Clear Lens Research Articles

The Effects of Blue-Light Filtering Intraocular Implants on Glare Geometry

Purpose One common complaint with natural opacified lenses is the deleterious effects of higher-order ocular aberrations and intraocular scatter, such as halos and starbursts, which are not always remedied with surgery and intraocular lens (IOL) implantation. Blue-light filtering (BLF) IOL filter scatter-prone short-wave light. Here, we determine whether BLF IOL reduce halo and starburst size. Methods This study was a case-control design, between- and within-subjects (contralateral implantation). Sixty-nine participants with either the BLF IOL (n = 25; AlconSN60AT), clear IOL (n = 24; AlconSA60AT or WF), or both (n = 20) IOL participated. Participants were exposed to a point source of broadband simulated sunlight, which created the appearance of halos/starbursts. Dysphotopsia was measured as the diameter of broadband light-induced halos and starbursts. Results A case-control analysis. Halo size was significantly larger (t[35.05] = 2.98, p = 0.005) in participants with the clear control lens (M = 3°55′ ± 2°48′), compared to the BLF IOL (M = 1°84′ ± 1°34′). Starburst size was not significantly different between groups. Contralateral analysis. Halo size was significantly smaller (t = −3.89, p = .001) in test eyes with the BLF (M = 3°16′ ± 2°35′) compared to the fellow control eyes (M = 5°42′ ± 3°17′). Starburst size was also significantly smaller (t = −2.60, p < 0.018) in BLF test eyes (M = 9°57′ ± 4°25′) than the fellow eye with the clear IOL (M = 12°33′ ± 5°25′). Conclusions BLF IOL filter short-wave light and mimic retinal screening by the young, natural crystalline lens. Such filtering can reduce some deleterious effects of bright light by decreasing ocular diffusion/halos and starbursts.

Visual Outcomes and Patient Satisfaction After Bilateral Refractive Lens Exchange with a Trifocal Intraocular Lens in Patients with Presbyopia.

Refractive lens exchange (RLE) patients represent a unique population with a different baseline and set of expectations compared to their cataract counterparts. Visual outcomes and patient satisfaction following RLE with bilateral implantation of a trifocal intraocular lens (IOL) were assessed in a cohort of patients with presbyopia and without cataract. Charts of patients with presbyopia who underwent femtosecond laser-assisted RLE with bilateral implantation of the PanOptix trifocal IOL (toric and non-toric) at a single-surgeon, private practice center from September 2019 to August 2020 were retrospectively reviewed. Eyes with prior keratorefractive surgery, amblyopia, or underlying pathology were excluded. Primary endpoints included corrected and uncorrected visual acuity at distance (CDVA and UDVA), intermediate (DCIVA and UIVA), and near (DCNVA and UNVA) at 6months. Secondary endpoints included residual refractive error, patient-reported satisfaction, spectacle independence, and visual disturbance profile as assessed by a validated questionnaire at 6months. Seventy-eight eyes of 39 patients (mean age 56 ± 6years; 79% female) were included. Most eyes were hyperopic (mean SE 2.35 ± 1.81). Postoperatively, 100% and 92% of eyes were within ± 1.00D and ± 0.50D of emmetropia, respectively. One hundred percent, 97%, and 97% of patients achieved UDVA, UNVA, and UIVA of logMAR 0.1 or better. Starbursts were the most frequent (67%) and bothersome (41%) visual disturbance cited, but nearly half (41%) of patients rated them as absent or "not bothersome at all." Overall, 77% of patients reported achieving complete spectacle independence with 87% and 90% of patients stating they were satisfied with their vision and would recommend the same procedure to others, respectively. RLE with bilateral implantation of the PanOptix IOL is a safe and effective procedure with good patient satisfaction. Because of their relatively clear native lenses and visually demanding needs compared to their cataract counterparts, surgeons should take extra precautions to counsel RLE patients on the limitations of trifocal technology.

Scharioth Macula Lens for patients with high myopia: a novel approach to achieve spectacle independence (binocular trifocal monovision).

We aimed to test a novel concept based on multiple IOL-implantation, targeting spectacle independence for patients with high and excessive myopia (26.0 mm < axial length; 6.0 D < refractive error). Therefore, we introduced the first results of five patients with high myopia. After clear lens extraction, one eye was targeted to emmetropia, and the other to mild myopia by implanting monofocal capsular bag IOLs with appropriate refractive powers in each case. The emmetropic eye was aimed to result in magnification and improved distance vision, while the mild myopic eye was supposed to ensure good intermediate vision. Thereafter, a Scharioth Macula Lens (SML) was implanted into the emmetropic eye in order to achieve sharp near vision. Visual acuity curves and defocus curves were plotted postoperatively. According to our results, this new concept seems to be an efficient approach of achieving appropriate uncorrected vision at all distances, by creating binocular trifocal monovision.

Implantable phakic contact lens exchange after seven years

Implantable phakic contact lens (IPCL) exchange or removal is commonly done in case of wrong size implantation leading to either pupillary block glaucoma or cataract, residual refractive error, recurrent uveitis, and endothelial cell loss. Usual time for phakic lens exchange is within 3–6 months after the primary procedure. In this case report, we have shown that IPCL exchange can be considered as an option even after a long period of 7 years in young, high myopic patients, where clear lens extraction and corneal refractive procedure are not recommended.

Association of clear vs blue-light filtering intraocular lenses with mental and behavioral disorders and diseases of the nervous system among patients receiving bilateral cataract surgery.

To analyze new-onset mental and behavioral disorders and nervous system diseases in patients with cataract implanted with either non-blue-light filtering (BLF) or BLF intraocular lenses (IOLs) in both eyes. Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland. A retrospective registry-based cohort study of patients operated between September 2007 and December 2018 who were followed until December 2021. We included 4986 patients who underwent bilateral cataract surgery. Patients were implanted with either non-BLF IOLs (N = 2609) or BLF IOLs (N = 2377) in both eyes. Follow-up before the first-eye surgery and between the first-eye and the second-eye surgery was performed to acknowledge the preexisting disorders and diseases. After the second-eye surgery, the groups were analyzed for the new-onset mental and behavioral disorders and diseases of the nervous system subcategorized by the International Classification of Diseases codes. 1707 male and 3279 female patients, aged 73.2 ± 8.6 years at the first-eye surgery and 74.3 ± 8.8 years at the second-eye surgery, were identified. In univariate log-rank tests, the use of BLF IOLs showed no association in overall new-onset disorders or diseases over non-BLF IOLs, in any subtype diagnosis codes except for sleep disorders, which favored BLF IOLs ( P = .003). A multivariate analysis adjusted for age and sex identified no associations in any new-onset disorders or diseases. Multivariate analysis of sleep disorders showed a nonsignificant advantage for BLF-IOLs (hazard ratio 0.756, 95% CI 0.534-1.070, P = .114). BLF IOLs were not associated with mental and behavioral disorders or diseases of the nervous system.

Objective cataract grading methods and expected contrast sensitivity reestablishment with multifocal intraocular lenses.

To determine the cut-off points for age and metrics provided by cataract grading objective systems for which a reestablishment in contrast sensitivity(CS) is expected after multifocal intraocular lens(MIOL) implantation. One hundred seven subjects were included in this retrospective analysis carried out during the screening for presbyopia and cataract surgery. Monocular distance corrected contrast sensitivity defocus curve (CSDC) and visual acuity were measured, and crystalline lens sclerosis was graded with three objective metrics: Ocular Scatter Index(OSI), Dysfunctional Lens Index(DLI) and Pentacam Nucleus Staging(PNS). A CS value of 0.8 logCS at far distance, following published literature on this matter, was selected to compute the cut-off that maximized the detection of eyes exceeding this value at the preoperative screening, either for age or objective metrics. The CDCS showed a stronger correlation than CDVA with objective grading methods, whereas all objective metrics were significantly correlated between them (p < 0.05). The cut-offs for age, OSI, DLI and PNS were ≤ 62, ≤ 1.25, ≥ 7.67 and ≤ 1, respectively. The OSI provided the highest area under the receiver operating characteristic curve (0.85) followed by the age (0.84), DLI (0.74) and PNS (0.63). Surgeons conducting clear lens exchange should communicate the possible distance CS loss after surgery with MIOL implantation according to the previous described cut-offs points. Age in combination with any cataract grading objective system is recommended to detect possible inconsistencies.

Nine Years' Follow-up of Bilateral Extremely Low Vaulting of Implantable Collamer Lens: Case Report

Purpose: To present a patient with bilateral implantable Collamer lens (ICL) implantation with extremely low vault who was followed up over 9 years and in whom no cataract was detected. Methods: A 56-year-old woman underwent uneventful bilateral ICL implantation and her postoperative ICL vaulting was 10 and 8 µm in the right and left eye, respectively. After consultation with the patient, it was decided to withhold surgical intervention and follow up closely. Results: Nine years postoperatively, the patient had normal ophthalmological examination results: uncorrected distance and near visual acuity of 20/20, normal intraocular pressure and open angle, stable ICL with low vaulting of 8 to 12 µm, clear lens with stable Objective Scatter Index scores, and normal posterior segment. Conclusions: This case report shows that even though low ICL vault is a risk factor for cataract development, withholding surgical intervention should be considered depending on the patient's age, characteristics, and compliance with close follow-up. [ Journal of Refractive Surgery Case Reports. 2023;3(1):e5–e9.]

Association between the site of clear corneal Phakic intraocular lens implantation incisions and the inflow of ocular surface fluid into the anterior chamber.

Posterior chamber phakic intraocular implantable collamer lens (ICL) implantation is an effective surgical option for the management of myopia. Over the past few years, the number of ICL surgeries has significantly increased. Postoperative inflammation and endophthalmitis are among the most serious complications after successful ICL surgery. Sometimes, when the blepharospasm is removed at the end of surgery, a small amount of the ocular surface fluid will flow into the anterior chamber, which can lead to an increased risk of infection and inflammation. However, little attention has been paid to this phenomenon. We conducted a retrospective study to compare the incidence of extraocular fluid inflow into the eye through the clear corneal incision (CCI) at two different positions (superior and temporal sides). A total of 116 patients with myopia underwent superior CCI ICL implantation (n = 58) or temporal CCI ICL implantation (n = 58) at our hospital from October to December 2021. The incidence of conjunctival sac fluid entering the anterior chamber after eyelid fixative was removed was compared in both groups. Both groups were well matched in all parameters. Ocular surface fluid inflow into the anterior chamber was significantly higher in the superior CCI group (25/58, 47.1%) than in the temporal CCI group (1/58, 1.7%) (p < 0.05). In the patients with ICL implantation, the temporal CCI was better than the superior CCI in avoiding the ocular surface fluid inflow into the anterior chamber, and the potential risk of infection and inflammation was lower.

Analysis of the Dysfunctional Lens Index as a Novel Criterion for Surgical Decision-Making in Age-Related Cataracts

ABSTRACT Background The dysfunctional lens index (DLI) provided by a ray-tracing aberrometry system is an objective index in cataract assessment. The purpose of this study is to evaluate correlations among Lens Opacities Classification System III (LOCS III) grades, Catquest 9SF scores, and the (DLI) and the DLI’s role in surgical decision-making in age-related mixed cataract. Methods This trial was registered at NIH (clinicaltrial.gov) on January 5, 2021 (NCT04711395). In this prospective cross-sectional study, age-related mixed cataract patients were recruited. One high-volume and two low-volume surgeons made surgical decisions based on corrected distance visual acuity (CDVA), LOCS III graded photographs, and Catquest 9SF scores. Their decision-making agreement was evaluated with Cohen’s kappa coefficient. Correlations among the parameters were analyzed. The optimal cut-off DLI was calculated using a receiver operating characteristic curve. Results Overall, 106 patients (106 eyes) were included. Very good agreement levels were noted among the high- and low-volume surgeons (Cohen’s kappa coefficient, 0.848) (95% CI, 0.748–0.948). The DLI had the strongest correlation with Catquest 9SF scores (R2 = 0.566), followed by with posterior subcapsular (R2 = 0.418), nuclear opalescence (R2 = 0.388), and cortical (R2 = 0.333, all P < .0001) cataract LOCS III grades. Catquest 9SF scores were correlated with cortical (R2 = 0.249), nuclear opalescence (R2 = 0.278), and posterior subcapsular (R2 = 0.235, all P < .0001) cataract LOCS III grades. A cut-off DLI of 5.36 was identified as a surgical criterion (specificity, 86.9%; sensitivity, 93.3%). Conclusions The DLI is valuable for objectively assessing patient complaints and lens opacity severity. LOCS III remains effective and economical in assessing early cortical cataracts with relatively clear central lenses. A cut-off DLI ≤5.36 could be a criterion for preoperative decision-making.

Visual Performance of a Violet-Filtering Intraocular Lens versus a Blue-Filtering Intraocular Lens of New/Old Manufacturing Processes.

This article compares the visual performance of a violet light-filtering colored lens (ZCB00V) and blue light-filtering intraocular lens (IOL; SN60WF) before and after modifying the manufacturing process for glistening suppression. In this retrospective study, conducted at Saneikai Tsukazaki Hospital, Himeji, Japan, a consecutive sample of 8943 eyes of 5119 patients were included and implanted with blue-filtering IOLs before and after modifying the manufacturing process (SN60WF-J (1318 eyes) and SN60WF-Q,A (1418 eyes), respectively), noncolored UV-cut IOLs (ZCB00 (1418 eyes)), and ZCB00V (3717 eyes). For each patient, the corrected distance visual acuity (CDVA) at 3 months postoperative (3MCDVA) and the area under log contrast sensitivity function (AULCSF) were measured. The 3MCDVA was -0.076 ± 0.1, -0.11 ± 0.13, -0.10 ± 0.17, and -0.11 ± 0.13, for SN60WF-J, SN60WF-Q,A, ZCB00, and ZCB00V, respectively. The SN60WF-J group revealed significant differences as compared to the other three groups (all p < 0.05). The mesopic AULCSF was 2.59 ± 0.20, 2.68 ± 0.19, -2.69 ± 0.18, and 2.76 ± 0.19, respectively, whereas the photopic AULSCF was 2.63 ± 0.23, 2.76 ± 0.25, -2.77 ± 0.25, and 2.88 ± 0.25. The SN60WF-J and ZCB00V groups exhibited significant differences as compared to the other three groups, whereas no significant differences were noted between the SN60WF-Q,A and the ZCB00 groups (all p < 0.05). The violet-filtering lens offers higher visual acuity and contrast sensitivity than the clear and blue-filtering lens. It was also found that the above functions were improved by modifying the manufacturing process.

A sensitive method to investigate the interaction of alpha-crystallin with cortical and nuclear lens lipid membranes derived from a single lens.

The levels of α-crystallin in eye lens cytoplasm decrease with a proportional increase in membrane-bound α-crystallin with age and cataract formation. The influence of differences in lipids composition between cortical membrane (CM) and nuclear membrane (NM) derived from a single lens on α-crystallin binding to these membranes is still unclear. This study aims to develop a sensitive electron paramagnetic resonance (EPR) spin-labeling method to investigate the binding of α-crystallin to the CM and NM derived from total lipids extracted from a single lens of a bovine. No binding of α-crystallin below the surface of CM and small binding of α-crystallin below the surface of NM was observed using cholesterol analogue spin-label (CSL) within these membranes. However, significant binding of α-crystallin on the surface of CM and NM was observed using 4-palmitamido-TEMPO (4PT) spin-label within these membranes. The percentage of membrane surface occupied and the binding affinity for NM are higher than for CM, correlating with less mobility and more order below and on the surface of NM than CM. The mobility decreases with no significant change in order and hydrophobicity below and on the surface of CM and NM with α-crystallin binding. Our results imply that α-crystallin primarily binds on the surface of bovine CM and NM, and such surface binding of α-crystallin to membranes in young and clear lenses may be helpful for membrane stability. However, α-crystallin binding increases hydrophobicity below the surface of the cortical membrane with low cholesterol (CMLC), mimicking the decreased cholesterol content in cataractous lenses, suggesting that α-crystallin binding below the surface of the CMLC forms a hydrophobic barrier for the passage of polar molecules supporting the barrier hypothesis in cataract formation.

Congenital aniridia - Hungarian data of a spectrum disease

Congenital aniridia is a rare disease, characterised by the complete or partial absence of the iris, but lesions may be present in all structures of the eye. To determine the prevalence of ocular diseases in congenital aniridia by analyzing patients from a Hungarian centre. Patients at the Department of Ophthalmology of Semmelweis University, examined between October 2005 and May 2022, have been included. After taking the patients' medical history, a detailed ophthalmological examination has been performed. Of the 82 patients in the database, 33 (age 25.69 ± 17.49 [5-59] years, 17 females [51.51%]) presented for examination and 65 eyes were examined. Nystagmus was found in 45 eyes of 23 patients (69.23%), and the patients' uncorrected distance visual acuity was 0.14 ± 0.128 (0.9 logMAR; 0.63-0.005). The aniridia-associated keratopathy was Grade 0 in 8 eyes (12.3%), Grade 1 in 10 eyes (15.38%), Grade 2 in 16 eyes (24.62%), Grade 3 in 4 eyes (6.15%) and Grade 4 in 25 eyes (38.46%). 30 eyes (46.15%) of 15 patients had secondary glaucoma, 6 eyes (9.2%) of 3 patients were glaucoma suspect. 8 eyes (12.3%) had a clear lens, 44 eyes (67.69%) had cataract, of which 22 (33.84%) were anterior cortical polar cataracts. 13 eyes (20%) were pseudophakic (PCL) and 7 eyes (10.77%) had lens dislocation or zonular insufficiency. Macular hypoplasia was found in 6 eyes of 3 patients (4.6%) and optic nerve head malformation in 2 eyes of 1 patient (3.03%). The ocular signs of congenital aniridia are aniridia-associated keratopathy, secondary glaucoma, cataract, macular and optic nerve head hypoplasia. Systematic collaboration of different ophthalmological specialties is required for the management and care of all these ocular abnormalities. Orv Hetil. 2023; 164(4): 148-155.

The effect of a short-wave filtering contact lens on color appearance

We assessed the effect of a contact lens that filters short-wavelength (SW) visible light on color appearance. These effects were modeled and measured by direct comparison to a clear contact lens. Sixty-one subjects were enrolled, and 58 completed as cohort; 31 were 18 to 39 years old (mean ± SD, 29.6 ± 5.6), 27 were 40 to 65 years old (50.1 ± 8.1). A double-masked contralateral design was used; participants randomly wore a SW-filtering contact lens on one eye and a clear control lens on the other eye. Subjects then mixed three primaries (including a short-wave primary, strongly within the absorbance of the test lens) until a perceived perfect neutral white was achieved with each eye. Color appearance was quantified using chromaticity coordinates measured with a spectral radiometer within a custom-built tricolorimeter. Color vision in natural scenes was simulated using hyperspectral images and cone fundamentals based on a standard observer. Overall, the chromaticity coordinates of matches that were set using the SW-filtering contact lens (n = 58; x = 0.345, y = 0.325, u' = 0.222, v' = 0.470) and clear contact lens (n = 58; x = 0.344, y = 0.325, u' = 0.223, v' = 0.471) were not significantly different, regardless of age group. Simulations indicated that, for natural scenes, the SW-filtering contact lens that was evaluated changes L/(L+M) and S/(L+M) chromatic contrast by no more than -1.4% to +1.1% and -36.9% to +5.0%, respectively. Tricolorimetry was used to measure color appearance in subjects wearing a SW-filtering lens in one eye and a clear lens in the other, and the results indicate that imparting a subtle tint to a contact lens, as in the SW-filtering lens that was evaluated, does not alter color appearance for younger or older subjects. A model of color vision predicted little effect of the lens on chromatic contrast for natural scenes.

Diverse presentations of ectopia lentis and lens coloboma in Marfan's syndrome.

Marfan's syndrome (MFS) is an autosomal dominant connective tissue disorder with defect in the fibrillin-1 gene. The most common ocular manifestation is subluxated lens in the superotemporal direction, accounting for 50%-85% of total cases. The association of lens coloboma with MFS has been described in literature, but the coexistence of lens coloboma with ectopia lentis is a rare feature. Here, we describe three cases of MFS including a case of bilateral lens coloboma with ectopia lentis: case 1 - a 39-year-old male with inferotemporal lens subluxation in the right eye and superotemporal lens subluxation in the left eye with open-angle glaucoma and high myopia, case 2 - a 15-year-old child with bilateral superonasal lens subluxation with lens coloboma, and case 3 - a 56-year-old female with bilateral lens coloboma. Case 1 and case 2 had clear lenses with good refractive correction; hence, they were optically rehabilitated with contact lenses, whereas case 3 was advised for cataract surgery. It is important to distinguish the lens coloboma from a more common entity, ectopia lentis as former usually remains stable while the latter might need a surgical intervention.

Luxation antérieure d’un cristallin clair post-traumatique

We here report the case of a 52-year-old patient admitted to the ophthalmic emergency department with ocular pain and redness following right ocular trauma. Ophthalmologic examination of the right eye revealed impaired near visual acuity of counting fingers, diffuse conjunctival hyperaemia, dislocation of the clear crystalline lens into the anterior chamber in front of the iris with contact with endothelial cells and ocular hypertonia 40 mmHg. Ocular ultrasound was normal. The patient received emergency medical treatment based on both local and general hypotonizing drug. Then phacoemulsification including direct surgical removal of the entire lens associated with anterior vitrectomy were performed. Postoperative outcome was marked by normalization of intraocular pressure and by the absence of optic nerve and corneal endothelial cell damage.

CHANGES IN THE VISION OF ADULT AMBLYOPIC PATIENTS FOLLOWING CLEAR LENS EXTRACTION.

The aim of the study was to retrospectively evaluate changes in vision after the implantation of trifocal (tIOL) or rotationally asymmetric multifocal artificial intraocular lenses (mIOL) in patients undergoing clear lens extraction. The main goal was to determine whether changes to central visual acuity occur after the implantation of an IOL at a follow-up examination after one year. Other objectives were to determine the difference between the groups with implanted diffractive and rotationally asymmetric artificial intraocular lenses, as well as to evaluate the risk of accurate correction in patients who had lived most of their lives "undercorrected". In our study, we present a retrospective longitudinal evaluation of results in patients after the implantation of an artificial intraocular lens. In the period from 2013 to 2020, we evaluated changes in the vision of 22 patients aged 39-59 years, of whom 18 were women and 5 were men. The average preoperative refraction of myopic eyes was +5.7 ±2.13 Dsf and +1.24 ±0.86 Dcyl. In amblyopic eyes, 7 diffractive lenses and 15 rotationally asymmetric lenses were used. Uncorrected distance visual acuity before surgery and one year (1Y) after was 0.13 ±0.09 vs. 0.57 ±0.28 (p &lt; 0.001); the best corrected distance visual acuity before and 1Y after was 0.53 ±0.22 vs. 0.62 ±0.29 (p = 0.024); uncorrected near visual acuity before and 1Y after was 0.06 ±0.06 vs. 0.48 ±0.32 (p &lt; 0.001); the best corrected near visual acuity before and afér the surgical procedure was 0.45 ±0.27vs. 0.55 ±0.35 (p = 0.014). Implantation of tIOL and mIOL lenses was effective in our group of patients with amblyopia, thus improving uncorrected distance and near visual acuity and without serious adverse effects. At the same time, we evaluate that the change in refraction and the removal of anisometropia lead to a significant change in the best corrected visual acuity for distance or near vision at the one-year follow-up examination.

Clear Lens Phacoemulsification with Implantation of Intraocular Lens in a Case of Bilateral Anterior Lenticonus Due to Alport Syndrome

Alport Syndrome (AS) is a rare disorder of basement membrane, which is progressive, hereditary and presents as nephritis associated with sensorineural hearing loss, and ocular abnormalities including anterior lenticonus. Anterior lenticonus secondary to Alport syndrome is difficult to correct, however clear lens phacoemulsification is a successful and safe treatment option for the anterior lenticonus associated with Alport Syndrome. We report visual status of a young patient with Alport Syndrome and bilateral anterior lenticonus, after clear lens phacoemulsification. A 17-year-old male with bilateral anterior lenticonus presented with decreased visual acuity. Systemic evaluation revealed Alport syndrome. Clear lens phacoemulsification and foldable acrylic intraocular lens implantation was done. Visual acuity improved after surgery. There were no notable complications. Clear lens phacoemulsification and foldable lens implantation are effective and safe procedures for individuals with this visual disorder.

Polyhexamethylene Biguanide Multipurpose Solutions on Bacterial Disinfection: A Comparison Study of Effectiveness in a Developing Country.

The aim of this study was to compare the antimicrobial action of commercially available multipurpose disinfection solutions (MPDS) with and without hydrogel contact lens for disinfection of isolated corneal bacteria. Five commercially available MPDS in Brazil (BioSoak, Clear Lens, OPTI-FREE, Renu, and UltraSept) were tested against Pseudomonas aeruginosa , Staphylococcus aureus , and Staphylococcus epidermidis . All five MPDS were also tested on P. aeruginosa and S. aureus biofilm in a Hioxifilcon A lens. OPTI-FREE and Renu were effective against all bacterial isolates without contact lenses. BioSoak was effective in inhibiting P. aeruginosa and S. epidermidis but not against S. aureus . UltraSept was effective for inhibiting S. epidermidis and S. aureus but not against P. aeruginosa . Clear Lens was effective in inhibiting only S. epidermidis but not P. aeruginosa and S. aureus . In contact lens bacterial biofilms, OPTI-FREE was the only MPDS to demonstrate significantly higher disinfection. MPDS containing dual biocides polyquaternium-1 and myristamidopropyl dimethylamine possess the highest disinfection action against multiple ocular pathogens with and without contact lenses when compared with other MPDS. Current single-action polyhexamethylene biguanide solutions are not entirely effective and should not be recommended.

Global Gene Expression Analysis Reveals Complex Cuticle Organization of the Tribolium Compound Eye.

The red flour beetle Tribolium castaneum is a resource-rich model for genomic and developmental studies. To extend previous studies on Tribolium eye development, we produced transcriptomes for normal-eyed and eye-depleted heads of pupae and adults to identify differentially transcript-enriched (DE) genes in the visual system. Unexpectedly, cuticle-related genes were the largest functional class in the pupal compound eye DE gene population, indicating differential enrichment in three distinct cuticle components: clear lens facet cuticle, highly melanized cuticle of the ocular diaphragm, which surrounds the Tribolium compound eye for internal fortification, and newly identified facet margins of the tanned cuticle, possibly enhancing external fortification. Phylogenetic, linkage, and high-throughput gene knockdown data suggest that most cuticle proteins (CPs) expressed in the Tribolium compound eye stem from the deployment of ancient CP genes. Consistent with this, TcasCPR15, which we identified as the major lens CP gene in Tribolium, is a beetle-specific but pleiotropic paralog of the ancient CPR RR-2 CP gene family. The less abundant yet most likely even more lens-specific TcasCP63 is a member of a sprawling family of noncanonical CP genes, documenting a role of local gene family expansions in the emergence of the Tribolium compound eye CP repertoire. Comparisons with Drosophila and the mosquito Anopheles gambiae reveal a steady turnover of lens-enriched CP genes during insect evolution.

Alternatives for corneal endothelial tissue engineering

AbstractCorneal endothelial diseases are common almost everywhere in the world and have 3 main origins: primary diseases, largely dominated by Fuchs' endothelial corneal dystrophy (FECD), iatrogenic diseases which mainly complicate lens surgery, whether cataract or clear lens, but also other surgeries. The frequency of these complications is very low but the number of these surgeries being gigantic (probably around 50 million cases/year/worlwide), the number of post‐surgical bullous keratopathy remains important. Post‐keratoplasty endothelial failure (early or late) is the 3rd cause.All these diseases “consume” 50% of corneal grafts in the world and a large part of the population does not have access to any graft. The number of corneal donors is absolutely insufficient to meet the world demand and corneal bioengineering appears to be a realistic solution to complete the offer. Because of its relative simplicity and the demonstrated effectiveness of endothelial keratoplasty, endothelial bioengineering is logically the first to be developed. The Japanese team of 2 Kyoto universities (Prof. S. Kinoshita, N. Koizumi and N. Okumura) is a pioneer in this field and has demonstrated the effectiveness of injection therapy, which consists of cultivating mature endothelial cells from a small number of corneas from young donors, then injecting them into the anterior chamber of patients. The industrialization of the process is underway in 2 different start‐ups, one in the United States, the other in Japan. In addition to injection therapy, the bioengineering of endothelial grafts (Tissue engineered endothelial keratoplasty, TEEK), which consists of cultivating endothelial cells on a “corneo‐compatible” carrier to exactly reproduce a DMEK or a DSAEK, has passed the preclinical stage. This presentation will detail these different processes, their current limitations and the short, medium and long term perspectives. These Advanced Therapy Medicinal products (ATMP) are clearly revolutionizing corneal transplantation. By offering a new treatment for endothelial diseases, they will make it possible to redirect donor corneas to other corneal diseases that have no therapeutic alternative. Finally, this paper will also discuss the prospects of medical and medico‐surgical treatments for FECD, which are at the frontier of endothelial bioengineering.