the lens structure, function and pathology · ps uppsala gullstrand lab universitet...
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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
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4LensImplantation
TitleUppsala universityUppsalaSweden
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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
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PS UPPSALAUNIVERSITETGullstrand lab
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PS UPPSALAUNIVERSITETGullstrand lab
Gunnhaga, 2011
Ogino et al., 20004 w 12 w
Embryology of the lens
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PS UPPSALAUNIVERSITETGullstrand lab
Aen_011_EmbryologyHyaloidVessels
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PS UPPSALAUNIVERSITETGullstrand lab
Macrosocopic anatomy
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PS UPPSALAUNIVERSITETGullstrand labLensInEye
Berger’s spatiumWieger’s ligament
Cloquet’s canal
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PS UPPSALAUNIVERSITETGullstrand lab
BergerSpatiumCalcification
Berger’s spatium
Intraocular lens
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PS UPPSALAUNIVERSITETGullstrand lab
Anatomical landmarks
Facies anterior Facies posterior
Lens axisAnterior pole Posterior pole
Nucleus
Lens capsule
Subcapsular zone
Equatorial zone
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PS UPPSALAUNIVERSITETGullstrand labAle_HumanLensGro
wth
050
100150200250
0 50 100
Age (Yrs)
Mas
s (m
g)Human lens growth
21.097 AgeMassLens ⋅=
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_5_3LensCapsuleThicknessMicroscopic anatomy
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_4_2LensEpithelium
Anterior chamber
Lens bulk
Lens capsule- Collagen- Glucoprotein
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PS UPPSALAUNIVERSITETGullstrand lab
SummaryThe lens epithelium
Bassnett et al.2010
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PS UPPSALAUNIVERSITETGullstrand labLensEpitheliumZones
Central zone
Germinative zone
Equatorial zone
Ion transport
Replication
Growth
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_4_2LensEpithelium
Lens capsule
Lens fiber
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_5LensEpithelialCell
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_7LensBowUltra
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PS UPPSALAUNIVERSITETGullstrand labAle_LensAnatomy
Lens fiber cells
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PS UPPSALAUNIVERSITETGullstrand lab
Lens nuclear zones
Embryonal nucleus
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PS UPPSALAUNIVERSITETGullstrand lab
Lens fiber structure
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_4_11_1LensFibersUltra
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PS UPPSALAUNIVERSITETGullstrand lab
Chemical composition
Protein50-60 %
Water30-40 %
Lipid membranesNucleic acidsElectrolytes
Water soluble – refractive index
Water insoluble - Structure
Electrophoretic separationα – crystallinβ – crystallinγ – crystallin
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PS UPPSALAUNIVERSITETGullstrand lab
Physiological aspects
Refraction: n= k [Protein]Osmotic problems
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PS UPPSALAUNIVERSITETGullstrand lab
Refractive index gradient humanAnterior - posterior
Side-Side
Pierscionek et al. 2015
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PS UPPSALAUNIVERSITETGullstrand lab
Ale004014004NaKPump
Lactic acid
Glutathion-synthesis
Ascorbic acid
Predominantlyanaerbic metabolism
Highly oxygen senstivive
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PS UPPSALAUNIVERSITETGullstrand labLensOxygen
Beebe et al., 2011
Lens oxygenAerobic metabolism
Normal After vitrectomyO2
Low
High
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PS UPPSALAUNIVERSITETGullstrand lab
AleLensZonulesZonules
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PS UPPSALAUNIVERSITETGullstrand labLensPotential
Zonules
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_1_2ZonulaeInsertion
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_5_7LensZonules
Cili
ary
body
diam
eter
Time
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PS UPPSALAUNIVERSITETGullstrand lab
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PS UPPSALAUNIVERSITETGullstrand lab
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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
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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
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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
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PS UPPSALAUNIVERSITETGullstrand lab
Title
Macular protectionwith IOLs
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PS UPPSALAUNIVERSITETGullstrand lab
ALE_5_1AckomodationPresbyopia
Pathology of the lens
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PS UPPSALAUNIVERSITETGullstrand labAccomodationAge
Acc
omod
atio
n (D
iopt
ers)
Age (Yrs)
5
10
15
20 40 60
Ackommodation versus age
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PS UPPSALAUNIVERSITETGullstrand lab
PLS_4_1_8Lens luxationLens luxation
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PS UPPSALAUNIVERSITETGullstrand lab
Cataract - Clinical definitionLight scattering in the lens causing visual disturbance
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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
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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
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PS UPPSALAUNIVERSITETGullstrand lab
PLS_6_1_8_2MorgagniskMorgagnic cataract
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Incision30
Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Kapsulorhexis31
Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Hydrodissektion32
Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4NucleusSculpture33
Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4NuclearFracture34
Title
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PS UPPSALAUNIVERSITETGullstrand lab
XXX_Op4NucleusFragmentRemoval35 Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4CortexRemoval
Title
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PS UPPSALAUNIVERSITETGullstrand lab
XXX_Op4LensImplantation Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4EvacuationVisco37
Title
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PS UPPSALAUNIVERSITETGullstrand labXXX_Op4Antibiotic
Title
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PS UPPSALAUNIVERSITETGullstrand lab
Preparation for fs cataract surgery
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PS UPPSALAUNIVERSITETGullstrand lab
fsCataractSurgery
Courtesy Daniel Palanker, Stanford Univ.
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PS UPPSALAUNIVERSITETGullstrand lab
FsCutInLensfs cuts in crystalline lens
Palanker et al., 2010
AfterCapsulorhexis Lens cuts
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PS UPPSALAUNIVERSITETGullstrand lab
CSS_4Skridskoåkare