the lens structure, function and pathology · ps uppsala gullstrand lab universitet...
TRANSCRIPT
PS UPPSALAUNIVERSITETGullstrand lab
PLS_7_1_1ChristmasTreeCat_ICordarone
The Lens Structure,Function and Pathology
UPPSALAUNIVERSITET
Per SöderbergGullstrand lab, Ophthalmology
Dept. of Neuroscience,Uppsala university, Sweden
Handout available at: http://www2.neuro.uu.se/ophthalmology/Downloads/LensHouston/lens.pdf
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4LensImplantation
TitleUppsala universityUppsalaSweden
PS UPPSALAUNIVERSITETGullstrand lab
GullstrandAllvar Allvar GullstrandNobel laureate 19111st professor of ophthalmologyUppsala University, Sweden
Professor Anders BillModern view of IOP controland ocular circulation
Pharmacia- Commericialization Healon- Commercialization Xalatan
PS UPPSALAUNIVERSITETGullstrand lab
PS UPPSALAUNIVERSITETGullstrand lab
Gunnhaga, 2011
Ogino et al., 20004 w 12 w
Embryology of the lens
PS UPPSALAUNIVERSITETGullstrand lab
Aen_011_EmbryologyHyaloidVessels
PS UPPSALAUNIVERSITETGullstrand lab
Macrosocopic anatomy
PS UPPSALAUNIVERSITETGullstrand labLensInEye
Berger’s spatiumWieger’s ligament
Cloquet’s canal
PS UPPSALAUNIVERSITETGullstrand lab
BergerSpatiumCalcification
Berger’s spatium
Intraocular lens
PS UPPSALAUNIVERSITETGullstrand lab
Anatomical landmarks
Facies anterior Facies posterior
Lens axisAnterior pole Posterior pole
Nucleus
Lens capsule
Subcapsular zone
Equatorial zone
PS UPPSALAUNIVERSITETGullstrand labAle_HumanLensGro
wth
050
100150200250
0 50 100
Age (Yrs)
Mas
s (m
g)Human lens growth
21.097 AgeMassLens ⋅=
PS UPPSALAUNIVERSITETGullstrand lab
ALE_5_3LensCapsuleThicknessMicroscopic anatomy
PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_4_2LensEpithelium
Anterior chamber
Lens bulk
Lens capsule- Collagen- Glucoprotein
PS UPPSALAUNIVERSITETGullstrand lab
SummaryThe lens epithelium
Bassnett et al.2010
PS UPPSALAUNIVERSITETGullstrand labLensEpitheliumZones
Central zone
Germinative zone
Equatorial zone
Ion transport
Replication
Growth
PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_4_2LensEpithelium
Lens capsule
Lens fiber
PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_5LensEpithelialCell
PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_7LensBowUltra
PS UPPSALAUNIVERSITETGullstrand labAle_LensAnatomy
Lens fiber cells
PS UPPSALAUNIVERSITETGullstrand lab
Lens nuclear zones
Embryonal nucleus
PS UPPSALAUNIVERSITETGullstrand lab
Lens fiber structure
PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_11_1LensFibersUltra
PS UPPSALAUNIVERSITETGullstrand lab
Chemical composition
Protein50-60 %
Water30-40 %
Lipid membranesNucleic acidsElectrolytes
Water soluble – refractive index
Water insoluble - Structure
Electrophoretic separationα – crystallinβ – crystallinγ – crystallin
PS UPPSALAUNIVERSITETGullstrand lab
Physiological aspects
Refraction: n= k [Protein]Osmotic problems
PS UPPSALAUNIVERSITETGullstrand lab
Refractive index gradient humanAnterior - posterior
Side-Side
Pierscionek et al. 2015
PS UPPSALAUNIVERSITETGullstrand lab
Ale004014004NaKPump
Lactic acid
Glutathion-synthesis
Ascorbic acid
Predominantlyanaerbic metabolism
Highly oxygen senstivive
PS UPPSALAUNIVERSITETGullstrand labLensOxygen
Beebe et al., 2011
Lens oxygenAerobic metabolism
Normal After vitrectomyO2
Low
High
PS UPPSALAUNIVERSITETGullstrand lab
AleLensZonulesZonules
PS UPPSALAUNIVERSITETGullstrand labLensPotential
Zonules
PS UPPSALAUNIVERSITETGullstrand lab
ALE_1_2ZonulaeInsertion
PS UPPSALAUNIVERSITETGullstrand lab
ALE_5_7LensZonules
Cili
ary
body
diam
eter
Time
PS UPPSALAUNIVERSITETGullstrand lab
PS UPPSALAUNIVERSITETGullstrand lab
PS UPPSALAUNIVERSITETGullstrand lab
Transmittance, eye ultraviolet radiation (UVR)
Boettner et al, 1962
0
0.5
1
280 300 320 340 360 380 400Wavelength (nm)
Tran
smitt
ance
PS UPPSALAUNIVERSITETGullstrand lab
00.20.40.60.8
1
0 0.2 0.4 0.6 0.8 1Rel. Age
Biol
. Eff.
Rel
.
Pigmented C57Bl6 mice, Zhang et al, manus
Albino SD rat,Dong et al. 2005
Rel. sensitivity as a function of age
PS UPPSALAUNIVERSITETGullstrand lab
S:T ERIKS
SJUKHUSÖGONPS
0.0
0.2
0.4
0.6
280 300 320 340 360 380 400 420
Wavelength (nm)
Tran
smitt
ance
PrenatalBirth0-2 yrs10-19 yrs
0.00
0.50
1.00
350 400 450 500 550 600
Wavelength (nm)
Tran
smitt
ance
20-29 yrs30-39 yrs40-49 yrs50-59 yrs60-69 yrs70-79 yrsBarker, unpublished
PS UPPSALAUNIVERSITETGullstrand lab
Title
Macular protectionwith IOLs
PS UPPSALAUNIVERSITETGullstrand lab
ALE_5_1AckomodationPresbyopia
Pathology of the lens
PS UPPSALAUNIVERSITETGullstrand labAccomodationAge
Acc
omod
atio
n (D
iopt
ers)
Age (Yrs)
5
10
15
20 40 60
Ackommodation versus age
PS UPPSALAUNIVERSITETGullstrand lab
PLS_4_1_8Lens luxationLens luxation
PS UPPSALAUNIVERSITETGullstrand lab
Cataract - Clinical definitionLight scattering in the lens causing visual disturbance
PS UPPSALAUNIVERSITETGullstrand lab
Cataract Types
PS
S :T E RIK S
Ö G O NSJUK HUS
PLS_6_1_12Cuneiform_I Cataract
Cortical
Nuclear
Posterior subcapsular
PS UPPSALAUNIVERSITETGullstrand lab
ALE_ProteinsCataractDevelopment
1.0
0.5
0.00 20 40 60 60
Age (Yrs)
Frac
tion
(rel
.) Soluble
Insoluble
Cataract
Soluble and insoluble proteins and cataract development
PS UPPSALAUNIVERSITETGullstrand lab
PLS_6_1_8_2MorgagniskMorgagnic cataract
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Incision30
Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Kapsulorhexis31
Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Hydrodissektion32
Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4NucleusSculpture33
Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4NuclearFracture34
Title
PS UPPSALAUNIVERSITETGullstrand lab
XXX_Op4NucleusFragmentRemoval35 Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4CortexRemoval
Title
PS UPPSALAUNIVERSITETGullstrand lab
XXX_Op4LensImplantation Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4EvacuationVisco37
Title
PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Antibiotic
Title
PS UPPSALAUNIVERSITETGullstrand lab
Preparation for fs cataract surgery
PS UPPSALAUNIVERSITETGullstrand lab
fsCataractSurgery
Courtesy Daniel Palanker, Stanford Univ.
PS UPPSALAUNIVERSITETGullstrand lab
FsCutInLensfs cuts in crystalline lens
Palanker et al., 2010
AfterCapsulorhexis Lens cuts
PS UPPSALAUNIVERSITETGullstrand lab
CSS_4Skridskoåkare