878
AMERICAN JOURNAL OF OPHTHALMOLOGY
nose, and throat practice. Walter and his brother Hedley were sent to the Medical School at McGill, where Hedley graduat ed in 1913, Walter a year later. After an internship at the Royal Victoria Hospital in Montreal and a residency at the Her man Knapp Memorial Eye Hospital in New York, Walter joined his father and brother in practice at Watertown. Both brothers joined the Canadian Army in 1917, and after serving overseas, were discharged in 1919 and returned to the family practice. Walter became an Ameri can citizen the following year. Atkinson belonged to many profession al societies, in some of which he attained high office. He was secretary-treasurer and later president of the American Ophthalmological Society, chairman of the American Board of Ophthalmology, and vice president of the American Academy of Ophthalmology and Oto-Laryngology. He was a member of the American Col lege of Surgeons, the American Medical Association, his state and county medical societies, the New York Commission for the blind, and the New York Academy of Medicine, and many social clubs and civic associations. Atkinson was the author of many medi cal articles, and his textbook, "Anesthesia In Ophthalmology," is recognized as an authoritative work. Additionally, he served on the editorial staff of the "Quar terly Review of Ophthalmology." Among the numerous professional hon ors conferred him were honorary mem bership in the French Ophthalmological Society, the degree of Doctor of Science from St. Lawrence University, and the Howe Medal of the American Ophthal mological Society. In 1973 the Society of Eye Surgeons, meeting in Athens, Greece, began a lecture series in his name. He is survived by his widow, the for mer Mary Gamble, and by two daugh ters, Jeanne (Mrs. Peter H. Remington),
JUNE, 1978
and Grace—"Gay"—(Mrs. W. Graham Wright). A son, John G. Atkinson, died in 1975. Gifted and charming, a gracious host and genial companion, Walter Atkinson will be remembered with admiration and affection in those circles to which he contributed so much in so many ways. GORDON M. BRUCE
Letters to the Editor must be typed double-spaced on 8V2 x 11-inch bond paper, with lV2-inch margins on all four sides, and limited in length to two man uscript pages. CORRESPONDENCE Spectral Transmittance of Intraocular Lenses Editor: The findings in the excellent article, "Spectral transmittance of intraocular lenses and retinal damage from intense light sources (Am. J. Ophthalmol. 85:167, 1978), by Martin A. Mainster, further cor roborate earlier work indicating that the lens serves to protect the retina from near ultraviolet light damage and provides a filter to eliminate chromatic aberration.2'3 The report also emphasizes the need for replacement lenses in aphakic eyes be they spectacles, contact lenses, or intraoc ular lenses, which have near-ultraviolet filters.3-4 Basic research experiments that provide actual evidence of retinal damage caused by nonintense near-ultraviolet light are, unfortunately, not discussed in the Main ster report. Dogfish retina photoreceptors were observed to be damaged, both on morphological and biochemical grounds,5 by in vitro exposure to subsolar diffuse near-ultraviolet emitting lamps. Moreover, the photoreceptors of albino mice were totally destroyed by 12-hour
VOL. 85, NO. 6
879
CORRESPONDENCE
daily exposures to black light lamps be tween 12 to 15 months. 6 The intensity of near-ultraviolet light again was much lower than that in sunlight. The lenses of these mice transmitted near-ultraviolet light well (little pigment present). Recent ly Matuk, Lou, and Parker7 have shown that protein synthesis in photoreceptors of rats was greatly inhibited by exposure to near-ultraviolet light. These observa tions point out that retinal damage from near-ultraviolet light exposure could re sult even from diffuse nonintense doses of near-ultraviolet light. In these cases thermal damage had not occurred. This information would then apply to human eyes without crystalline lenses. Another situation to be considered is the use of light sensitive or light sensitiz ing drugs in aphakic individuals for other medically related problems, such as glau coma or psoriasis, in which the drugs epinephrine or methoxsalen may be used. These circumstances could lead to more easily induced retinal damage than in aphakic individuals not using these drugs. Retinas of aphakic eyes could be rendered more vulnerable to nearultraviolet light exposure caused by the easier access of the light sensitive drugs to the posterior portion of the eye. An epinephrine-induced maculopathy has been reported by Kolker and Becker.8 S. G. Kramer, M.D. (personal communi cation) has also described an increased uptake of epinephrine by aphakic animal retinas over that in phakic controls. Another problem of aphakic individu als with corrected vision is that of exces sive glare.10 Vision-corrective devices with tinting would be useful in eliminat ing some of this glare as well as protect ing the retina from damage and improv ing visual acuity. I think such data suggest that all aphakic individuals be provided with re placement lenses, not only for focusing,
but also for filtering near-ultraviolet light anterior to the retina. SEYMOUR ZIGMAN, P H . D .
REFERENCES 1. Cooper, G. F., and Robson, J. G.: The yellow color of the lens of man and other primates. J. Physiol. 203:411, 1969. 2. Zigman, S.: Eye lens color. Formation and function. Science 171:807, 1971. 3. Near-UV light. A factor in cataract formation. Ophthalmology Times 2:2, 1977. 4. Zigman, S., and Bagley, S. J.: Near-ultraviolet light effects on dogfish retinal rods. Exp. Eye Res. 12:155, 1971. 5. Zigman, S., and Vaughan, T.: Near-ultraviolet light effects on the lenses and retinas of mice. Invest. Ophthalmol. 13:462, 1974. 6. Matuk, Y., Lou, P., and Parker, J. A.: Biosyn thesis of proteins by the retina. Inactivation by near-UV light and the effects of tryptophan, epineph rine, and catalase. Invest. Ophthalmol. 16:1104, 1977. 7. Kolker, H. E., and Becker, B.: Epinephrine maculopathy. Arch. Ophthalmol. 79:552, 1968. 8. Miller, D., and Lazenby, G. W.: Glare sensitivi ty in corrected aphakes. Ophthalmic Surg. 8:54, 1977.
Retinal Dialysis Secondary to Use of the Kaufman vitrector Editor: During a routine cataract extraction, vitreous appeared in the wound. The Kaufman Vitrector was inserted through a widely dilated pupil into the vitreous. Af ter a moment of suction with a 30-ml sy ringe, a membrane-like structure, presum ably the anterior vitreous face, enter ed the porthole of the Vitrector. Sudden ly, a fingerlike projection of diaphanous tissue appeared from the superior periph ery and approached the port of the Kauf man Vitrector. This tissue was presum ably retinal and appeared to be attached to the vitreous that was being aspirated through the Vitrector. After removal of the Vitrector, excision of the vitreous with scissors and Week sponges was per formed. At the end of the procedure, the superior half of the retina floated freely in
AMERICAN JOURNAL OF OPHTHALMOLOGY
nose, and throat practice. Walter and his brother Hedley were sent to the Medical School at McGill, where Hedley graduat ed in 1913, Walter a year later. After an internship at the Royal Victoria Hospital in Montreal and a residency at the Her man Knapp Memorial Eye Hospital in New York, Walter joined his father and brother in practice at Watertown. Both brothers joined the Canadian Army in 1917, and after serving overseas, were discharged in 1919 and returned to the family practice. Walter became an Ameri can citizen the following year. Atkinson belonged to many profession al societies, in some of which he attained high office. He was secretary-treasurer and later president of the American Ophthalmological Society, chairman of the American Board of Ophthalmology, and vice president of the American Academy of Ophthalmology and Oto-Laryngology. He was a member of the American Col lege of Surgeons, the American Medical Association, his state and county medical societies, the New York Commission for the blind, and the New York Academy of Medicine, and many social clubs and civic associations. Atkinson was the author of many medi cal articles, and his textbook, "Anesthesia In Ophthalmology," is recognized as an authoritative work. Additionally, he served on the editorial staff of the "Quar terly Review of Ophthalmology." Among the numerous professional hon ors conferred him were honorary mem bership in the French Ophthalmological Society, the degree of Doctor of Science from St. Lawrence University, and the Howe Medal of the American Ophthal mological Society. In 1973 the Society of Eye Surgeons, meeting in Athens, Greece, began a lecture series in his name. He is survived by his widow, the for mer Mary Gamble, and by two daugh ters, Jeanne (Mrs. Peter H. Remington),
JUNE, 1978
and Grace—"Gay"—(Mrs. W. Graham Wright). A son, John G. Atkinson, died in 1975. Gifted and charming, a gracious host and genial companion, Walter Atkinson will be remembered with admiration and affection in those circles to which he contributed so much in so many ways. GORDON M. BRUCE
Letters to the Editor must be typed double-spaced on 8V2 x 11-inch bond paper, with lV2-inch margins on all four sides, and limited in length to two man uscript pages. CORRESPONDENCE Spectral Transmittance of Intraocular Lenses Editor: The findings in the excellent article, "Spectral transmittance of intraocular lenses and retinal damage from intense light sources (Am. J. Ophthalmol. 85:167, 1978), by Martin A. Mainster, further cor roborate earlier work indicating that the lens serves to protect the retina from near ultraviolet light damage and provides a filter to eliminate chromatic aberration.2'3 The report also emphasizes the need for replacement lenses in aphakic eyes be they spectacles, contact lenses, or intraoc ular lenses, which have near-ultraviolet filters.3-4 Basic research experiments that provide actual evidence of retinal damage caused by nonintense near-ultraviolet light are, unfortunately, not discussed in the Main ster report. Dogfish retina photoreceptors were observed to be damaged, both on morphological and biochemical grounds,5 by in vitro exposure to subsolar diffuse near-ultraviolet emitting lamps. Moreover, the photoreceptors of albino mice were totally destroyed by 12-hour
VOL. 85, NO. 6
879
CORRESPONDENCE
daily exposures to black light lamps be tween 12 to 15 months. 6 The intensity of near-ultraviolet light again was much lower than that in sunlight. The lenses of these mice transmitted near-ultraviolet light well (little pigment present). Recent ly Matuk, Lou, and Parker7 have shown that protein synthesis in photoreceptors of rats was greatly inhibited by exposure to near-ultraviolet light. These observa tions point out that retinal damage from near-ultraviolet light exposure could re sult even from diffuse nonintense doses of near-ultraviolet light. In these cases thermal damage had not occurred. This information would then apply to human eyes without crystalline lenses. Another situation to be considered is the use of light sensitive or light sensitiz ing drugs in aphakic individuals for other medically related problems, such as glau coma or psoriasis, in which the drugs epinephrine or methoxsalen may be used. These circumstances could lead to more easily induced retinal damage than in aphakic individuals not using these drugs. Retinas of aphakic eyes could be rendered more vulnerable to nearultraviolet light exposure caused by the easier access of the light sensitive drugs to the posterior portion of the eye. An epinephrine-induced maculopathy has been reported by Kolker and Becker.8 S. G. Kramer, M.D. (personal communi cation) has also described an increased uptake of epinephrine by aphakic animal retinas over that in phakic controls. Another problem of aphakic individu als with corrected vision is that of exces sive glare.10 Vision-corrective devices with tinting would be useful in eliminat ing some of this glare as well as protect ing the retina from damage and improv ing visual acuity. I think such data suggest that all aphakic individuals be provided with re placement lenses, not only for focusing,
but also for filtering near-ultraviolet light anterior to the retina. SEYMOUR ZIGMAN, P H . D .
REFERENCES 1. Cooper, G. F., and Robson, J. G.: The yellow color of the lens of man and other primates. J. Physiol. 203:411, 1969. 2. Zigman, S.: Eye lens color. Formation and function. Science 171:807, 1971. 3. Near-UV light. A factor in cataract formation. Ophthalmology Times 2:2, 1977. 4. Zigman, S., and Bagley, S. J.: Near-ultraviolet light effects on dogfish retinal rods. Exp. Eye Res. 12:155, 1971. 5. Zigman, S., and Vaughan, T.: Near-ultraviolet light effects on the lenses and retinas of mice. Invest. Ophthalmol. 13:462, 1974. 6. Matuk, Y., Lou, P., and Parker, J. A.: Biosyn thesis of proteins by the retina. Inactivation by near-UV light and the effects of tryptophan, epineph rine, and catalase. Invest. Ophthalmol. 16:1104, 1977. 7. Kolker, H. E., and Becker, B.: Epinephrine maculopathy. Arch. Ophthalmol. 79:552, 1968. 8. Miller, D., and Lazenby, G. W.: Glare sensitivi ty in corrected aphakes. Ophthalmic Surg. 8:54, 1977.
Retinal Dialysis Secondary to Use of the Kaufman vitrector Editor: During a routine cataract extraction, vitreous appeared in the wound. The Kaufman Vitrector was inserted through a widely dilated pupil into the vitreous. Af ter a moment of suction with a 30-ml sy ringe, a membrane-like structure, presum ably the anterior vitreous face, enter ed the porthole of the Vitrector. Sudden ly, a fingerlike projection of diaphanous tissue appeared from the superior periph ery and approached the port of the Kauf man Vitrector. This tissue was presum ably retinal and appeared to be attached to the vitreous that was being aspirated through the Vitrector. After removal of the Vitrector, excision of the vitreous with scissors and Week sponges was per formed. At the end of the procedure, the superior half of the retina floated freely in
