fibrin and Foreign-Body-Reaction

Inflammatory reactions following IOL-implantation are being caused by different factors. A recent finding refers to the fact that bacteria of usually low pathogenity (i.e. Probionibacterium acnes, Staph. epidermidis, Staph. aureus haemolyticus) can enter the eye during implantation into the capsular bag and can cause an initially localized endophthalmitis. Previously this clinical appearance had frequently been mistaken as a "Toxic Lens Syndrome". Clinically, a persisting or increasing fibrin reaction with or without hypopyon, a typical whitish appearance of the capsule and a more or less marked vitreous infiltration up to a generalized endophthalmitis may be observed. For diagnostic purposes an isolation of germs from the fibrin network in the pupillary area or from the excised fragments of the capsular bag can be successful. Therapy of choice are locally applied antibiotics (i.e. the combination of Cephalosporin with Tobramycin) or eventually an operative intervention. If this is performed in the early course, the IOL can be saved in the majority of cases, although the visual acuity is usually reduced. Postoperative inflammatory reactions can also be caused by individual disposition (pseudoexfoliation, glaucoma, uveitis). No importance is being attributed furthermore to diagnoses like "Toxic Lens Syndrome" or "Pseudo-phako-anaphylactic Endophthalmitis'. Postoperative inflammatory reactions can be divided into five different clinical courses. In cases of bacterial contamination the prognosis is worsened by mono-steroid therapy.

Topics: Endophthalmitis; Fibrin; Foreign-Body Reaction; Humans; Lenses, Intraocular; Postoperative Complications

Topics: Animals; Anticoagulants; Blood Platelets; Blood Vessel Prosthesis; Cattle; Cells; Chick Embryo; Dogs; Endothelium; Fibrin; Fibroblasts; Forecasting; Foreign-Body Reaction; Granulation Tissue; Heart Valve Prosthesis; Hematocrit; Humans; Polyethylene Terephthalates; Prosthesis Design; Proteins; Species Specificity; Swine; Textiles; Thrombosis

In two double-blind controlled trials the anti-inflammatory effects of dexamethasone were examined in post-cataract extraction eyes after lens implantation in 321 patients. In the first trial, 103 patients were included. 49 eyes received eye-drops with 0.1% dexamethasone and antibiotics, the control-group of 54 eyes received the same antibiotics without any steroids. The follow-up was 2 months. In the case of unexpected complications, the patients dropped out. This was the case in 48% of the steroid-group and in 79% of the control-group. The main reason for this statistically significant difference were inflammatory complications in the control-group, which are difficult to quantify. The incidence of fibrinous reactions was not significantly different in the two groups, probably because of small numbers. In the second trial, we looked for fibrinous reactions. The follow-up was 3 weeks, 218 patients participated. They were divided into three groups: 71 patients received eyedrops with 0.1% dexamethasone 4x daily, 77 patients received the same drops 4x daily up to the fifth postoperative day, from then on 1x daily. 70 patients received the same drops 1x daily. A mild fibrinous reaction was seen in 10% of the high-dose-group, in 6% of the medium-dose-group and in 21% of the low-dose-group. Only the difference between the last two groups is statistically significant. We conclude that the therapy with corticosteroids after cataract extraction and lens implantation may be reduced early in the postoperative course.

Topics: Adult; Aged; Aged, 80 and over; Cataract Extraction; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug Combinations; Female; Fibrin; Foreign-Body Reaction; Humans; Hydrocortisone; Lenses, Intraocular; Male; Middle Aged; Neomycin; Polymyxin B; Postoperative Complications; Prospective Studies; Sulfonamides

A prospective study of the peroperative behaviour of eyes with pseudoexfoliation syndrome (PEX) in cataract surgery was carried out between June 1989 and July 1990, including 164 eyes with PEX and 164 eyes in the control group. All eyes underwent either phakoemulsifikation or extracapsular extraction with implantation of a posterior chamber lens. Intraoperative the eyes with PEX fairly often failed to reach adequate mydriases (23%) compared with the control group (5.5%). The rate of postoperative fibrinoid reactions was almost the same in both groups (7.9% in eyes with PEX, 7.5% in the control group). Even though the cataract extraction and implantation of the IOL sometimes is slightly more difficult due to inadequate mydriasis, there is no evidence for an increased rate of severe intraoperative complications. The incidence of ruptures of the posterior capsule and vitreous loss was 1.2% and 0.6% respectively in eyes with PEX, the former is within our results of cataract surgery, delivered from a study of 6000 consecutive cases from 1982 to 1985 (0.73%).

Topics: Aged; Female; Fibrin; Foreign-Body Reaction; Glaucoma; Humans; Lens Capsule, Crystalline; Lenses, Intraocular; Male; Postoperative Complications; Prospective Studies; Risk Factors

After spinal cord injury, gliomesenchymal scaring inhibits axonal regeneration as a physical barrier. In peripheral nerve injuries, native spider silk was shown to be an effective scaffold to facilitate axonal re-growth and nerve regeneration. This study tested a two-composite scaffold made of longitudinally oriented native spider silk containing a Haemocomplettan fibrin sheath to bridge lesions in the spinal cord and enhance axonal sprouting. In vitro cultivation of neuronal cells on spider silk and fibrin revealed no cytotoxicity of the scaffold components. When spinal cord tissue was cultured on spider silk that was reeled around a metal frame, migration of different cell types, including neurons and neural stem cells, was observed. The scaffold was implanted into spinal cord lesions of four Wistar rats to evaluate the physical stress caused on the animals and examine the bridging potential for axonal sprouting and spinal cord regeneration. However, the implantation in-vivo resulted in a granulomatous foreign body reaction. Spider silk might be responsible for the strong immune response. Thus, the immune response to native spider silk seems to be stronger in the central nervous system than it is known to be in the peripheral body complicating the application of native spider silk in spinal cord injury treatment.

Topics: Animals; Fibrin; Foreign-Body Reaction; Nerve Regeneration; Rats; Rats, Wistar; Silk; Spinal Cord; Spinal Cord Injuries; Spinal Cord Regeneration; Tissue Scaffolds

Implantation of biomaterials and medical devices in the body triggers the foreign body reaction (FBR) which is characterized by macrophage fusion at the implant surface leading to the formation of foreign body giant cells and the development of the fibrous capsule enveloping the implant. While adhesion of macrophages to the surface is an essential step in macrophage fusion and implanted biomaterials are known to rapidly acquire a layer of host proteins, a biological substrate that is responsible for this process in vivo is unknown. Here we show that mice with genetically imposed fibrinogen deficiency display a dramatic reduction of macrophage fusion on biomaterials implanted intraperitoneally and subcutaneously and are protected from the formation of the fibrin-containing fibrous capsule. Furthermore, macrophage fusion on biomaterials implanted in Fib

Topics: Animals; Biocompatible Materials; Fibrin; Foreign-Body Reaction; Mice; Polymers; Prostheses and Implants

Recent studies utilizing shape memory polymer foams to coat embolizing coils have shown potential benefits over current aneurysm treatments. In the current study utilizing a rabbit-elastase aneurysm model, the performance of test article (foam-coated coil [FCC]) and control (bare platinum coils [BPCs]) devices were compared at 30, 90, and 180 days using micro-CT and histological assessments. The host response was measured by identifying the cells regionally present within the aneurysm, and assessing the degree of residual debris and connective tissue. The 3D reconstructions of aneurysms provided context for histologic findings, and aided in the overall aneurysm assessment. At all time points, >75% of the cells categorized in each aneurysm were associated with a bioactive yet biocompatible host response (vs. the remainder of cells that were associated with acute inflammation). The extracellular matrix exhibited a transition from residual fibrin at 30 days to a greater degree of connective tissue at 90 and 180 days. Although the control BPC-treated aneurysms exhibited a greater degree of connective tissue at the earliest time point examined (30 days), by 180 days, the FCC-treated aneurysms had more connective tissue and less debris overall than the control aneurysms. When considering cell types and extracellular matrix composition, the overall host response scores were significantly better in FCC-treated aneurysms at the later time point. Based on the results of these metrics, the FCC device may lead to an advanced tissue remodeling response over BPC occlusion devices.

Topics: Animals; Blood Vessel Prosthesis; Coated Materials, Biocompatible; Fibrin; Foreign-Body Reaction; Humans; Inflammation; Intracranial Aneurysm; Pancreatic Elastase; Platinum; Prosthesis Design; Rabbits; Risk Assessment; Smart Materials; Time Factors; Treatment Outcome; X-Ray Microtomography

Mast cell activation has been shown to be an initiator and a key determinant of foreign body reactions. However, there is no non-invasive method that can quantify the degree of implant-associated mast cell activation. Taking advantage of the fact that fibrin deposition is a hallmark of mast cell activation around biomaterial implants, a near infrared probe was fabricated to have high affinity to fibrin. Subsequent in vitro testing confirmed that this probe has high affinity to fibrin. Using a subcutaneous particle implantation model, we found significant accumulation of fibrin-affinity probes at the implant sites as early as 15 min following particle implantation. The accumulation of fibrin-affinity probes at the implantation sites could also be substantially reduced if anti-coagulant - heparin was administered at the implant sites. Further studies have shown that subcutaneous administration of mast cell activator - compound 48/80 - prompted the accumulation of fibrin-affinity probes. However, implant-associated fibrin-affinity probe accumulation was substantially reduced in mice with mast cell deficiency. The results show that our fibrin-affinity probes may serve as a powerful tool to monitor and measure the extent of biomaterial-mediated fibrin deposition and mast cell activation in vivo.

Topics: Animals; Female; Fibrin; Foreign-Body Reaction; Mast Cells; Mice; Mice, Inbred BALB C

The reaction of rat tissues was studied using the methods of light microscopy 4, 12, 18 days, 1, 2, 6 and 12 months after hypodermic implantation of polymeric films made of polyhydroxyalkanoates (PHA). It was found that polymer, like any foreign matter in an organism, become immediately covered by fibrin. By day 4, there the deformation and destruction of polymeric films were observed due to fibrin contraction. Further, the foreign body was covered by a connective tissue capsule. Under the action of myofibroblasts, the capsule around PHA contracted, thus further deforming and breaking the polymer. Small particles of polymer were covered by macrophages, after some time the cytoplasm of macrophages fused forming the giant cells of foreign body type. After the prolonged period, small fragments of polymeric films were almost completely degraded by macrophages. Large polymeric fragments that were not deformed or crushed, became encapsulated by fibrous tissue and remained unchanged for long time periods.

Topics: Animals; Biocompatible Materials; Connective Tissue; Fibrin; Foreign Bodies; Foreign-Body Reaction; Macrophages; Male; Polyhydroxyalkanoates; Polymers; Rats

Topics: Adult; Angiography, Digital Subtraction; Catheterization, Central Venous; Catheters, Indwelling; Equipment Design; Fibrin; Foreign-Body Migration; Foreign-Body Reaction; Humans; Male; Prosthesis Failure; Pulmonary Artery; Vena Cava Filters; Vena Cava, Inferior

The role of echocardiography for the evaluation of thrombus formation on indwelling intracardiac catheters is well established. Considerably less well described, however, are the echocardiographic characteristics of the so-called retained fibrin sheath, a sleeve of fibrin that surrounds the catheter at the point at which it enters the vein that commonly remains adherent to the vessel wall after catheter removal. The authors report the transesophageal echocardiographic findings of a retained fibrin sheath following catheter removal in a patient with end-stage renal disease and infective endocarditis of the aortic valve.

Topics: Aortitis; Cardiac Catheterization; Echocardiography, Transesophageal; Female; Fibrin; Foreign-Body Reaction; Humans; Middle Aged; Renal Dialysis

We sought to evaluate tissue reactions within and at the surface of devices for interventional therapy of septal defects and to identify antigen characteristics of neotissues.. Atrial or ventricular septal defect-occlusion devices (Amplatzer, n=7; Cardioseal/Starflex, n=3) were processed using a uniform protocol after surgical removal from humans (implantation time, 5 days to 4 years). Devices were fixed in formalin and embedded in methylmethacrylate. Serial sections were obtained by sectioning with a diamond cutter and grinding, thus saving the metal/tissue interface for histologic evaluation. Immunohistochemical staining was performed using conventional protocols. Superficial endothelial cells stained positive for von Willebrand factor. Within the newly formed tissues, fibroblast-like cells were identified with a time-dependent expression of smooth muscle cell maturation markers (smooth muscle actin, smooth muscle myosin, h-caldesmon, and desmin) beside extracellular matrix components. Neovascularization of the newly formed tissues was demonstrated with the typical immunohistochemical pattern of capillaries and small vessels. Inflammatory cells could be identified as macrophages (CD68+) and both T-type and B-type lymphocytes (CD3+, CD79+).. This is the first presentation of results from serial immunohistochemical staining of a collection of explanted human septal-occlusion devices. A time-dependent maturation pattern of the fibroblast-like cells in the neotissues around the implants could be described. Neoendothelialization was seen in all specimens with implantation times of 10 weeks or more. The time course of neoendothelialization, as seen in our study, further supports the clinical practice of anticoagulant or antiplatelet therapy for 6 months after implantation. This time interval should be sufficient to prevent thromboembolic events due to thrombus formation at the foreign surface of cardiovascular implants.

Topics: Biomarkers; Cardiac Catheterization; Cell Proliferation; Coronary Vessels; Device Removal; Endothelial Cells; Fibrin; Fibroblasts; Foreign-Body Reaction; Heart Septal Defects, Atrial; Heart Septal Defects, Ventricular; Humans; Immunohistochemistry; Inflammation; Prosthesis Design; Prosthesis Failure; Septal Occluder Device; Time Factors; Tunica Intima

Gelatin and gelatin/chitosan gels, crosslinked using glutaraldehyde, were previously developed as substrates for three-dimensional cell-assembly techniques. In this study, the biocompatibility and biodegradation of gelatin and gelatin/chitosan gels were evaluated following implantation in rat livers for periods up to 16 weeks. The two gels were characterized by different inflammatory responses and degradation rates. The gelatin/chitosan gel is more efficient in inducing fibrin formation and vascularization at the implant-host interface. The degrees of inflammatory reaction for the gelatin/chitosan gel were significantly stronger than the gelatin gel. Advanced biodegradation of the gelatin gels was observed. These data indicate that the gelatin gel has better liver tissue biocompatibility and a faster biodegraded rate than the gelatin/chitosan gel.

Topics: Absorbable Implants; Animals; Biocompatible Materials; Biodegradation, Environmental; Chitosan; Female; Fibrin; Foreign-Body Reaction; Gelatin; Gels; Granulocytes; Liver; Materials Testing; Rats; Rats, Sprague-Dawley; Tissue Engineering; Tissue Scaffolds

The conventional technique of microvascular anastomosis may cause trauma to the vessel wall. In addition, the technique is difficult for beginners and is time consuming. The duration of ischemia is an important limiting factor for muscle transfer. In the case of multiple-digit replantations, fatigue developed in the surgeon may also result in suboptimal results. This study was performed to establish an easier and shorter method of microvascular anastomosis using the Arista hemostatic agent.. In this study, 20 carotid arteries obtained from rats were equally divided into two groups. The arteries were then divided and repaired using three simple interrupted stay sutures with Arista powder. Evaluations were performed using the following three methods: (1) clamping time during the vessel anastomosis, (2) patency test (after 1 hour, 24 hours, and 28 days), and (3) light microscopic findings.. The clamping time in the conventional suture anastomosis group was 21+/-4 minutes, whereas that of the minimal suture in the Arista group was 12+/-2 minutes; the difference between the two groups was statistically significant (P<.001). There was no significant difference between the patency rates of the two groups (P= .474). It was observed that the Arista group showed qualitatively less perivascular foreign-body giant cell reaction than the control group. There was no evidence of vascular mural fibrinoid necrosis, indicating that Arista was nontoxic for the vessel walls.. The Arista-assisted microvascular anastomosis is an alternative to the conventional suture-only method because it reduces the anastomosis time significantly and does not cause narrowing of the vessel wall. We believe that this technique has the potential for improving the performance of microvascular anastomosis in clinical practice.

Topics: Anastomosis, Surgical; Animals; Carotid Arteries; Constriction; Fibrin; Foreign-Body Reaction; Giant Cells, Foreign-Body; Hemostatics; Male; Microspheres; Microsurgery; Necrosis; Rats; Rats, Wistar; Starch; Suture Techniques; Time Factors; Vascular Patency; Vascular Surgical Procedures

Topics: Adolescent; Catheterization, Central Venous; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Foreign-Body Migration; Foreign-Body Reaction; Hemostasis; Humans; Incidental Findings; Medical Errors; Plasminogen Activator Inhibitor 1; Radiography, Thoracic; Time Factors

Topics: Aged; Carcinoma, Renal Cell; Fibrin; Foreign-Body Reaction; Humans; Kidney Neoplasms; Male; Neoplasm Recurrence, Local; Nephrectomy

We evaluated histologically samples of synovial tissue from the knees of 50 patients with rheumatoid arthritis (RA). The samples were taken during revision for aseptic loosening. The findings were compared with those in 64 knees with osteoarthritis (OA) and aseptic loosening and in 18 knees with RA without loosening. The last group had been revised because of failure of the inlay or the coupling system of a constrained prosthesis. All the patients had had a total ventral synovectomy before implantation of the primary prosthesis. In all three groups a foreign-body reaction and lymphocellular infiltration were seen in more than 80% of the tissue samples. Deposits of fibrin were observed in about one-third to one-half of the knees in all groups. Typical signs of the reactivation of RA such as rheumatoid necrosis and/or proliferation of synovial stromal cells were found in 26% of knees with RA and loosening, but not in those with OA and loosening and in those with RA without loosening. Our findings show that reactivation of rheumatoid synovitis occurs after total knee replacement and may be a cofactor in aseptic loosening in patients with RA.

Topics: Aged; Arthritis, Rheumatoid; Female; Fibrin; Foreign-Body Reaction; Humans; Knee Prosthesis; Lymphocytes; Male; Middle Aged; Osteoarthritis; Prosthesis Failure; Recurrence; Reoperation; Synovitis

Despite being inert and nontoxic, implanted biomaterials often trigger adverse foreign body reactions such as inflammation, fibrosis, infection, and thrombosis. With regard to the inflammatory responses to biomaterial implants, it was previously found that a crucial precedent event was the spontaneous adsorption and denaturation of fibrinogen on implant surfaces. It was further found that interactions between the phagocyte integrin Mac-1 (CD11b/CD18) and one short sequence within the fibrinogen D domain (gamma 190-202; P1) at least partially explained phagocyte accumulation on implant surfaces. However, the reason that adsorbed fibrinogen is proinflammatory--while soluble fibrinogen clearly is not--remained obscure. In this study, therefore, the question of how fibrinogen is converted to a proinflammatory state when adsorbed to biomaterial surfaces is investigated. In soluble fibrinogen, the 13 amino acid P1 sequence was found to be hidden. However, the adsorption and denaturation of fibrinogen on the surfaces of commonly used biomaterials lead to the exposure of P1 and a second neo-epitope, gamma 377-395 (P2), which also interacts with Mac-1 and is similarly occult in the soluble protein. The extent of biomaterial-mediated P1 and P2 exposure appears directly related to the severity of inflammatory responses to a test panel of biomaterials. Finally, thrombin-mediated conversion of fibrinogen to fibrin also exposes both P1 and P2 epitopes. These observations may help explain both the inflammation caused by many types of implanted biomaterials and that which occurs naturally following thrombotic events. (Blood. 2001;98:1231-1238)

Topics: Adsorption; Animals; Binding Sites; Biocompatible Materials; Cell Adhesion; Epitopes; Fibrin; Fibrinogen; Foreign-Body Reaction; Humans; Inflammation; Macrophage-1 Antigen; Male; Mice; Models, Animal; Phagocytes; Polyethylene Terephthalates; Protein Binding; Protein Structure, Tertiary; Thrombin

After catheterization, 42% to 100% of central venous catheters are surrounded by a "fibrin sleeve." This sleeve has been considered the cause of catheter-related infections, withdrawal occlusion, and pulmonary embolism. The reactions between the vein wall and the catheter were studied.. A silicone catheter was placed in the anterior caval vein of 123 rats. After in situ fixation at scheduled intervals, the pathologic changes were studied on semi-serial histologic sections by means of light microscopy, transmission electron microscopy, and scanning electron microscopy (SEM). In 36 rats, the catheter was withdrawn immediately; in 72 rats, it was left in situ up to 6 months; and in 15 rats, the study was performed up to 10 months after withdrawal of a catheter that had remained in situ for 6 months.. In the group in which the catheter was withdrawn immediately, mural thrombi disappeared by day 7. In the group in which the catheter remained in situ, thrombi remained around the proximal portion of the catheter. This pericatheter thrombosis (PCT) was invaded by migrating and proliferating smooth muscle cells (SMCs), originating from an injured vein wall, and transformed from day 7 into a tissue composed predominantly of SMCs and collagen and covered by endothelial cells. Later, the number of cells decreased, and the relative amount of collagen increased. Up to 10 months after withdrawal of the catheter, the collapsed sleeve was still present within the vein.. The sleeve around a central venous catheter is not a fibrin sleeve, but a stable cellular-collagen tissue covered by endothelium. It is mainly formed by smooth muscle cells migrating from the injured vein wall into the early pericatheter thrombus.

Topics: Animals; Catheterization, Central Venous; Catheters, Indwelling; Collagen; Connective Tissue; Endothelium, Vascular; Equipment Failure Analysis; Fibrin; Foreign-Body Reaction; Male; Microscopy, Electron; Microscopy, Electron, Scanning; Muscle, Smooth, Vascular; Rats; Rats, Wistar; Silicone Elastomers; Surface Properties; Thrombosis; Veins

In a prospective randomised study 30 mongrel rabbits received two standard colon-resections. Three types of drains were tested: (latex-rubber-) Penrose-drains, rubbertube- and silicontube-drains, which were placed in the lower abdomen. As a closed drainage-system the extraperitoneal tip of the drain was placed in a closed subcutis-pocket. One of the two colon-anastomoses also was drained. The findings were recorded on the 7th postoperative day. A single mechanic alteration was found, an ulcer caused by a silicon-drain, that pushed against the abdominal wall. The other signs of mechanic irritation were microscopically unspecified inflammatory reactions to the foreign body drain. There was no ascending infection caused by the drain. All infections came from complications of the colon resections. In contrast to common opinions the drains in the lower abdomen showed no adhesions to the abdominal wall or organs. Only the entrance of the drain into the peritoneum and the cotton-gaze of Penrose-drains showed in nearly all cases adhesions. The large amount of adhesions to the anastomosis-drains came from complications of the colon-anastomoses. As a cause of material, rubber- and latex-rubber-drains showed large fibrin-clots on their surfaces. 7 days after the operation only about 20% of the drains had sufficient function. The rest was occluded by fibrin-clots in the lumen of the drain or the cotton-gaze. Over all there is no difference in changes and effects of the three different types of drains, but silicon as material showed advantages.

Topics: Animals; Biomechanical Phenomena; Colectomy; Drainage; Equipment Failure Analysis; Fibrin; Foreign-Body Reaction; Latex; Peritoneum; Rabbits; Rubber; Silicones; Surface Properties; Tissue Adhesions; Wound Healing

The postoperative course after cataract surgery can be complicated by the formation of severe fibrinous membranes, especially in cases with previous goniotrepanation, after syn echiolysis, iridotomy or iris suturing, and in patients with diabetes or uveitis. This study retrospectively analyzes the efficacy of intraocular tissue plasminogen activator (tPA) for fibrinolysis in these conditions commonly considered as contraindications to tPA therapy. When antiinflammatory therapy was unsuccessful in lysing fibrinous membranes, 10 micrograms of tPA (Actilyse) was injected into the anterior chamber following the first postoperative day (n = 15). In addition, topical corticosteroids and cycloplegics were given postoperatively. Lysis of the fibrinous membranes was achieved in all patients. However, in three cases lysis was incomplete or recurred. Complications of intraocular tPA therapy consisted of mild hyphema (n = 1) and transient dysfunction of the corneal endothelial cells (n = 2). In conclusion, the results suggest intraocular low-dose tPA as an effective approach for the treatment of severe fibrinous membranes after cataract surgery even in high-risk patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anterior Chamber; Child; Child, Preschool; Female; Fibrin; Fibrinolysis; Foreign-Body Reaction; Humans; Injections; Lenses, Intraocular; Male; Middle Aged; Retrospective Studies; Tissue Plasminogen Activator

To assess whether annexin V-coated poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) prevent postoperative inflammation in rabbit eyes.. Department of Ophthalmology, Hôpital Purpan, Toulouse, France.. Thirteen IOLs coated with annexin V were implanted in 13 rabbit eyes; the contralateral eyes received uncoated IOLs. Postoperative fibrin was quantitated by daily slitlamp examination until the anterior chamber was completely clear. Results were analyzed using a Wilcoxon test. Ocular toxicity was evaluated by light and electron microscopy.. Eyes with the annexin V-coated IOLs had less severe inflammation on the first postoperative day, and the inflammation resolved more quickly than in eyes with uncoated IOLs (P < .05). No annexin V was released postoperatively, nor were there signs of ocular toxicity.. Annexin V-coated lenses effectively reduced postoperative inflammation in rabbit eyes.

Topics: Animals; Annexin A5; Cataract Extraction; Endophthalmitis; Enzyme-Linked Immunosorbent Assay; Fibrin; Follow-Up Studies; Foreign-Body Reaction; Lenses, Intraocular; Methylmethacrylates; Postoperative Complications; Rabbits

Postoperative fibrinous reactions following the small-incision technique seem to be very rare. Problem cases can be treated with tissue Plasmin Activator.. To investigate the new prophylactic and therapeutic possibilities the last 2,056 cataract procedures with PMMA lens implantation were statistically analyzed.. In 152 (7.4%) fibrin cases we observed after ECCE (n = 586) 12.8%, after phacoemulsification (PE) with sutured 6.5-mm corneoscleral incision (n = 546) 7.0% and after PE with clear corneal selfsealing 4.1-mm incision (n = 924) only 3.9% fibrinous reactions (p < 0.01). In case of ECCE the rate of fibrinous reactions amounted to 22.4% following prolonged procedures (< 50 min), while it was low as 9.5% with a short period of time (< 30 min) (p < 0.01). In 8 steroid-resistant cases we applied 25 micrograms Plasmin Activator intraocularly. The injections led to complete dissolution of the fibrinous membranes without complications.. Postoperative fibrinous reactions can be reduced statistically significantly by application of the corneal small-incision technique. The most efficient therapy is intraocular Plasmin Activator fibrinolysis.

Topics: Aged; Aged, 80 and over; Female; Fibrin; Fibrinolysis; Foreign-Body Reaction; Humans; Injections; Lenses, Intraocular; Male; Methylmethacrylates; Risk Factors; Tissue Plasminogen Activator

To determine the effects of Nd: YAG laser to disrupt the fibrinous membrane and remnant substance on the anterior surface of intraocular lens.. Nd: YAG laser was applied on 23 cases of fibrinous membrane formation and 8 cases of remnant substance on the anterior surface of intraocular lenses (IOL) which had not responded well to steroid therapy. Eighteen cases were male and 13 female. The mean age was 49.7 years (range, 5 approximately 78 years). The interval between IOL implantation and laser therapy was 0.5 approximately 30 months in the fibrinous membrane cases and 3 approximately 10 days in the remnant substance cases. The energy applied was 0.8 approximately 3.0 mJ/exp. with 2 approximately 112 exposures. Mean follow-up period was 3.6 months.. Complications during therapy included only 2 cases of slight iris bleeding. Visual acuity after therapy was improved 1 line in 16 cases, 2 lines in 11 cases, 3 lines in 1 case, 4 lines in 1 case and 5 lines in 2 cases. No post-therapy complication was found.. Nd: YAG laser lysis is an effective alternative to remove the fibrinous membrane and remnant substances on the anterior surface of IOL.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Fibrin; Fibrinolysis; Follow-Up Studies; Foreign-Body Reaction; Humans; Laser Therapy; Lenses, Intraocular; Male; Middle Aged; Postoperative Complications; Time Factors; Visual Acuity

To study the prevention and treatment of the membrane formation on the lens surface after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation.. We reviewed the records of 312 cataractous patients that had undergone ECCE with PCIOL implantation between 1989 and 1993. Postoperatively all patients were examined under slit-lamp microscopy. The membrane formation on the surface of PCIOL in pupilar area was divided into four grades. Two membranes of surgical removal were observed under a transmission electron microscopy. One PCIOL of surgical removal was observed under a scanning electron microscopy.. Of 312 patients, 21 had the membrane formation on the surface of the PCIOL postoperatively. The incidence of the membrane formation was 6.7%. Comparisons with cases of senile cataract showed the incidence to be significantly the highest among: 1. patients who had traumatic cataract (P < 0.05); 2. patients with complicated cataract (P < 0.05). Intraoperatively residual lens cortex and rupture of posterior capsule, interval time between the first and second eye operations less than 1 month are the main factors of membrane formation. The ultrastructure in membrane and cytology on the lens surface showed that the membrane on the surface of PCIOLs is usually composed of a cellular protein film and cellular elements, including macrophages, fibroblast-like cells, epithelioid cells, giant cells, fibroblasts and collagen fibrils, etc.. The cellular response on the surface of an implanted PCIOL is a chronic foreign-body inflammatory reaction and the membrane of the surface of implanted PCIOL is a reactive membrane of the foreign-body.

Topics: Eye; Fibrin; Foreign-Body Reaction; Humans; Lenses, Intraocular

A monolayer of proliferating lens epithelium on the anterior surface of an intraocular lens was found cytologically and confirmed histologically in a postmortem examination of one eye of a 57-year-old man. The man had had extracapsular cataract surgery five years earlier. This pathological finding confirms observations with specular microscopy.

Topics: Cataract Extraction; Cell Division; Epithelium; Fibrin; Foreign-Body Reaction; Humans; Lens, Crystalline; Lenses, Intraocular; Male; Microscopy; Middle Aged

Periapical tissue response to retrograde fillings of amalgam and IRM were compared in the mandibular canine of the adult male ferret. Teeth were cleaned and shaped with a standard technique and obturated with gutta-percha. The root apex was then exposed and retrofillings were placed. The animals were grouped according to observation periods of 5, 10, and 15 weeks. At the proper time the animals were killed and the lower canine tooth along with the surrounding bone was removed. The tissue blocks were examined clinically, radiographed, and prepared for histologic examination. The clinical and radiographic examination indicated both materials to be well tolerated by periapical tissues. Microscopic examination of amalgam specimens showed a decrease in inflammation and the formation of a fibrous capsule over the 15-week period. IRM specimens showed persistent inflammation and slower healing potential.

Topics: Alveolar Process; Animals; Biocompatible Materials; Collagen; Connective Tissue; Dental Amalgam; Ferrets; Fibrin; Foreign-Body Reaction; Giant Cells; Gutta-Percha; Inflammation; Male; Methylmethacrylates; Osteogenesis; Periapical Tissue; Retrograde Obturation; Root Canal Filling Materials; Root Canal Therapy; Wound Healing; Zinc Oxide-Eugenol Cement

Previous ocular diseases (e.g. herpetic keratouveitis), glaucoma, previous ocular surgery and surgery longer than normal turned out to be the main risk factors for a fibrinoid reaction after an extracapsular cataract extraction with posterior chamber lens implantation in patients of the Universitäts-Augenklinik Düsseldorf between June 1989 and March 1990. This result was obtained from a retrospective study of the medical records. No special risks could be concluded neither from the presence of general diseases (e.g. diabetes mellitus, consumptive basic diseases), immuno-suppressive treatment, constitutional factors, nor from age, sex, operative method nor from the surgeon. Preoperative antiexsudative prophylactic treatment is suggested for patients with one or more risk factor.

Topics: Adult; Aged; Aged, 80 and over; Female; Fibrin; Foreign-Body Reaction; Humans; Lenses, Intraocular; Male; Methylmethacrylates; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors

We studied the fibrinous reaction after intraocular lens (IOL) implantation in the posterior chamber of cynomolgus monkeys. In 50% of the eyes, we implanted an IOL made of conventional poly-(methyl methacrylate) (PMMA); in the remaining eyes we implanted a PMMA IOL with a heparin modified surface. Two, 4, 8, and 18 weeks after surgery the eyes were examined by slitlamp for fibrinous reactions on and around the IOL surface. At weeks 4, 8, and 18 there was a marked decrease in fibrinous reaction in the eyes with a heparin surface modified IOL. The results of this study accord with earlier findings that heparin surface modification improves the biocompatibility of the IOL.

Topics: Animals; Cataract Extraction; Female; Fibrin; Foreign-Body Reaction; Heparin; Lenses, Intraocular; Macaca fascicularis; Male; Methylmethacrylates; Surface Properties

The first biocompatibility studies on the DuPont perfluorosulphonic acid polymer (Nafion) are presented. Presterilized samples of commercially cast and solution cast Nafion membranes were implanted subcutaneously, intraperitoneally and intravenously in male Sprague-Dawley rats. Scanning electron microscopy and histological examination of explanted samples and surrounding tissues reveal little, if any, evidence of acute or chronic foreign body inflammatory response. The fibrous capsules surrounding the implant remain nominally thin (less than 100 microns) after more than 3 months in situ, while the surrounding tissue remains well vascularized. Nafion polymer exhibits sufficient biocompatibility to make it a viable candidate for some implantable biosensor applications. It may, however, be necessary to compensate for the effect of the progression of fibrous encapsulation on sensor performance, particularly during the acute response stage.

Topics: Abdominal Muscles; Animals; Biosensing Techniques; Collagen; Connective Tissue; Feasibility Studies; Fibrin; Fibroblasts; Fibrosis; Fluorocarbon Polymers; Foreign-Body Reaction; Male; Materials Testing; Membranes, Artificial; Microscopy, Electron, Scanning; Prostheses and Implants; Rats; Rats, Inbred Strains; Surface Properties; Vena Cava, Inferior

The bursting strength of sutured and laser-welded vascular anastomoses were assessed in a rat aorta model. Postoperative investigations included postmortems, light and scanning electron microscopy and measurements of bursting strength at set intervals (30 min, 3, 14 and 28 days postoperatively, p.o.). Laser-bonded anastomoses consistently demonstrated lower bursting strengths than suture controls, with statistically significant differences at 30 min and 3 days p.o. (p less than 0.01). Laser anastomosis was easier and faster to perform, the foreign body reaction was markedly lower than in sutured controls. Formation of aneurysms was not observed.

Topics: Anastomosis, Surgical; Animals; Aorta; Biomechanical Phenomena; Endothelium, Vascular; Fibrin; Foreign-Body Reaction; Laser Therapy; Microsurgery; Rats; Rats, Inbred Strains; Sutures; Tensile Strength; Wound Healing

Hydroxyapatite, lanthanum-containing hydroxyapatite, and lanthanum- and zirconium-containing hydroxyapatite discs were implanted subcutaneously in the backs of rats. The implanted discs and surrounding tissues were removed at 5 and 12 hours, and 1, 3, 7, 14, 30 and 60 days after implantation, and fixed in paraformaldehyde. Tissue samples were dehydrated and embedded in paraffin. Paraffin sections were cut and stained with hematoxylin and eosin, van Gieson's, and Masson's trichrome. The early tissue reaction was exudative due to fibrin deposition and infiltration by polymorphonuclear leukocytes and macrophages. The later reaction was characterized by the formation of fibrous tissue without inflammatory cell infiltration. The tissue reaction to all three types of material was identical by two months after implantation.

Topics: Animals; Biocompatible Materials; Dental Implants; Female; Fibrin; Foreign-Body Reaction; Hydroxyapatites; Lanthanum; Macrophages; Neutrophils; Rats; Rats, Inbred Strains; Zirconium

A safe, effective method for securing autologous and alloplastic implants would benefit modern surgery substantially. We studied the effects of a new autologous fibrin tissue adhesive with various alloplastic implants and ear cartilage. Twelve rabbits had Proplast (a woven combination of Teflon and organic fibers), Silastic, Supramid polyfilament surgical sheeting, and ear cartilage implanted. One side of each animal had implants secured with tissue adhesive. The other, control side had identical implants placed in "subcutaneous tunnels." The tissue adhesive was biodegradable and produced no apparent toxic reaction, infection, or foreign-body reaction. It did not adhere to Silastic, but bound to the other implants. Glued implants had no more clinical or histologic evidence of inflammation than controls. Autologous fibrin tissue adhesive seems to be promising as a safe, biologic bonding material for securing certain alloplastic and autologous implants.

Topics: Animals; Aprotinin; Biocompatible Materials; Cartilage; Drug Combinations; Factor XIII; Fibrin; Fibrin Tissue Adhesive; Fibrinogen; Foreign-Body Reaction; Male; Prostheses and Implants; Rabbits; Skin; Thrombin; Tissue Adhesives

Topics: Epithelium; Fibrin; Foreign-Body Reaction; Histiocytes; Humans; Lens Capsule, Crystalline; Lenses, Intraocular; Postoperative Complications

Examination with a specular microscope facilitates diagnostic evaluation of cells on the surface of intraocular lenses. Similarly, slit-lamp examination makes specular microscopic studies possible. However, image resolution and magnification are not achieved by using this method, though the amount of time and instrumental effort is minimal. Various types of cells can be differentiated. Fibroblast-like cells can only be demonstrated readily in the specular areas, whereas multinucleate giant cells can usually also be seen by using focal illumination. It is difficult to differentiate the smaller, mononucleated cells.

Topics: Fibrin; Fibroblasts; Foreign-Body Reaction; Histiocytes; Humans; Lenses, Intraocular; Microscopy; Postoperative Complications

Nerve anastomoses glued with "Fribrinkleber" can be protected from tissue plasminogen-activators both by natural and synthetic inhibitors of fibrinolysis whether administered locally or systemically. The glued nerve-anastomoses do not attain the bond strength of sutured nerves, but show less foreign body reaction. Gluing nerves with Fibrinkleber" combined with inhibition of fibrinolysis would seem to be a good method for reuniting severed nerves. It may be especially useful in nerve transplantation if tension is avoided.

Topics: Animals; Factor VIII; Fibrin; Fibrinogen; Foreign-Body Reaction; Peripheral Nerve Injuries; Peripheral Nerves; Rats; Sciatic Nerve; Thrombin; Time Factors; Tissue Adhesives

Topics: Adult; Eosinophils; Erythrocytes; Fibrin; Foreign-Body Reaction; Gloves, Surgical; Granulation Tissue; Granuloma; Hemosiderin; Humans; Iatrogenic Disease; Leukocytes; Male; Postoperative Complications; Scrotum; Splenectomy; Starch; Testicular Hydrocele; Tissue Adhesions

Topics: Animals; Biocompatible Materials; Bone Marrow; Bone Nails; Bone Regeneration; Femur; Fibrin; Foreign-Body Reaction; Guinea Pigs; Stainless Steel