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August 1985

Hyaloid Membrane vs Posterior Capsule as a Protective Barrier

Author Affiliations

Hartford, Conn

Arch Ophthalmol. 1985;103(8):1112. doi:10.1001/archopht.1985.01050080024007

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To the Editor.  —It is now well accepted that there is a relationship between intracapsular cataract extraction/lensectomy and postoperative development of rubeosis iridis and neovascular glaucoma in patients undergoing vitrectomy.1 Recently, my associates and I demonstrated the relationship between intracapsular cataract extraction and postoperative development of rubeosis iridis and neovascular glaucoma in diabetic patients, especially in patients with active proliferative diabetic retinopathy.2 The article by Thompson and Glaser3 in the Archives is especially timely and significant because of the current trend toward extracapsular cataract extraction as well as the work being done in Glaser's laboratory on the isolation and identification of a diffusable angiogenesis factor.Their article seemingly shows the importance of the posterior capsule of the lens as a barrier to the diffusion of 20,000- and 70,000-dalton dextran from the vitreous to the anterior chamber, thereby providing experimental data to possibly explain the above clinical findings.

Okun E, McMeel JW:  Discussion of closed vitrectomy in diabetic retinopathy , in Freeman HM, Hirose T, Schepens CL (eds): Vitreous Surgery and Advances in Fundus Diagnosis and Treatment . New York, Appleton-Century-Crofts, 1977, pp 311-312.
Aiello LM, Wand M, Liang G:  Neovascular glaucoma and vitreous hemorrhage following cataract surgery in patients with diabetes mellitus . Ophthalmology 1983;90:814-819.Article
Thompson JT, Glaser BM:  Role of lensectomy and posterior capsule in movement of tracers from vitreous to aqueous . Arch Ophthalmol 1985;103:420-421.Article
Epstein DL, Hashimoto JM, Anderson PJ, et al:  Experimental perfusion through the anterior and vitreous chambers with possible relationships to malignant glaucoma . Am J Ophthalmol 1979;88:1078-1086.
Glaser BM, D'Amore PA, Michels RG:  The effect of human intraocular fluid on vascular endothelial cell migration . Ophthalmology 1981;88:986-991.Article