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Abstract Introduction Although uncommon, incomplete capsulotomy, anterior capsule tags and anterior capsule tears are still encountered during femtosecond laser-assisted cataract surgery (FLACS), resulting in surgical complications. This highlights the need to improve femtosecond laser-assisted capsulotomy technique to reduce capsulotomy-related complications. Therefore, the purpose of this study was to investigate the efficacy of a newly developed, modified technique of setting capsulotomy irradiation thickness in lowering the incidence of capsulotomy-related complications in FLACS. Methods This open-label prospective, comparative cohort study included 440 eyes (220 patients) treated with FLACS using the LenSx laser system (Alcon Laboratories, Inc. Fort Worth, TX, USA). Varying capsulotomy irradiation thicknesses were applied in each eye of the same patient. In Group 1, capsulotomy irradiation thickness was set between the upper edge of the highest point of the anterior capsule and the lower edge of the lowest point of the anterior capsule (modified technique). In Group 2, this was set between the center of the highest point of the anterior capsule and the center of the lowest part of the anterior capsule (conventional technique). Incidence rates of incomplete capsulotomy, anterior capsule tags and tears, and posterior capsule tears were compared. Results Preoperative baseline characteristics showed no significant differences. Mean total of the irradiation thicknesses was 877.1 ± 81.9 µm in Group 1 and 808.9 ± 80.0 in Group 2, with a statistically significant difference (P

Introduction: Although uncommon, incomplete capsulotomy, anterior capsule tags and anterior capsule tears are still encountered during femtosecond laser-assisted cataract surgery (FLACS), resulting in surgical complications. This highlights the need to improve femtosecond laser-assisted capsulotomy technique to reduce capsulotomy-related complications. Therefore, the purpose of this study was to investigate the efficacy of a newly developed, modified technique of setting capsulotomy irradiation thickness in lowering the incidence of capsulotomy-related complications in FLACS. Methods: This open-label prospective, comparative cohort study included 440 eyes (220 patients) treated with FLACS using the LenSx laser system (Alcon Laboratories, Inc. Fort Worth, TX, USA). Varying capsulotomy irradiation thicknesses were applied in each eye of the same patient. In Group 1, capsulotomy irradiation thickness was set between the upper edge of the highest point of the anterior capsule and the lower edge of the lowest point of the anterior capsule (modified technique). In Group 2, this was set between the center of the highest point of the anterior capsule and the center of the lowest part of the anterior capsule (conventional technique). Incidence rates of incomplete capsulotomy, anterior capsule tags and tears, and posterior capsule tears were compared. Results: Preoperative baseline characteristics showed no significant differences. Mean total of the irradiation thicknesses was 877.1 ± 81.9 µm in Group 1 and 808.9 ± 80.0 in Group 2, with a statistically significant difference (P < 0.001). Incidences of incomplete capsulotomy were 1.8% and 7.7%, anterior capsule tags were 2.3% and 8.6%, and anterior capsule tears were 0% and 3.2% in Groups 1 and 2, respectively. These differences were statistically significant (P = 0.006, 0.005, and 0.015, respectively). No posterior capsule tears were reported in either group. Conclusion: The modified technique for capsulotomy in FLACS may significantly reduce the occurrence of capsulotomy-related complications, maximizing the benefits of FLACS. [ABSTRACT FROM AUTHOR]

Traumatic radial head dislocation without a bone-associated lesion is uncommon, and irreducible cases are rare. We herein present a case of isolated irreducible anteromedial radial head dislocation due to anterior capsule and annular ligament interposition in a 16-year-old female patient. The patient was injured when she was thrown by an opponent during a judo match, and her right elbow was outstretched, combined with forearm pronation. Open reduction was required because of soft tissue interposition into the radiocapitellar joint. The ruptured anterior capsule and annular ligament were repaired using the overlapping suture technique; hence, the radial head was stabilized. At 3.5 years follow-up, the patient had satisfactory elbow function, and redislocation did not occur; however, mild degenerative changes were observed on radiographs. We discussed the injury mechanism using anatomical features in this case and previous literature. [ABSTRACT FROM AUTHOR]

Abstract Purpose To compare morphological changes in the anterior capsule of two intraocular lenses (IOLs) with different anterior edge designs 6 months after femtosecond laser-assisted capsulotomy surgery (FLACs). Methods This study included 168 eyes from168 patients undergoing FLACs. Group A included 74 eyes from 74 patients who had an Acrysof IQ Restor SN6AD3 IOL implantation with a flat anterior edge and Group B included 94 eyes of 94 patients with a TECNIS Multifocal ZMB00 IOL implantation and a "peak-like" anterior edge. All patients were followed up for 6 months. We assessed anterior capsule morphological changes including variation of anterior opening diameters and lens epithelial cell (LEC) proliferation in four directions, variation of anterior opening area, and the level of anterior capsule opacification (ACO). Results Variation of anterior opening diameters in 4 directions were significantly lower in Group B (P

AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery. METHODS: The current study involved a retrospective analysis of the medical records of 86 patients with vitreous hemorrhage, who underwent pars plana vitrectomy and cataract surgery. The patients were classified into two groups. The trypan blue group (n=45) comprised patients who underwent anterior capsule staining with 0.03% trypan blue under an air bubble. The control group (n=41) comprised of patients who underwent intracameral illuminator-assisted capsulorhexis. The status of endothelial cell density (ECD) in both the groups was analyzed. RESULTS: The trypan blue group displayed significant decline in ECD at 1mo (7.91% loss, P

Purpose: To compare morphological changes in the anterior capsule of two intraocular lenses (IOLs) with different anterior edge designs 6 months after femtosecond laser-assisted capsulotomy surgery (FLACs). Methods: This study included 168 eyes from168 patients undergoing FLACs. Group A included 74 eyes from 74 patients who had an Acrysof IQ Restor SN6AD3 IOL implantation with a flat anterior edge and Group B included 94 eyes of 94 patients with a TECNIS Multifocal ZMB00 IOL implantation and a "peak-like" anterior edge. All patients were followed up for 6 months. We assessed anterior capsule morphological changes including variation of anterior opening diameters and lens epithelial cell (LEC) proliferation in four directions, variation of anterior opening area, and the level of anterior capsule opacification (ACO). Results: Variation of anterior opening diameters in 4 directions were significantly lower in Group B (P < 0.05). Obvious shrinkage ratio of anterior opening diameters and contraction of anterior opening area (P < 0.05) appeared in Group A. LEC proliferation was along the "peak" in Group B, while it spread to the edge of anterior capsule in Group A. ACO grades 6 months after operation in Groups A and B were as follows: grade I in 28.38% and 82.98% of eyes, grade II in 51.35% and 17.02% of eyes, and grade III in 20.27% and 0% of eyes, respectively. Conclusions: These findings suggest that a "peak-like" IOL anterior edge design played an important role in maintaining the morphology of anterior capsule in the early postoperative stage. [ABSTRACT FROM AUTHOR]

This study aims to investigate the efficacy of natural blue dye from the butterfly pea flower to be a candidate blue vital dye for staining the anterior capsule of the crystalline lens. The blue dye was extracted from the butterfly pea flower with warm deionized water and sterilized by filtration. The stability of the extracted blue dye solution was performed for 12 months. The efficacy of staining the anterior capsule of the lens was performed using a cataract-induced porcine eyeball ex vivo model. Cataract was induced either by microwave radiation or injection of solvents. Histological examination of the corneal endothelial cells was evaluated after exposure to the extracted blue dye for 5 min. For the present study, the blue dye of the butterfly pea flowers could be successfully extracted. The dye was found to be stable at 12 months when stored at 4oC in the dark and was appeared to be stable even when stored at room temperatures with high concentration. Both microwave radiation and solvents injection led to a loss of lens transparency. The former resulted in a whitish haze while the latter led to a yellowish appearance. The capsule showed significant blue-stains when exposed to an aqueous solution of the blue dye (500 mg/ml). Histology revealed normal corneal endothelium structure, indicate that there is no notable cytotoxicity after blue dye staining. A blue dye from the butterfly pea flowers, extracted into an aqueous solution, exhibited potential for staining the anterior capsule of the crystalline lens. [ABSTRACT FROM AUTHOR]

Fibrosis is driven by a misdirected cell response causing the overproduction of extracellular matrix and tissue dysfunction. Numerous pharmacological strategies have attempted to prevent fibrosis but have attained limited efficacy with some detrimental side effects. While stem cell treatments have provided more encouraging results, they have exhibited high variability and have not always improved tissue function. To enhance stem cell efficacy, we evaluated whether mechanical memory could direct cell response. We hypothesized that mechanically pre-conditioning on a soft matrix (soft priming) will delay adipose-derived stem cell (ASC) transition to a pro-fibrotic phenotype, expanding their regenerative potential, and improving healing in a complex tissue environment. Primary ASCs isolated from rat and human subcutaneous fat exhibited mechanical memory, demonstrated by a delayed cell response to stiffness following two weeks of soft priming including decreased cell area, actin coherency, and extracellular matrix production compared to cells on stiff substrates. Soft primed ASCs injected into our rat model of post-traumatic elbow contracture decreased histological evidence of anterior capsule fibrosis and increased elbow range-of-motion when evaluated by joint mechanics. These findings suggest that exploiting mechanical memory by strategically controlling the culture environment during cell expansion may improve the efficacy of stem cell-based therapies targeting fibrosis. [ABSTRACT FROM AUTHOR]

Rohit Om Parkash, Shruti Mahajan, Tushya Om Parkash Dr Om Parkash Eye Institute, Amritsar, India Purpose: To describe a trypan blue dye staining technique under air, a modification of the previously described 30 G needle under-air technique.Design: This is a prospective, randomized study of 1,000 eyes of 952 patients undergoing phacoemulsification in a private practice setting from January 2015 to August 2016. Three variants as a modification of the previously known 30 G needle technique are described. In our technique, after injecting one drop of the dye under air, the needle is kept in the anterior chamber (AC) for 15 seconds. In the second variation, along with the additional hold time, 0.05 mL air is injected prior to dye injection to deepen the AC in eyes with shallow ACs or in cases with increased posterior pressure. The third variation is the selective painting approach in which more than one drop is injected for a homogenous staining.Main outcome measures: The main outcome measures were safety and reproducibility of the technique along with homogeneity and uniformity of the anterior capsule staining.Results: AC remained stable during the hold time of 15 seconds with no egress of air. No iatrogenic trauma occurred in any of the cases. All cases had a homogeneously stained anterior capsule. The staining intensity was excellent in 80.8% of the eyes and good in 19.2% of the eyes.Conclusion: This is a safe, simple, and cost-effective technique which achieves consistent, uniform, and reproducible staining. It overcomes the shortcomings of the known 30 G needle technique. Keywords: trypan blue staining, anterior capsule staining, under air, 30 G needle technique, effective staining, uniform staining

Purpose: The present study aimed to evaluate the potential corneal endothelial cell toxicity of trypan blue (TB) and Brilliant Blue G (BBG), two dyes used to stain the anterior capsule in cataract surgery. Methods: We conducted a single-center, prospective, randomized study in which 150 eyes of 117 patients were randomly divided into control (CT), TB, and BBG groups. Preoperative and postoperative (1, 3, and 6 months) values for corrected distance visual acuity (CDVA), corneal endothelial cell count, and central corneal thickness were compared among the three groups.Results: A total of 111 eyes from 88 patients were completely analyzed. The CDVA (logarithm of the minimal angle of resolution) values in the CT, TB, and BBG groups 1 month after surgery were 0.001, 0.023, and 0.019, respectively. The corneal endothelial cell counts 6 months after surgery were 2711 ± 225, 2748 ± 251, and 2680 ± 284 cells/mm2, respectively. The central corneal thicknesses 6 months after surgery were 524.3 ± 35.5, 532.2 ± 36.1, and 531.4 ± 33.0 µm, respectively. There were no significant differences in CDVA, endothelial cell count, or central corneal thickness among the three groups during the follow-up period.Conclusions: Our findings indicate that neither TB nor BBG was associated with detectable toxicity to corneal endothelial cells during cataract surgery, even when injected directly into the anterior chamber. Additionally, BBG exhibited equivalent staining efficiency to TB. [ABSTRACT FROM AUTHOR]

AIM: To explore the application value of polishing anterior capsule and equator in the phacoemulsification and intraocular lens implantation. METHODS: Totally 112 cases of cataract patients in our hospital from May 2012 to January 2015 were selected as research objects. They were divided into unpolished and polished group according to whether the anterior capsule and equatorial part polished or not with the informed consents, 56 cases in each group. The patients were followed up for 18mo after phacoemulsification and intraocular lens implantation. The clinical efficacy of the two groups was compared.RESULTS: The complication rates of the two groups were 7.1% and 16.1%, that of the polished group was lower and the difference was statistically significant(PPCONCLUSION: Polishing anterior capsule and equator can significantly improve the effect of phacoemulsification combined with intraocular lens implantation in the treatment of cataract.