0000000000143025
AUTHOR
Sabine Kurz
Epidemiological evaluation of intraoperative antibiosis as a protective agent against endophthalmitis after cataract surgery.
PURPOSE To evaluate risk factors for endophthalmitis after cataract surgery and to retest recent findings on the protective effect of intraoperative antibiosis and the promoting effect of the clear corneal as compared to sclerocorneal incision. DESIGN Survey study. PARTICIPANTS Five hundred thirty-eight ophthalmosurgical centers in Germany. MAIN OUTCOME MEASURE Responder specific endophthalmitis incidence. RESULTS A total of 310 (58%) questionnaires were computed resulting in an overall count of 404 356 cataract surgeries and 291 self-reported endophthalmitis cases (crude rate 0.072%). The risk of postoperative endophthalmitis for sclerocorneal versus clear corneal incisions was not signifi…
Optical coherence tomography of macular thickness after biaxial vs coaxial microincision clear corneal cataract surgery
PURPOSE To evaluate macular thickness changes after biaxial microincision versus coaxial small incision cataract surgery using optical coherence tomography (OCT). METHODS This prospective, randomized, marked study comprised 70 patients (70 eyes) undergoing biaxial microincision surgery or conventional coaxial phacoemulsification. Patients were evaluated by Stratus OCT preoperatively and 1 day, 4 weeks, and 8 weeks postoperatively. Best-corrected visual acuity (BCVA), phacoemulsification power, and effective phacoemulsification time (EPT) were evaluated. RESULTS In the biaxial group, median foveal thickness changed from 160 microm preoperatively to 168 microm 8 weeks postoperatively (p=0.018…
Application of an ectopic expression system for the selection of protein-isoform-specific antibodies. The monoclonal antibody K1 C3 is specific for the RCK1 potassium channel
Monoclonal antibodies were raised against a fusion protein consisting of a fragment of 141 amino acids of the C-terminal region of the rat brain voltage-gated K(+)-channel protein (RCK1) and the lambda N protein (fusion protein I). Selection of K(+)-channel-specific hybridoma cell lines was performed by means of an ELISA employing a fusion protein consisting of the K(+)-channel-specific peptide sequence and glutathione S-transferase (fusion protein II). For final selection of RCK1 isoform-specific antibodies, a panel of Xenopus oocytes was employed, each injected with cRNA coding for a specific RCK isoform (RCK 1, 2, 4 or 5). Several days after injection, cryosections of embedded oocytes we…
Monocular versus binocular pupillometry.
Purpose To quantify differences between monocular and binocular pupil size measurement under scotopic and mesopic conditions. Setting Department of Ophthalmology, Johannes Gutenberg-University, and Department of Medical Biometry, Epidemiology and Informatics, University of Mainz, Mainz, Germany. Methods Computerized dynamic pupillometry (P2000 SA, Procyon Instruments Ltd.) was used at 3 illumination levels: scotopic at 0.03 lux, mesopic low at 0.82 lux, and mesopic high at 6.4 lux. One hundred forty eyes of 70 healthy volunteers without ocular pathology were examined. The subjects were divided into 2 groups. In the first group, the pupil diameter was measured binocularly first. In the secon…
Patchwork Pattern of Transcriptional Reactivation in the Lungs Indicates Sequential Checkpoints in the Transition from Murine Cytomegalovirus Latency to Recurrence
The lungs are a relevant organ site of primary and recurrent human cytomegalovirus (hCMV) disease (for overviews, see references 21, 22, 31, 34, 39, and 44). Murine CMV (mCMV) can serve us as a model for studying CMV pneumonia in acute infection (6, 27, 33, 37) as well as for studying viral latency, reactivation, and recurrence in the lungs (2, 17, 18, 42, 43). We have shown recently that transcription from the major immediate-early (MIE) transcription unit ie1-ie3 (hereafter referred to as ie1/3), which is driven by a strong MIE promoter-enhancer (MIEPE) (3), occurs during pulmonary latency of mCMV but fails to initiate the productive cycle (17). Notably, the paralogous MIEPE of hCMV can f…
Spring constants of capsular tension rings.
Purpose To determine the spring constants of several types of capsular tension rings (CTRs). Setting Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. Methods Fourteen models of CTRs provided by 9 companies were tested; all were 11.0 mm in diameter. The CTRs were positioned in a special retainer of a material-testing machine and compressed at a constant speed of 10.0 mm per minute. The distance and force values were recorded, and each CTR model was tested 3 times using a new specimen each time. The resulting measurements were used to calculate a mean spring constant for each CTR model. Results All tested CTRs showed linear proportionality between force and compress…
Effect of a closed foldable equator ring on capsular bag shrinkage in cataract surgery.
To evaluate the effect of a closed foldable equator ring (CFER) versus a conventional capsular tension ring (CTR) on capsular bag shrinkage.Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany.In this prospective study, 70 eyes of 70 patients were randomized to 2 groups using a 1:1 block scheme. After uneventful cataract surgery, a capsular measuring ring was implanted in all eyes to measure the capsular bag diameter in vivo. In Group 1, a CTR was implanted in the capsular bag. In Group 2, a CFER was inserted. Biometric characteristics such as axial length and the horizontal and vertical corneal radii were measured preoperatively. The capsular bag diameter and capsulor…
Cytomegalovirus inhibits the engraftment of donor bone marrow cells by downregulation of hemopoietin gene expression in recipient stroma
ABSTRACT Cytomegalovirus (CMV) disease after bone marrow (BM) transplantation is often associated with BM graft failure. There are two possible reasons for such a correlation. First, a poor hematopoietic reconstitution of unrelated etiology could promote the progression of CMV infection by the lack of immune control. Alternatively, CMV infection could interfere with the engraftment of donor BM cells in recipient BM stroma. Evidence for a causative role of CMV in BM aplasia came from studies in long-term BM cultures and from the murine in vivo model of CMV-induced aplastic anemia. A deficiency in the expression of essential stromal hemopoietins, such as stem cell factor (SCF), has indicated …
The Xenopus Oocyte as an Ectopic Expression System for the Selection of Protein Isoform-Specific Antibodies
A panel of Xenopus oocytes, each injected with cRNA coding for one specific isoform of the rat brain RCK family of voltage gated potassium channel proteins, was employed to screen for isoform-specific monoclonal antibodies. Several days after injection, cryosections of embedded oocytes were produced and were employed in immunohistochemical analysis of antibody binding. Of the advantageous properties of the assay, it employs the native antigen, it can be applied to homooligomeric and heterooligomeric proteins, and cryosections of the same batch can be stored frozen for later tests. The method may be advantageous also for the selection of isoform-specific antibodies of other protein families.
ReSTOR® Diffractive versus Array®2 Zonal-progressive Multifocal Intraocular Lens: a Contralateral Comparison
PURPOSE. To evaluate near and distance visual performance after implantation of a diffractive multifocal intraocular lens (MIOL) (AcrySof ReSTOR ® ) or a refractive MIOL (Array ® 2) in bilateral cataract surgery. METHODS. In this prospective, comparative trial, 18 patients with bilateral cataract were selected to have lens surgery with asymmetric MIOL implantation. Eighteen eyes received ReSTOR MIOL and the 18 fellow eyes were implanted with Array 2. Five months after second lens implantation, main postoperative outcomes were uncorrected and distance corrected near visual acuities (VA). Secondary outcomes were distance VA and near acuity with power add, contrast sensitivity with and without…
Focal Transcriptional Activity of Murine Cytomegalovirus during Latency in the Lungs
ABSTRACT Interstitial pneumonia is a frequent and critical manifestation of human cytomegalovirus (CMV) disease in immunocompromised patients, in particular in recipients of bone marrow transplantation. Previous work in the murine CMV infection model has identified the lungs as a major organ site of CMV latency and recurrence. It was open to question whether the viral genome is transcriptionally silent or active during latency. Transcription could be latency associated and thus be part of the latency phenotype. Alternatively, transcriptional activity could reflect episodes of reactivation. We demonstrate here that transcription of the immediate-early (IE) transcription unit ie1-ie3 selectiv…
Capsular bag shrinkage after implantation of a capsular bending or capsular tension ring.
To evaluate the influence of a capsular bending ring (CBR) or tension ring (CTR) on capsular bag shrinkage.Department of Ophthalmology, Johannes Gutenberg-University, and Department of Medical Biometry, Epidemiology and Informatics, University of Mainz, Mainz, Germany.In 92 eyes of 92 patients, a capsular measuring ring (CMR) was implanted after phacoemulsification to measure capsular bag size in vivo. Patients were randomized into 3 groups: The first received a CMR and CBR, the second received a CMR and CTR, and the third received a CMR alone. Measurements were performed preoperatively, intraoperatively, during the first 3 postoperative days, and after 1 and 3 months. Preoperative biometri…
Modulation of central corneal thickness by various riboflavin eyedrop compositions in porcine corneas
Purpose To evaluate the modulatory effect of various riboflavin 0.1% and 0.2% compositions on the central corneal thickness (CCT) in fresh porcine corneas. Setting Department of Ophthalmology, Johannes Gutenberg University of Mainz, Mainz, Germany. Design Experimental study. Methods The CCT in freshly enucleated porcine globes was measured by ultrasound pachymetry before and after (if applicable) deepithelialization and every 10 minutes thereafter during 120 minutes of eyedrop application. In Groups 1 and 2 (controls), no eyedrops were applied. In Groups 3 and 4, isotonic riboflavin eyedrops were used. In Groups 5 to 9, hypotonic riboflavin eyedrops were given. In Groups 10 and 11, preparat…
Bone marrow failure by cytomegalovirus is associated with an in vivo deficiency in the expression of essential stromal hemopoietin genes.
Bone marrow (BM) failure associated with cytomegalovirus (CMV) infection is a feared complication after clinical BM transplantation. Experiments in long-term BM cultures have indicated that BM stromal cells (BMSC) are targets of productive CMV infection, but an in situ infection of BM stroma remained to be documented, and the pathomechanism is open to question. Here we describe a murine in vivo model of lethal CMV aplastic anemia (CMV-AA). The reconstitution of hematopoietic progenitor cells expressing stem cell factor (SCF) receptor was found to be defective in CMV-AA. While murine CMV replication in permissive parenchymal tissues is cytolytic, the hematopoietic cord was found to be a site…
Latency versus persistence or intermittent recurrences: Evidence for a latent state of murine cytomegalovirus in the lungs
The state of cytomegalovirus (CMV) after the resolution of acute infection is an unsolved problem in CMV research. While the term "latency" is in general use to indicate the maintenance of the viral genome, a formal exclusion of low-level persistent productive infection depends on the sensitivity of the assay for detecting infectious virus. We have improved the method for detecting infectivity by combining centrifugal infection of permissive indicator cells in culture, expansion to an infectious focus, and sensitive detection of immediate-early RNA in the infected cells by reverse transcriptase PCR. A limiting-dilution approach defined the sensitivity of this assay. Infectivity was thereby …
Preemptive CD8 T-Cell Immunotherapy of Acute Cytomegalovirus Infection Prevents Lethal Disease, Limits the Burden of Latent Viral Genomes, and Reduces the Risk of Virus Recurrence
ABSTRACT In the immunocompetent host, primary cytomegalovirus (CMV) infection is resolved by the immune response without causing overt disease. The viral genome, however, is not cleared but is maintained in a latent state that entails a risk of virus recurrence and consequent organ disease. By using murine CMV as a model, we have shown previously that multiple organs harbor latent CMV and that reactivation occurs with an incidence that is determined by the viral DNA load in the respective organ (M. J. Reddehase, M. Balthesen, M. Rapp, S. Jonjic, I. Pavic, and U. H. Koszinowski. J. Exp. Med. 179:185–193, 1994). This predicts that a therapeutic intervention capable of limiting the load of lat…
Biaxial Microincision versus Coaxial Small-Incision Clear Cornea Cataract Surgery
Objective To compare clinical outcomes of biaxial microincision (1.5 mm) and coaxial small-incision (2.75 mm) clear cornea cataract surgery. Design Randomized controlled clinical trial. Participants Seventy eyes of 70 patients were examined at a German university eye hospital. Intervention The 70 patients (70 eyes) were assigned randomly (1:1) to a biaxial or conventional coaxial incision group. Both groups underwent phacoemulsification using pulsed ultrasound energy with variable duty cycles, followed by microincision intraocular lens implantation. Main Outcome Measures Best-corrected visual acuity (BCVA), astigmatism, laser flare photometry value, effective phacoemulsification time (EPT),…
Contrast sensitivity after implantation of a spherical versus an aspherical intraocular lens in biaxial microincision cataract surgery.
Purpose To determine whether implantation of a microincision intraocular lens (IOL) with a modified anterior surface, designed to compensate for the positive spherical aberration of the cornea in eyes of cataract patients, results in improved pseudophakic quality of vision in pseudophakic eyes after biaxial microincision phacoemulsification. Setting Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. Methods In a nonrandomized parallel cohort investigation, the visual performance of 52 eyes of 52 patients unilaterally implanted with the aspherical Acri.Smart 36 A IOL (Acri.Tec) were compared with those of 25 eyes of 25 age-matched patients unilaterally implanted with…
Sulcus implantation of a single-piece foldable acrylic intraocular lens after posterior capsular rupture in cataract surgery.
Purpose. To evaluate the safety of a foldable acrylic single-piece intraocular lens (IOL) in cases of complicated cataract surgery and sulcus implantation. The setting was University and private anterior segment surgery practices. Methods. In this observational case series study, 13 eyes of 13 patients were included after complicated phacoemulsification with extensive posterior capsule rupture with or without vitreous loss. A foldable acrylic single-piece IOL (Rayner Superflex 620H; Rayner Intraocular Lenses Limited, Hove, East Sussex, UK) was implanted in the ciliary sulcus in each eye. Postoperative follow-up included best-corrected visual acuity, anterior segment biomicroscopy, IOL centr…