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PubMed1983

Effects of dexamethasone and other glucocorticoid steroids on tyrosine hydroxylase activity in the superior cervical ganglion.

Dexamethasone is known to elicit an increase of tyrosine hydroxylase activity in the superior cervical ganglion. The details of such a glucocorticoid effect were investigated in the present study. Of 4 glucocorticoids (dexamethasone, corticosterone, hydrocortisone and triamcinolone) examined in rats, only the synthetic steroid dexamethasone was found to be effective in increasing ganglionic tyrosine hydroxylase activity (by 50% at 48 h after drug administration). Corticosterone even at doses as high as 50 mg/kg failed to show an effect. Since recent reports indicate that a cytoplasmic glucocorticoid receptor is not present in the sympathetic ganglion, it is unlikely that the dexamethasone effect involves a receptor-mediated mechanism. Moreover, the dexamethasone effect was totally blocked by chlorisondamine, a nicotinic cholinergic receptor antagonist. The possibility of an enhanced impulse flow from the CNS, however, was excluded by the finding that decentralization immediately prior to dexamethasone administration did not prevent the increase of ganglionic tyrosine hydroxylase activity, although earlier decentralization (24 h or longer) abolished the steroid effect. Significantly, in the freshly decentralized ganglia, the increase of tyrosine hydroxylase activity by dexamethasone was still blocked by chlorisondamine. Since synaptic activity in terminals is known to continue for a brief period following nerve transection, our data support the contention that the primary site of the dexamethasone effect may be the preganglionic terminals.

Animals↗
PubMed1994

Daily changes in presynaptic cholinergic activity of rat sympathetic superior cervical ganglion.

The in vitro capacity of sympathetic superior cervical ganglia (SCG) to take up [3H]choline from the extracellular medium, to synthesize acetylcholine from [3H]choline, and to release [3H]acetylcholine in response to a high K+ concentration, were examined in rats throughout a 24-h cycle. Both the release of [3H]acetylcholine and the synthesis of [3H]acetylcholine from [3H]choline exhibited significant diurnal variations, showing maxima during the first half of the night. After these maxima, nocturnal acetylcholine release and synthesis decayed to daytime levels and remained low until the end of the night. [3H]Choline uptake by rat SCG did not vary significantly throughout a 24-h period. A 1.5-h exposure of rats to darkness at the 5th hour of light phase of the daily photoperiod did not change significantly any parameter studied. A 20-min, 5-Hz, electrical stimulation of the preganglionic trunk of SCG excised from rats at noon increased significantly subsequent K(+)-induced [3H]acetylcholine release but did not change [3H]acetylcholine synthesis. In decentralized SCG of rats subjected to a unilateral SCG decentralization and a contralateral sham-operation 7 days earlier, [3H]acetylcholine release and synthesis were highly reduced or abolished at the decentralized side, while [3H]choline uptake remained unaltered. The present results suggest that an activation of preganglionic rat SCG neurons takes place during the first half of the scotophase.

Acetylcholine↗
PubMed1994

Cyclosporine effect on ornithine decarboxylase activity in rat submaxillary lymph nodes. Modulation by parasympathetic nerves.

This study was performed: (1) to assess whether cyclosporine affected the increase in submaxillary lymph node ornithine decarboxylase activity induced by complete Freund's adjuvant injection to rats bearing a regional parasympathetic decentralization; (2) to examine the effect of cyclosporine on cholinergic markers in submaxillary lymph nodes of rats injected with complete Freund's adjuvant or its vehicle. The unilateral parasympathetic decentralization of the submaxillary lymph nodes was achieved by unilateral chorda tympani section; each rat was also contralaterally sham-operated. A 73% decrease of choline acetyltransferase activity and a 78% decrease of neuronal [3H]choline uptake, were found in the ipsilateral side 2 weeks after surgery. Cyclosporine (5 or 20 mg/kg) or its vehicle was s.c. injected once daily for 5 days. Freund's complete adjuvant or its vehicle was injected s.c. 1 h before the 3rd injection of cyclosporine. The animals were killed 2 h after the last cyclosporine injection. Parasympathetic decentralization of the submaxillary lymph nodes was followed, 2 weeks later, by a significant inhibition of cyclosporine activity on Freund's adjuvant-induced ornithine decarboxylase. In rats injected with complete Freund's adjuvant or its vehicle, sympathetic denervation of submaxillary lymph nodes achieved by unilateral superior cervical ganglionectomy, augmented the stimulatory activity of cyclosporine on choline acetyltransferase and neuronal choline uptake. Cyclosporine treatment did not modify the total [3H]choline uptake, regardless of Freund's adjuvant injection or of intactness of the sympathetic innervation. Choline acetyltransferase and choline uptake were significantly augmented by the injection of Freund's adjuvant alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Effect of stress and cyclosporine on ornithine decarboxylase activity in rat submaxillary lymph nodes.

This study was performed: (1) to assess whether the stress produced in rats by daily turpentine oil injections for 5 days, or by restraining the animals for 30 min during 5 days, affected basal and Freund's adjuvant-stimulated submaxillary lymph node ornithine decarboxylase activity, an indicator of cell proliferation; (2) to analyze whether the activity of the immunosuppressive drug cyclosporine on submaxillary lymph node ornithine decarboxylase activation after Freund's adjuvant injection was modified in stressed rats; (3) to examine the mediation of stress effects on submaxillary lymph node ornithine decarboxylase activation by regional sympathetic or parasympathetic nerves. Animals subjected to a unilateral superior cervical ganglionectomy, or to a unilateral chorda tympani section, together with a contralateral sham-operation were employed. After turpentine oil or restraint stress, a significant decrease in submaxillary lymph node ornithine decarboxylase was found. A unilateral sympathetic denervation of submaxillary lymph nodes counteracted in part the inhibitory effect of stress on ornithine decarboxylase activation, as well as augmented the enzyme response in innervated submaxillary lymph nodes. Ornithine decarboxylase activation attained similar values in parasympathetic decentralized or intact submaxillary lymph nodes and the unilateral parasympathetic decentralization did not interfere with the inhibition of enzyme activity found in turpentine oil-stressed rats. Cyclosporine administration (5 or 20 mg/kg) significantly decreased Freund's adjuvant-induced ornithine decarboxylase activity in the submaxillary lymph nodes of control rats, but failed to modify it in turpentine oil-stressed animals. In this latter group, a higher (40 mg/kg) dose of cyclosporine decreased ornithine decarboxylase activity on the innervated side only. A diminished inhibitory response to cyclosporine was found in the parasympathetic decentralized submaxillary lymph nodes of unstressed rats. The results support the view that the immunosuppressive effects of cyclosporine may diminish during stress, in part due to changes in the traffic of neural signals in local sympathetic nerves.

Animals↗
PubMed1983

Competitive bidding and voucher payments for implementing the new federalism with special emphasis on programs for the aging.

Principles from the economics of decentralization are applied to the planning and budgeting of social services for the elderly. The standard model of corporate decentralized planning and budgeting is extended to allow different levels of government to pursue qualitatively different goals. A safety-net voucher plan is also proposed to protect the most vunerable population from possible termination of services due to poorly formulated local plans. Such a decentralized planning and budgeting system would make Federal and State influence on local plans proportional to their contribution to total expenditures.

Aged↗
PubMed1981

The spatial structure of Latin American cities.

"Using published census data, metropolitan area population and employment statistics are constructed for several large Latin American cities in 1950, 1960, and 1970, and compared to similar statistics from selected North American cities. The Latin cities are experiencing decentralization of population and some decentralization of employment. Overall population density patterns of large Latin cities resemble those in older North American cities; newer North American cities have lower densities and are much more decentralized than Latin cities. High-status groups are somewhat concentrated in the central cities of Latin American metropolitan areas, but their concentrations there are declining."

Americas↗
PubMed1994

Neural input regulates tissue NGF and growth of the adult rat urinary bladder.

To gain insight into the effect of innervation on neurotrophin production, NGF levels in the urinary bladder were measured following unilateral ganglionectomy (bladder denervation) or separation of the post-ganglionic bladder neurons from the central nervous system of the adult rat (bladder and ganglion decentralization). These interruptions of the neural input to half of the bladder caused histological evidence of smooth muscle growth, increased bladder weight (denervation-3 weeks: 98.6 +/- 6 mg; decentralization-3 weeks: 94.0 +/- 7 mg vs. control: 79.6 +/- 4 mg, P < 0.05), transient increases in tissue NGF up to 10-fold (1.99 +/- 0.65 pg NGF/bladder control vs. 20.24 +/- 0.53 (P < 0.05) denervated, ipsilateral, 1 week) and hypertrophy of the neurons in the pelvic ganglia supplying the bladder (control: 340 +/- 4.4 microns2; denervated-3 weeks: 530 +/- 6.8 microns2, P < 0.05; decentralized-3 weeks: 463 +/- 6.8 microns2, P < 0.05). These data suggest that neural input has a significant role in regulating growth of the bladder. Furthermore, the findings show that innervation influences tissue levels of NGF in the bladder.

Animals↗
PubMed1986

Maturation of opioid sensitivity of fetal mouse dorsal root ganglion neuron perikarya in organotypic cultures: regulation by spinal cord.

Opioid agonists selectively decrease the duration of the Ca2+ component of the action potential recorded from embryonic dorsal root ganglion neurons in dissociated cell cultures. In contrast, no significant alterations in the action potentials generated by adult dorsal root ganglion neurons in vivo were detected during opioid exposure. In the present study, the perikaryal opioid sensitivity of fetal mouse dorsal root ganglion neurons was analyzed during maturation in organotypic explant cultures. To determine whether spinal cord might influence this sensitivity, neuron perikarya were tested in ganglia grown: (a) in isolation; (b) attached to spinal cord explants; and (c) attached to spinal cord, but decentralized by a dorsal root transection in mature explants 1-2 weeks before the tests. After 2-8 weeks in culture, the duration of the Ba2+-enhanced Ca2+ component of intracellularly recorded action potentials was measured prior to and during bath exposure to the opioid, [D-Ala2, D-Leu5]enkephalin. Sensitive neurons were characterized by a marked, reversible reduction (averaging about 50%) in the duration of the Ca2+ component (which was antagonized by naloxone). The fraction of opioid-sensitive neuron perikarya in dorsal root ganglia grown attached to cord explants was significantly lower (48%) than in ganglia grown isolated (78%) or decentralized in vitro (79%). The mean duration of the Ca2+ component was significantly shorter in ganglion cells which had been grown attached to cord, or subsequently decentralized, compared to cells grown in isolated ganglia (by 24 and 38%, respectively). This difference was even larger in the opioid-insensitive groups. Although opioid-sensitive perikarya in ganglia grown attached to cord had a significantly longer Ba2+-enhanced Ca2+ component than that of insensitive neurons, some of the insensitive perikarya in all 3 types of explant paradigms displayed Ca2+ components which were as prolonged as those of sensitive cells. The results obtained in this study support the hypothesis that the observed decrease in the fraction of opioid-sensitive perikarya during development of fetal mouse dorsal root ganglia is due to regulation by interactions with their central target tissue, the spinal cord. The developmental decrease in the duration of the Ca2+ component of the action potential of these ganglion cells is also enhanced by the presence of the spinal cord. However, regulation of functional opiate receptors and Ca2+ component duration of the ganglion cell perikarya appear to be independent processes.

Action Potentials↗
PubMed2004

Custom-contoured ablation pattern method for the treatment of decentered laser ablations.

PURPOSE: To evaluate the custom-contoured ablation pattern (C-CAP) method as a tool for providing customized laser ablations for decentered ablations based on corneal topography data. SETTING: Department of Ophthalmology, Stanford University, Stanford, California, USA. METHODS: In a prospective noncomparative interventional case series, 8 eyes from 7 post-laser in situ keratomileusis (LASIK) patients and 1 post-photorefractive keratectomy (PRK) patient with symptomatic laser decentration were treated with the C-CAP method. The Zeiss Humphrey topography system was used to identify and analyze decentered ablations. The computer software allowed the surgeon to preoperatively model the effect of various ablation schemes on the preoperative topography until a scheme that alleviated the decentration was identified. The planned ablation parameters, which included size, depth, and location of the ablation, were programmed into the Visx S4 excimer laser before treatment. RESULTS: The mean follow-up after C-CAP ablation was 4.2 months (range 1.8 to 6.3 months). At the last postoperative examination, no eye lost a line of best spectacle-corrected visual acuity (BSCVA). The uncorrected visual acuity (UCVA) improved by 3 lines in 1 eye (12.5%), by 2 lines in 1 eye (12.5%), and by 1 line in 3 eyes (37.5%); it remained unchanged in 2 eyes (25.0%) and decreased by 1 line in 1 eye (12.5%). The BSCVA improved by 3 lines in 1 eye (12.5%), by 2 lines in 2 eyes (25.0%), and by 1 line in 3 eyes (37.5%); it remained unchanged in 2 eyes (25.0%). In all eyes, including those without improvement in UCVA or BSCVA, a significant improvement in centration and subjective complaints was achieved. The pre-C-CAP and post-C-CAP root-mean-square (RMS) wavefront data were available in 5 of 8 eyes. The total and higher-order RMS aberrations decreased by 41.7% (P =.0027) and 45.5% (P =.039), respectively, after C-CAP treatment. CONCLUSIONS: Early U.S. results show the topography-driven C-CAP method is an effective tool to address untreatable postsurgical decentration. This method is presented as a technique to enhance the overall quality of vision, reduce patient-perceived visual aberrations, regularize the corneal surface, and maximize BSCVA.

Adult↗
PubMed2006

Correction of hyperopia by intracorneal lenses: two-year follow-up.

PURPOSE: To assess the safety and efficacy of intracorneal lenses as a surgical alternative for the correction of hyperopia. SETTING: Al-Azhar University and El Magrabi Eye Hospital, Cairo, Egypt. METHODS: Twenty-three eyes of 21 patients who had a mean hyperopia of 4.3 diopters (D) +/- 0.71 (SD) (range +2.5 to +6.0 D) received Permavision lenses (Anamed Inc.), which are made of a highly permeable hydrogel with a water content of 78% and a refractive index close to that of corneal tissue (1.376). The Moria M2 microkeratome was used to make a 160 microm corneal flap with a diameter of +/-8.5 mm. The intracorneal lens was placed beneath the flap after minimal interface irrigation. RESULTS: Clinical examination showed mild corneal edema and a myopic shift during the first week postoperatively. In 17 eyes (73.9%), the postoperative uncorrected visual acuity was similar to the preoperative best corrected visual acuity (BCVA); 1 eye (4.3%) lost 1 line of preoperative BCVA. In 5 eyes (21.7%), various degrees of lens opacification with some degree of corneal haze were seen after uneventful follow-up. Decentration of 0.5 to 1.0 mm was seen in 2 eyes (8.6%), 1 of which had the lens explanted because of significant opacification. Induced astigmatism was evident in 1 eye (-1.5 D). A total of 16 eyes (69.6%) were within +/-0.5 D of target, and 20 eyes (86.9%) were within +/-1.0 D (87%). No flap melting or extrusion of the lens was recorded in 24 months of follow-up. Night halos and glare were reported in 3 eyes; all had a lens diameter of 5.0 mm. CONCLUSIONS: Intracorneal hydrogel lenses were tolerated relatively well by stromal tissue, providing a reasonably stable and predictable way to correct moderate hyperopia. However, induced astigmatism, stromal opacification, decentration, and night halos and glare occurred in a significant number of eyes. To ensure safety, deep flap cuts are preferred and these eyes should be watched carefully to avoid decentration of the lens in the early postoperative period.

Adult↗
PubMed2006

Aberrations induced in wavefront-guided laser refractive surgery due to shifts between natural and dilated pupil center locations.

PURPOSE: To determine the aberrations induced in wavefront-guided laser refractive surgery due to shifts in pupil center location from when aberrations are measured preoperatively (over a dilated pupil) to when they are corrected surgically (over a natural pupil). SETTING: Center for Visual Science and Department of Ophthalmology, University of Rochester, Rochester, New York, USA. METHODS: Shifts in pupil center were measured between dilated phenylephrine hydrochloride (Neo-Synephrine [2.5%]) and nonpharmacological mesopic conditions in 65 myopic eyes treated with wavefront-guided laser in situ keratomileusis (Technolas 217z, Bausch & Lomb). Each patient's preoperative and 6-month postoperative wave aberrations were measured over the dilated pupil. Aberrations theoretically induced by decentration of a wavefront-guided ablation were calculated and compared with those measured 6 months postoperatively (6.0 mm pupil). RESULTS: The mean magnitude of pupil center shift was 0.29 mm +/- 0.141 (SD) and usually occurred in the inferonasal direction as the pupil dilated. Depending on the magnitude of shift, the fraction of the higher-order postoperative root-mean-square wavefront error that could be due theoretically to pupil center decentrations was highly variable (mean 0.26 +/- 0.20 mm). There was little correlation between the calculated and 6-month postoperative wavefronts, most likely because pupil center decentrations are only 1 of several potential sources of postoperative aberrations. CONCLUSIONS: Measuring aberrations over a Neo-Synephrine-dilated pupil and treating them over an undilated pupil typically resulted in a shift of the wavefront-guided ablation in the superotemporal direction and an induction of higher-order aberrations. Methods referencing the aberration measurement and treatment with respect to a fixed feature on the eye will reduce the potential for inducing aberrations due to shifts in pupil center.

Adult↗
PubMed2006

Scheimpflug measurement of intraocular lens position after piggyback implantation of foldable intraocular lenses in eyes with high hyperopia.

PURPOSE: To investigate the position of 3-piece foldable intraocular lenses (IOLs) after piggyback implantation for high hyperopia. SETTING: University Eye Hospital, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. METHODS: Eight eyes of 5 highly hyperopic patients had phacoemulsification and implantation of 2 foldable IOLs. In 3 eyes, both IOLs were implanted in the capsular bag. In 5 eyes, 1 IOL was placed in the capsular bag and the second IOL in the ciliary sulcus. Intraocular lens optic tilt and decentration, combined thickness of both IOLs, and anterior chamber depth (ACD) were measured postoperatively over a period of 18 months using Scheimpflug photography. RESULTS: All eyes with both IOLs in the capsular bag showed interpseudophakic opacification, with a mean increase in combined IOL thickness of 0.4 mm, a decrease in ACD of 0.3 mm, and a corresponding hyperopic shift of 4.00 diopters. Eyes in which the anterior IOL was placed in the ciliary sulcus showed no changes in refraction or combined IOL thickness. In these eyes, the anterior IOL had a higher mean decentration (0.49 mm +/- 0.20 [SD] after 12 months) than the posterior IOL (0.21 +/- 0.13 mm after 12 months). CONCLUSIONS: Piggyback IOL implantation with placement of 2 foldable IOLs in the capsular bag can be followed by a hyperopic shift that may be caused in part by displacement of the IOLs. Placement of the anterior IOL in the ciliary sulcus can lead to higher decentration of this IOL.

Adult↗
PubMed2006

Prospective intrapatient comparison of 6.0-millimeter optic single-piece and 3-piece hydrophobic acrylic foldable intraocular lenses.

PURPOSE: To compare postoperative performance and stability of 6.0-mm optic single- and 3-piece acrylic foldable intraocular lenses (IOLs). DESIGN: Prospective, randomized, self-controlled trial. PARTICIPANTS: Eighty eyes of 40 patients with bilateral senile cataracts. INTERVENTION: Phacoemulsification and IOL implantation were performed. One eye of a patient was randomly assigned to the SA60AT single-piece IOL, and the contralateral eye was allocated to the MA60AC 3-piece IOL. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), spherical equivalent, aqueous flare intensity, anterior chamber depth, amount of IOL decentration and tilt, area of anterior capsule opening, and degree of posterior capsule opacification (PCO) were measured 2 days, 1 week, and 1, 3, 6, and 12 months after surgery. Specular microscopy was performed at 12 months postoperatively. RESULTS: In the SA60AT group, the anterior chamber depth did not show significant changes after surgery (P>0.05; paired t test), and the refraction remained highly stable throughout the 1-year study period. The MA60AC group showed significant shallowing of the anterior chamber (P<0.05) and a myopic shift (P<0.05) up to 1 month after surgery. There were no significant differences between the 2 groups (P>0.05) in BCVA, aqueous flare intensity, the amount of IOL decentration, IOL tilt, area of anterior capsule opening, and degree of PCO throughout the 12-month follow-up period. CONCLUSIONS: Both the SA60AT single-piece and MA60AC 3-piece lenses showed a minimum amount of decentration, tilt, anterior capsule contraction, and PCO. Although the MA60AC showed significant forward shift and myopic refractive changes after surgery, the SA60AT displayed little axial movement associated with highly stable refraction after surgery. This feature of the SA60AT should facilitate earlier spectacle prescription and quicker visual/social rehabilitation of patients after cataract surgery.

Acrylic Resins↗
PubMed2006

Optical models for human myopic eyes.

Data from the author's investigations and other studies are used to construct refractive dependent models. These models include a gradient index lens and aspheric corneal, lens and retinal surfaces. Elements that alter with refraction are anterior corneal radius, vitreous length and retinal shape (vertex radius of curvature and asphericity) and decentration. Two versions of the models are produced, one with centred and symmetrical optical elements, and one with tilts of the lens and decentrations and tilts of the retina. The centred model predicts increase in spherical aberration in myopia. It predicts the relative change in mean sphere in the periphery between the horizontal and vertical meridians that has been observed in a recent experimental study. It overestimates peripheral astigmatism by about 50%. The decentred version has limited success in predicting changes in peripheral refraction of average eyes.

Adolescent↗
PubMed1997

Retreatment of decentered excimer photorefractive keratectomy ablations.

PURPOSE: To present two cases of excimer photorefractive keratectomy decentration associated with visual distortion secondary to irregular astigmatism. METHOD: Patients were retreated with a repeat photorefractive keratectomy using a technique whereby the circle of adherent epithelium overlying the decentered ablation served as a mask. RESULTS: After retreatment, there was significant improvement in the patients' visual symptoms, decreased astigmatism on refraction, and better centration on corneal topography. CONCLUSION: This method appears to offer an effective means to treat photorefractive keratectomy ablation zone decentration by improving the abnormalities introduced by the initial decentration.

Adult↗
PubMed1997

Diurnal changes in cyclosporine effect on ornithine decarboxylase and noradrenergic and cholinergic activities in submaxillary lymph nodes.

Diurnal changes in cyclosporine efficacy to affect ornithine decarboxylase activity, [3H]norepinephrine uptake and [3H]choline conversion into [3H]acetylcholine were examined in rat submaxillary lymph nodes. Cyclosporine (5 or 20 mg/kg) caused a dose-dependent decrease in lymph node ornithine decarboxylase, being active at 5 or 20 mg/kg in Freund's adjuvant-treated rats, and at 20 mg/kg in rats treated with the adjuvant's vehicle. In immunized rats the lower cyclosporine dose was ineffective when injected during the night. Cyclosporine increased lymph node [3H]norepinephrine uptake dose dependently, with significant differences between the 20 mg/kg dose and controls in vehicle-treated rats and between 5 or 20 mg/kg and controls in Freund's adjuvant-treated rats. In immunized rats, 5 mg/kg cyclosporine increased [3H]norepinephrine uptake when injected at 13:00 or 17:00 h. Both doses of cyclosporine augmented lymph node synthesis of [3H]acetylcholine to a similar extent. In immunized and non-immunized rats cyclosporine suppressed the diurnal rhythm of lymph node adrenergic and cholinergic activity found in controls. After unilateral sympathetic denervation (by superior cervical ganglionectomy) and/or unilateral parasympathetic decentralization (by chorda tympani section), cyclosporine (5 mg/kg) decreased Freund's adjuvant-induced activation of lymph node ornithine decarboxylase when injected at 17:00 or 01:00 h. On the sham-operated side, cyclosporine was effective when injected at 17:00 h only. Decentralization, or a combined ganglionectomy plus decentralization, decreased lymph node ornithine decarboxylase activity. The results active regulation of the effects of cyclosporine in submaxillary lymph nodes by local autonomic nerves.

Animals↗
PubMedDate not supplied

Comparison of two procedures: photorefractive keratectomy versus laser in situ keratomileusis for low to moderate myopia.

PURPOSE: A prospective study was conducted to compare the effectiveness, safety, and stability of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for correction of low to moderate myopia. METHODS: Forty-five patients with a manifest refraction (PRK, -4.54 +/- 0.80; LASIK, -4.82 +/- 1.10) from -1.50 to -6.00 diopters (D) were treated and followed-up for 6 months. In each case, 1 eye received PRK and the other LASIK. The first eye treated, and the surgical method used in the first eye, were randomized. Uncorrected and corrected visual acuity, manifest refraction, corneal haze, and topographic analysis of ablation decentration were examined. RESULTS: The uncorrected visual acuity was 20/20 or better in 35 PRK eyes (77.8%) and 28 LASIK eyes (62.2%) at 6 months (P =.107). At 6 months, 28 eyes (62.2%) that received PRK showed a spherical equivalent of within +/-0.5 D as compared with 24 eyes (53.4%) that received LASIK (P =.393). The amount of ablation decentration was 0.37 +/- 0.25 mm in PRK eyes and 0.49 +/- 0.38 mm in LASIK eyes at 3 months (P =.36). CONCLUSIONS: In our study, PRK and LASIK were found to be similarly effective and predictive of correction in low to moderate myopia. PRK has the advantage of less ablation decentration and is safer than LASIK, so we recommend PRK for eyes with low to moderate myopia.

Cornea↗
PubMed2001

Anterior capsule opacification: correlation of pathologic findings with clinical sequelae.

OBJECTIVE: To evaluate the degree of anterior capsule opacification (ACO) in human eyes obtained postmortem containing various rigid and foldable posterior chamber intraocular lens (PC-IOL) designs and compare the findings with clinical sequelae of capsular shrinkage. DESIGN: Comparative autopsy tissue study with clinicopathologic correlations. MATERIALS: Three hundred formalin-fixed human eyes containing the following PC-IOL styles were analyzed: (1) one-piece polymethyl methacrylate (PMMA) optic-PMMA haptic (n = 50), one-piece silicone-plate IOL, with large (2) or small (3) fixation holes (n = 35), (4) three-piece PMMA optic-Prolene haptic (n = 50), (5) three-piece acrylic optic-PMMA haptic (n = 55), three-piece silicone optic with PMMA (6) or polyimide (7) haptics (n = 30), and (8) three-piece silicone optic-Prolene haptic (n = 80) lenses. TESTING: The eyes were sectioned in the equatorial plane for gross examination of the capsular bag from a posterior view. The cornea and iris were then excised for evaluation from an anterior view. MAIN OUTCOME MEASURES: ACO was scored in each eye from 0 to IV, according to the degree/area of capsule opacification. Capsulorrhexis size and IOL decentration were measured with calipers. RESULTS: The overall differences among the IOL groups regarding the three parameters were significant (ACO score: P < 0.001; capsulorrhexis diameter: P = 0.036; IOL decentration: P = 0.012). Mean ACO scores were highest with the large- and small-hole one-piece silicone-plate lenses (2.543 +/- 0.950) and lowest with the three-piece acrylic optic-PMMA haptic lenses (0.600 +/- 0.710). Of 10 cases of capsulorrhexis phimosis observed in the study, 7 cases were associated with three-piece silicone optic-Prolene haptic lenses, which also presented the highest mean decentration (0.375 +/- 0.601 mm). CONCLUSIONS: Our results confirm previous histopathologic observations that the rate of ACO is the lowest with acrylic lenses and higher with plate-haptic silicone IOLs. Nevertheless, clinical sequelae of capsular shrinkage are also very important with three-piece silicone optic-Prolene haptic designs. Thus, IOL material and design are significant factors in the development of ACO, but they ultimately also influence the clinical presentation of capsular shrinkage.

Acrylic Resins↗