BACKGROUND: The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body.
METHODS: A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery.
RESULTS: Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05).
CONCLUSIONS: In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.

Posterior Capsule Opacification (PCO), the most frequent complication of cataract surgery, is caused by the infiltration and proliferation of lens epithelial cells (LECs) at the interface between the intraocular lens (IOL) and posterior lens capsule (PLC). According to the \"no space, no cells, no PCO\" theory, high affinity (or adhesion force) between the IOL and PLC would decrease the IOL: PLC interface space, hinder LEC migration, and thus reduce PCO formation. To test this hypothesis, an in vitro hemisphere-shaped simulated PLC (sPLC) was made to mimic the human IOL: PLC physical interactions and to assess their influence on LEC responses. Three commercially available IOLs with different affinities/adhesion forces toward the sPLC, including Acrylic foldable IOL, Silicone IOL, and PMMA IOL, were used in this investigation. Using the system, the physical interactions between IOLs and sPLC were quantified by measuring the adhesion force and interface space using an adhesion force apparatus and Optical Coherence Tomography, respectively. Our data shows that high adhesion force and tight binding between IOL and sPLC contribute to a small interface space (or \"no space\"). By introducing LECs into the in vitro system, we found that, with small interface space, among all IOLs, acrylic foldable IOLs permitted the least extent of LEC infiltration, proliferation, and differentiation (or \"no cells\"). Further statistical analyses using clinical data revealed that weak LEC responses are associated with low clinical PCO incidence rates (or \"no PCO\"). The findings support that the in vitro system could simulate IOL: PLC interplays and predict IOLs\' PCO potential in support of the \"no space, no cells, no PCO\" hypothesis.

Intravitreal injection (IVI) of anti-angiogenic drugs is one of the most common therapeutic procedures in ophthalmology. In recent years, a new non-contact study method has been developed - anterior segment optical coherence tomography (AS-OCT), which allows the formation of three-dimensional images of the lens and provides more detailed information about its structure and morphology.
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
Интравитреальное введение (ИВВ) антиангиогенных препаратов — одна из самых распространенных терапевтических процедур в офтальмологии. В последние годы получил развитие новый, бесконтактный метод исследования — оптическая когерентная томография (ОКТ) переднего отрезка глаза (AS-OCT), позволяющий формировать трехмерные изображения хрусталика и дающий более подробную информацию о его структуре и морфологии.
UNASSIGNED: Изучить с помощью ОКТ риски развития изменений задней капсулы хрусталика у пациентов после ИВВ афлиберцепта.
UNASSIGNED: В исследовании участвовало 100 человек (14 мужчин и 86 женщин) с нативным хрусталиком и неоваскулярной формой возрастной макулярной дегенерации (ВМД). Средний возраст составил 70,57±7,98 года. Во время исследования (12 мес) всем пациентам выполняли ИВВ афлиберцепта в режиме T&Е (TREAT&EXTEND). Все испытуемые были разделены на 2 группы: с общим количеством ИВВ меньше 10 — 1-я группа (50 пациентов) и больше 10 — 2-я группа (50 пациентов, из которых в исследование было включено 49). Всем пациентам проводилась ОКТ с использованием прибора Optopol REVO NX (Польша) и протокола Anterior B-scan Wide перед включением в исследование, через 3, 6 и 12 мес.
UNASSIGNED: Таким образом мы выявили, что риск развития надрыва задней капсулы хрусталика, визуализируемый при помощи ОКТ, зависит от общего числа ИВВ (коэффициент корреляции 0, 473 p=0,001): чем больше ИВВ, тем выше вероятность того, что после следующей ИВВ произойдет повреждение задней капсулы, причем после 15-й инъекции риск развития повреждения задней капсулы резко возрастает.
UNASSIGNED: В статье проанализированы факторы риска развития повреждений задней капсулы хрусталика, выявляемые на ОКТ. Представлены 3 группы риска развития надрыва (или повреждения) задней капсулы хрусталика в зависимости от количества проведенных интравитреальных инъекций.

暂无摘要。

暂无摘要。

OBJECTIVE: To describe clinical features of non-diabetic canine cataracts with presumed pre-existing posterior capsule rupture (PLCR) and their surgical outcomes.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.

YAG laser interventions are associated with the risk of complications, including corneal.
OBJECTIVE: To study the mechanisms of laser destruction in exposing the posterior lens capsule (PLC) tissue to Nd:YAG laser irradiation, and to evaluate its side effects on the cornea.
METHODS: The experiment involved 6 autopsy samples of human posterior lens capsule with different optical and mechanical properties, which were exposed to laser irradiation. We used the Nd:YAG ophthalmic laser LPULSA SYL-9000 Premio manufactured by «LightMed» (Taiwan/USA) and an experimental Nd:YAG laser system (1.064 μm). The following parameters were compared: the power of the incident radiation and radiation transmitted through the PLC, the mechanical stresses in the PLC tissue, the kinetic energy of the laser ablation products, and the pressure of gas bubbles during laser exposure in capsule samples of different densities. In the clinical part of the work, the negative effects of Nd:YAG laser on the cornea at different PLC densities were assessed using the endothelial microscope SP 3000P («Topcon», Japan).
RESULTS: The experiment showed that in hard samples of PLC there are star-shaped point perforations with a diameter of 50±20 μm with partial rarefaction around the point defects. Damage to soft PLC samples in the form of large complete perforations was up to 200 µm in size. The temperature of laser irradiation necessary to achieve breakdown in soft PLC samples was 90 °C, in hard samples - 120 °C. The results of the experiment indicate that the final outcome - destruction of the PLC tissue - is safer to achieve not by increasing the energy, but by increasing the number of laser pulses. Clinical study results confirm a significant effect of the density of PLC on the values of laser energy and on the state of the cornea after laser intervention.
CONCLUSIONS: The experimental data on the mechanisms of laser destruction of the lens capsule should contribute to the development of new and improvement of already known technologies aimed at reducing the risks associated with laser surgeries.
Проведение YAG-лазерных вмешательств сопряжено с риском развития осложнений, в том числе со стороны роговицы.
UNASSIGNED: Изучение механизмов лазерной деструкции (ЛД) при воздействии на ткань задней капсулы хрусталика (ЗКХ), оценка побочного влияния излучения Nd:YAG-лазера на роговицу.
UNASSIGNED: В эксперименте изучали шесть аутопсийных образцов ЗКХ человека с различными оптическими, механическими свойствами, подвергнутых лазерному воздействию. Использовали Nd:YAG-лазерный деструктор LPULSA SYL-9000 Premio («LightMed», Тайвань, США) и экспериментальную Nd:YAG-установку (1,064 мкм). Сравнивали мощность падающего, прошедшего через ЗКХ излучения, оценивали механические напряжения в ткани ЗКХ, кинетическую энергию продуктов лазерной абляции, давление газовых пузырьков во время лазерного воздействия в разнородных образцах капсулы. В клинической практике при помощи конфокального микроскопа SP3000P («Topcon», Япония) оценивали негативное влияние Nd:YAG-лазера на роговицу при различной плотности ЗКХ.
UNASSIGNED: Эксперимент показал наличие в твердых образцах ЗКХ точечных сквозных перфораций звездчатой формы диаметром 50±20 мкм с несквозным разрежением вокруг точечных дефектов. Повреждения в мягких образцах ЗКХ в виде крупных сквозных перфораций имели размер до 200 мкм. Температура для ЛД, необходимая для получения пробоя в мягких образцах ЗКХ, составила 90 °C, в твердых — 120 °C. Результаты эксперимента показали, что достижение конечного результата — деструкции ткани ЗКХ — безопаснее обеспечивать за счет увеличения количества импульсов, а не повышения энергии. Результаты клинического исследования подтверждают достоверное влияние плотности ЗКХ на значения лазерной энергии и состояние роговицы после вмешательства.
UNASSIGNED: Полученные в эксперименте данные о механизмах ЛД капсулы хрусталика должны способствовать разработке новых, совершенствованию известных технологий, уменьшающих риски, связанные с проведением лазерного вмешательства.

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Posterior lenticonus is a congenital condition characterized by the thinning and bowing of posterior lenticular capsule. Cataract develops when normal intra-lenticular pressure bulges the posterior capsule at the circumscribed portion of inherent thin posterior lens capsule, leading to derangement of lamellar lens fibers. This condition poses a surgical challenge as the presentation varies from thin, bulging posterior capsule to large, pre-existing posterior capsular dehiscence.
This video highlights the tips for the surgical management of various scenarios of posterior lenticonus.
In this video, tips for surgical management of various scenarios of posterior lenticonus are illustrated. Intraoperatively, ruptured posterior capsule is suspected by the presence of a fish-tail sign. The anterior capsulotomy is relatively easier in a flatter anterior lens capsule, owing to reduced intra-lenticular pressure. Hydro-dissection is avoided to prevent extension of pre-existing posterior capsular dehiscence or creation of rupture in a thinned-out capsule. The peripheral lens cortex aspiration is initiated first, followed by in each quadrant. In a presence of ruptured posterior capsule by vigilant inspection at this stage, the surgeon should change the direction of lens matter aspiration by aspirating the central lenticular matter first, followed by peripheral cortex like \"inside-out\". In absence of posterior capsule dehiscence, peripheral cortex is aspirated first, followed by central lens matter aspiration like \"outside-in\". Adequate anterior vitrectomy is performed until there are no vitreous tags.
In the presence of pre-existing posterior capsular defect, the lens matter is aspirated from the center (inside-out), whereas in the absence of capsular defect, the lens matter is aspirated from the periphery (outside-in).
https://youtu.be/8G6BCbFwr8Q.

The cytokine transforming growth factor beta (TGFβ) has a role in regulating the normal and pathological response to wound healing, yet how it shifts from a pro-repair to a pro-fibrotic function within the wound environment is still unclear. Using a clinically relevant ex vivo post-cataract surgery model that mimics the lens fibrotic disease posterior capsule opacification (PCO), we investigated the influence of two distinct wound environments on shaping the TGFβ-mediated injury response of CD44+ vimentin-rich leader cells. The substantial fibrotic response of this cell population occurred within a rigid wound environment under the control of endogenous TGFβ. However, TGFβ was dispensable for the role of leader cells in wound healing on the endogenous basement membrane wound environment, where repair occurs in the absence of a major fibrotic outcome. A difference between leader cell function in these distinct environments was their cell surface expression of the latent TGFβ activator, αvβ3 integrin. This receptor is exclusively found on this CD44+ cell population when they localize to the leading edge of the rigid wound environment. Providing exogenous TGFβ to bypass any differences in the ability of the leader cells to sustain activation of TGFβ in different environments revealed their inherent ability to induce pro-fibrotic reactions on the basement membrane wound environment. Furthermore, exposure of the leader cells in the rigid wound environment to TGFβ led to an accelerated fibrotic response including the earlier appearance of pro-collagen + cells, alpha smooth muscle actin (αSMA)+ myofibroblasts, and increased fibrotic matrix production. Collectively, these findings show the influence of the local wound environment on the extent and severity of TGFβ-induced fibrotic responses. These findings have important implications for understanding the development of the lens fibrotic disease PCO in response to cataract surgery wounding.