PURPOSE: To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. METHODS: This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. RESULTS: Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. CONCLUSION: silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

PURPOSE: To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. METHODS: This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. RESULTS: Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. CONCLUSION: silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

PURPOSE: To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. METHODS: This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. RESULTS: Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. CONCLUSION: silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

PURPOSE: To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. METHODS: This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. RESULTS: Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. CONCLUSION: silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

PURPOSE: To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. METHODS: This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. RESULTS: Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens' epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. CONCLUSION: silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

Purpose: To evaluate the value of swept-source anterior segment optical coherence tomography (AS-OCT) in the diagnosis and management of laser in situ keratomileusis (LASIK) flap-related complications. Methods: This prospective study included 25 eyes with LASIK flap-related complications imaged using swept-source AS-OCT between February and August 2016 at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan. Results: Imaging of flap-related LASIK complications using AS-OCT revealed specific and non-specific findings. Of note, epithelial ingrowth showed as highly reflective lesions below the LASIK flap in the form of islands, nests, or a continuous sheet with or without changes in the overlying flap. Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae showed as corrugations on the stromal surface with regular overlying epithelium. Less common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface. Interface debris showed as a highly reflective interface lesion with or without a surrounding reaction. One eye with a flap that was torn and lost intraoperatively showed epithelialisation over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day. AS-OCT was useful for assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut. Conclusion: Swept-source AS-OCT is useful not only for diagnosis but also for management of eyes with LASIK flap-related complications by allowing non-invasive, non-contact, real time acquisition of cross-sectional AS images.

Purpose: To evaluate the value of swept-source anterior segment optical coherence tomography (AS-OCT) in the diagnosis and management of laser in situ keratomileusis (LASIK) flap-related complications. Methods: This prospective study included 25 eyes with LASIK flap-related complications imaged using swept-source AS-OCT between February and August 2016 at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan. Results: Imaging of flap-related LASIK complications using AS-OCT revealed specific and non-specific findings. Of note, epithelial ingrowth showed as highly reflective lesions below the LASIK flap in the form of islands, nests, or a continuous sheet with or without changes in the overlying flap. Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae showed as corrugations on the stromal surface with regular overlying epithelium. Less common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface. Interface debris showed as a highly reflective interface lesion with or without a surrounding reaction. One eye with a flap that was torn and lost intraoperatively showed epithelialisation over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day. AS-OCT was useful for assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut. Conclusion: Swept-source AS-OCT is useful not only for diagnosis but also for management of eyes with LASIK flap-related complications by allowing non-invasive, non-contact, real time acquisition of cross-sectional AS images.

Purpose: To evaluate the value of swept-source anterior segment optical coherence tomography (AS-OCT) in the diagnosis and management of laser in situ keratomileusis (LASIK) flap-related complications. Methods: This prospective study included 25 eyes with LASIK flap-related complications imaged using swept-source AS-OCT between February and August 2016 at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan. Results: Imaging of flap-related LASIK complications using AS-OCT revealed specific and non-specific findings. Of note, epithelial ingrowth showed as highly reflective lesions below the LASIK flap in the form of islands, nests, or a continuous sheet with or without changes in the overlying flap. Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae showed as corrugations on the stromal surface with regular overlying epithelium. Less common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface. Interface debris showed as a highly reflective interface lesion with or without a surrounding reaction. One eye with a flap that was torn and lost intraoperatively showed epithelialisation over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day. AS-OCT was useful for assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut. Conclusion: Swept-source AS-OCT is useful not only for diagnosis but also for management of eyes with LASIK flap-related complications by allowing non-invasive, non-contact, real time acquisition of cross-sectional AS images.

Purpose: To evaluate the value of swept-source anterior segment optical coherence tomography (AS-OCT) in the diagnosis and management of laser in situ keratomileusis (LASIK) flap-related complications. Methods: This prospective study included 25 eyes with LASIK flap-related complications imaged using swept-source AS-OCT between February and August 2016 at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan. Results: Imaging of flap-related LASIK complications using AS-OCT revealed specific and non-specific findings. Of note, epithelial ingrowth showed as highly reflective lesions below the LASIK flap in the form of islands, nests, or a continuous sheet with or without changes in the overlying flap. Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae showed as corrugations on the stromal surface with regular overlying epithelium. Less common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface. Interface debris showed as a highly reflective interface lesion with or without a surrounding reaction. One eye with a flap that was torn and lost intraoperatively showed epithelialisation over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day. AS-OCT was useful for assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut. Conclusion: Swept-source AS-OCT is useful not only for diagnosis but also for management of eyes with LASIK flap-related complications by allowing non-invasive, non-contact, real time acquisition of cross-sectional AS images.

Purpose: To evaluate the value of swept-source anterior segment optical coherence tomography (AS-OCT) in the diagnosis and management of laser in situ keratomileusis (LASIK) flap-related complications. Methods: This prospective study included 25 eyes with LASIK flap-related complications imaged using swept-source AS-OCT between February and August 2016 at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan. Results: Imaging of flap-related LASIK complications using AS-OCT revealed specific and non-specific findings. Of note, epithelial ingrowth showed as highly reflective lesions below the LASIK flap in the form of islands, nests, or a continuous sheet with or without changes in the overlying flap. Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae showed as corrugations on the stromal surface with regular overlying epithelium. Less common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface. Interface debris showed as a highly reflective interface lesion with or without a surrounding reaction. One eye with a flap that was torn and lost intraoperatively showed epithelialisation over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day. AS-OCT was useful for assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut. Conclusion: Swept-source AS-OCT is useful not only for diagnosis but also for management of eyes with LASIK flap-related complications by allowing non-invasive, non-contact, real time acquisition of cross-sectional AS images.