- Email: [email protected]
Prospective analysis of pediatric pseudophakia: myopic shift and postoperative outcomes.
2000. They excluded 11 eyes that had a history of intraoperative complications, ocular inflammation, or both. Among the 151 eyes included in the study, 12 had been treated with latanoprost for open-angle glaucoma. Among these, the latanoprost was 1 week preoperatively in eight eyes and continued preoperatively and postoperatively in four eyes. There were no cases of clinically significant CME in 139 eyes that had not been treated with latanoprost. There were four cases of clinically significant CME in the eyes receiving latanoprost, compared with no cases in eyes in which it had been discontinued 1 week preoperatively (P ⫽ .003). None of the patients with CME had diabetes mellitus or any systemic or ocular inflammatory disease. In all four cases, there was a loss of at least 3 lines of Snellen acuity between the 1-week and 1-month examination. In all four cases, the vision returned to the 1-week postoperative level with discontinuation of latanoprost and treatment with topical ketorolac. The authors conclude that the topical use of latanoprost is a significant etiologic factor in the development of postoperative CME—Michael D. Wagoner *Saras Ramanathan, MD, Department of Ophthalmology and Visual Science, University of Chicago, 5841 South Maryland Avenue, MC 2114, Chicago, IL 60637.
●
Vascular endothelial growth factor is increased in aqueous humor of glaucomatous eyes. Hu DN, Ritch G,* Liebmann J, Liu Y, Cheng B, Hu MS. J Glaucoma 2002;11:406 – 410.
T
HE AUTHORS EVALUATED VASCULAR ENDOTHELIAL
growth factor (VEGF) concentration in the aqueous humor of eyes with and without glaucoma. The concentration of VEGF was measured using a sandwich ELISA kit in aqueous humor aspirates taken during anterior segment surgery from 87 patients, of whom 54 had glaucoma (27 primary open-angle glaucoma, 8 angle-closure glaucoma, 16 exfoliative glaucoma) and 33 had cataract only. There was a statistically significant elevation (P ⬍ .001) of VEGF concentration glaucoma (146.7 ⫾ 51 pg/ml) eyes compared with cataract only (102.4 ⫾ 29.7 pg/ml) eyes. There were no significant differences between primary openangle glaucoma (140.4 ⫾ 51.0 pg/ml), angle-closure glaucoma (142.8 ⫾ 40.2 pg/ml), or exfoliative glaucoma (158.6 ⫾ 58.9 pg/ml). There was no correlation between age, gender, previous history of medical, laser, or surgical treatment and anterior segment VEGF concentration. An unusually high VEGF concentration was detected in one eye with neovascular glaucoma (759 pg/ml) and two eyes with uveitic glaucoma (322 pg/ml). The aqueous humor VEGF concentrations in 6 cataract only (106 ⫾ 35.2 pg/ml) and 40 glaucoma (148.8 ⫾ 114.7 pg/ml) eyes was significantly higher (P ⬍ .01) than plasma concentrations in cataract (63.0 ⫾ 20.9 pg/ml) and glaucoma (81.6 ⫾ 48.4 VOL. 135, NO. 6
pg/ml) patients. The correlation coefficient between aqueous and plasma VEGF concentration was 0.114 in cataract and 0.229 in glaucoma patients, indicating that there is no significant correlation between VEGF concentrations in the aqueous humor and plasma. The authors conclude that aqueous VEGF concentration is increased in eyes with glaucoma.—Michael D. Wagoner *Robert Ritch, MD, Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th Street, New York, New York 10003, USA; e-mail: [email protected]
● Phakic intraocular lens to correct high myopic amblyopia in children. Lesueur LC,* Arne JL. J Refract Surg 2002;18:519 –523.
T
HE AUTHORS EVALUATED THE ANATOMIC AND FUNC-
tional outcomes of posterior phakic chamber lens (ICL) implantation for correction of high myopia with amblyopia in children. Twelve eyes of 11 children, ages 3 to 16 years, in whom conventional therapy with contact lenses and spectacles had been unsuccessful, underwent insertion of a Staar Surgical ICL. The mean preoperative spherical equivalent was ⫺12.70 diopters (D) (range ⫽ ⫺8.00 to ⫺18.00 D). The best corrected spectacle acuity ranged from 20/63 to counting fingers. After a mean period of follow-up of 20.5 months (range ⫽ 3– 48 months), the ICL position was stable in all eyes, none of which had had any significant intraocular inflammation, elevation of intraocular pressure, or developed secondary lenticular opacities. The mean spherical equivalent was ⫹0.71 D (range ⫽ ⫺0.75 to ⫹2.00 D). The mean best-corrected visual acuity was 20/63. All but two patients (aged 15 and 16 years) experienced improvement in best-corrected visual acuity. The mean uncorrected visual acuity improved from counting fingers to 20/125. Orthotropia was reestablished postoperatively in seven of eight patients with strabismus, three of whom were esotropic and four of whom were exotropic preoperatively. The authors conclude that the Staar Surgical ICL is an effective method to treat high myopia with strabismus and amblyopia in children.—Michael D. Wagoner *Laurence C. Lesueur, MD, Service d’Ophtalmologie, CHU Toulouse Purpan, Place Baylac, 31059 Toulouse Cedex, France; e-mail: [email protected]
● Prospective analysis of pediatric pseudophakia: myopic shift and postoperative outcomes. Crouch ER, Crouch ER,* Pressman SH. J AAPOS 2002;6:277–282.
T
HE AUTHORS PROSPECTIVELY EVALUATED THE RE-
fractive errors of 52 eyes of 42 children who had cataract surgery and intraocular lens (IOL) implantation. The study included children between 12 months and 18
ABSTRACTS
927
years of age who were evaluated at 4 weeks, 3 months, 6 months, 1 year, and every 6 months thereafter. The mean follow-up was 5.45 years with a range of 3.0 to 10.5 years. Forty-two eyes had developmental cataracts. There were 10 bilateral cases. Of the 52 eyes, 85% had 20/40 vision or better. Visual acuity of 20/30 or better was achieved in 95% of bilateral eyes. In unilateral cataracts, visual acuity was 20/50 or better in 74% of eyes. Children operated on at 12 months to 2 years of age had a mean myopic shift of ⫺5.96 diopters (D); children operated on at 3 and 4 years of age had a ⫺3.66-D shift; children operated on at 5 and 6 years of age had a ⫺3.40-D shift; children operated on at age 7 and 8 years had a ⫺2.03-D shift; children operated on at age 9 and 10 years had a ⫺1.88-D shift; children operated on at 11 to 14 years of age had a shift of ⫺0.97 D; and children operated on at 15 to 18 years of age had a ⫺ 0.38-D shift. The operated eye showed a greater mean myopic shift than the nonoperated eye. There was no correlation between myopic shift of amblyopic vs nonamblyopic eyes or traumatic vs nontraumatic cataracts. The authors conclude that the greatest rate of refractive growth or change occurred between 1 and 3 years of age. After 3 years of age, the rate of refractive growth followed a more linear trend.—Michael D. Wagoner
● Autologous transplantation of genetically modified iris pigment epithelial cells: a promising concept for the treatment of age-related macular degeneration and other disorders of the eye. Semkova I, Kreppel F, Welsandt G, Luther T, Kozlowski J, Janicki H, Kochanek S,* Schraemeyer U. Proc Nat Acad Sci U S A 2002;99:13090 – 13095.
S
*Earl R. Crouch, Jr., MD, Department of Ophthalmology, Eastern Virginia Medical School, 880 Kempsville Road, Suite 2500, Norfolk, VA 23502; e-mail: [email protected]
928
AMERICAN JOURNAL
UBMACULAR TRANSPLANTATION OF AUTOLOGOUS
iris pigment epithelial (IPE) cells has been proposed as a treatment to replace the damaged retinal pigment epithelium following surgical removal of choroidal neovascular membranes in patients with age-related macular degeneration. Pigment epithelium-derived factor (PEDF) has strong antiangiogenic and neuroprotective properties in the eye. In this study, subretinal transplantation of PEDF expressing IPE cells inhibited choroidal neovascularization in rat models of laser-induced rupture of Bruch membrane and of oxygen-induced ischemic retinopathy. Pigment epithelium– derived factor expressing IPE transplants also increased the survival and preserved rhodopsin expression of photoreceptor cells in the RCS rat, a model of retinal degeneration. These findings are promising for IPE cells expressing PEDF as a possible treatment for exudative age-related macular degeneration.—Hans E. Grossniklaus *Stefan Kochanek, Center for Molecular Medicine Cologne, Kerpener Strasse 34, D-50931, Cologne, Germany; e-mail: Stefan.Kochanek@ medizin.uni-koein.de
OF
OPHTHALMOLOGY
JUNE 2003
●
Vascular endothelial growth factor is increased in aqueous humor of glaucomatous eyes. Hu DN, Ritch G,* Liebmann J, Liu Y, Cheng B, Hu MS. J Glaucoma 2002;11:406 – 410.
T
HE AUTHORS EVALUATED VASCULAR ENDOTHELIAL
growth factor (VEGF) concentration in the aqueous humor of eyes with and without glaucoma. The concentration of VEGF was measured using a sandwich ELISA kit in aqueous humor aspirates taken during anterior segment surgery from 87 patients, of whom 54 had glaucoma (27 primary open-angle glaucoma, 8 angle-closure glaucoma, 16 exfoliative glaucoma) and 33 had cataract only. There was a statistically significant elevation (P ⬍ .001) of VEGF concentration glaucoma (146.7 ⫾ 51 pg/ml) eyes compared with cataract only (102.4 ⫾ 29.7 pg/ml) eyes. There were no significant differences between primary openangle glaucoma (140.4 ⫾ 51.0 pg/ml), angle-closure glaucoma (142.8 ⫾ 40.2 pg/ml), or exfoliative glaucoma (158.6 ⫾ 58.9 pg/ml). There was no correlation between age, gender, previous history of medical, laser, or surgical treatment and anterior segment VEGF concentration. An unusually high VEGF concentration was detected in one eye with neovascular glaucoma (759 pg/ml) and two eyes with uveitic glaucoma (322 pg/ml). The aqueous humor VEGF concentrations in 6 cataract only (106 ⫾ 35.2 pg/ml) and 40 glaucoma (148.8 ⫾ 114.7 pg/ml) eyes was significantly higher (P ⬍ .01) than plasma concentrations in cataract (63.0 ⫾ 20.9 pg/ml) and glaucoma (81.6 ⫾ 48.4 VOL. 135, NO. 6
pg/ml) patients. The correlation coefficient between aqueous and plasma VEGF concentration was 0.114 in cataract and 0.229 in glaucoma patients, indicating that there is no significant correlation between VEGF concentrations in the aqueous humor and plasma. The authors conclude that aqueous VEGF concentration is increased in eyes with glaucoma.—Michael D. Wagoner *Robert Ritch, MD, Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th Street, New York, New York 10003, USA; e-mail: [email protected]
● Phakic intraocular lens to correct high myopic amblyopia in children. Lesueur LC,* Arne JL. J Refract Surg 2002;18:519 –523.
T
HE AUTHORS EVALUATED THE ANATOMIC AND FUNC-
tional outcomes of posterior phakic chamber lens (ICL) implantation for correction of high myopia with amblyopia in children. Twelve eyes of 11 children, ages 3 to 16 years, in whom conventional therapy with contact lenses and spectacles had been unsuccessful, underwent insertion of a Staar Surgical ICL. The mean preoperative spherical equivalent was ⫺12.70 diopters (D) (range ⫽ ⫺8.00 to ⫺18.00 D). The best corrected spectacle acuity ranged from 20/63 to counting fingers. After a mean period of follow-up of 20.5 months (range ⫽ 3– 48 months), the ICL position was stable in all eyes, none of which had had any significant intraocular inflammation, elevation of intraocular pressure, or developed secondary lenticular opacities. The mean spherical equivalent was ⫹0.71 D (range ⫽ ⫺0.75 to ⫹2.00 D). The mean best-corrected visual acuity was 20/63. All but two patients (aged 15 and 16 years) experienced improvement in best-corrected visual acuity. The mean uncorrected visual acuity improved from counting fingers to 20/125. Orthotropia was reestablished postoperatively in seven of eight patients with strabismus, three of whom were esotropic and four of whom were exotropic preoperatively. The authors conclude that the Staar Surgical ICL is an effective method to treat high myopia with strabismus and amblyopia in children.—Michael D. Wagoner *Laurence C. Lesueur, MD, Service d’Ophtalmologie, CHU Toulouse Purpan, Place Baylac, 31059 Toulouse Cedex, France; e-mail: [email protected]
● Prospective analysis of pediatric pseudophakia: myopic shift and postoperative outcomes. Crouch ER, Crouch ER,* Pressman SH. J AAPOS 2002;6:277–282.
T
HE AUTHORS PROSPECTIVELY EVALUATED THE RE-
fractive errors of 52 eyes of 42 children who had cataract surgery and intraocular lens (IOL) implantation. The study included children between 12 months and 18
ABSTRACTS
927
years of age who were evaluated at 4 weeks, 3 months, 6 months, 1 year, and every 6 months thereafter. The mean follow-up was 5.45 years with a range of 3.0 to 10.5 years. Forty-two eyes had developmental cataracts. There were 10 bilateral cases. Of the 52 eyes, 85% had 20/40 vision or better. Visual acuity of 20/30 or better was achieved in 95% of bilateral eyes. In unilateral cataracts, visual acuity was 20/50 or better in 74% of eyes. Children operated on at 12 months to 2 years of age had a mean myopic shift of ⫺5.96 diopters (D); children operated on at 3 and 4 years of age had a ⫺3.66-D shift; children operated on at 5 and 6 years of age had a ⫺3.40-D shift; children operated on at age 7 and 8 years had a ⫺2.03-D shift; children operated on at age 9 and 10 years had a ⫺1.88-D shift; children operated on at 11 to 14 years of age had a shift of ⫺0.97 D; and children operated on at 15 to 18 years of age had a ⫺ 0.38-D shift. The operated eye showed a greater mean myopic shift than the nonoperated eye. There was no correlation between myopic shift of amblyopic vs nonamblyopic eyes or traumatic vs nontraumatic cataracts. The authors conclude that the greatest rate of refractive growth or change occurred between 1 and 3 years of age. After 3 years of age, the rate of refractive growth followed a more linear trend.—Michael D. Wagoner
● Autologous transplantation of genetically modified iris pigment epithelial cells: a promising concept for the treatment of age-related macular degeneration and other disorders of the eye. Semkova I, Kreppel F, Welsandt G, Luther T, Kozlowski J, Janicki H, Kochanek S,* Schraemeyer U. Proc Nat Acad Sci U S A 2002;99:13090 – 13095.
S
*Earl R. Crouch, Jr., MD, Department of Ophthalmology, Eastern Virginia Medical School, 880 Kempsville Road, Suite 2500, Norfolk, VA 23502; e-mail: [email protected]
928
AMERICAN JOURNAL
UBMACULAR TRANSPLANTATION OF AUTOLOGOUS
iris pigment epithelial (IPE) cells has been proposed as a treatment to replace the damaged retinal pigment epithelium following surgical removal of choroidal neovascular membranes in patients with age-related macular degeneration. Pigment epithelium-derived factor (PEDF) has strong antiangiogenic and neuroprotective properties in the eye. In this study, subretinal transplantation of PEDF expressing IPE cells inhibited choroidal neovascularization in rat models of laser-induced rupture of Bruch membrane and of oxygen-induced ischemic retinopathy. Pigment epithelium– derived factor expressing IPE transplants also increased the survival and preserved rhodopsin expression of photoreceptor cells in the RCS rat, a model of retinal degeneration. These findings are promising for IPE cells expressing PEDF as a possible treatment for exudative age-related macular degeneration.—Hans E. Grossniklaus *Stefan Kochanek, Center for Molecular Medicine Cologne, Kerpener Strasse 34, D-50931, Cologne, Germany; e-mail: Stefan.Kochanek@ medizin.uni-koein.de
OF
OPHTHALMOLOGY
JUNE 2003