To describe the findings of a recently described syndrome, the dead bag syndrome, in which the capsular bag appears to be clear many years postoperatively, becoming diaphanous and floppy and unable to support the intraocular lens (IOL) within it.
A study using live rabbits, with subsequent analysis of excised corneas stained with trypan blue/alizarin red, showed that torsional ultrasound led to less corneal endothelial cell damage than classical longitudinal ultrasound.
Purpose
Autoimmune Polyendocrinopathy Syndrome (APS) is a rare condition caused by an autoimmune failure of two or more endocrine glands. In this case, we report the ocular findings and correlated histopathology from a human eye donor with a prior clinical history of Type 1 APS.
Observations
The 23 year-old patient originally presented with blurred vision at the 20/125 level caused by papilledema of the right eye. Bilateral pigmentary changes in the peripheral retinal were also noted. The patient passed away due to electrolyte abnormalities related to autoimmune illness. Histopathology of the posterior segments documents that these pigmentary changes were caused by pigment deposition around inner retinal vessels with corresponding outer retina atrophy. Postmortem genetic sequence analyses revealed a homozygous R257X (C to T substitution) mutation within exon 6 of the
AIRE
gene.
Conclusions and importance
The retinal findings in Type 1 Autoimmune Polyendocrinopathy Syndrome resemble those observed in individuals with retinitis pigmentosa, suggesting that similar pathological processes occur in both.
fibroblasts and causing fibrotic changes in the bag. There is no evidence, of which we are aware, that removing LECs leads to an underlying capsular abnormality. It is our view that the risks for adverse events from not performing LEC removal far outweigh the potential benefits in capsular bag maintenance. 5 In the dead bag condition, we believe a capsular abnormality or some trophic process occurs in the presence of remaining LECs and precludes their growth and long-term survival.It is still not clear where the defect lies in these dead or dystrophic bags. Any entity that affects the long-term stability/integrity of the intraocular lens support structure deserves our attention.
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