Selective and specific targeting of lens epithelial cells during cataract surgery using sealed- capsule irrigation

Maloof, Anthony; Neilson, Geoff; Milverton, E. J.; Pandey, Suresh K

doi:10.1016/s0886-3350(03)00058-0

Cited by 65 publications

(51 citation statements)

References 6 publications

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“…A recent Cochrane review [22] of 53 studies looking at interventions for preventing PCO found that sharp-edged IOLs gave a significantly lower PCO score and YAG (yttrium aluminium garnet) laser rate than roundedged IOLs. It is conceivable that IOLs will be designed that can deliver slow release molecules to reduce inflammation (dexamethasone-coated IOL reduced post-operative inflammation in rabbit eyes) [23] or PCO rate, or devices such as the Perfect Capsule [24], irrigated with antimitotic agents such as 5-fluorouracil, will be used to prevent PCO (shown to be successful in young rabbit eyes) [25].…”

Section: Clinical Aspects Of Congenital or Paediatric Cataract (A) Comentioning

confidence: 99%

Clinical and experimental advances in congenital and paediatric cataracts

Churchill

Graw

2011

Phil. Trans. R. Soc. B

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Cataracts (opacities of the lens) are frequent in the elderly, but rare in paediatric practice. Congenital cataracts (in industrialized countries) are mainly caused by mutations affecting lens development. Much of our knowledge about the underlying mechanisms of cataractogenesis has come from the genetic analysis of affected families: there are contributions from genes coding for transcription factors (such as FoxE3, Maf, Pitx3) and structural proteins such as crystallins or connexins. In addition, there are contributions from enzymes affecting sugar pathways (particularly the galactose pathway) and from a quite unexpected area: axon guidance molecules like ephrins and their receptors. Cataractous mouse lenses can be identified easily by visual inspection, and a remarkable number of mutant lines have now been characterized. Generally, most of the mouse mutants show a similar phenotype to their human counterparts; however, there are some remarkable differences. It should be noted that many mutations affect genes that are expressed not only in the lens, but also in tissues and organs outside the eye. There is increasing evidence for pleiotropic effects of these genes, and increasing consideration that cataracts may act as early and readily detectable biomarkers for a number of systemic syndromes.

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Section: Clinical Aspects Of Congenital or Paediatric Cataract (A) Comentioning

confidence: 99%

Clinical and experimental advances in congenital and paediatric cataracts

Churchill

Graw

2011

Phil. Trans. R. Soc. B

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“…48 To be used routinely in human subjects, toxic effects on neighbouring tissues would need to be avoided and sealed capsule irrigation has been suggested for safe application of pharmaceutical agents. 138,139 In conclusion, numerous challenges need to be addressed successfully to restore accommodative function to the presbyopic eye. The ultimate goal of restoring eye focus to youthful levels is yet to be achieved and much further work is necessary before such a treatment becomes available for human use.…”

Section: Discussionmentioning

confidence: 99%

Accommodating intraocular lenses: a review of design concepts, usage and assessment methods

Sheppard

Bashir

Wolffsohn

et al. 2010

Clinical and Experimental Optometry

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The correction of presbyopia and restoration of true accommodative function to the ageing eye is the focus of much ongoing research and clinical work. A range of accommodating intraocular lenses (AIOLs) implanted during cataract surgery has been developed and they are designed to change either their position or shape in response to ciliary muscle contraction to generate an increase in dioptric power. Two main design concepts exist. First, axial shift concepts rely on anterior axial movement of one or two optics creating accommodative ability. Second, curvature change designs are designed to provide significant amplitudes of accommodation with little physical displacement. Single-optic devices have been used most widely, although the true accommodative ability provided by forward shift of the optic appears limited and recent findings indicate that alternative factors such as flexing of the optic to alter ocular aberrations may be responsible for the enhanced near vision reported in published studies. Techniques for analysing the performance of AIOLs have not been standardised and clinical studies have reported findings using a wide range of both subjective and objective methods, making it difficult to gauge the success of these implants. There is a need for longitudinal studies using objective methods to assess long-term performance of AIOLs and to determine if true accommodation is restored by the designs available. While dual-optic and curvature change IOLs are designed to provide greater amplitudes of accommodation than is possible with single-optic devices, several of these implants are in the early stages of development and require significant further work before human use is possible. A number of challenges remain and must be addressed before the ultimate goal of restoring youthful levels of accommodation to the presbyopic eye can be achieved.

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“…Cell growth was measured daily using the 3-(4,5-dimethythiazl-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)2H-tetrazolium inner salt (MTT) test. 32 …”

Section: Immunoblottingmentioning

confidence: 99%

“…Apoptosis was evaluated quantitatively by measuring phosphatidylserine externalization, an early apoptotic alteration. 32 This was performed by fluorescence staining using the annexin V-FLUO staining kit (Roche, France) as per the manufacturer's recommendations. The proportion of annexin V-stained cells was determined.…”

Section: Analysis Of Apoptosismentioning

confidence: 99%

Prevention of posterior capsule opacification by the induction of therapeutic apoptosis of residual lens cells

et al. 2005

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Posterior capsule opacification (PCO) is a common complication of cataract surgery. Using adenovirus(Ad)-mediated gene transfer, we overexpressed the proapoptotic molecules p53, procaspase 3, Bax, and TRAIL to induce therapeutic programmed cell death of residual lens cells to prevent PCO. Overexpressed TRAIL did not induce apoptosis in cultured rabbit lens cells or in human lens cells. Overexpressed p53 induced apoptosis of lens cells in vitro and ex vivo, but was unable to prevent PCO in vivo. Overexpressed procaspase 3 was associated with engagement of many components of the apoptotic pathway, including cleavage of intracellular caspase targets such as PARP and inter-nucleosome DNA fragmentation. Even when only slightly overexpressed, Bax caused apoptosis of transduced rabbit and human lens cells by engaging the mitochondrial pathway, including catalytic activation of the caspases. A single in vivo injection of Ad vectors expressing either Bax or procaspase 3 into the capsular bag at the end of phacoemulsification prevented PCO in rabbits. These experiments show that Ad-mediated Bax or procaspase 3 overexpression is capable of inducing therapeutic programmed cell death in vitro and in vivo in residual lens cells and preventing PCO in a rabbit model of PCO. Manipulation of proapoptotic molecule expression could be a novel gene therapy approach for prevention of PCO.

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Selective and specific targeting of lens epithelial cells during cataract surgery using sealed- capsule irrigation

Abstract: We describe the technique of sealed capsule irrigation, which aims to reduce posterior capsule opacification and better control lens epithelial cell activity.

Cited by 65 publications

References 6 publications

Clinical and experimental advances in congenital and paediatric cataracts

Clinical and experimental advances in congenital and paediatric cataracts

Accommodating intraocular lenses: a review of design concepts, usage and assessment methods

Prevention of posterior capsule opacification by the induction of therapeutic apoptosis of residual lens cells

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