By James C. Bobrow, MD
This part underwent significant revision for the 2008-2009 version. part eleven studies the anatomy, body structure, embryology, and pathology of the lens. It additionally covers the epidemiology of cataracts and their overview and administration in adults. moreover, an summary of lens and cataract surgical procedure is equipped, problems of cataract surgical procedure are mentioned, and cataract surgical procedure in detailed occasions is explored. comprises many new photos.
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Additional resources for 2008-2009 Basic and Clinical Science Course: Section 11: Lens and Cataract (Basic and Clinical Science Course 2008-2009)
In primary aphakia, the lens placode fails to form from the surface ectoderm in the developing embryo. In secondary aphakia, the more common type, the developing lens is spontaneously absorbed. Both forms of aphakia are usually associated with other malformations of the eye. lenticonus and lentiglobus Lenticonus is a localized, cone-shaped deformation of the anterior or posterior lens surface (Fig 4-4). Posterior lenticonus is more common than anterior lenticonus and is usually unilateral and axial in location.
Together, the 2 sugars increase the osmotic pressure within the lens, drawing in water. At first, the energy-dependent pumps of the lens are able to compensate, but ultimately they are overwhelmed. The result is swelling of the fibers, disruption of the normal cytoskeletal architecture, and opacification of the lens. Galactose is also a substrate for aldose reductase, producing the alcohol galactitol (dulcitol). Galactitol, however, is not a substrate for sugar alcohol dehydrogenase and thus accumulates rapidly, producing the same osmotic effects-and the same consequences-as sorbitol.
Lens Sutures and the Fetal Nucleus As lens fibers grow anteriorly and posteriorly, a pattern emerges where the ends of the fibers meet and interdigitate with the ends of fibers arising on the opposite side of the lens, near the anterior and posterior poles. These patterns of cell association are known as sutures. Y-shaped sutures are recognizable at about 8 weeks of gestation, with an erect Y-suture appearing anteriorly and an inverted Y-suture posteriorly (Fig 4-2). As the lens fibers continue to form and the lens continues to grow, the pattern oflens sutures becomes increasingly complex, resulting in 12 or more suture branches in the adult eye.