(2014). Heavy metal analysis in lens and aqueous humor of cataract patients by total reflection X-ray fluorescence spectrometry . Powder Diffraction, 29, pp 155-158. doi:10.1017/ S0885715614000281. Heavy Metal Analysis In Lens And Aqueous Humor Of Cataract Patients By Total Reflection X-Ray Fluorescence SpectrometryMartina Schmeling, Bruce I. Gaynes, And Susanne Tidow-Kebritchi The human eye is continuously exposed to the environment yet little is known about how much of toxins, specifically heavy metals are present in its different parts and how they influence vision and acuity. To shed light into this subject, aqueous humor and lens samples were collected from 14 cataract patients to study the presence and concentration of selected metals in the eye. Subjects undergoing routine cataract surgery were consecutively enrolled for study by simple random sampling. Prior to surgery, subject demographic were compiled. The surgical procedure involved small incision cataract removal using phacoemulsification. During the procedure, a small aliquot of aqueous humor was retained for analysis, whereas homogenized lens fragments were obtained during phacoemulsification. A balanced salt solution was used as control for each set of samples. Both ocular specimens were analyzed by total reflection X-ray fluorescence spectrometry after dilution and addition of an internal standard. The data obtained show substantial variations in elemental signature between the two media (aqueous humor and lens) and the patients themselves. Most commonly found heavy metals in both types of media were chromium and manganese. Barium was found in the lens, but not in aqueous tissue, whereas nickel was found only in the aqueous humor. Concentrations were generally higher in aqueous samples. Further study and increased sample size are required to more accurately elucidate the relationship between systemic and ocular metal accumulation and the impact of metal accumulation on measures of visual function and ocular disease.

Anterior ischemic optic neuropathy (AION) is a well-described cause of visual loss in patients who have undergone cardiac surgery with cardiopulmonary bypass. The etiology of AION following cardiac surgery with cardiopulmonary bypass is believed to be multifactorial. Microembolisation and pump-related platelet dysfunction have been considered risk factors for the development of AION following cardiac surgery with cardiopulmonary bypass. Currently, 10-15% of cardiac procedures are performed without cardiopulmonary bypass to reduce morbidity. To the best of our knowledge, this is the second report of a patient who underwent off-pump cardiac surgery and developed an AION postoperatively. The patient's potential risk factors were severe anemia, new onset of atrial fibrillation with rapid ventricular rate, hypotension postoperatively, a small optic disc, uncontrolled diabetes mellitus and a past medical history of hypertension and coronary artery disease.

Animal, tissue culture, and human studies have evaluated the effects of fish oil supplementation in patients with rheumatoid arthritis (RA) over the last two decades. These studies have clearly shown potentially beneficial changes in cytokine and eicosanoid metabolism. The overall clinical improvement, however, has been only moderate. European clinical trials have shown significant pain reduction in patients with RA treated with vitamin E. A recent animal study in RA‐prone mice evaluated the effects of vitamin E in addition to omega‐3 and omega‐6 fatty acids on cytokine and eicosanoid production. The authors suggest that vitamin E might have an additional positive effect on autoimmune disease by decreasing proinflammatory cytokines and lipid mediators. Is this information ultimately important in terms of dietary advice for patients with RA? Are further clinical trials indicated? The following article will present a brief critical review.

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