To report our findings in three cases of a clouding of the anterior surface of an implanted intraocular lens that developed within 14 days after implantation. Three eyes were implanted with the same model IOL and a steam-like clouding developed on the anterior surface of the IOL. The clouding occurred on days 4, 7, and 14 after the implantation in an area of the IOL that was in contact with the aqueous humor. The clouding was accompanied by a reduction of vision in all cases but without any other abnormalities such as inflammation. The clouding was resolved by irrigation and aspiration of the anterior chamber in 2 cases at 2 and 34 days after the onset, and a spontaneous disappearance in 1 case at 14 days after the onset of the clouding. After the disappearance of the clouding, the visual acuity improved, and there were no recurrences. The solution used to irrigate the anterior chamber was collected and examined to confirm the absence of cellular materials. Elemental analyses confirmed that sodium and chloride were the predominant ions. The IOL implanted was the XACT lens (Advanced Vision Science, USA) which is a hydrophobic acrylic IOL and is characterized by having higher water content compared to other IOLs. In addition, it is packaged in 0.9% saline to maintain the pre-hydrated condition. These aspects may be related to the cause of the clouding. This IOL was implanted in 3271 eyes in our clinic, and 3 of them (0.09%) developed this clouding. We report our findings in 3 eyes that developed a clouding on the anterior surface of the lens soon after implantation. The clouding was localized to the area in contact with the aqueous. The cause of the clouding was not determined.
In this retrospective case series, we investigated factors associated with posterior capsule aperture (PCA) reclosure following neodymium-yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy. The study encompassed patients who underwent cataract surgery with intraocular lens (IOL) implantation or a combined vitrectomy, cataract surgery, and IOL implantation between 2009 and 2022. PCA reclosure was observed in 22 eyes of 17 patients: 45% (10 eyes) underwent the triple procedure, and 55% (12 eyes) received cataract surgery with IOL implantation. In our clinic, 14% of patients were given IOLs with a 4% water content, while 73% (13 eyes) of those experiencing PCA reclosure had IOLs with a 4% water content. The mean interval between Nd:YAG capsulotomies was notably shorter than that between the initial cataract surgery and the first Nd:YAG laser capsulotomy. We also identified five stages of PCA reclosure progression. In conclusion, IOL water content may be linked to PCA reclosure, and the time to recurrence is shorter with each successive reclosure. Further research is needed to verify these findings and uncover additional contributing factors.
SUMMARY Jak3 is a member of the Janus kinase family which plays an important role in cytokine signal transduction. Jak3 associates the γc chain of receptors for IL-2, IL-4, IL-7, IL-9 and IL-15, and is essential for the signal transduction of these cytokines. We have isolated Jak3 kinase from renal mesangial cells and demonstrated the constitutive expression of Jak3 in glomeruli in vivo. To investigate the physiological and pathological role of Jak3 in glomeruli, we prepared anti-Jak3 antibody and analysed the localization of Jak3 in glomeruli of renal biopsy samples from various nephritis patients and normal subjects. Among 61 nephritis patients and four normal subjects investigated in the present study, Jak3 was selectively localized to glomerular epithelia of IgA-N patients (14/34 cases) and focal glomerulosclerosis patients (1/5 cases), but not detected in minimal changes (n = 6), membranous glomerulonephropathy (n =7), crescentic glomerulonephritis (n = 4), lupus nephritis patients (n = 5), and normal subjects (n = 4). The intense immunoreactivity for Jak3 is significantly associated with the decrease in creatinine clearance (81.5 ± 10.4 ml/min versus 104.3 ± 29.6 ml/min; P<0.05, Student’s t-test) and the increase in level of serum creatinine (1.13 ± 0.33 mg/dl versus 0.75 ± 0.23 mg/dl; P<0.01, Student’s t-test) in IgA-N patients. Furthermore, γc chain was concomitantly expressed with Jak3 in glomerular epithelia in vivo and in vitro, suggesting that signal transduction via γc-Jak3 cascade may be involved in the pathogenesis of glomerular injury of IgA-N. Taken together with the recent findings that IL-4-secreting T lymphocytes in affected glomeruli injure glomerular epithelium, the responsiveness of glomerular epithelium for IL-4 may be pathologically enhanced in IgA-N.
