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Immediate changes in protein-concentration in aqueous humor induced by intracapsular lens extraction in human eyes

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Summary

In 71 patients that underwent intracapsular extraction of the cataract it was possible to collect aqueous humor (a.h.) in sufficient quantities at the beginning and at the end of the operation. Using radial immunodiffusion albumin, IgG and α-1-antitrypsin were measured in the samples. In secondary a.h. huge variations in the concentrations were apparent. The primary permeability of the blood-aqueous barrier and the time between sampling had no influence on the relative increase of the proteins.No statistically significant difference was found between normotensives and hypertensives and patients with or without myopia of higher degree (over 6 diopters). The relative increase of proteins according to their difference in molecular weight followed the same pattern as described for anterior uveitis. In patients for whom an enzymatic zonulolysis with trypsin was used for the extraction, the relative increase of IgG was significantly smaller than in those that did not receive this treatment (P<0.005).

The possible sources contributing to the formation of secondary a.h. are discussed.

Zusammenfassung

Es konnten bei 71 Patienten, die wegen Trübungen der Augenlinse einer intracapsulären Extraktion unterzogen wurden, am Beginn der Operation primäres und unmittelbar vor Ende der Operation neugebildetes, “sekundäres” Kammerwasser (KW) in zur Untersuchung ausreichenden Mengen entnommen werden. In den Proben wurden mit Hilfe der radialen Immundiffusion Albumin, IgG und α-l-Antitrypsin bestimmt. Dabei fanden sich im sekundären KW außerordentlich große Schwankungen in der Konzentrationszunahme der verschiedenen Proteine. Die primäre Durchgängigkeit der Blut-Kammerwasser-Schranke und das Zeitintervall zwischen den Probenentnahmen schienen auf den relativen Anstieg der Eiweißkörper keinen Einfluß zu haben. Ebensowenig fand sich ein statistisch gesicherter Unterschied zwischen Hypertonikern und Normotensiven oder Myopen (über 6 dptr) und Patienten mit nur geringen Brechungsfehlern. Der Anstieg der einzelnen Proteine folgte jedoch, entsprechend ihrem Mole-kulargewicht, dem Verteilungsmuster wie es für die vordere Uveitis beschrieben wurde. Patienten, bei welchen eine enzymatische Zonulolyse mit Trypsin zur Extraktion verwendet wurde, wiesen einen statistisch signifikant geringeren relativen Anstieg des IgG im sekundären KW, im Vergleich zur unbehandelten Gruppe, auf (P > 0,005).

Die möglichen Quellen, welche zur Bildung des sekundären KW beitragen können, werden diskutiert.

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Authors and Affiliations

  1. II. Universitäts-Augenklinik Wien and Institut für Medizinische Computerwissenschaften der Universität Wien, A-1090, Wien, Österreich

    Günther Grabner, Georg Zehetbauer, Heinz Bettelheim & Wolfgang Dorda

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  1. Günther Grabner
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  2. Georg Zehetbauer
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  3. Heinz Bettelheim
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  4. Wolfgang Dorda
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Grabner, G., Zehetbauer, G., Bettelheim, H. et al. Immediate changes in protein-concentration in aqueous humor induced by intracapsular lens extraction in human eyes. Albrecht von Graefes Arch. Klin. Ophthalmol. 210, 275–289 (1979). https://doi.org/10.1007/BF00417541

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