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      Intraocular Acrylic Allergy: Is it Something to Sneeze at?

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          Abstract

          Cataract surgery is most commonly performed with acrylic intraocular lens (IOL) implantation. To date, there have been no reported cases of intraocular acrylic allergy despite increasing rates of acrylic-induced contact dermatitis elsewhere in the body. Concern regarding acrylate sensitization is gaining traction in the ophthalmology community. This commentary explores the lack of intraocular atopy and whether an acrylic allergy necessitates extensive preoperative consideration.

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          Posterior capsular opacification: a problem reduced but not yet eradicated.

          Posterior capsular opacification (PCO) is the most frequent complication of cataract surgery. Advances in surgical techniques, intraocular lens materials, and designs have reduced the PCO rate, but it is still a significant problem. The only effective treatment for PCO, Nd:YAG laser capsulotomy carries vision-related complications and risks and puts a significant financial burden on the health care system. This review contains current knowledge about the mechanisms of PCO development. Posterior capsular opacification is caused mainly by remnant lens epithelial cell proliferation and migration, epithelial-mesenchymal transition, collagen deposition, and lens fiber generation. All of these processes are influenced by cytokines, growth factors, and extracellular matrix proteins. We also describe advances and improvements in surgical techniques, intraocular lens materials, and the designs and use of therapeutic agents leading to safe, effective, and less expensive strategies to eradicate PCO.
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            Endophthalmitis After Cataract Surgery in the US, A Report from the IRIS Registry, 2013-2017

            To determine recent incidence and visual outcomes for acute-onset endophthalmitis after cataract surgery performed in the United States.
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              Non-invasive observation of repeated adenoviral GFP gene delivery to the anterior segment of the monkey eye in vivo.

              Glaucoma is a group of chronic eye diseases often associated with an elevated intraocular pressure (IOP). If not controlled, the condition leads to blindness. The eye tissue responsible for maintaining aqueous humor resistance and thus normal IOP is the trabecular meshwork (TM). Adenoviral vectors are capable of transducing the TM in several rodent species. Because of the relevance of the non-human primate model in the study of glaucoma, gene transfer to the eyes of cynomolgus monkeys was investigated. Four cynomolgus monkeys were injected with AdenoGFP into the anterior chamber: two monkeys received 10(9) pfu and the other two 10(7) pfu. One monkey received four consecutive injections into the same eye (10(7) pfu in each injection) over a 7-month period. In vivo gene transfer (fluorescence) and IOP were evaluated by standard clinical ophthalmic instruments (slit lamp biomicroscopy, gonioscopy and tonometry). Histopathology and cellular distribution were assessed postmortem. The first injection of the lower viral dose resulted in marked TM-preferred gene transfer visible non-invasively by in vivo gonioscopy. The expression of the transgene lasted for 3-4 weeks with little or no signs of clinical inflammation. Gene transfer was achieved on three sequential occasions (3-4 weeks each) but failed and induced substantial, albeit reversible, corneal abnormalities on the fourth occasion. Gene transfer to the TM and cornea can be monitored non-invasively in non-human primates, allowing correlation of gene transfer with physiological parameters. Because of ocular immune privilege, repeated anterior chamber administrations of adenoviral vectors expressing appropriate genes may have therapeutic potential for glaucoma.
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                Author and article information

                Contributors
                cornea2020@me.com
                Journal
                Ophthalmol Ther
                Ophthalmol Ther
                Ophthalmology and Therapy
                Springer Healthcare (Cheshire )
                2193-8245
                2193-6528
                14 July 2021
                14 July 2021
                September 2021
                : 10
                : 3
                : 393-396
                Affiliations
                [1 ]GRID grid.477402.2, Hoopes Vision Research Center, Hoopes Vision, ; 11820 S. State St., Ste.200, Draper, UT 84020 USA
                [2 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, John A. Moran Eye Center, , University of Utah School of Medicine, ; Salt Lake City, UT USA
                [3 ]Utah Lions Eye Bank, Murray, UT USA
                [4 ]GRID grid.134563.6, ISNI 0000 0001 2168 186X, University of Arizona College of Medicine Phoenix, ; Phoenix, AZ USA
                [5 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, University of Utah School of Medicine, ; Salt Lake City, UT USA
                Author information
                http://orcid.org/0000-0003-1024-6250
                Article
                374
                10.1007/s40123-021-00374-x
                8319285
                34260041
                1fcce1b8-e270-49b4-b109-351b80948651
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 28 May 2021
                : 1 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100001818, Research to Prevent Blindness;
                Categories
                Commentary
                Custom metadata
                © The Author(s) 2021

                acrylates,acrylic,biocompatibility,contact dermatitis,intraocular lens,patch testing

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