The lens is nourished during embryologic life by the tunica vasculosa lentis, which posteriorly is comprised of the hyaloid artery (a part of the primary vitreous), and anteriorly by the embryologic pupillary membrane.
The lens fibers are produced at the equator and compressed toward the nucleus as new cells are formed thus contributing to leticular sclerosis.
Lens metabolism is most active at the equator and mediated predominantly by anaerobic glycolysis, and to a lesser extent, by the hexose monophosphate shunt, sorbitol pathway, and the Krebs cycle.
Laser posterior capsulotomy, or YAG laser capsulotomy, is a noninvasive procedure performed on the eye to remove the opacification (cloudiness) that develops on the posterior capsule of the lens of the eye after extraction of a cataract.
One form of PCO is a fibrosis that forms inside the capsule by lens epithelial (covering) cells that migrate from the anterior capsule to the posterior capsule when the anterior lenscapsule is opened to remove the primary cataract and insert the IOL.
The greatest capsule opacification is found around the edges of the IOL, where the anterior and posterior lenscapsules adhere and form a seam, called Soemmering's ring.
Since the lenscapsule is formed of firm, essentially non-viable tissue, inflammation, trauma and erosion are substantially less likely to occur than is the case with prior art devices supported by or contacting the ciliary body and/or the iris or using rigid plates or other types of loops contacting the capsule.
The lens body 6 of 4 mm to 6 mm diameter is provided with a planar posterior face 7, a cylindrical peripheral surface 8 and a spherical anterior face 9 of desired curvature to give the required optical characteristics for the particular patient in which it is to be implanted.
Since foot portion 22 engages the lenscapsule with greater force than foot portion 20, except in rare cases where the capsule is unusually small, the area of the lenscapsule engaged by portion 22 is deflected radially outwardly a greater distance than the area engaged by foot portion 20.
Comparative Ophthalmology Notes: Chapter 10 - Lens(Site not responding. Last check: 2007-10-14)
This is the appearance of the lens at birth.
Clinically the lens will appear notched or may be abnormal in shape, theoretically due to uneven tension on the lenscapsule in the area of the uveal coloboma during development.
The defect in the lenscapsule often appears as a circular defect of the lens and the protruding material may be opaque.
Resorption of lens proteins is recognized clinically by wrinkling or flattening of the anterior lenscapsule.
In the event the lens epithelium is still viable at the time of surgery (young animals and immature cataracts), the surgical stimulation stimulates the epithelium to replicate and secrete lens material.
The immune response is characterized histologically by lenscapsule rupture, intra-lenticular neutrophils, and perilenticular mononuclear cells (Figure 4).
The lenscapsule is a clear, membrane-like structure that is quite elastic, a quality that keeps it under constant tension.
This adjustment in lens shape, to focus at various distances, is referred to as “accommodation” or the “accommodative process” and is associated with a concurrent constriction (decrease in size) of the pupil.
Through this opening, the lens nucleus is removed, either as a whole or by dissolving it into tiny pieces and vacuuming out the pieces, a procedure called “phacoemulsification.” Next, the lens cortex also is sucked out, leaving the lenscapsule in place, and into the lenscapsule is inserted the artificial lens implant.
True exfoliation should not be confused with so-called pseudo-exfoliation of the lenscapsule which in earlier literature was referred to as senile exfoliation of the lenscapsule.
A senile or aging form of true exfoliation of the lenscapsule that does not seem to be related to infrared heat is currently the most common type of true exfoliation seen in the United States.
True exfoliation of the lenscapsule is rare and is seen in those with exposure to high temperatures, such as glassblowers, is associated with cataract, and is rarely associated with glaucoma.
Typical structure of lens in the form of anterior cortex, nucleus and posterior cortex is optically important as each of these three portions act as a separate lens (lenticules) because the refractive index of nucleus is more than that of cortex.
Although any lens opacity whether or not it leads to decrease in vision is technically cataract, yet an opacity in the periphery of the lens, which is stationary and not hampering vision should be diagnosed just Lens Opacity in order to avoid causing unnecessary anxiety to the patient.
Although the lens appears grayish white in both these conditions but on DDO cataract shows up as fl patches but clear red glow is seen in nuclear sclerosis.
In lenscapsules treated with trypan blue and light for one minute, the stress at 25% strain was 459.5 ± 117.4 x 103 Pa compared with 337.3 ± 120.3 x 103 Pa in the non-treated specimens.
Treating the lenscapsule with trypan blue and light for one minute “is a realistic time scheme also for a real cataract operation, especially after subcapsular injection of the dye,” Dr. Wollensak wrote in his study.
Indeed, in lenscapsules treated with 0.1% glutaraldehyde for 30 minutes, the stress at 25% strain was 1418.3 ± 257.32 x 103 Pa compared to 336.4 ± 130.8 x 103 Pa in the non-treated specimens, signifying a 321.6 % increase, he said.
The natural lens of the eye is held in place by a thin clear membrane called the lenscapsule.
The capsule completely surrounds the lens and separates it from the thick fluid in the back of the eye, called the vitreous, and the thinner fluid in the front of the eye, called the aqueous.
Leaving the capsule in place during surgery is a great advancement because it allows the vision after surgery to be more stable and provides for less surgical complications.
Then the clouded lens is cut loose with a thin needle and suctioned out, leaving intact the rear wall of the transparent capsule that encloses the lens.
A folded flexible plastic lens one-quarter of an inch in diameter can be inserted through the cut with a scissors-like device called an injector and positioned behind the pupil against the capsule wall.
The procedure to remove the natural lens and replace it with a synthetic one is done under a general or local anesthesia with injections made in muscles around the eye.
CIGNA - Nd:YAG laser posterior capsulotomy for cataracts(Site not responding. Last check: 2007-10-14)
The most common complication of adults having standard extracapsular surgery or extracapsular surgery using phacoemulsification for cataracts is clouding of the part of the lens covering (capsule) that remains after surgery, called posterior capsule opacification.
A laser (Nd:YAG laser) is used to cut a hole in the clouded back lining of the lenscapsule to allow light to pass through the membrane to the retina at the back of the eye.
The procedure is not necessary unless vision loss caused by clouding of the lenscapsule is seriously affecting the person's vision and lifestyle.
Eye - Abstract of article: Phacoemulsification in true exfoliation of the lens capsule: a case series(Site not responding. Last check: 2007-10-14)
Vision blue aided uneventful capsulorrhexis differentiating its edge from the true exfoliation edge, and in the first two cases, the anterior capsule was sent for histopathology and ultrasound of the fellow eye was requested.
Ultrasound and histopathology demonstrated lamellar separation of the anterior portion of the lenscapsule, confirming the diagnosis of true exfoliation.
True exfoliation of the lenscapsule can masquerade as a partial capsulorrhexis and should be looked for before surgery and immediately before capsulorrhexis to avoid creating a partial thickness capsulorrhexis and its related surgical complications.
A phakic IOL is a lens that is surgically implanted.
The front part of the lens envelope, the lenscapsule, is carefully opened so that the lens material can be removed.
Once the entire cataract has been removed, a folded intraocular lens (IOL) chosen by the surgeon for your individual needs is inserted through the original incision and centered in the lenscapsule.
the superficial portion of the lenscapsule splits from the
of the anterior portion of the lenscapsule, confirming the
Carol L. Karp, MD Jacqueline R. Fazio, MD William W. Culbertson, MD Richard Green, MD From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla (Drs Karp, Fazio, and Culbertson), and The Wilmer Ophthalmological Institute and Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Md (Dr Green).
Apoptosis and leakage of cellular material through the lenscapsule are observed in neonatal lenses, and lenses degenerate within 3 weeks of birth.
Electron microscopy revealed altered structure of the lenscapsule through which cells had formed extensions.
The results suggest that in the lenscapsule, HS chains have a structural function and are essential in the insulation of the lens from its environment and in regulation of incoming signals.
JCRS: Vol. 30, No. 1, January 2004(Site not responding. Last check: 2007-10-14)
Three-step technique for staining the anterior lenscapsule with indocyanine green or trypan blue
A 3-step technique for staining the anterior lenscapsule was developed to optimize the use of a capsule dye (trypan blue or indocyanine green) during capsulorhexis.
The dye is slowly injected through a 27-gauge cannula (Duckworth and Kent), selectively mixing with the BSS and allowing relatively accurate painting of the anterior capsule, approximating the size and shape of the intended capsulorhexis.
This is largely due to the long-term clinical results of the lens.
The AcrySof® ReSTOR® lens is a breakthrough lens that uses apodized diffractive technology (similar to technology used in telescopes and microscopes) to give patients a full range of vision - near through distance - and to reduce dependency on reading glasses or bifocals following cataract surgery.
The AcrySof® IQ IOL is designed to conform to the natural shape of the lenscapsule.