in bovine corneal stroma and epithelium in response to in vitro toxic challenges in the enucleated eye test.

PURPOSE: To assess whether changes in lactate dehydrogenase (LDH) activity, as a marker of cell damage, could be detected in corneal stroma and corneal epithelium after toxicity measurements using the enucleated eye test (EET). METHODS: The corneal surface of isolated bovine eyes was continuously wetted with commercial balanced salt solution (BSS) over 4 h at 37 degrees C and central corneal thickness (CCT) was measured. Initial 5-min challenges were made with dilute solutions of benzalkonium chloride (up to 0.032%) or NaOH (up to 0.4 M). The residual LDH activity in the corneal epithelium and corneal stroma were then assessed. RESULTS: Dose-dependent increases in CCT of up to 70% were measured. A strong correlation (r = -0.961) was found between increases in CCT and decreases in stromal LDH activity, but the correlation was much less (r = -0.512) for epithelial LDH activity. CONCLUSIONS: LDH activity can be used as one marker for cell integrity in the corneal stroma and epithelium, although dose-dependent correlations may not be high.

Animals↗

Influence of intraocular pressure on aqueous outflow facility in enucleated eyes of different mammals.

Freshly enucleated monkey, calf, and human eyes were quantitatively perfused with mock aqueous humor through the anterior chamber by a constant pressure technique. After baseline perfusion at 15 mm Hg, intraocular pressure was raised to 45 mm Hg and later reduced back to 15 mm Hg. Calf and human (both adult and infant) eyes had lower outflow facilities at 45 than at 15 mm Hg. However, four types of monkey eyes did not show decreased facility of outflow at elevated perfusion pressure, and after return of pressure to 15 mm Hg, facility of outflow actually increased compared to baseline, unlike both calf and human eyes. The results indicate that there are significant differences in the response of enucleated mammalian eyes to an elevation in perfusion pressure. Factors other than, or in addition to, collapse of Schlemm's canal may be important in the pathogenesis of the pressure-induced decrease in outflow facility found in human eyes.

Adult↗

Ultrasonographic determination of the dimensions of ocular components in enucleated eyes of the one-humped camel (Camelus dromedarius).

The refractive status and visual capabilities of the one-humped camel are not currently known. Schematic eyes are important tools in studying the optical characteristics and refractive status of an eye. The variables required in developing a schematic eye for a particular animal species include the dimensions of the optical components. We have employed A-scan ultrasonography to measure the dimensions of optical components in freshly enucleated eyes of the one-humped camel. Measurements were made in eyes immersed in distilled water kept at 20 degrees C. The average values of the optical components were as follows: anterior chamber depth = 5.27 mm, lens thickness = 10.93 mm, vitreous chamber depth = 14.85 mm and axial length = 31.05 mm. The uncorrected average corneal thickness was 0.76 mm. These values would have to be confirmed in live animal subjects before they can be used to design a schematic eye for the one-humped camel.

Animals↗

Fusing human rod outer segments from an eye enucleated for choroidal melanoma.

In the retina from an eye enucleated for choroidal melanoma apposed rod outer segments were seen by transmission electron microscopy to be fusing together in groups by the confluence of their plasma membranes and the formation of cytoplasmic bridges between adjacent outer segments. These fusions were seen in areas distant from the melanoma but where the retina was not normal in appearance.

Cell Membrane↗

Prolonged expression of c-Fos protein in the lateral habenular nucleus of the Japanese monkey (Macaca fuscata) after eye enucleation.

To elucidate the effect of traumatic stress on the lateral habenular nucleus, we investigated the time course of the expression of c-Fos protein in this nucleus of the Japanese monkey (Macaca fuscata) after enucleation of one eye using c-Fos protein immunocytochemistry. c-Fos protein-like immunoreactive neurons were significantly increased; the increase started 1 h after the enucleation and remained high for 3-9 h in the lateral habenular nucleus on both sides. These results suggest that the prolonged expression of c-Fos protein occurred in the lateral habenular nucleus after traumatic stress through multiple transsynaptic activations.

Animals↗

The role of crossed and uncrossed optic pathways mediating black-white discrimination in rats with one eye enucleated at birth.

It has been reported that rats with one eye enucleated at birth (OEB) are able to relearn a black-white discrimination task originally learned with both the visual cortices intact faster than rats monocularly enucleated at three months of age (OET) when relearning is made after the visual cortex contralateral to the remaining eye is destroyed. Two experiments examined the hypothesis that functional enhancement of uncrossed optic pathways produced by monocular enucleation at birth might be the sole factor to produce such a phenomenon. The results showed that faster relearning in OEBs could not be totally explained by the hypothesis, and suggest that only when (1) there is a learning effect in the visual cortex ipsilateral to the remaining eye produced by interaction of visual information through the callosal fibers with an increased amount of information through uncrossed optic pathways during original learning and (2) relearning is mediated by enhanced functioning of uncrossed optic pathways, would such phenomenon be produced.

Animals↗

A fixation device for enucleated eyes.

We have constructed an ophthalmic fixation device that stabilizes an enucleated eye, and helps both in the pathologic examination of the eye and in ophthalmic practice surgery.

Eye↗

A study of the morphology of canine eyes enucleated or eviscerated due to complications following phacoemulsification.

This study was undertaken to describe the histopathologic abnormalities observed in canine eyes enucleated or eviscerated due to complications following phacoemulsification; to correlate these findings with the clinical abnormalities reported, and to suggest, if apparent, likely causes and effects of these abnormalities. Sixty-six canine globes or evisceration samples received for histopathologic interpretation over a 10-year period (1990-2000) were studied. All globes and evisceration samples were obtained from clinical patients examined by board-certified ophthalmologists. Hematoxylin and eosin (H&E) and alcian blue/periodic acid Schiff (PAS) stained sections were examined by light microscopy in every case. A tissue Gram stain was used when indicated. Clinical information obtained from the pathology submission form was reviewed in all cases, and obtained from questionnaires completed and returned by an ophthalmologist for 51 cases (77%). The most frequent histopathologic diagnoses were glaucoma (76%) and retinal detachment (64%). The most frequently reported clinical abnormalities in this series were glaucoma (86%) and uveitis (82%). Five problem areas were identified that appear to make a significant contribution to the failure of canine cataract surgery and merit further investigation: pre-iridal fibrovascular membranes; lens fiber regrowth; lens epithelial membranes; endophthalmitis, and the health of the corneal surgical incision.

Animals↗

[Intraocular silicone oil tamponade. A clinico-pathologic study of 36 enucleated eyes].

BACKGROUND: Previous histological studies have shown that intraocular silicone oil induces irreversible changes in ocular tissues, especially the retina. The purpose of this study was to analyze, in a larger group of enucleated eyes, changes in intraocular tissue after silicone oil injection, dependent on intraocular pressure, how long the oil was in the eye, and the viscosity of intraocular silicone oil. PATIENTS AND METHODS: We did histological examinations on 36 enucleated globes with intraocular silicone oil after vitreoretinal surgery and compared them with 68 enucleated globes treated with buckle and encircling band using immunohistochemistry (n = 5) and electron microscopy (n = 7). For statistical evaluation we used the chi(2) test and analysis of variance. RESULTS: After silicone oil injection we observed a more pronounced reduction in corneal endothelial cells (58%), more frequent closed chamber angle (86%), atrophy of the ciliary body (80%) (P < 0.05), proliferative vitreoretinopathy (89%), and glaucomatous atrophy of the optic nerve (56%) (P < 0.01). The retinae showed independent of the use of silicone oil a loss of inner and outer segments of photoreceptors and of ganglion cells and thinning and rareficaton of all other retinal layers. Globes with silicone oil revealed vacuoles both free and incorporated by macrophages in all layers of the retina. Similar vacuoles were seen in the optic nerve, choroid, retinal pigment epithelium, ciliary body, iris, chamber angle and the corneal endothelium. Silicone oil vacuoles were seen in the retina and optic nerve by 1 month after surgery in two eyes with high intraocular pressure (42 mmHg). Six of eight eyes with normal intraocular pressure levels showed retinal vacuoles, 3 of them after 2 months. Vacuoles in the optic nerve were found in eight of nine eyes with intraocular instillation of 1000 mPa silicone oil. There was no clinicohistopathological correlation between the presence of vacuoles in the retina or optic nerve and the duration and viscosity of intraocular silicone oil. CONCLUSIONS: This study suggests that vacuoles in eyes with silicone oil instillation can be found in the retina after 4 weeks. The period of intraocular silicone oil should be limited to 3-6 months.

Diabetic Retinopathy↗

Displaced retinal ganglion cells in normal rats and rats with one eye enucleated at birth.

The displaced retinal ganglion cells in normal rats and rats with left eye enucleated at birth were studied using the fluorescent dye Fast blue as neuronal marker. The dye was introduced to the right optic tract of the rats 7 days before perfusion. Frozen coronal sections of the brains and retinal whole-mounts from all rats were examined under ultraviolet illumination. In the normal rat, the displaced cells constituted 0.91% and 2.07% of the entire population of cells projecting to the contralateral and ipsilateral side of the brain, respectively. While the contralaterally projecting displaced cells were widely distributed in the retina, the ipsilateral ones concentrated mainly in the temporal retinal crescent in all rats studied. However, an increase in the number of the ipsilaterally projecting displaced cells was detected in unilaterally enucleated rats as compared to that observed in normal animals.

Animals↗

Histopathologic characteristics of uveal melanomas in eyes enucleated from the Collaborative Ocular Melanoma Study. COMS report no. 6.

PURPOSE: To describe the principal histopathologic findings in a series of 1,527 globes with uveal melanoma and the relationship of these findings to each other. METHODS: All eyes enucleated in the Collaborative Ocular Melanoma Study (COMS) were examined independently by three ophthalmic pathologists and the findings recorded on a data form. A composite of findings was obtained after adjudication. RESULTS: The diagnosis was choroidal melanoma in 1,527 (99.7%) of 1,532 cases examined. Misdiagnoses were metastatic adenocarcinoma (four) and hemangioma (one). Spindle cell (9.0%), mixed cell (86.0%), and epithelioid cell (5.0%) types were observed. Medium tumors were located more posteriorly than large tumors. Considerable local invasion was seen: rupture of Bruch's membrane (87.7%), invasion of the retina (49.1%), tumor cells in the vitreous (25.2%), vortex vein invasion (8.9%), invasion of tumor vessels by tumor cells (13.8%), and invasion into emissary canals (55.0%). Overall, 81.1% demonstrated local invasion, excluding rupture of Bruch's membrane. Scleral invasion was present in 55.7% of eyes, and extrascleral extension was present in 8.2%. Mitotic activity was significantly reduced in eyes that had received preenucleation radiation treatment (P < .001). The number of macrophages in the tumor increased with increased pigmentation (P < .001) and increased necrosis (P < .01). CONCLUSION: The accuracy of diagnosis in the COMS is high, with histopathologic confirmation of the diagnosis at 99.7%. Extensive local invasion of the tumor was seen. Preenucleation irradiation significantly reduced the number of mitotic figures. An association was found regarding the presence of macrophages, the level of pigmentation, and degree of necrosis.

Adult↗

Preliminary results on phosphorus-31 nuclear magnetic resonance evaluation of human uveal melanoma in enucleated eyes.

Clinical evaluation of uveal melanomas by nuclear magnetic resonance (NMR) techniques depends on ascertaining how these tumors characteristically appear in NMR images and spectra. The authors have determined NMR characteristics of suspected uveal melanomas by phosphorus-31 (31P) NMR spectroscopy of freshly enucleated human eyes. Nuclear magnetic resonance examination was performed at 8.45 Tesla within 90 minutes after enucleation. Enucleated eyes were maintained at 4 degrees C in tissue culture medium during the 30 minutes required for transport. Nuclear magnetic resonance spectra were obtained within 10 minutes, a clinically acceptable time, using a two-turn 31P surface coil. Spectral parameters included 10-kHz spectral width, 1024 data points, and 0.5-second recycle delay. Phosphorus-31 NMR spectroscopy allowed differentiation of choroidal melanomas from normal ocular structures. Differentiating features include significant peaks in tumor spectra due to the phosphodiesters glycerol 3-phosphoryl ethanolamine (GPE) and glycerol 3-phosphorylcholine (GPC), and the phosphomonoesters phosphorylethanolamine (PE) and phosphorylcholine (PC). These preliminary data are encouraging and suggest that clinical trials at the lower magnetic field strengths available in NMR imaging systems seem feasible and warrant investigation.

Choroid Neoplasms↗

Appearance of calretinin-immunoreactive neurons in the upper layers of the rat superior colliculus after eye enucleation.

The effects of retinal deafferentation on a calcium-binding protein, calretinin, in the upper layers (superficial gray layer and optic nerve layer) of the rat superior colliculus were examined. In intact rats and on the ipsilateral side of unilaterally eye-enucleated rats, the superficial gray layer and optic nerve layer contained a few dispersed calretinin-immunoreactive cells. On the contralateral side to the enucleation, the number of immunostained cells in the superficial gray layer and optic nerve layer was increased. These findings suggest that retinal deafferentation results in an increase in contents of calretinin in some cell bodies within the upper layers of the superior colliculus.

Afferent Pathways↗

[Incidence of the pseudo-exfoliation syndrome in enucleated eyes].

A total of 455 enucleated globes were examined for a pseudoexfoliation syndrome. The typical alterations could be diagnosed most clearly from the ciliary processes. The diagnosis is frequently missed in first examinations of routine sections. Among 323 nonselected eyes with secondary glaucoma, which had to be enucleated following painful amaurosis, pseudoexfoliation syndrome was found in 3.4%. On the other hand, in 132 eyes with intraocular tumors it was found only once. Our examinations provide indications that pseudoexfoliation syndrome possibly causes an unusually high incidence of deleterious secondary changes which render enucleation necessary.

Actin Cytoskeleton↗