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Biomedical subjects

C F Bahn

Publications and source records attributed to C F Bahn.

13 recordsLinked to original sources

Effect of 1% sodium hyaluronate (Healon) on a nonregenerating (feline) corneal endothelium.

A series of experiments were performed to investigate the effect of 1% sodium hyaluronate (Healon) on the nonregenerating corneal endothelium of the cat. Aqueous humor replacement with 1% sodium hyaluronate resulted in mild, transient elevations of intraocular pressure compared to eyes that were injected with balanced salt solution. Sodium hyaluronate 1% protected the feline endothelium against cell loss incurred by contact with hyaluronate-coated intraocular lenses compared to endothelial contact with lenses that were not coated with sodium hyaluronate. The use of intraoperative 1% sodium hyaluronate, however, did not protect against endothelial cell loss incurred by penetrating keratoplasty or prevent subsequent skin graft-induced corneal homograft rejections. Homograft rejections were milder, however, in some eyes that received grafts coated with 1% sodium hyaluronate. Image analysis of photographs of trypan blue- and alizarin red-stained corneal buttons after trephining, stretching of Descemet's membrane, rubbing against iris-lens preparations, or immediately after penetrating keratoplasty demonstrated that the stretching of the posterior cornea is an important cause of endothelial damage that would not be protected against by a viscoelastic coating.

Animals↗

Postnatal development of corneal endothelium.

Comparison specular micrographs of infant and adult corneas from cats, cows, dogs, rabbits, and humans demonstrate that a large decrease in central endothelial cell density occurs during maturation of the cornea. Central endothelial cell counts of developing cat, dog, and rabbit corneas decrease rapidly during the first months of life. This rapid decline in endothelial cell density correlates with growth of the cornea to the adult size. Central endothelial cell counts of adult cat, cow, deer, dog, pig, rabbit, and human corneas are similar (2500 cells/mm2) despite a wide variation in corneal size. Comparison of observed endothelial cell counts with two hypothetical situations, one of unrestricted endothelial mitosis and the other of only endothelial hypertrophy, indicates that hypertrophy of individual cells is primarily responsible for achieving the adult cell density of 2500 cells/mm2 for these species. This observation is true for species that have a high adult endothelial mitotic capacity (rabbit) as well as those that do not (cat). The human cornea is a special case because the decline in central endothelial cell density indicates that a large apparent corneal endothelial cell loss (approximately 45%) occurs early in postnatal development.

Adult↗

Classification of corneal endothelial disorders based on neural crest origin.

The corneal endothelium is derived from the neural crest. A general classification of disorders of development of the neural crest has been previously presented (Johnston). Disorders of the corneal endothelium may be considered according to a modification of this scheme to reflect its true embryologic origin. In this classification, corneal endothelial disorders are categorized as abnormalities of neural crest cell formation (cyclopia), migration (Peters' anomaly), proliferation (iridocorneal endothelial syndrome), final differentiation (Fuchs' dystrophy), and acquired abnormalities (metaplasia, abiatrophy, and proliferation).

Adult↗

A randomized trial of pressure patching for epithelial defects after keratoplasty.

A prospective randomly controlled trial of the effectiveness of pressure patching in the treatment of epithelial defects after keratoplasty in 41 patients (19 in the patched group and 22 in the unpatched group) showed no significant differences in healing between the two groups (P less than .25 to P less than .49 on postoperative days 1 to 6). The mean time needed for complete healing was 2.11 days in the patched group and 2.09 days in the unpatched group. Patients with bullous keratopathy preoperatively had larger initial defects (31.4 mm2) than those without (20.1 mm2) but the time needed for healing did not differ significantly (2.35 days vs 1.9 days; P less than .10).

Bandages↗

Evidence for corneal endothelial cell hypertrophy during postnatal growth of the cat cornea.

Endothelial cell counts made from specular micrographs of 1-month-old kitten and adult cat corneas demonstrate that a progressive increase in endothelial cell size and a reduced endothelial cell density occurs during the postnatal development of the cat cornea. In addition to confirming the difference in cell size, scanning electron micrographs show that kitten endothelial cells are much more pleomorphic than those of the adult. When the number of corneal endothelial cells/mm2 and the size of the whole cornea are calculated for the kitten and adult, hypertrophy rather than mitosis appears to be the principal mechanism responsible for maintaining a confluent endothelial cell monolayer during the postnatal development of the feline cornea. Hypertrophy also appears to play a role in establishing the adult corneal endothelial cell population of the rabbit when the previously published data of others are treated in a similar manner to those of the kitten and adult cat. Thus, endothelial cell hypertrophy plays a role in establishing an "adult" endothelial cell monolayer in species that have a widely divergent corneal endothelial cell mitotic capacity.

Animals↗

Penetrating keratoplasty in the cat. A clinically applicable model.

A series of 28 consecutive penetrating keratoplasties were performed on adult cats. Donor corneas (n = 14) were maintained in culture medium for 14--24 hours prior to transplantation. Rotational autografts (n = 7) were used to control for cell loss caused by culture maintenance as well as for the effects of surgery. Additional homografts (n = 7) were transplanted following removal of the corneal endothelium to study the extent of host corneal endothelial cell regeneration. Pre- and post-operative endothelial cell counts of the homografts made from specular micrographs demonstrated an average cell loss of 30% one month following surgery. A similar 30% average cell loss was present in the rotational autografts. Clinically, both homografts and autografts remained clear and were near normal in thickness. Homografts lacking endothelium exhibited persistent, severe edema that correlated with the inability of the host corneal endothelium to resurface the graft. Clinical and morphologic evidence of mild homograft rejection as observed in 15% of the animals that received normal homografts. Corneal endothelial cell loss following penetrating keratoplasty in the cat approximates that observed following the same procedure in the human. Additionally, regenerative capacity of the corneal endothelium in the cat, like that of the human, is limited. These features suggest that this cooperative, hardy animal is an excellent model in which to study many aspects of corneal transplantation that have direct application to the treatment of human corneal disease.

Animals↗

Evaluation of coated and uncoated synthetic absorbable sutures in rabbit limbal wounds.

Polymer coatings have been applied to braided synthetic absorbable sutures to decrease tissue drag and improve knot tying characteristics. To examine the possibility that increased "slipperiness" would decrease knot security, coated (Dexon Plus) and uncoated (Dexon S) polyglycolic acid sutures were compared in rabbit limbal wounds. Both suture types had comparable knot security, tissue reaction, and absorption rates, while the coated sutures caused less tissue drag. Clinical trials of coated polyglycolic acid suture for limbal wounds are warranted.

Absorption↗

Complications associated with bovine corneal endothelial cell-lined homografts in the cat.

Cultured bovine corneal endothelial cells were subcultured onto feline corneas from which the native endothelium had been mechanically removed, and transplanted into cats via penetrating keratoplasty. Although the transplants remained thin and clear in the immediate postoperative period, correlative clinical and morphologic analysis disclosed evidence of a host response directed against the heterologous endothelium by the ninth postoperative day. Eyes with rotational autografts or transplanted homografts did not disclose evidence of a similar host response.

Animals↗

Endothelial physiology and intraocular lens implantation.

The endothelium is the cellular monolayer which lines the posterior surface of the cornea. This layer is important in clinical ophthalmology because it is vital to maintenance of the transparency of the cornea and vision through its pump and barrier functions which limit the ingress of fluid into the cornea from the aqueous. When the function of the corneal endothelium becomes compromised, the corneal stroma swells as it hydrates. Subsequently, epithelial bullae form with painful recurring epithelial erosions, and finally corneal scarring and blindness result. The relatively vulnerable position of the corneal endothelium renders it susceptible to iatrogenic injury during intraocular procedures, especially IOL implantation: the poor regenerative (mitotic) capacity of the human corneal endothelium limits its ability to recover normal function once it is injured.

Animals↗

Pathogenic effects of bullous pemphigoid autoantibodies on rabbit corneal epithelium.

Bullous pemphigoid (BP) is associated with circulating autoantibodies reactive with an antigen(s) of the basement membrane zone (BMZ) of skin and mucosae. The pathogenicity of these autoantibodies, although suspected, is unconfirmed. We have investigated the effects of BP autoantibodies on a closely related tissue, the corneal epithelium of the rabbit. IgG fractions from the sera of seven patients with BP were purified by (a) ammonium sulfate precipitation, (b) ion exchange chromatography, or (c) gel filtration. Control IgG was prepared by ion exchange chromatography of pooled normal human gamma globulins. 32 rabbits received corneal intrastromal injections of BP IgG fractions (50 microliter, 0.95-2.05 mg total dose) in one eye, and control IgG (50 microliter, 1.8 mg) in the contralateral cornea. 28 of 32 BP IgG injections produced corneal inflammatory lesions, 10 of which developed visible blisters. Histologically, lesions showed polymorphonuclear cells clustering along the BMZ, and subepithelial blister formation. Immunofluorescence showed in vivo bound IgG and C3 at the BMZ. The intensity of inflammation was dose dependent and correlated often with in vitro complement fixation titers of the fractions. None of 32 corneas injected with control IgG became inflamed. BP IgG fractions injected intradermally into the ear skin of rabbits failed to produce inflammation. This may be due to slow clearance of IgG in the cornea, and optimal binding by the corneal epithelium. The intracorneal injections of BP IgG reproduce the clinical, histological, and immunological features of BP. This study provides evidence that BP autoantibodies are pathogenic.

Animals↗

Reactions to an anterior chamber lens--two years after implantation.

For two and a half years this 99-year-old man had done well with his anterior chamber lens of the Choyce type. He donated the eye for pathological evaluation after his death. The eye exhibited some superior corneal edema, distortion of the lower iris with formation of pockets to hold the inferior feet of the implant, some iris atrophy, slight iritis, minimal bleeding, slight neovascularization, and vacuolic degeneration of the pigment epithelium. The observation of a callus-like formation of connective tissue on all those parts of the iris surface that have had contact with the lens implant is the most important finding. This indicates that the iris can not only adjust to the foreign substance of the implant, but it can also give it firm and lasting support. The authors suspect a mild stage of cystoid macular edema with fibrinous exudation into vitreous and preretinal spaces to be present in this case.

Aged↗