Rupture Of Lens Capsule Research Articles

Investigating the etiology of ocular changes in Monodactylus argenteus housed in a shoaling ring exhibit.

To evaluate the pathologic ocular changes in a population of aquarium-housed Monodactylus argenteus and investigate potential underlying causes for the large number of affected fish in this exhibit. 11 Monodactylus argenteus were evaluated from a shoaling ring exhibit within an aquarium, and 19 control fish without ocular abnormalities were obtained from commercial fish suppliers. Physical and ocular examinations were performed antemortem. Postmortem samples of liver, heart, dorsal epaxial muscle, and lenses of affected and control fish were analyzed for amino acid profiles. The aqueous humor from affected and control fish was collected postmortem, and osmolality was analyzed. Tissues from affected and control fish were submitted for histopathology. Ocular abnormalities in affected fish included corneal lesions, cataracts, lens capsule rupture, and unilateral left-sided lens luxation and buphthalmos. Lens luxation and buphthalmos were directly correlated. Aqueous humor osmolality in control fish differed significantly compared to affected fish but was not correlated to lens abnormality score. Affected fish had significantly lower lens concentrations of arginine, asparagine, glycine, isoleucine, serine, and tyrosine than control fish. One affected fish had severe buphthalmos, cataracts, and panophthalmitis caused by gram-positive cocci. Cataracts and traumatic lesions were common in affected M argenteus. Dietary amino acid content and aqueous humor osmolality imbalances were not likely a cause of the cataracts. Differences in lens amino acid concentrations between affected and control fish may be related to cataract formation. Consideration of species-appropriate tank parameters may mitigate ocular lesions including cataracts in aquarium fish.

CASE REPORTS: Bilateral anterior lens capsule ruptures in Alport syndrome: case series and literature review

We present 3 cases of bilateral anterior lens capsule rupture, all leading to a subsequent diagnosis of Alport syndrome. Clinicians should be alert to the ocular and systemic features of Alport syndrome, especially when presented with a spontaneous rupture of the anterior lens capsule in young males. Ophthalmologists are often the first contact for patients with Alport syndrome, and a sound knowledge of the associated features will enable timely referral to other members of a multidisciplinary team required to treat such patients. Diagnosis and subsequent testing of affected families further aids in genetic counseling and early, comprehensive treatment.

Application of optical coherence tomography in the assessment of the posterior lens capsule during anti-angiogenic therapy

This study uses optical coherence tomography method to analyze the risks of developing changes in the posterior lens capsule in patients after IVI of an anti-angiogenic drug. The study involved 100 people (14 men and 86 women) with a natural lens and neovascular age-related macular degeneration (nAMD). The average age was 70.57±7.98 years. During the study (12 months), all patients underwent IVI of an anti-angiogenic drug aflibercept in the treat-and-extend (T&E) mode. All subjects were divided into 2 groups: with a total number of IVI less than 10 - group 1 (50 patients), and more than 10 IVI - group 2 (50 patients, of which 49 were included in the study). All patients underwent OCT using the Optopol REVO NX device (Poland) with the Anterior B-scan Wide protocol before inclusion in the study, as well as after 3, 6 and 12 months. It was found that the risk of developing a posterior lens capsule rupture, visualized using OCT, depends on the total number of IVI (correlation coefficient 0.473 p=0.001): the more IVI, the higher the probability that damage to the posterior capsule will occur after the next IVI, and after the 15th injection the risk of developing damage to the posterior capsule increases sharply. The astudy analyzed the risk factors for the development of posterior lens capsule damage that can be detected using OCT, and presented three risk groups for the development of rupture (or damage) of the posterior lens capsule depending on the number of intravitreal injections performed.

Анализ интраоперационных и ранних послеоперационных осложнений при факоэмульсификации катаракты

Relevance. Despite the high level of cataract surgery, in some cases complications arise that lead to a decrease in visual functions, an increase in the duration of inpatient treatment and additional economic costs. Analysis of the results of cataract phacoemulsification helps to increase the effectiveness of predicting complications and their prevention. Aim. Analysis of intraoperative and early postoperative complications in cataract surgery for 2021–2022, conducted on the basis of the 2nd ophthalmological department of the State Budgetary Institution “N.A. Semashko Regional Clinical Hospital” Ryazan, Russia. Material and methods. Retrospective analysis of 66 case histories of patients who had complications in the intra- and postoperative period of cataract surgery. Results. Intraoperative complications included: posterior capsule opening (22 cases), dislocation of lens masses into the vitreal cavity (10 cases), hemorrhagic ciliochoroidal detachment (4 cases), expulsive hemorrhage (2 cases), hyphema (2 cases). In the postoperative period, the following complications were detected: hyphema – 2, hemophthalmos-4, ciliochoroidal detachment – 5, dislocation of intraocular lens (IOL) – 5, retained lenticular material in the anterior chamber – 4, exudative reaction – 12, keratopathy – 6, pupillary block – 1, endophthalmitis – 1. Conclusion. The improvement of the phacoemulsification technique together with the preoperative preparation of patients with cataracts made it possible to achieve a low level of intra- and postoperative complications (1.16% in 2021 and 0.89% in 2022, respectively, of all operated patients with cataracts). However, after analyzing the nature of complications, we identified a number of patterns: among intraoperative complications, the most common is the opening of the posterior capsule of the lens (0,29%), among postoperative – an exudative reaction (0,16%). Keywords: сataract phacoemulsification, complications of cataract phacoemulsification, rupture of the posterior lens capsule, exudative inflammatory eye response, expulsive hemorrhage.

Open Globe Injury with Corneal Laceration Full-Thickness, Anterior Lens Capsule Rupture, and Traumatic Cataract

Introduction: Ocular trauma is a common, preventable cause of visual impairment. Mechanical eye injuries affect the eye in many ways ranging from mild to severe morbidity. In this case, we inform the sequence of what we found in this ocular trauma and how we treat this case. Case Presentation: A 26-year-old male patient presented with pain and stiffness in the right eye. The patient was involved in an accident 16 hours before being admitted to the emergency room. Previously, the patient had been taken to a secondary hospital. No medications were given. The patient was referred directly to a tertiary hospital for further management. The visual acuity of the right eye and left eye were 1/300 and 6/6. Soft palpation indicated decreased intraocular pressure (IOP) on the right eye. Slit lamp examination found conjunctival hyperemia, full-thickness corneal laceration, irregular iris, posterior synechiae, declining pupil reflex, and hazy lens. Fundus reflex declined. The right eyeball exploration showed a membrane at the camera oculi anterior and a suspected hazy lens with mass and capsule of the lens. Doubtful prognosis on the right eyeball. Conclusions: The outcome of ocular trauma might be debatable and vary in any condition. Proper management can avoid unprecedented complications and improve patient visual results. A good perspective will also make satisfied both the patient and the physician.

"Capsule drape wrap"-a new technology for iridoschisis management during phacoemulsification.

To introduce a new technique for iridoschisis management during phacoemulsification: "capsule drape wrap". "Capsule drape wrap" technique was used for an 80-year-old man with idiopathic iridoschisis in the right eye during phacoemulsification. The inserted flexible nylon iris hooks to hold anterior capsule in place, the margin of the anterior capsule could act as drape wrap, tracking the fibrillary iris strands firmly from free floating and stabilizing the capsular bags simultaneously. The eye with iridoschisis was successfully treated. Iris fibrils remained immobile during the procedure, and despite the severity of iridoschisis, there were no intraoperative complications such as tear of the iris, hyphema, iris prolapse, loss of mydriasis, or rupture of the posterior lens capsule during phacoemulsification. The best-corrected visual acuity was increased by 0.1 (logMAR) 6mo after the surgery. "Capsule drape wrap" for iridoschisis is easily manageable, prevents further disruption to the loose iris fibers and ensures the stability of capsule-iris complex simultaneously, consequently minimizing the risk of surgical complications in phacoemulsification.

The clinical outcomes of 33 canine eyes following the novel sulcus fixation technique of an injectable acrylic lens through a 3-mm corneal incision.

This retrospective study introduces and evaluates transscleral fixation using a horizontal mattress suture of a conventional injectable acrylic intraocular lens (IOL) inserted through a 3-mm corneal incision in dogs. This technique was applied to four groups: lens subluxation (group SL, n=15), anterior or posterior lens luxation (group APLL, n=9), lens capsule tear or rupture (group LCTR, n=7), and dislocation of the lens capsule containing an IOL (group IOLD, n=4). Patients were followed up for an average of 366.7 days (range: 94-830 days) after the surgery. Each IOL was well-centered and the overall visual success rate was 74.3% (26/35). Retinal detachment (4/35) was the most common cause of blindness, followed by glaucoma (3/35), hyphema of unknown etiology (1/35), and severe uveitis accompanied by deep corneal ulcer (1/35). This technique enables sulcus fixation of an IOL, inserted through a 3-mm corneal incision, which is less traumatic than conventional techniques, without the need for specifically designed IOL for sulcus fixation. In this series, this technique enabled to contribute to restore emmetropic vision in dogs.

Ophthalmic findings caused by Encephalitozoon cuniculi (strain III) in a dog

A 2-year-old female mixed-breed canine patient from Namibia presented originally with chronic uveitis. A serum antibody titer and a PCR test performed on the aqueous humor were positive for encephalitozoon cuniculi. The left eye showed an immature anterior focal cortical cataract in the periphery with suspected lens capsule rupture and signs of chronic uveitis. An incipient anterior focal cortical cataract was also perceivable in the patient's right eye. Despite local treatment as well as systemic administration of carprofen, prednisolone, and fenbendazol recurrent uveitis occurred. The patient then underwent bilateral extracapsular lensextraction via phacoemulsification. A PCR test of the lens material was positive for encephalitozoon cuniculi strain III. Recurring uveitis and secondary glaucoma 10 months post-op resulted in permanent blindness of the left eye. The patient then continued to receive local anti-inflammatory treatment. The last recheck examination of both eyes, 31 month post-op, revealed no signs of uveitis. This is the first case reported of a cataract in a canine patient caused by encephalitozoon cuniculi strain III.

Phacoemulsification of cataract in the case of capsular bag damage

Purpose: to analyze the results of complicated cataract phacoemulsification with implantation of various types of intraocular lenses and fixation techniques. Material and methods. 48 patients (51 eyes) with complicated cataracts and weakened ligamentous apparatus of the lens or intraoperative rupture of the posterior lens capsule were divided into two groups: the study group I consisted of 21 patients (23 eyes, aged 71.4 ± 4.5 years) who had cataract phacoemulsification with an implantation of RSP-III IOL which was performed through a 2.4 mm small self-sealing incision using an injector and the control group II consisting of 27 patients (28 eyes, aged 73.6 ± 4.1 years) who had. Cataract phacoemulsification with an anterior chamber IOL implantation using an incision widened to 6.0 mm. Results. By the end of 1-year follow-up period, uncorrected visual acuity was 0.8 ± 0.1 in group 1 and 0.5 ± 0.1 in group II. In 100% of the patients of group 1 the correct position of the IOL was achieved in the early postoperative period (1–3 days) and maintained in the late period (1 year), whereas in group II, two eyes of 28 operated (7.14 %) showed a forward displacement of the anterior chamber IOL, which involved a contact with corneal endothelium. IOP stayed within the normal range in 21 eyes of group I patients (91.3 %), albeit two eyes (8.7 %) revealed transitory hypertension. In group II, 21 eyes (75 %) had normal IOP in the first three postoperative days, while 7 eyes (25 %) revealed an IOP increased to 29–30 mm Hg. In contrast to group I, group II patients showed induced corneal astigmatism which was decreasing during the follow-up period. Conclusion. In the case of a rupture of the posterior capsule during cataract phacoemulsification, or failure of the ligamentous apparatus of the lens of various origins, the implantation of the RSP-III IOL through a small self-sealing incision using an injector is the method of choice, which allows achieving a stable position of the IOL in the early and long-term follow-up periods, and high visual acuity with the minimal values of corneal astigmatism.

Novel clinical presentation and PAX6 mutation in families with congenital aniridia.

To explore the clinical phenotype and genetic defects of families with congenital aniridia. Four Chinese families with aniridia were enrolled in this study. The detailed ocular presentations of the patients were recorded. Whole exome sequencing (BGI MGIEasy V4 chip) was used to detect the gene mutation. Sanger sequencing was performed to validate the potential pathogenic variants, and segregation analysis was performed on all available family members. By whole exome sequencing and Sanger sequencing, three recurrent mutations (c.112del, p.Arg38Glyfs*16; c.299G > A, p.Trp100* and c.718C > T, p.Arg240*) and one novel mutation (c.278_281del, p.Glu93Alafs*30) of PAX6 were identified. All the mutations were co-segregated with the phenotype in the families. We also observed spontaneous anterior lens capsule rupture in aniridia for the first time. We report spontaneous anterior lens capsule rupture as a novel phenotype of aniridia and three recurrent mutations and one novel mutation of PAX6 in families with aniridia. Our results expanded the phenotype and genotype spectra of aniridia and can help us better understand the disease.

Posterior lens capsule rupture in non‐diabetic canine cataracts: Pre‐operative, intra‐operative, and post‐operative findings

To describe clinical features of non-diabetic canine cataracts with presumed pre-existing posterior capsule rupture (PLCR) and their surgical outcomes. Clinical records of 497 non-diabetic canines that underwent elective cataract surgery were reviewed. Twelve canines met the inclusion criteria indicative of PLCR pre-dating surgery. The incidence of presumed pre-existing PLCR was 12/497 (2.4%). Cataracts included were unilateral in 10 out of 12 canines (83.3%) and bilateral in the remaining two (16.7%). Four eyes (28.6%) had clinically detectable pre-operative lens-induced uveitis. The mean age at cataract diagnosis for cases included was 6.6 years, and golden retrievers were the most common breed affected (28.6%). Phacoemulsification surgery was performed at a median time of 110 days (range 17-403 days) after presentation. Pre-existing PLCR was found intra-operatively as a large ellipse spanning the posterior capsule from equator to equator centrally in 12 eyes and peripherally in two eyes. The capsular defect in all eyes with PLCR incorporated a distinct "pseudo-capsule" preventing vitreal presentation and ruling out intraoperative surgeon rupture. Ten eyes (71.4%) received an intraocular lens implant (IOL), and 13 eyes (92.9%) maintained vision throughout a mean follow-up period of 12 months. Posterior lens capsule rupture of blunt trauma origin and associated cataract formation, as reported in humans, may also be an infrequent but distinct cause of some cases of non-diabetic canine cataracts. Medical management of phacolytic uveitis and delayed phacoemulsification surgery may be beneficial by allowing time for "pseudo-capsule" development, increasing the likelihood of IOL placement and improved visual outcomes.

Bilateral symmetrical spontaneous anterior capsule rupture of the cataractous lens in a child

We report the management of a rare case of bilateral, symmetrical, and spontaneous anterior lens capsule rupture with total soft cataractous lens in a 7-year-old child. The patient had no other predisposing factors or systemic associations. Bilateral lens aspiration was done through the fibrosed capsular opening, which behaved like a stable capsulorhexis and hydrophobic intraocular lens was implanted. At 6 weeks follow-up, the patient had good visual outcome without any astigmatism. Although capsule rupture is reported in trauma, Alports syndrome or in hypermature cataracts, to our best knowledge this is the first case report of bilateral symmetrical spontaneous anterior capsule rupture in an otherwise normal child.

Post‐operative outcomes in canine eyes receiving a rhexis‐fixated prosthetic intra‐ocular lens: 30 cases (2014‐2020)

To report the outcomes following the insertion of a rhexis-fixated prosthetic intraocular lens (IOL) in dogs undergoing lens removal. The results are from 30 eyes of 28 dogs, undergoing lendectomy, in which the lens capsule could not accommodate a conventional prosthetic endo-capsular IOL. The reported cases had sustained either spontaneous or traumatic lens capsule rupture, or accidental intra-operative iatrogenic lens capsule disruption, or had required a planned, large, anterior or posterior continuous curvilinear capsulorhexis, all of which precluded insertion of a prosthetic IOL within the lens capsule. An acrylic IOL (XVET; Medicontur) was modified and positioned across the anterior and/or posterior capsulorhexes. Other than haptic luxation in three cases, no complications were seen that were directly attributable to the rhexis-fixated lens. Over a follow-up period from three to 76 months (mean 20.7months) 26/30 eyes remained visual. Blindness developed in three eyes due to retinal detachment and one eye was enucleated due to regrowth of a ciliary body adenoma. Rhexis fixation provided an alternative method to implant a prosthetic IOL when the lens capsule was unable to accommodate a conventional endo-capsular IOL.

Intraocular Foreign Bodies: Clinical Characteristics and Factors Affecting Visual Outcome.

Objective To investigate the clinical characteristics and factors affecting visual outcome in patients with intraocular foreign bodies (IOFBs) and determine the risk factors for the development of endophthalmitis. Study Design. A retrospective case-series study design was adopted. Subjects In total, 242 patients (242 eyes) who were hospitalized and underwent surgical treatment for IOFB at the Second Hospital of Hebei Medical University between January 1, 2008, and December 31, 2019, were included. Methods The demographic data, cause of injury, characteristics of IOFBs, postinjury ocular manifestations, and surgical details of the subjects were collected, and the factors affecting visual outcome and endophthalmitis development were analyzed. Results The most common cause of IOFBs was the propulsion of foreign bodies into the eye due to hammering (149 cases, 61.57%), followed by foreign body penetration (57 cases, 23.55%). Most of the subjects were young adult men who sustained injuries in the work environment. Poorer visual outcomes were found in subjects with initial presenting symptoms visual acuity (PVA) < 0.1, largest IOFB diameter ≥ 3 mm, IOFBs located in the posterior segment, wound length > 5 mm, entrance wound length larger than the largest IOFB diameter, concomitant retinal detachment, concomitant vitreous hemorrhage, concomitant endophthalmitis, and concomitant proliferative vitreoretinopathy (PVR). Factors related to the development of endophthalmitis included lens capsule rupture, time of stage 1 repair surgery ≥ 24 h after trauma, removal of IOFBs ≥ 24 h after trauma, and nonadministration of intravitreal antibiotic injection. Conclusion Among patients with IOFBs, initial PVA < 0.1, entrance wound length larger than the largest IOFB diameter, concomitant endophthalmitis, and concomitant PVR were risk factors for poor visual outcomes. Lens capsule rupture was a risk factor for endophthalmitis development, and the administration of intravitreal antibiotic injection was a protective factor against endophthalmitis development.

Macrophage recruitment in immune-privileged lens during capsule repair, necrotic fiber removal, and fibrosis

SummaryEmerging evidence challenges the lens as an immune-privileged organ. Here, we provide a direct mechanism supporting a role of macrophages in lens capsule rupture repair. Posterior lens capsule rupture in a connexin 50 and aquaporin 0 double-knockout mouse model resulted in lens tissue extrusion into the vitreous cavity with formation of a “tail-like” tissue containing delayed regressed hyaloid vessels, fibrotic tissue and macrophages at postnatal (P) 15 days. The macrophages declined after P 30 days with M2 macrophages detected inside the lens. By P 90 days, the “tail-like” tissue completely disappeared and the posterior capsule rupture was sealed with thick fibrotic tissue. Colony-stimulating factor 1 (CSF-1) accelerated capsule repair, whereas inhibition of the CSF-1 receptor delayed the repair. Together, these results suggest that lens posterior rupture leads to the recruitment of macrophages delivered by the regression delayed hyaloid vessels. CSF-1-activated M2 macrophages mediate capsule rupture repair and development of fibrosis.

Bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s syndrome

Background: The purpose of this paper was to report a case of bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s syndrome. Case presentation: A 12-years-old child was referred to our hospital for cataract extraction secondary to decreased visual acuity in the right eye two years after lensectomy and posterior chamber intraocular lens implant in the left eye secondary to assumed traumatic cataract. Slit-lamp examination showed a ruptured anterior capsule in the right eye with lens matter in the anterior chamber. Clinically the patient was anemic and deaf; he was referred for pediatric evaluation and was diagnosed with Alport’s syndrome and end-stage renal disease. Once the patient’s hypertension was controlled, a lensectomy and posterior chamber intraocular lens implant was performed. Results: Lensectomy and posterior chamber intraocular lens implant removed the cataract and allowed the restoration of visual acuity. Conclusions: Ophthalmologists may be the first to consider the diagnosis of Alport’s syndrome based on lens changes. Uncontrolled Blood pressure can delay surgery, during which time intraocular pressure (IOP) should be monitored closely. Results of lensectomies with foldable IOL implantation are successful. To our knowledge, this is the second report of a case of bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s syndrome.

Lens capsule rupture in a nonaccidental trauma

Here we present an image of the lens capsule rupture of the left eye of a 6-month-old female believed to be a victim of nonaccidental trauma. Grossly, the lens of the left eye appears irregular in shape compared with the lens of the right eye), showing this is unlikely artifactual or due to tissue processing. The image demonstrates a capsule break with distinct scrolling pattern at the edge. There are numerous hemorrhages of varying sizes in all retinal layers with rare blood cells seen in the vitreous cavity, as well as the optic nerve hemorrhage, not pictured.

Macrophage Recruitment in Immune-Privileged Lens During Capsule Repair, Necrotic Fiber Removal and Fibrosis

Emerging evidence of the presence of immune cells challenges the concept of the lens as an immune privileged organ, however, the underlying mechanism remains elusive. Here, we provide a direct mechanism supporting a role of macrophage recruitment in immuno-privileged lens during capsule rupture repair, fiber cell removal and fibrosis. Posterior lens capsule rupture was observed in a connexin (Cx) 50 and aquaporin 0 (AQP0) double knockout (dKO) mouse model. A ruptured posterior lens capsule resulted in lens fiber tissue extrusion into the vitreous cavity, forming a disorganized “tail-like” tissue at postnatal age of 15 days (P15). This “tail-like” tissue also contained hyaloid vessels, fibrotic tissue and macrophages. The regression of the hyaloid vessel system that contains macrophages was delayed. Moreover, fiber cell debris were detected inside the macrophages, suggesting phagocytic engulfment by macrophages. Additionally, necrotic fiber cells were surrounded by macrophages in the “tail-like” lens tissue. These macrophages were reduced after P30, and phenotypically distinct M2 macrophages were detected inside the lens, which coincided with an increase in necrotic fiber cells. By P90, the “tail-like” tissue completely disappeared, and the posterior capsule rupture was healed and replaced with thick fibrotic tissue. Furthermore, administration of colony stimulating factor 1 (CSF-1) activated polarization of macrophages to M2 and accelerated capsule repair, while inhibition of the CSF-1 receptor delayed the repair process. Taken together, these results suggest that necrotic fiber cells associated with lens posterior rupture lead to the recruitment of macrophages, which are delivered by the regression delayed hyaloid vessel system. M2 macrophages activated by CSF-1 mediate capsule rupture repair, fiber cell removal and development of fibrosis.

Retrospektywna ocena powikłanych operacji zaćmy z implantacją na torebkę przednią jednoczęściowych zwijalnych soczewek wewnątrzgałkowych

Cel pracy: Ocena odległych wyników leczenia w grupie pacjentów poddanych operacji fakoemulsyfikacji zaćmy z fiksacją na torebkę przednią jednoczęściowych zwijalnych soczewek wewnątrzgałkowych.&#x0D; Materiał i metody: Grupę badaną stanowiło 24 oczu u 24 pacjentów, którzy w latach 2008–2015 zostali poddani operacji fakoemulsyfikacji zaćmy na Oddziale Okulistyki Centralnego Szpitala Klinicznego MSWiA w Warszawie. W grupie tej po śródoperacyjnym przerwaniu torebki tylnej soczewki zastosowano implantację jednoczęściowej zwijalnej soczewki wewnątrzgałkowej do komory tylnej z fiksacją na torebce przedniej soczewki. Oceniano ostrość wzroku, ciśnienie wewnątrzgałkowe, odcinek przedni i tylny oczu przed zabiegiem chirurgicznym, w 1. i 7. dobie po operacji oraz w okresie 6–84 miesięcy od zabiegu.&#x0D; Wyniki: W obserwacji trwającej od 6 miesięcy do 7 lat wykazano poprawę najlepszej skorygowanej ostrości wzroku (BCVA, best corrected visual acuity) średnio o 2 linie na tablicy Snellena oraz stwierdzono: u 25% badanych podwyższone ciśnienie wewnątrzgałkowe lub konieczność modyfikacji leczenia przeciwjaskrowego, u 42% pacjentów dyspersję barwnika z listka barwnikowego tęczówki, u 17% transiluminację tęczówki.&#x0D; Wnioski: Zastosowanie jednoczęściowej zwijalnej soczewki tylnokomorowej do fiksacji na torebce przedniej soczewki w sytuacji uniemożliwiającej jej implantację śródtorebkową u 67% pacjentów pozwoliło na poprawę pooperacyjnej ostrości wzroku. Jeśli decydujemy się na takie rozwiązanie, powinniśmy zapewnić pacjentom możliwość częstych kontroli, gdyż u 25% spośród nich możerozwinąć się jaskra wtórna. W przypadku gdy nie dysponujemy trzyczęściową soczewką tylnokomorową, wyżej opisany sposób fiksacji jednoczęściowej zwijalnej soczewki jest względnie bezpieczną techniką chirurgiczną.

Ocular porcupine quilling in dogs: Gross, clinical and histopathologic findings in 17 cases (1986-2018).

The objectives of this retrospective study were to evaluate the histopathologic changes associated with porcupine ocular quill injuries in dogs, to discuss the various methods of quill detection when quills are not grossly visible, and to discuss the pathogenesis of delayed ocular quill injuries in dogs. Seventeen globes sustaining ocular quilling injuries from 17 dogs (1986-2018) were identified in the COPLOW archives and the gross and histologic changes tabulated and compared. All cases were dogs, with one whole globe submitted from each patient. Sixteen of 17 cases had known or suspected porcupine encounters in the weeks or years preceding enucleation. Histopathologic findings included retinal detachment, hyphema, cataract, granulomatous to pyogranulomatous inflammation (uveitis, endophthalmitis, panophthalmitis), lens capsule rupture, suppurative phakitis, scleral perforation, stromal keratitis, breaks in Descemet's membrane, preiridal fibrovascular membrane, anterior and posterior synechia, Schnabel's cavernous atrophy, and periorbital fibrosis. Quill-associated ocular trauma can have a significant deleterious effect on vision and result in enucleation. The time from initial quilling to the manifestation of ocular signs may be prolonged (weeks to years). Any dog presenting for ocular signs with a history of a previous porcupine encounter should be carefully checked for quill migration into the globe as the source of ocular disease. Quills may not be visible grossly, and ancillary imaging techniques can be utilized with various rates of success.