... Training and Jobs Home > Statistics and Data > Cataracts Cataracts Listen Language English Cataracts Defined A cataract is a clouding of the ... 2010 2010 U.S. Age-Specific Prevalence Rates for Cataract by Age, and Race/Ethnicity The risk of ...
A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age ... than half of all Americans either have a cataract or have had cataract surgery. A cataract can ...
Lam, Dennis; Rao, Srinivas K; Ratra, Vineet; Liu, Yizhi; Mitchell, Paul; King, Jonathan; Tassignon, Marie-José; Jonas, Jost; Pang, Chi P; Chang, David F
Cataract is the leading cause of reversible blindness and visual impairment globally. Blindness from cataract is more common in populations with low socioeconomic status and in developing countries than in developed countries. The only treatment for cataract is surgery. Phacoemulsification is the gold standard for cataract surgery in the developed world, whereas manual small incision cataract surgery is used frequently in developing countries. In general, the outcomes of surgery are good and complications, such as endophthalmitis, often can be prevented or have good ouctomes if properly managed. Femtosecond laser-assisted cataract surgery, an advanced technology, can automate several steps; initial data show no superiority of this approach over current techniques, but the results of many large clinical trials are pending. The greatest challenge remains the growing 'backlog' of patients with cataract blindness in the developing world because of lack of access to affordable surgery. Efforts aimed at training additional cataract surgeons in these countries do not keep pace with the increasing demand associated with ageing population demographics. In the absence of strategie that can prevent or delay cataract formation, it is important to focus efforts and resources on developing models for efficient delivery of cataract surgical services in underserved regions. For an illustrated summary of this Primer, visit: http://go.nature.com/eQkKll. PMID:27188414
... for Cataracts? Cataract Causes Cataract Diagnosis Cataract Treatment Cataract Surgery IOL Implants: Lens Replacement and Cataract Surgery Cataract Vision Simulator Cataract Vision Simulator Jun. 11, ...
A cataract is a cloudy or opaque area in the lens of the eye. Cataracts usually develop as a person gets older and ... substances can also accelerate the development of a cataract. Cataracts can cause visual problems such as difficulty ...
... home to avoid falls and injuries. The only treatment for a cataract is surgery to remove it. If a cataract ... Early diagnosis and treatment are key to preventing permanent ... a hypermature cataract) can begin to leak into other parts of ...
... the following ways, depending on the type of cataract: Phacoemulsification: With this procedure, the doctor uses a tool that produces sound waves to break up the cataract into small pieces. The pieces are then suctioned ...
... please review our exit disclaimer . Subscribe Recognizing Cataracts Watch for Vision Changes as You Age As life ... your eyes from harmful ultraviolet rays from the sun. Try wearing sunglasses or a hat with a ...
Until very recently, ocular exposure guidelines were based on the assumption that radiation cataract is a deterministic event requiring threshold doses generally greater than 2 Gy. This view was, in part, based on older studies which generally had short follow-up periods, failed to take into account increasing latency as dose decreased, had relatively few subjects with doses below a few Gy, and were not designed to detect early lens changes. Newer findings, including those in populations exposed to much lower radiation doses and in subjects as diverse as astronauts, medical workers, atomic bomb survivors, accidentally exposed individuals, and those undergoing diagnostic or radiotherapeutic procedures, strongly suggest dose-related lens opacification at significantly lower doses. These observations resulted in a recent re-evaluation of current lens occupational exposure guidelines, and a proposed lowering of the presumptive radiation cataract threshold to 0.5 Gy/year and the occupational lens exposure limit to 20 mSv/year, regardless of whether received as an acute, protracted, or chronic exposure. Experimental animal studies support these conclusions and suggest a role for genotoxicity in the development of radiation cataract. Recent findings of a low or even zero threshold for radiation-induced lens opacification are likely to influence current research efforts and directions concerning the cellular and molecular mechanisms underlying this pathology. Furthermore, new guidelines are likely to have significant implications for occupational and/or accidental exposure, and the need for occupational eye protection (e.g. in fields such as interventional medicine).
This report reviews the relationship of ionizing radiation to the occurrence of cataracts (posterior lenticular opacities) among the A-bomb survivors in Hiroshima and Nagasaki. The new DS86 doses are available for 1,983 (93.4%) of the 2,124 A-bomb survivors analyzed in 1982. The DS86 kerma neutron component for Hiroshima is much smaller than its comparable T65DR component, but still 4.2 fold higher (0.38 Gy at 6 Gy) than that in Nagasaki (0.09 Gy at 6 Gy). Thus, if the eye is especially sensitive to neutrons, there may yet be some useful information on their effects, particularly in Hiroshima. Under the best fitting dose-response model, an L (gamma)-L (neutron) with two thresholds, both the gamma and neutron regression coefficients of the occurrence of cataracts on dose are positive and highly significant for the DS86 eye organ doses. The DS86 gamma coefficient is almost the same as that associated with the T65DR gamma dose, the ratio of the two coefficients being 1.1 (95% confidence limits: 0.5-2.3) for DS86 kerma in the individual dose data, and if the risks based on the DS86 eye organ dose and DS86 kerma are compared, the ratio is 1.3 (0.6-2.8). However, the risk estimates associated with neutron exposure are 6.4 (2.2-19.2) fold higher for the DS86 kerma than the T65DR kerma and 1.6 (0.5-2.3) fold higher for the DS86 eye organ dose than for the DS86 kerma. (author)
Cataract surgery usually works very well. The operation has few risks, the pain and recovery period are short, ... improved. Ninety-five percent or more of all cataract surgeries result in improved vision.
Cataract, or lens opacification, remains a major cause of blindness worldwide. Cataracts reduce vision in over eighty million people, causing blindness in eighteen million people. The number afflicted by cataract will increase dramatically as the proportion of the elderly global population increase...
... Lasers are used to remove cataracts FACT: In cataract treatment, the clouded lens is surgically removed and then ... membrane behind the implant may become cloudy after cataract surgery. Laser treatment then may be used to open up the ...
David Yorston FRCS FRCOphth
The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.
Hazari Ajit; Sangwan Virender
Purpose:To study the visual outcome of cataract surgery in eyes with uveitis.Methods: A retrospective analysis of patients with uveitis operated for cataract. Results: 106 eyes of 89 patients with uveitis were operated for cataract. In 62.3% eyes (66/106), post -operative follow-up was at least 6 months. There was significant improvement (P<0.001) in visual acuity after cataract surgery. Provided the uveitis was well controlled for three months pre-operatively, additional pre...
M Babar Qureshi
Full Text Available Training in cataract surgery is one of the key factors needed to ensure high quality cataract surgery with good visual outcomes and patient satisfaction. The training has to impart the right skills to the right person by the right trainer and in the right environment.
Eye disturbance caused by atomic bomb radiation can be divided into three groups: direct injury immediately after exposure, eye lesions associated with radiation syndrome, and delayed disturbance. The crystalline lens of the eye is the most radiosensitive. Atomic bomb cataract has been investigated in a number of studies. The first section of this chapter discusses radiation cataract in terms of the incidence and characteristics. The second section deals with atomic bomb cataract, which can be diagnosed based on the four criteria: (1) opacity of the crystalline lens, (2) a history of proximal exposure, (3) lack of eye disease complicating cataract, and (4) non-exposure to radiation other than atomic bombing. The prevalence of cataract and severity of opacity are found to correlate with exposure doses and age at the time of exposure. Furthermore, it is found to correlate with distance from the hypocenter, the condition of shielding, epilation, and the presence or absence or degree of radiation syndrome. (N.K.)
... retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal ... which have shown varying results in delaying the progression of cataract. Genetic studies, which show promise for ...
The NASA-McGannon cataract surgery tool is a tiny cutter-pump which liquefies and pumps the cataract lens material from the eye. Inserted through a small incision in the cornea, the tool can be used on the hardest cataract lens. The cutter is driven by a turbine which operates at about 200,000 revolutions per minute. Incorporated in the mechanism are two passages for saline solutions, one to maintain constant pressure within the eye, the other for removal of the fragmented lens material and fluids. Three years of effort have produced a design, now being clinically evaluated, with excellent potential for improved cataract surgery. The use of this tool is expected to reduce the patient's hospital stay and recovery period significantly.
Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision
Full Text Available Purpose:To study the visual outcome of cataract surgery in eyes with uveitis.Methods: A retrospective analysis of patients with uveitis operated for cataract. Results: 106 eyes of 89 patients with uveitis were operated for cataract. In 62.3% eyes (66/106, post -operative follow-up was at least 6 months. There was significant improvement (P<0.001 in visual acuity after cataract surgery. Provided the uveitis was well controlled for three months pre-operatively, additional pre-operative anti-inflammatory medications did not significantly affect (P=0.842 post -operative inflammation. Patients who received extracapsular cataract extraction (ECCE or phacoemulsification with posterior chamber IOL (PCIOL obtained better visual acuity at 6 weeks (P=0.009 and P=0.032 respectively than those with only ECCE without IOL. In 37 eyes vision did not improve due to persistent uveitis (23.9%, 16/67, cystoid macular oedeme (20.9%, 14/67, and posterior capsule opacification (14.9%, 10/67. Conclusion: Cataract extraction and PCIOL implantation is safe in eyes with uveitis. Additional preoperative medications may not alleviate post-operative inflammation if uveitis is well controlled for at least three months before surgery.
Park, Sang Jun; Lee, Ju Hyun; Kang, Se Woong; Hyon, Joon Young; Park, Kyu Hyung
This study aimed to investigate the prevalence and clinical determinants of cataract and cataract surgery in Korean population. The 2008-2012 Korean National Health and Nutrition Examination Survey was analyzed, which included 20,419 participants aged ≥ 40 years. The survey is a multistage, probability-cluster survey, which can produce nationally representative estimates. Prevalence of cataract and cataract surgery was estimated. Clinical determinants for those were investigated using logistic regression analyses (LRAs). The prevalence of cataract was 42.28% (95% confidence interval [CI], 40.67-43.89); 40.82% (95% CI, 38.97-42.66) for men and 43.62% (95% CI, 41.91-45.33) for women (P = 0.606). The prevalence of cataract surgery was 7.75% (95% CI, 7.30-8.20); 6.38% (95% CI, 5.80-6.96) for men and 9.01% (95% CI, 8.41-9.61) for women (P Cataract was associated with older age (P Cataract surgery was consistently associated with older age, occupation, DM, asthma, and anemia in two LRAs, which compared participants with cataract surgery to those without cataract surgery and those having a cataract but without any cataract surgery, respectively. Hypertension, arthritis, and dyslipidemia were associated with cataract surgery at least in one of these LRAs. These results suggest that there are 9.4 million individuals with cataract and 1.7 million individuals with cataract surgery in Korea. Further studies are warranted to reveal the causality and its possible mechanism of developing/exacerbating cataract in novel determinants (i.e., anemia, asthma, and arthritic conditions) as well as well-known determinants. PMID:27247507
This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1). 2. Extracapsular cataract extraction with intraocular lens i...
When this paper was about to go to press, the International Commission on Radiological Protection released a statement recommending a change in the threshold dose for the eye lens and dose limits for eye for occupationally exposed persons. It is clear that the earlier published threshold for radiation cataract is no longer valid. Epidemiological studies among Chernobyl clean-up workers, A bomb survivors, astronauts, residents of contaminated buildings, radiological technicians and recent surveys of staff in interventional rooms indicate that there is an increased incidence of lens opacities at doses below 1 Gy. Nevertheless, eye lens dosimetry is at a primitive stage and needs to be developed further. Despite uncertainties concerning dose threshold and dosimetry, it is possible to significantly reduce the risk of radiation cataract through the use of appropriate eye protection. By increasing awareness among those at risk and better adoption and increased usage of protective measures, radiation cataract can become preventable despite lowering of dose limits. (authors)
Labiris, Georgios; Toli, Aspasia; Polychroni, Damaskini; Gkika, Maria; Angelonias, Dimitrios; Kozobolis, Vassilios P.
A systematic review of the recent literature regarding the implementation of the liquefaction in cataract surgery and its short-term and long-term outcomes in various parameters that affect the quality of patients' life, including visual rehabilitation and possible complications was performed based on the PubMed, Medline, Nature and the American Academy of Ophthalmology databases in November 2013 and data from 14 comparative studies were included in this narrative review. Liquefaction is an innovative technology for cataract extraction that uses micropulses of balanced salt solution to liquefy the lens nucleus. Most studies reported that liquefaction is a reliable technology for mild to moderate cataracts, while fragmentation difficulties may be encountered with harder nuclei. PMID:26949656
ALEXANDER, H B
Today the erisophake offers the most successful means for the intracapsular extraction of cataracts. The advantages of this method are that no counterpressure is required so that the incidence of vitreous loss is reduced; the vacuum cup provides a firmer grasp of the lens with less danger of rupture of the lens capsule; and the vacuum cup can be used for the delivery of practically all types of cataract in the adult, including intumescent and Morgagnian cataracts as well as lenses with exfoliating and friable capsules. While the forceps method of intracapsular extraction is generally successful in not more than 70 to 75 per cent of cases, the erisophake may offer success in 90 per cent of cases. PMID:14792378
Sacca, S; Marletta, A; Pascotto, A; Barabino, S; Rolando, M.; Giannetti, R.; Calabria, G.
AIM—To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma. METHODS—108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucl...
Full Text Available The lens is a multicellular, but avascular tissue that must stay transparent to allow normal transmission of light and focusing of it on the retina. Damage to lens cells and/or proteins can cause cataracts, opacities that disrupt these processes. The normal survival of the lens is facilitated by an extensive network of gap junctions formed predominantly of connexin46 and connexin50. Mutations of the genes that encode these connexins (GJA3 and GJA8 have been identified and linked to inheritance of cataracts in human families and mouse lines. In vitro expression studies of several of these mutants have shown that they exhibit abnormalities that may lead to disease. Many of the mutants reduce or modify intercellular communication due to channel alterations (including loss of function or altered gating or due to impaired cellular trafficking which reduces the number of gap junction channels within the plasma membrane. However, the abnormalities detected in studies of other mutants suggest that they cause cataracts through other mechanisms including gain of hemichannel function (leading to cell injury and death and formation of cytoplasmic accumulations (that may act as light scattering particles. These observations and the anticipated results of ongoing studies should elucidate the mechanisms of cataract development due to mutations of lens connexins and abnormalities of other lens proteins. They may also contribute to our understanding of the mechanisms of disease due to connexin mutations in other tissues.
Koopmans, SA; VanRij, G
A questionnaire was sent to 240 members of the Netherlands Intraocular implant Club (NIOIC) to register their policy followed in 1993 with regard to anticoagulant therapy (ACT) and the use of aspirin in patients having cataract surgery. Ninety-one (32%) forms were suitable for analysis. Most eye sur
Venkatesh Rengaraj; Das Manoranjan; Prashanth Sadasivam; Muralikrishnan Radhakrishnan
PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS) in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC). MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye u...
Hirokane, Kenji; Kosaka, Toshiya; Nii, Hiroki; Kiuchi, Yoshiaki; Nakano, Kensuke; Choshi, Kanji [Hiroshima Univ. (Japan). School of Medicine
Extracapsular cataract extraction and intraocular lens implantation was performed on 4 eyes of 3 patients with radiation cataract. Case 1 was a 60-year-old man who was exposed to the ionizing radiation of the atomic bomb in Hiroshima 730 meters from the center of the explosion. He developed atomic bomb radiation senile cataracts in both eyes. Despite cataract surgery, a central plaque remained on the posterior capsule in the region corresponding to the central dense opacity in both eyes. Case 2 was an 81-year-old man who was in a streetcar 1,000 meters from the center of the explosion at the time of the atomic bombing. Senile and radiation-induced cataract decreased the visual acuity in both eyes. After extracapsular cataract extraction in his right eye, central opacification and a fibrous white membrane remained on the posterior capsule. These were removed by Nd-YAG laser capsulotomy six days after surgery. Case 3 was a 56-year-old man who developed radiation cataract after radiation therapy to a malignant lymphoma in the right orbit. Phacoemulsification and aspiration could not remove the fibrous white membrane from the posterior capsule in this case. Central opacities and fibrous white membranes on the posterior capsule after cataract surgery appears to be a characteristic of radiation cataract. (author).
Extracapsular cataract extraction and intraocular lens implantation was performed on 4 eyes of 3 patients with radiation cataract. Case 1 was a 60-year-old man who was exposed to the ionizing radiation of the atomic bomb in Hiroshima 730 meters from the center of the explosion. He developed atomic bomb radiation senile cataracts in both eyes. Despite cataract surgery, a central plaque remained on the posterior capsule in the region corresponding to the central dense opacity in both eyes. Case 2 was an 81-year-old man who was in a streetcar 1,000 meters from the center of the explosion at the time of the atomic bombing. Senile and radiation-induced cataract decreased the visual acuity in both eyes. After extracapsular cataract extraction in his right eye, central opacification and a fibrous white membrane remained on the posterior capsule. These were removed by Nd-YAG laser capsulotomy six days after surgery. Case 3 was a 56-year-old man who developed radiation cataract after radiation therapy to a malignant lymphoma in the right orbit. Phacoemulsification and aspiration could not remove the fibrous white membrane from the posterior capsule in this case. Central opacities and fibrous white membranes on the posterior capsule after cataract surgery appears to be a characteristic of radiation cataract. (author)
Full Text Available Purpose: To evaluate the outcome of phacoemulsification in eyes with subluxated cataract. Materials and Methods: This retrospective study comprised 22 eyes of 20 consecutive patients with subluxated cataracts of varying aetiology operated between March 1998 and March 2001. Detailed preoperative assessment included visual acuity (VA, slitlamp examination, presence of vitreous in anterior chamber, extent of subluxation, intraocular pressure (IOP and detailed fundus examination. Phacoemulsification was done to retain the natural bag support and all patients had acrylic foldable Acrysof IOL implantation either in-the-bag or by scleral fixation. Postoperative observations included best-corrected visual acuity (BCVA, IOP, pupillary reaction and the IOL position. Results: The aetiology of the subluxation was traumatic in 11 patients and non-traumatic in 9 patients. Fifteen were males and 5 were females. Mean follow-up was 11.7 ± 9.71 months (range 4-39. The average age was 39.15 ± 16.33 (range 5 - 74. A 2-port anterior chamber vitrectomy was performed in 6 eyes (27.2%. Capsule tension ring (CTR was implanted in 15 eyes (68.18%. Twelve eyes (54.5% had in-the-bag implants, while 5 (22.72% had scleral fixation. The remaining 5 eyes (22.72% had one haptic in-the-bag and another sutured to sclera. No major intraoperative complications were noted. Twelve eyes (54.5% had clinically and geometrically well centered IOLs while 9 eyes (40.9% had geometrically decentered IOLs. One patient was lost to follow-up. Fifteen eyes (55.55% had postoperative BCVA of 6/12 - 6/6 while 2 eyes (7.40% had BCVA of 6/18. The remaining 4 eyes (14.81% had less than 6/24 BCVA due to pre-existing posterior segment pathology. Postoperative complications included rise in IOP in 1 eye (4.54%, pupillary capture of the IOL optic in 2 eyes (9.09%; the same 2 eyes (9.09% required redialing of IOL. One eye (4.54% had to undergo refixation (one haptic was fixed to sclera year after cataract
Cairns, L.; Sommer, A
Despite the fact that two community-based surgeons switched from routine intracapsular cataract extraction to planned extracapsular cataract surgery and routine implantation of posterior chamber lenses, they did not materially increase the size of their surgical load or change their indications for cataract surgery. In contrast a similar change in surgical technique by two high-referral hospital-based surgeons was associated with a marked increase in operative rates and increased preoperative...
Gupta, Varun B; Manjusha Rajagopala; Basavaiah Ravishankar
Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise...
The question was studied of whether or not uranium miners with a long history of work underground develop alterations of the eye lens as a result of a long-term chronic exposure to gamma radiation. Investigated were the area of opacities and the occurrence of alterations of the lens posterior pole in a group of 800 uranium miners (i.e., 1,600 eyes) with work underground longer than 10 years. As against controls, no statistical differences were found in the lens transparency. Significant differences were also not found in the extent of cataracts and the occurrence of posterior pole alterations, nor in the rate of an increased occurrence of cataracts due to age. (L.O.)
Kuchle, M.; A. Amberg; Martus, P.; Nguyen, N.; NAUMANN, G.
AIM/BACKGROUND—The pseudoexfoliation (PEX) syndrome is frequently associated with impairment of the blood-aqueous barrier. This study analysed if this might stimulate secondary cataract following cataract extraction. METHODS—This historical cohort study included 197 eyes of 197 patients (99 with and 98 without PEX) that underwent extracapsular cataract extraction with posterior chamber lens implantation (PMMA optic) between 1985 and 1991. Secondary cataract was defined as opacification of the...
Nagy, Zoltan Z.; McAlinden, Colm
Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages ...
Reading, V M
The changes in corneal curvature were determined at regular intervals over a one-year period following intracapsular cataract extraction by microsurgical techniques. During the first postoperative month photokeratometric measurements showed rapid changes in astigmatism associated with large changes in the direction of the axis. Thereafter astigmatism against-the-rule predominated. Data from the small group of patients who underwent surgery in which the technique of phacoemulsification was use...
Panda Anita; Kumar T
Fifty eyes were evaluated following penetrating keratoplasty and cataract extraction. Twenty five of them had intracapsular lens extraction while the remaining 25 had intercapsular method of extracapsular lens extraction. Both operative and post operative complications were more in group I. Visual outcome and graft clarity were also better in eyes of group II. Combined keratoplasty and intercapsular method of extracapsular lens extraction was recommended in eyes having both corneal and lentic...
Full Text Available Fifty eyes were evaluated following penetrating keratoplasty and cataract extraction. Twenty five of them had intracapsular lens extraction while the remaining 25 had intercapsular method of extracapsular lens extraction. Both operative and post operative complications were more in group I. Visual outcome and graft clarity were also better in eyes of group II. Combined keratoplasty and intercapsular method of extracapsular lens extraction was recommended in eyes having both corneal and lenticular pathology.
The radiation-induced cataract has been up to now considered as a quite rare pathology, needing high-dose radiations (beyond a dose threshold roughly estimated at 2 Grays to the lens) consisting mainly in head tumour radiotherapy complications. Several new studies on different exposed populations such as astronauts, japanese atomic bomb survivors, people undergoing X-ray examinations, Chernobyl accident 'liquidators' as well as data from animal experiments, suggest that dose threshold for detectable opacities as well as for clinical posterior sub-capsular cataract occurring, might be far lower than those previously assumed. Even the existence of a dose threshold is no longer an absolute certitude insofar as radiation-induced cataract pathogenesis might consist not really in a deterministic effect (direct tissue harmful effect, killing or seriously injuring a critical population of cells) as believed until now, but rather in a stochastic effect (genomic damage in target-cells, altered cell division, abnormal lens fiber cell differentiation). More practically, these new data may lead us to reconsider radioprotection of specifically exposed populations: mainly patients and workers. Regarding workers, labour legislation (lens equivalent dose limit of 150 mSv during 12 consecutive months) might be, in the medium term, reassessed downwards. (author)
Dose assessments for cataract threshold doses are available based on epidemiological studies of radiotherapy patients, survivors of the nuclear bombing of Hiroshima and Nagasaki, and of persons with occupational exposure to radiation. According to these, short-term application of low-level LET radiation of a dose ranging between 0.5 and 2.0 Gy may suffice to cause a cataract in the course of a few months or years which results in inpairment of vision (UNSCEAR, 1982). In fractionated irradiation, cataractogenic threshold dose increases to 4 Sv at treatment times between 3 weeks and 3 months, and to more than 5 Sv at more than 3 months (ICRP 41). Densely ionizing radiation must be assumed to have threshold doses between 2 and 20 Sv. An ICRP assessment (ICRP Publ. No. 41, 1984) gives a threshold dose of more than 8 Sv for a vision-impairing cataract if these was protracted irradiation at a low-level dose rate. Concerning radiation protection, a maximum lens dose of 150 mSv per annum was recommended which should not be exceeded. This indicates a maximum of 7.5 Sv of exposure throughout a period of 50 years of working life. (orig./HP)
Md. Jawed; Himadri; De, Abhijit; Rathindra; Deshmukh Md Saudmiya
BACKGROUND: Manual small incision cataract surgery (SICS) has given visual results almost equivalent to Phacoemulsification but limited studies are available regarding the efficacy of small incision cataract surgery in phaco suitable immature cataracts. OBJECTIVE: To compare manual small incision cataract surgery and Phacoemulsification in immature cataracts. MATERIALS AND METHODS: A single blind randomized controlled trial was conducted with 105 eyes each for small incisi...
Full Text Available In our country both pterygium and cataract have a high incidence. Hence in this study, thirty patients with pterygium and cataract were treated with a simultaneous pterygium excision and cataract extraction procedure. These patients after pterygium excision were treated intra-operatively with 500 rads of beta radiation over the pterygium site. Then, the cataract was extracted and the patients were treated post-operatively with topical betamethasone 0.1% for a duration of three months. They were followed up for a duration of 6 months postoperatively. Nineteen patients (63% had visual recovery to 6/12. Twelve of 30 patients (40% had recurrence of pterygium. The combined procedure did not result in any surgical complications following cataract removal. Post-operatively, after 6 months 13 patients had with the rule astigmatism (WRA for a mean WRA of 1.3 D, and 17 had against the rule astigmatism (ARA for a mean ARA of 1.2 D.
Gawęcki, Maciej; Grzybowski, Andrzej
The authors present systematic review of aetiology and treatment of diplopia related to cataract surgery. The problem is set in the modern perspective of changing cataract surgery. Actual incidence is discussed as well as various modalities of therapeutic options. The authors provide the guidance for the contemporary cataract surgeon, when to expect potential problem in ocular motility after cataract surgery. PMID:26998351
Maciej Gawęcki; Andrzej Grzybowski
The authors present systematic review of aetiology and treatment of diplopia related to cataract surgery. The problem is set in the modern perspective of changing cataract surgery. Actual incidence is discussed as well as various modalities of therapeutic options. The authors provide the guidance for the contemporary cataract surgeon, when to expect potential problem in ocular motility after cataract surgery.
The visual outcome in infants undergoing surgery for bilateral congenital cataract has improved considerably because of improved surgical methods and the realisation that early detection, allowing early cataract extraction and immediate optical correction, can prevent otherwise irreversible deprivation amblyopia. The management of unilateral congenital cataract is still of the most difficult problems in paediatric ophtalmology. In unilateral congenital cataract, interven...
Nagy, Zoltan Z; McAlinden, Colm
Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages have resulted in improved visual and refractive outcomes in the short term. Complication rates are low which reduce with surgeon experience. This review article focuses on the Alcon LenSx system. PMID:26605364
Full Text Available Cataract and glaucoma are common co morbidities. Cataract surgery is frequently performed in patients with glaucoma. In this study, a review of literature with search terms of cataract, glaucoma and intraocular pressure is followed by evaluation and synthesis of data to determine the effect of cataract surgery on intraocular pressure. Cataract surgery seems to lower intraocular pressure on a sustained basis, especially in patients with higher preoperative intraocular pressure. The mechanism of action of these finds remains speculative.
Varun B Gupta
Full Text Available Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc., traumatic, complicated (inflammatory and degenerative diseases of eye, metabolic (diabetes, galactosemia etc., toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc. are implicated as significant risk factors in the development of cataract.
Porela-Tiihonen, Susanna; Kokki, Hannu; Kaarniranta, Kai; Kokki, Merja
Cataract surgery is the most common ophthalmological surgical procedure, and it is predicted that the number of surgeries will increase significantly in the future. However, little is known about the recovery after surgery. The first aim of this study was to evaluate the prevalence, severity and duration of pain and other ocular discomfort symptoms experienced after cataract surgery. The other objectives were to identify the factors associated with lower postoperative patient satisfaction and to measure the effect of cataract surgery on patients' health-related quality of life (HRQoL) and visual function in everyday life. The study design was a prospective follow-up study. The course of the recovery and the presence of ocular symptoms were evaluated by interviewing the patients via a questionnaire at 1 day, 1 week, 6 weeks and one year after surgery The visual functioning in everyday life was measured with Visual Functioning Index VF-7 and Catquest-9SF-questionnaires and furthermore the HRQoL was measured with the 15D-instrument before surgery and at 12 months after surgery. The patients returned the questionnaires by mail and were interviewed in the hospital on the day of the surgery. The same patients filled-in all the questionnaires. The patient reports were used to collect the data on medical history. A total of 303 patients were approached at Kuopio University Hospital in 2010-2011 and of these 196 patients were eligible and willing to participate, with postoperative data being available from 186 (95%) patients. A systematic review article was included in the study procedure and it revealed the wide range in the reported incidence of postoperative ocular pain. Some of the identified randomized controlled studies reported no or only minor pain whereas in some studies significant pain or pain lasting for several weeks has been described in more than 50% of the study patients. In the present study setting, pain was reported by 34% during the first
Haargaard, Birgitte; Nyström, Alf; Rosensvärd, Annika; Tornqvist, Kristina; Magnusson, Gunilla
between January 2008 and December 2012 were included. Statistical comparison of the different screening strategies was made. RESULTS: The number of children undergoing surgery for congenital cataract before 1 year of age was 31 (17 bilateral cases) in Denmark and 92 (38 bilateral cases) in Sweden. The......PURPOSE: To analyse and discuss screening for the detection of congenital cataract in two Nordic countries, Denmark and Sweden. METHODS: Until 2011, in Denmark, no guideline concerning screening for congenital cataract existed. Since 2011, Danish guidelines regarding eye examination include...... examination with a pencil light at age 5 weeks, whereas newborn red reflex examination using a handheld ophthalmoscope is routine protocol in Swedish maternity wards. Data regarding age of referral were derived from the Pediatric Cataract Register (PECARE). All children operated on before 1 year of age...
Chan, Elsie; Mahroo, Omar A R; Spalton, David J
Modern cataract surgery is safe in more than 95 per cent of patients. In the small number of cases where a serious complication occurs, the most common is an intra-operative posterior capsular rupture. This can lead to vitreous loss or a dropped nucleus and can increase the risk of post-operative cystoid macular oedema or retinal detachment. Post-operatively, posterior capsular opacification is the most common complication and can be readily treated with a YAG capsulotomy. The most devastating complication is endophthalmitis, the rate of which is now significantly decreased through the use of intracameral antibiotics. As a clinician, the most important step is to assess the patient pre-operatively to predict higher risk individuals and to counsel them appropriately. In these patients, various pre- or intra-operative management steps can be taken in addition to routine phacoemulsification to optimise their visual outcome. PMID:20735786
Full Text Available Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender.
Until recently it was believed that the cataract (opacity of the eye lens) is a deterministic effect with a dose threshold of several Gray in dependence on the exposure conditions. Studies in Hiroshima and Nagasaki, in the vicinity of Chernobyl, of American radiologic technologists, astronauts, and patients after having received several computer tomographies of the head region, however, have shown that this assumption is not correct. It had been overlooked in the past that with decreasing dose the latency period is increasing. Therefore, the originally available studies were terminated too early. The more recent studies show that, in the case of a threshold existing at all, it is definitely below 0.8 Gy independently of an acute or a chronic exposure. All studies, however, include 0 Gy in the confidence interval, so that the absence of a dose threshold cannot be excluded. The German Commission on Radiological Protection (Strahlenschutzkommission, SSK) suggested therefore among others: targeted recording of the lens dose during activities which are known to be associated with possible significant lens exposure, examination of the lens should be included as appropriate in the medical monitoring of people occupationally exposed to radiation, if there is potentially high lens exposure, adoption of research strategies to develop a basic understanding of the mechanisms underlying radiation induced cataracts. The International Commission on Radiological Protection (ICRP) actually assumes a threshold dose of 0.5 Gy and, based on this assumption, has recommended in 2011 to reduce the dose limit for the eye lens from 150 mSv in a year to 20 mSv in a year for people occupationally exposed to ionising radiation. (orig.)
Feng H; Adelman RA
Hao Feng, Ron A Adelman Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA Purpose: To evaluate the incidence and prevalence of cataract formation, progression, and extraction in patients that underwent vitreoretinal procedures and to evaluate factors that can potentially predispose patients to postoperative cataracts.Materials and methods: The medical records of consecutive patients who underwent vitreoretinal surgery at the Yale Eye Cent...
Hodgkins, P R; Teye-Botchway, L; Morrell, A. J.; Fetherston, T J; Perthen, C; Brown, N E
Peribulbar and retrobulbar anaesthesia are commonly used techniques in cataract extraction. They offer satisfactory analgesia and akinesia but serious complications although uncommon are consistently reported. Intravenous sedation combined with a facial nerve block offers an alternative method of anaesthesia. This is a retrospective study of patients who underwent extracapsular cataract extraction using this technique between 1 January 1986 and 1 September 1990. The operating conditions were ...
Cataract is the most common cause of blindness in the world. An attack of phacolytic and phacomorphic glaucoma as a result of neglected cataract constitutes a medical emergency that must be addressed immediately. Ocular emergencies such as these is challenging for the surgeon with guarded or poor prognosis. We describe the presentation, management and prognosis of three cases of phacomorphic and phacolytic glaucoma. All three patients underwent aggressive management of intraocular pressure. D...
Full Text Available AIMS: To study various factors responsible for visual outcome after cataract surgery in complicated cataract secondary to uveitis. SETTINGS AND STUDY DESIGN: A Retrospective, Clinical study was carried out at tertiary eye care center in central Maharashtra from Jan. 2002 to Jan. 2007 which included 60 eyes of 52 patients. METHODS AND MATERIAL: It was a retrospective study of patients with uveitis undergone cataract surgery between Jan. 2002 to Jan. 2007, at Shri Ganapati Netralaya, Jalna. It included patients of all age groups, both genders, diagnosed of complicated cataract due to uveits subjected to cataract surgery with IOL implantation and detailed preoperative and postoperative -UCVA, BCVA, SLE, and Fundus evaluation with at least 3 months follow up. Follow up was on 1'st post-operative day, 1 week post-operative, 1 month post-operative and 3 months post-operative. We excluded patients with complicated cataract other than uveitic origin, post-operative follow up less than 3 months and patients with ocular diseases other than uveitis. TESTS APPLIED: Paired & Unpaired t-test. RESULTS: 1 Visual acuity: BCVA (>6/12 in 43(71.67 % eyes. 2 TYPE OF SURGERY: ECCE+IOL,(3 SICS+IOL,(5 SICS+AV(1 PE+IOL.(51 3 Type of IOL used: PMMA,(46 HSM,(2 Acrylic.(11 4 Postoperative complications:- CME-1(1.66%, Recurrence of Uveitis-9(15%, PCO:-19(31.66%, Posterior synaechie: 3 (5%, Hyphema:-2 (3.33%, Hypotony:-4 (6.66%, Secondary Glaucoma:-2 (3.33% RD:-1 (1.66%. CONCLUSIONS: 1 Visual outcome after cataract surgery in complicated cataract is statistically significant (P<0.0001 in our study. 2 The best technique of surgery remains Phacoemulsification with in-the-bag IOL implantation of PCIOL. 3 Use of pupil dilating technique's (Iris hook, Sphincterotomy is helpful in making adequate size capsulorrhexis and thereby reducing post-operative complications like anterior capsular opacification & capsular phimosis. 4 The most important predictor of successful cataract
Sangal, Neha; Chen, Teresa C
Pseudoexfoliation (PXF) syndrome is characterized by the deposition of distinctive fibrillar material in the anterior segment of the eye. It is an age-related process that is associated with open and narrow angle glaucomas and the formation of cataracts. Not only is PXF associated with the formation of dense nuclear cataracts, it is also well known that those presenting with PXF are at a higher risk of developing complications during, and even after, cataract surgery. Complications associated with cataract surgery in PXF can occur from poor pupillary dilation, zonular weakness leading to intraoperative or postoperative lens dislocation and vitreous loss, postoperative intraocular pressure (IOP) spikes potentiating glaucomatous damage, capsular phimosis, prolonged inflammation, and postoperative corneal decompensation. The surgeon should be prepared to encounter the various potential intraoperative and postoperative complications in eyes with pseudoexfoliation syndrome during cataract surgery. In this way, the surgeon can plan his/her surgical technique to help avoid surprises during cataract surgery and be prepared to manage the potential postoperative complications that can occur in pseudoexfoliation eyes. PMID:25325866
Full Text Available PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC. MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye using irrigating vectis. Intraoperative and postoperative findings (according to OCTET classification as well as postoperative visual outcomes were used as main measures to report the safety and efficacy of the surgery. RESULTS: Of the 100 eyes, 16 had intumescent, 67 had mature and 17 had hypermature cataract. Intraoperatively CCC was incomplete in 4 eyes (4% and had to be converted to canopener capsulotomy. None of the eyes had posterior capsular rupture or zonular dialysis and no eyes were converted to conventional Extra Capsular Cataract Extraction (ECCE. Postoperatively, 6 eyes (6% developed corneal oedema with >10 Descemets folds and 7 eyes (7% had corneal oedema with < 10 Descemets folds. Mild iritis was seen in 6 eyes (6% and moderate iritis with fibrin membrane was seen in 3 eyes (3%. Iridodialysis was observed in 1 eye (1%. Of the 99 patients (99% categorised under good visual outcomes category, 94 patients (94% had a best-corrected visual acuity of 6/9 or better on the 40th post-operative day. CONCLUSION: In developing countries like India where phacoemulsification may not be affordable to a majority of those requiring cataract surgery, MSICS proves to be a safe and efficacious alternative for white cataracts especially with the adjunctive use of trypan blue dye.
Full Text Available BACKGROUND: There are different complications of the cataract surgery described in the literature. The impact of these complications on the visual function is in correlation with many factors, some of them being imprecise and unable to be used as prognostic factors before and after the surgery. The modern technique and the surgeon’s experience lowers the complications incidence to a minimum, but even so, some problems cannot be avoided. AIM: The aim of this study is to analyse the early cataract surgery complications for patients operated in 2012 at the Ophthalmology Unit, Railway Hospital, Iaşi. MATERIAL AND METHOD: We conducted a retrospective analysis of the medical records of the patients who underwent cataract surgery in 2012. There were a total of 480 cataract surgeries, the majority of them (92,7% being age related cataracts in different stages of evolution, of which 31.45% being mature cataracts. In 476 eyes, artificial lens was inserted per-primam (474 eyes with posterior chamber intraocular lens and 2 eyes with anterior chamber intraocular lens, in one case the posterior chamber intraocular lens was sutured to the sclera, in 3 cases the eyes remained without lens. RESULTS: The incidence of severe complications or with potential of severe development was: severe corneal oedema 0.83% (4 cases, remaining lens fragments in the vitreous cavity 0.62% (3 cases, toxic anterior segment syndrome (TASS 0.41% (2 cases. There were no endophthalmitis, expulsive haemorhage or retinal detachment after cataract surgery. CONCLUSIONS: The number of early complications of our patients is the same with numbers shown in other studies. With a better surgical technique, a good examination of the patient, a thorough explanation of the procedure to the patient, the use of high quality substances during surgery and proper technology we can lower even more the incidence of the complications.
Frampton, Geoff; Harris, Petra; Cooper, Keith; Lotery, Andrew J; Shepherd, Jonathan
Background Elective cataract surgery is the most commonly performed surgical procedure in the NHS. In bilateral cataracts, the eye with greatest vision impairment from cataract is operated on first. First-eye surgery can improve vision and quality of life. However, it is unclear whether or not cataract surgery on the second eye provides enough incremental benefit to be considered clinically effective and cost-effective. Objective To conduct a systematic review of clinical effectiv...
Mohammad-Ali Javadi; Sepehr Feizi; Hamid-Reza Moein
Purpose: To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK), cataract removal and intraocular lens implantation (triple procedure), and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods: This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either opensky extracapsular cataract extraction (ECCE) or phacoemul...
Full Text Available Arie Y Nemet,1 Joel Hanhart,2 Igor Kaiserman,3,4 Shlomo Vinker5,6 1Department of Ophthalmology, Meir Medical Center, Kfar Saba, 2Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, 3Department of Ophthalmology, Barzilai Medical Center, Ashkelon, 4Faculty of Health Sciences, Ben Gurion University, Be'er Sheba, 5Department of Family Medicine, Clalit Health Services, Rehovot, 6Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel Background: Calcium is considered an important factor in the development of both osteoporosis and cataract. This study evaluated the association between osteoporosis and cataracts. Objective: To evaluate the prevalence of osteoporosis among patients undergoing cataract surgery, and the association between the two. Patients and methods: This was a retrospective observational case-control study, conducted in the Central District of Clalit Health Services (a district of the largest health maintenance organization in Israel. All Clalit members in the district older than 50 years who underwent cataract surgery from 2000 to 2007 (n=12,984 and 25,968 age- and sex-matched controls comprised the sample. Electronic medical records of all patients in the study were reviewed. The main outcome measure was the prevalence of osteoporosis and the odds ratio of having osteoporosis among cataract patients compared with controls. Results: Demographically, 41.8% were men with a mean age of 68.7 ± 8.2 years. A logistic regression model for osteoporosis showed that age, female sex, higher socioeconomic class, smoking, chronic renal failure, hyperthyroidism, rheumatoid arthritis, inflammatory bowel diseases, and cataract are all associated with increased prevalence of osteoporosis. Obesity is a protective factor for osteoporosis. In all age-groups, osteoporosis was more prevalent in cataract patients than in the control group. Conclusion: Among other well-known risk factors, osteoporosis is associated with the
Muraine, M; Gueudry, J; Retout, A; Genevois, O
Corneal pathologies leading to keratoplasty are often associated with cataract and combined surgery is therefore mandatory. Triple procedure with penetrating keratoplasty and concurrent cataract extraction followed by intra ocular lens (IOL) implantation is usually the preferential choice because visual rehabilitation is theoretically more rapid. Surgeons have to be aware of surgical conditions during open-sky surgery because vitreous pressure is not counterbalanced by anterior chamber pressure. Today, many surgeons prefer non-simultaneous procedures with cataract surgery performed months after grafting because of the improvement in spherical refractive error. More recently, new triple procedures, Descemet's stripping automated keratoplasty and concurrent cataract surgery have gained popularity, especially in patients with Fuchs dystrophy associated with cataract. Surgery starts with phacoemulsification, followed by endothelium exchange through a 3 to 5 mm incision. Advantages against classic triple procedure are quick visual rehabilitation, fewer induced refractive errors, minimal postoperative discomfort and corneal integrity. Surgeons have to consider an eventual postoperative hyperopic shift secondary to corneal lenticule shape when choosing adequate intraocular lens. PMID:22921023
Full Text Available This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1. 2. Extracapsular cataract extraction with intraocular lens implantation and posterior capsulorhexis (PCCC and optic capture which was performed on 24 eyes (group 2. 3. Extracapsular cataract extraction with intraocular lens implantation, posterior capsulorhexis and anterior vitrectomy which was performed on 24 eyes (group 3. All patients were followed up more than one year. Our results showed that posterior capsule opacity (PCO was developed in 20 eyes with intact capsules in group 1. All eyes had a clear visual axis in group 2. PCO developed only in one eye in group 3. In conclusion, PCCC and optic capture with or without anterior vitrectomy are effective methods in preventing PCO in infant and children. (Med J Indones 2003; 12: 21-6Keywords: posterior capsule opacification, posterior capsulorhexis, optic capture, anterior vitrectomy
Melancia, Diana; Abegão Pinto, Luis; Marques-Neves, Carlos
Cataract surgery is one of the most performed surgeries in the developed world. In addition to its significant impact on visual acuity, phacoemulsification has been hailed as a potential intraocular pressure (IOP)-lowering procedure. While current evidence suggests an overall significant and sustained decrease in IOP to exist after cataract surgery, the specific ocular characteristics that could help predict which patients are likely to benefit from this IOP-lowering effect remain unclear. This definition is important in glaucoma patients if this surgery is to be used in the treatment for this disease. Our review aims to summarize the literature on the subject, depicting possible mechanisms behind this IOP decrease, which type of patients are more likely to benefit from this surgery for IOP-lowering purposes and ultimately help optimizing disease management for the increasing number of patients with concomitant glaucoma and cataract. PMID:25765255
Full Text Available Hao Feng, Ron A Adelman Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA Purpose: To evaluate the incidence and prevalence of cataract formation, progression, and extraction in patients that underwent vitreoretinal procedures and to evaluate factors that can potentially predispose patients to postoperative cataracts.Materials and methods: The medical records of consecutive patients who underwent vitreoretinal surgery at the Yale Eye Center with at least 6 months of follow-up and no prior intraocular surgery were obtained. Preoperative, intraoperative, and postoperative data were recorded and analyzed in this retrospective observational study. The main outcome measures were defined as cataract extraction, formation, and progression after vitreoretinal procedures. The lens status of the surgical eye was recorded preoperatively and at 1 month, 3 months, 6 months, 12 months, 24 months, and 36 months postoperatively.Results: A total of 193 eyes of 180 patients fulfilled the inclusion criteria. The percentages of eyes with mild lens change were 96% after 20-gauge pars plana vitrectomy (PPV, 72% after small gauge (23- and 25-gauge PPV, 38% after scleral buckle (SB, 38% after pneumatic retinopexy (PR, and 91% after PPV plus SB (PPV+SB. Posterior subcapsular and nuclear sclerotic cataracts were the most common with almost all developing within 24 months. There was no statistically significant difference (P=1.00 between the rate of cataract extraction after 20-gauge (41% and small gauge PPV (42%, but there was a statistically significant difference between PPV and non-PPV (SB, 6%; PR, 7%; P<0.001 and PPV and PPV+SB groups (69%; P=0.0063.Conclusion: Cataracts were common following PPV regardless of the gauge. SB and PR led to the lowest while PPV+SB led to the highest risk of postoperative cataracts. Keywords: cataracts, vitreoretinal surgery, vitrectomy, scleral buckle, pneumatic retinopexy
Oliveira Regina de Souza Carvalho de Salles
Full Text Available OBJECTIVE: To identify in adult patients suffering from cataract the perceptions regarding the disease and its surgical treatment. MATERIALS AND METHODS: An exploratory survey was conducted among adult patients suffering from cataract and participating in a large-scale cataract management program at the University of São Paulo General Hospital in 2004. The interviews were conducted by research assistants previously trained to pose questions and record answers. RESULTS: The sample consisted of 170 men and women (43.5% and 56.5%, respectively, aged between 40 and 88 years. Of the 170 participants, 43.5% were from the State of São Paulo, 14.7% from the State of Bahia, 12.4% from the State of Minas Gerais, 5.9% from the State of Pernambuco, 1.8% from other countries, and the remaining 21.7% were from other Brazilian states. Of those who were actively working (n = 87, 43.7% had an occupational level corresponding to nonspecialized manual labor, 27.6% were in specialized manual labor jobs, 25.3% had routine nonmanual occupations, 1.1% supervised manual labor, and 2.3% had low-ranking supervision or inspection jobs over nonmanual occupations. Of those who were not actively working (n = 82, 53.6% were retired, 45.2% were housewives, and 1.2% were unemployed. Concerning conceptions about cataract, 79.0% referred to it as "a small skin fold that gradually covers the eye" and 32.4% mentioned, in addition, other conceptions. Concerning the cause, of the alternatives presented to them, 80% reported aging, 47.1% blamed "overusing the eyes in the workplace or at home", 7.1% believed they had cataract due to some kind of "spell." Of the associated answers, 94.1% referred to "blurred vision" in people suffering from cataract, 72.4% thought the person may become blind, and 66.5% believed that the patients suffering from cataract are depressed because they cannot see. Regarding surgery, 28.8% were afraid of undergoing surgery; of those, 16.3% cited with the fear
Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper
performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...
Full Text Available Pseudoexfoliation (PEX syndrome is an age-related systemic disorder with major ocular manifestations. It is characterized by the production and deposition of fibrillogranular amyloid-like extracellular material within many ocular tissues. Pseudoexfoliation is also a risk factor for glaucoma and also correlated to an increased incidence of cataract formation. Cataract surgery in eyes with pseudoexfoliation is connected with many complications and presents challenges that require careful preoperative planning and intraoperative care to ensure safe surgery and successful postoperative outcome. Zonular weakness and poor pupillary dilation are the two major risk factors for surgical complications and poor visual acuity after surgery. With proper preparation and the use of specialized adjunctive devices, phacoemulsification is the preferred procedure of cataract extraction in this group of patients. Postoperatively, patients require frequent and detailed follow-up to monitor for complications such as intraocular pressure rise, inflammation and intraocular lens dislocation. In conclusion, with appropriate preoperative, intraoperative and postoperative care, the risk of complications can be minimized and favorable outcomes may be achieved in cataract surgery in eyes with pseudoexfoliation syndrome.
... when they want. I Driving is a complex skill. Our ability to drive safely can be challenged by changes in our ... drive with you to see how well you drive with your cataract. I The ... to improve your driving skills. Improving your skills could help keep you and ...
Full Text Available The senile cataracts have been graded on the basis of density objectively. The letter visual acuity, laser interferometric visual acuity and pin hole visual acuity were compared in various grades of cataracts and controls (phakic and aphakic in 140 eyes. It was found that good correlation exists in all eyes except when cataract density is grade III or IV. The laser interferometry has good prognostic value when the predictability is assessed in early stages of cataract (Grade I & II.
Mohd R.A. Manaf; Aljunid, Syed M; Faridah H. Annuar; Chuah K. Leong; Normalina Mansor
A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques) and six months (for ECCE only). Effectiveness of cataract surgery was ...
Suzan Güven Yılmaz; Duygu İnci Bozbıyık; Süheyla Köse; Önder Üretmen
Pur po se: To evaluate the long-term visual outcome and to determine the surgical complications after cataract surgery in patients with unilateral childhood cataract. Ma te ri al and Met hod: We retrospectively reviewed the records of 18 cases with unilateral childhood cataract who had undergone cataract surgery before the age of seven. Primary intraocular lens (IOL) implantation was made in children who were older than 1 year of age. Secondary IOL implantation was made after 18 m...
Nijkamp, M D; Sixma, H.J.; Afman, H.; Hiddema, F; Koopmans, S.A.; Borne, B. van den; Hendrikse, F.; Nuijts, R M M A
PURPOSE: To examine the potential of a questionnaire (QUOTE Cataract) to measure quality of care from the perspective of cataract patients in quality-assurance or improvement programs. SETTING: Department of Ophthalmology, University Hospital Maastricht, Maastricht, University Hospital Groningen, Groningen, and Rotterdam Eye Hospital, Rotterdam, The Netherlands. METHODS: Cataract patients (N = 540) who had cataract surgery 2 to 8 months previously rated 31 quality-of-care aspects in terms of ...
Wassilieff, S. [Ecole des Applications Militaires de l' Energie Atomique, 50 - Cherbourg Octeville (France)
The radiation-induced cataract has been up to now considered as a quite rare pathology, needing high-dose radiations (beyond a dose threshold roughly estimated at 2 Grays to the lens) consisting mainly in head tumour radiotherapy complications. Several new studies on different exposed populations such as astronauts, japanese atomic bomb survivors, people undergoing X-ray examinations, Chernobyl accident 'liquidators' as well as data from animal experiments, suggest that dose threshold for detectable opacities as well as for clinical posterior sub-capsular cataract occurring, might be far lower than those previously assumed. Even the existence of a dose threshold is no longer an absolute certitude insofar as radiation-induced cataract pathogenesis might consist not really in a deterministic effect (direct tissue harmful effect, killing or seriously injuring a critical population of cells) as believed until now, but rather in a stochastic effect (genomic damage in target-cells, altered cell division, abnormal lens fiber cell differentiation). More practically, these new data may lead us to reconsider radioprotection of specifically exposed populations: mainly patients and workers. Regarding workers, labour legislation (lens equivalent dose limit of 150 mSv during 12 consecutive months) might be, in the medium term, reassessed downwards. (author)
Cataracts were reported as of June 1984, by 6% (12/218) of patients injected with 224Ra as juveniles and by 5% (32/681) injected as adults. The high incidence among those injected as juveniles is unusual and their subsequent ages, when reporting the cataracts, averaged only 34 years (range 14-46 years). In the juveniles of known dosage receiving more than 28 μCi 224Ra/kg, the cataract incidence was 14% (11/80) compared to only 0.8% (1/131) below 28 μ Ci 224Ra/kg. The cataract incidence increased significantly with dosage in the juveniles and in the adults. The appearance of these cataracts, as viewed by slitlamp biomicroscopy or in histological sections, is described. The appearance did not differ from classical radiation cataract in principle. (orig.)
A group of 831 patients were studied, after injection with known dosages of radium 224 in Germany shortly after the Second World War. From a total of 58 cataract diagnoses, 25 occurred before the age of 54. Data consist of ophthalmological reports from examinations after vision impairment. Mathematical analysis suggests that almost all of the 25 early cataracts and a substantial part of the later cataracts are treatment-related. The probability of induction of severe cataracts is roughly proportional to the square of the dosage, that is, the radium 224 activity per unit body weight, and also to the square of the time after treatment. An extended analysis also accounts for spontaneous cataracts; this shows for the spontaneous cataracts a probability that increases with roughly the eighth power of the age. (author)
Thomsen, Ann Sofia Skou; Kiilgaard, Jens Folke; Kjaerbo, Hadi; la Cour, Morten; Konge, Lars
PURPOSE: To evaluate the EyeSi(™) simulator in regard to assessing competence in cataract surgery. The primary objective was to explore all simulator metrics to establish a proficiency-based test with solid evidence. The secondary objective was to evaluate whether the skill assessment was specific...... to cataract surgery. METHODS: We included 26 ophthalmic trainees (no cataract surgery experience), 11 experienced cataract surgeons (>4000 cataract procedures) and five vitreoretinal surgeons. All subjects completed 13 different modules twice. Simulator metrics were used for the assessments. RESULTS......: Total module score on seven of 13 modules showed significant discriminative ability between the novices and experienced cataract surgeons. The intermodule reliability coefficient was 0.76 (p < 0.001). A pass/fail level was defined from the total score on these seven modules using the contrasting...
Kar, Sushil Kumar; Bhuyan, Lopamudra; Nanda, Ashok Kumar
Aim: Pseudoexfoliation (PXE) is a common and clinically important systemic condition in elderly people that affects the outcome of cataract surgery. It can cause various complications during cataract surgery due to pupillary rigidity and zonular weakness and instability. The purpose of this study was to evaluate the frequency and types of complications of Phacoemulsification in patients with cataract and PXE.Materials and Methods: This cross sectional, prospective study was carried out on 60 ...
Kothadia AD; AM Shenoy; Shabaraya AR; Rajan MS; UM Viradia; Patel NH
Phycocyanin is a biliprotein pigment found in blue-green algae Spirulina platensis, which have attracted attention because of their nutritional value and medicinal properties. This pigment has antioxidant, anti-inflammatory and hepatoprotective activity in different experimental models. This data supports the view that phycocyanin may prevent cataract progression. Cataract preventive action of phycocyanin was evaluated against naphthalene and galactose induced cataract experimental models in ...
Moreschi, Carlo; Da Broi, Ugo; Lanzetta, Paolo
Traumatic cataract is due to lens damage when mechanical, irradiative, electrical or chemical agents injury the globe. The appearance of a traumatic cataract is typically short and unilateral with rare spontaneous resolution and often involves other ocular anatomical areas. Medico-legal evaluation of the appearance and the consequences of a traumatic cataract requires a correct methodological approach with the support of qualified ophthalmological competences. PMID:23357390
Dahan, E; Judelson, J; Welsh, N H
Labrador keratopathy (LK) is an acquired corneal degeneration thought to be caused by chronic exposure to solar irradiation. Reports so far suggest that it is a progressive or at least a stationary condition. There are no detailed reports on recommended therapy. A prospective clinical study was conducted to show regression of LK following extracapsular cataract extraction. Seventeen black patients (26 eyes) with LK and mature cataracts underwent extracapsular cataract extraction. The severity...
Mody, Vino C Jr
Background: Cataract is the major cause of blindness in the world, and long-term solar ultraviolet radiation (UVR) is a major risk factor. The pathogenesis of UVRinduced cataract is studied in various animal models and cell systems. The significance of oxidation processes in cataract and other eye diseases has made the study of protective antioxidants increasingly important. Ascorbate, or vitamin C, is an important dietary antioxidant and essential nutrient in the human and ...
Zheng Selin, Jinjin
Age-related cataract is a clouding of the lens that leads to decreased vision. It increases with age and is one of the leading causes of blindness worldwide. The only treatment currently available is surgery. Therefore, it is important to identify modifiable risk factors for cataract prevention. The cause of cataract is not fully understood and may be multifactorial, involving oxidative stress, a condition of disrupted balance between oxidants and antioxidants. Oxidative damage to lens protei...
Introduction. Cataracts cause about 50% of world blindness. There is little likelihood of effective prevention becoming available in the next few years and so the only treatment will remain surgical. For many of the other major causes of world blindness, like trachoma, xerophthalmia and onchocerciasis, the remedy is community-based, not hospital-based, and requires prevention rather than treatment. The prevalence of blinding cataract will only increase as people live longer, so cataract will ...
Enhanced incidence of severe cataracts has been observed in a group of 831 patients injected with Ra224 in Germany shortly after the 1939-45 war. From 58 diagnoses 25 occurred before the age of 54. There was a strong correlation between observed incidence and injected activity. Almost all the 25 early cataracts, and a substantial number of the later could be treatment-related. The probability of induction of severe cataracts is roughly proportional to the square of the time after treatment. Extended analysis also accounts for spontaneous cataracts, a probability increasing with roughly the eighth power of the age. (UK)
The history of the cataract operations dates back to thousands of years ago. Initially, surgery was carried out using rudimentary operating techniques resulting in the loss of many eyes. Cataract surgery has evolved immersely and now it is a highly refined surgical practice. Evolution of the cataract surgery was closely linked to broadening of anatomical-pathological knowledge and to the development of the instruments applied. Although Daviel performed the first intentional cataract removal in 1747, almost one hundred years passed before the extracapsular cataract extraction method finally replaced the old couching technique. By the middle of the 20th century, with the progression of the operation techniques and instruments, different forms of intracapsular cataract extraction methods became prevalent. Introduction and widespread use of the artificial intraocular lenses from the second half of the 20th century led to the rediscovery and further perfection of the extracapsular cataract extraction technique. Today, phacoemulsification through small incision, along with the foldable intraocular lenses is the gold standard of cataract surgery. The aim of this study is to present the different cataract surgery methods applied throughout the centuries, as well as the difficulties encountered. It discusses pioneering steps of each era, in order to give a closer look at the most frequently performed surgical intervention in ophthalmology. PMID:24184933
Zhao, Ling; Chen, Xiang-Jun; Zhu, Jie; Xi, Yi-Bo; Yang, Xu; Hu, Li-Dan; Ouyang, Hong; Patel, Sherrina H; Jin, Xin; Lin, Danni; Wu, Frances; Flagg, Ken; Cai, Huimin; Li, Gen; Cao, Guiqun; Lin, Ying; Chen, Daniel; Wen, Cindy; Chung, Christopher; Wang, Yandong; Qiu, Austin; Yeh, Emily; Wang, Wenqiu; Hu, Xun; Grob, Seanna; Abagyan, Ruben; Su, Zhiguang; Tjondro, Harry Christianto; Zhao, Xi-Juan; Luo, Hongrong; Hou, Rui; Perry, J Jefferson P; Gao, Weiwei; Kozak, Igor; Granet, David; Li, Yingrui; Sun, Xiaodong; Wang, Jun; Zhang, Liangfang; Liu, Yizhi; Yan, Yong-Bin; Zhang, Kang
The human lens is comprised largely of crystallin proteins assembled into a highly ordered, interactive macro-structure essential for lens transparency and refractive index. Any disruption of intra- or inter-protein interactions will alter this delicate structure, exposing hydrophobic surfaces, with consequent protein aggregation and cataract formation. Cataracts are the most common cause of blindness worldwide, affecting tens of millions of people, and currently the only treatment is surgical removal of cataractous lenses. The precise mechanisms by which lens proteins both prevent aggregation and maintain lens transparency are largely unknown. Lanosterol is an amphipathic molecule enriched in the lens. It is synthesized by lanosterol synthase (LSS) in a key cyclization reaction of a cholesterol synthesis pathway. Here we identify two distinct homozygous LSS missense mutations (W581R and G588S) in two families with extensive congenital cataracts. Both of these mutations affect highly conserved amino acid residues and impair key catalytic functions of LSS. Engineered expression of wild-type, but not mutant, LSS prevents intracellular protein aggregation of various cataract-causing mutant crystallins. Treatment by lanosterol, but not cholesterol, significantly decreased preformed protein aggregates both in vitro and in cell-transfection experiments. We further show that lanosterol treatment could reduce cataract severity and increase transparency in dissected rabbit cataractous lenses in vitro and cataract severity in vivo in dogs. Our study identifies lanosterol as a key molecule in the prevention of lens protein aggregation and points to a novel strategy for cataract prevention and treatment. PMID:26200341
Lorand, L.; Hsu, L K; Siefring, G E; Rafferty, N S
A protein polymer characteristically present in human cataract was shown to contain significant amounts of gamma-glutamyl-epsilon-lysine isopeptides. It is proposed that these crosslinks are produced by the action of transglutaminase (R-glutaminyl-peptide:amine-gamma-glutamyl-yltransferase, EC 126.96.36.199), which is all the more plausible because lens contains the enzyme and endogenous protein substrates for it. The enzyme is similar to that obtained from liver and is Ca2+ dependent. Highest app...
Two cases of adrenomyeloneuropathy (AMN) in a family and the results of their MRI study are reported. Case 1, a 24-year-old male proband, was admitted to our hospital because of gait disturbance for three years. Bilateral cataracts were pointed out at birth, which required left side lenticotomy at age four. Neurological examinations on admission revealed a marked spastic paraparesis with pathological reflexes and a mild hypesthesia in the distal part of the left leg. No abnormal findings were detected in X-ray studies on the spine and spinal cord, electromyography and nerve conduction test. Serum very long chain fatty acids (VLCFAs) levels were apparently elevated, and the serum cortisol response to ACTH was low. Case 2, a 53-year-old woman, is the mother of Case 1 having a complaint of gait disturbance since age 51. She presented a mild spastic paraparesis with localized hypesthesia in the distal part of the both legs. She also had bilateral congenital cataracts. Her serum VLCFAs analysis indicated the intermediate levels between that of AMN and the normal control. Adrenal functions were normal. Cranial MRI (TR 2,000 msec/TE 80 msec) study disclosed high signal intensity areas in bilateral internal capsules in Case 1. These findings, suggesting the pathological change of dysmyelination, seemed to be well compatible with the clinical pictures. With these clinical findings and the laboratory data, these two cases were diagnosed as AMN. In addition, association of congenital cataract with AMN in both cases was characteristic in this family, which hasn't been reported in the literature. On regarding the genetic background of these two disorders, AMN and congenital cataract, it was speculated that each gene could be closely located on the same or very adjacent locus, possibly on Xq. (author)
Thompson, D. A.; Møller, H; Russell-Eggitt, I.; Kriss, A
BACKGROUND: Patching the fellow eye in infancy is a well recognised therapy to encourage visual development in the lensectomised eye in cases of unilateral congenital cataract. The possibility of iatrogenic deficits of the fellow eye was investigated by comparing the vision of these patients with untreated unilateral patients and binocularly normal controls. METHODS: Sweep visual evoked potentials (VEPs) offer a rapid and objective method for estimating grating acuity. Sweep VEPs were used to...
Littlewood, K R; Constable, I J
One hundred eyes undergoing intracapsular cataract extraction and 100 undergoing extracapsular extraction were examined prospectively within one week postoperatively and again at 6-10 weeks postoperatively. Indirect ophthalmoscopy showed vitreous haemorrhage in 36% of the intracapsular group and 13% of the extracapsular group. Vitreous haemorrhage was significantly related to the occurrence of operative hyphaema (p less than 0.01) but not to iridectomy (p greater than 0.05). In the intracapsu...
Smith, R. J.; Doran, R.; Caswell, A
Comments are made on the method of removing the anterior capsule during the performance of extracapsular cataract operations. The difficulty of performing this manoeuvre adequately is emphasised. Observations carried out during the postoperative period by means of the slit-lamp revealed some hitherto undescribed changes in the capsule. The edge of the anterior capsule can be clearly seen and looks like broken glass. Fine fibrils have been observed attached to the fractured capsular edge. In t...
Dujić Mirjana P.
Full Text Available Background. Transient ocular misalignment as a complication of parabulbar and peribulbar anesthesia has already been reported in the literature. The aim of our study was to present a case of irreversible iatrogenic vertical strabismus after cataract surgery, which had to be operated on. Methods. Clinical and orthoptic evaluation of a female patient with vertical diplopia after phacoemulsification cataract surgery. Results. One week after the uneventful surgery, a 68-year-old patient complained of a sudden vertical deviation in the operated eye. The patient had not had a history of previous motility disorders. On examination, the patient showed hypertropia in the left eye of 15−20 degrees in primary position. Three and 6 months postoperatively, there was no a spontaneous improvement, while the persistent vertical deviation was 40 prism dioptres. Strabismus surgery was required 1 year after the cataract surgery. Conclusion. Diplopia is a complication of peribulbar anesthesia which could be persistent. The superior and inferior rectus muscle are especially vulnerable. Its occurrence may be technique - related and the incidence increases when hyaluronidase is not available.
Sangshin; Park; Eun-Hee; Lee
·AIM: To determine the effect of metabolic syndrome on age-related cataract formation.·METHODS: We analyzed data for 2852 subjects [41.8%men and 58.2% women; mean(±SD) age, 52.9 ±13.9y],taken from the Korea National Health and Nutrition Examination Survey 2008. Metabolic syndrome was diagnosed by criteria proposed by the Joint Interim Societies. Cataract was diagnosed by using the Lens Opacities Classification System III. The association between metabolic syndrome and cataract was determined using age-adjusted and multivariable logistic regression analyses.· RESULTS: In multivariable analyses, men with metabolic syndrome had a 64% increased risk of nuclear cataract [odds ratio(OR), 1.64; 95% confidence interval(CI), 1.12-2.39]. Women with metabolic syndrome had a56% increased risk of cortical cataract(OR, 1.56; 95% CI,1.06-2.30). Men and women with metabolic syndrome had a 46%(OR, 1.46; 95% CI, 1.01-2.12) and 49%(OR,1.49; 95% CI, 1.07-2.08) increased risk of any cataract,respectively. The prevalence of nuclear and any cataract significantly increased with an increasing number of disturbed metabolic components in men, and prevalence of all types of cataracts increased in women. Men using hypoglycemic medication had an increased risk of nuclear(OR, 2.62; 95% CI, 1.41-4.86) and any(OR, 2.27;95% CI, 1.14-4.51) cataract, and women using antidyslipidemia medication had an increased risk of cortical(OR, 2.18; 95% CI, 1.12-4.24) and any(OR, 2.21;95% CI, 1.14-4.26) cataract.·CONCLUSION: Metabolic syndrome and its components,such as abdominal obesity, high blood pressure, andimpaired fasting glucose, are associated with age-related cataract formation in the Korean population.
Medsinge, Anagha; Nischal, Ken K
Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. PMID:25609909
Manayi, Azadeh; Abdollahi, Mohammad; Raman, Thiagarajan; Nabavi, Seyed Fazel; Habtemariam, Solomon; Daglia, Maria; Nabavi, Seyed Mohammad
Cataract is one of the most important leading causes of blindness in the world. Extensive research showed that oxidative stress may play an important role in the initiation and progression of a cataract and other age-related eye diseases. Extra-generation of reactive oxygen and nitrogen species in the eye tissue has been shown as one of the most important risk factors for cataracts and other age-related eye diseases. With respect to this, it can be hypothesized that dietary antioxidants may be useful in the prevention and/or mitigation of cataract. Lutein is an important xanthophyll which is widely found in different vegetables such as spinach, kale and carrots as well as some other foods such as eggs. Lutein is concentrated in the macula and suppresses the oxidative stress in the eye tissues. A plethora of literature has shown that increased lutein consumption has a close correlation with reduction in the incidence of cataract. Despite this general information, there is a negligible number of review articles considering the beneficial effects of lutein on cataracts and age-related eye diseases. The present review is aimed at discussing the role of oxidative stress in the initiation and progression of a cataract and the possible beneficial effects of lutein in maintaining retinal health and fighting cataract. We also provide a perspective on the chemistry, sources, bioavailability and safety of lutein. PMID:26042352
Full Text Available Management of endothelial dysfunction in phakic patients is sometimes a dilemma for corneal surgeons. Phakic patients with visually significant cataract and endothelial dysfunction are preferably managed by performing combined cataract surgery with endothelial keratoplasty. However, combined surgery may be deferred in eyes with early incipient cataract, younger age and where anterior chamber is poorly visualized. As cataract formation may be accelerated after endothelial keratoplasty, these eyes may need cataract surgery subsequently. Surgical intervention in eyes with endothelial keratoplasty is of concern as this may affect the graft adversely and threaten graft survival. In this report, we describe the intraoperative surgical details and postoperative clinical course of a patient who underwent phacoemulsification with intraocular lens implantation after Descemet stripping automated endothelial keratoplasty (DSAEK.
Blumenthal, M; Glovinsky, Y
Of the three classical approaches to surgery for coexisting cataract and glaucoma, last year's publications dealt with the surgical consequences of combined cataract and glaucoma operations only. When used in combined cataract and glaucoma surgery, a small-incision extracapsular cataract extraction (ECCE) with phacoemulsification (PHACO) was found to be only slightly superior to the standard manual ECCE in terms of postoperative intraocular pressure (IOP) control. Injections of 5-fluorouracil postoperatively did not improve IOP control in PHACO-ECCE-trabeculectomy or manual ECCE-trabeculectomy. A preliminary uncontrolled report suggests, however, that intraoperative mitomycin C application in PHACO-ECCE-trabeculectomy may result in excellent postoperative IOP control without antiglaucomatous medications, and with no significant mitomycin C-related complications. Controlled studies on mitomycin C application in small-incision cataract and glaucoma surgery are needed to assess its long-term effect on IOP and astigmatism. PMID:10150852
Full Text Available Anagha Medsinge,1,2 Ken K Nischal1,2 1Pediatric Ophthalmology, Strabismus, and Adult Motility, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, (UPMC 2University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Abstract: Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. Keywords: children, pediatric cataract, infantile
Waudby Carol J
Full Text Available Abstract Background The eMERGE (electronic MEdical Records and Genomics network, funded by the National Human Genome Research Institute, is a national consortium formed to develop, disseminate, and apply approaches to research that combine DNA biorepositories with electronic health record (EHR systems for large-scale, high-throughput genetic research. Marshfield Clinic is one of five sites in the eMERGE network and primarily studied: 1 age-related cataract and 2 HDL-cholesterol levels. The purpose of this paper is to describe the approach to electronic evaluation of the epidemiology of cataract using the EHR for a large biobank and to assess previously identified epidemiologic risk factors in cases identified by electronic algorithms. Methods Electronic algorithms were used to select individuals with cataracts in the Personalized Medicine Research Project database. These were analyzed for cataract prevalence, age at cataract, and previously identified risk factors. Results Cataract diagnoses and surgeries, though not type of cataract, were successfully identified using electronic algorithms. Age specific prevalence of both cataract (22% compared to 17.2% and cataract surgery (11% compared to 5.1% were higher when compared to the Eye Diseases Prevalence Research Group. The risk factors of age, gender, diabetes, and steroid use were confirmed. Conclusions Using electronic health records can be a viable and efficient tool to identify cataracts for research. However, using retrospective data from this source can be confounded by historical limits on data availability, differences in the utilization of healthcare, and changes in exposures over time.
Galichanin, Konstantin; Talebizadeh, Nooshin; Söderberg, Per
Cataract is the leading cause of blindness in the world (1). The World Health Organization defines cataract as a clouding of the lens of the eye which impedes the transfer of light. Cataract is a multi-factorial disease associated with diabetes, smoking, ultraviolet radiation (UVR), alcohol, ionizing radiation, steroids and hypertension. There is strong experimental (2-4) and epidemiological evidence (5,6) that UVR causes cataract. We developed an animal model for UVR B induced cataract in both anesthetized (7) and non-anesthetized animals (8). The only cure for cataract is surgery but this treatment is not accessible to all. It has been estimated that a delay of onset of cataract for 10 years could reduce the need for cataract surgery by 50% (9). To delay the incidence of cataract, it is needed to understand the mechanisms of cataract formation and find effective prevention strategies. Among the mechanisms for cataract development, apoptosis plays a crucial role in initiation of cataract in humans and animals (10). Our focus has recently been apoptosis in the lens as the mechanism for cataract development (8,11,12). It is anticipated that a better understanding of the effect of UVR on the apoptosis pathway will provide possibilities for discovery of new pharmaceuticals to prevent cataract. In this article, we describe how cataract can be experimentally induced by in vivo exposure to UVR-B. Further RT-PCR and immunohistochemistry are presented as tools to study molecular mechanisms of UVR-B induced cataract. PMID:23222480
Rajni; Mohd Ayaz; Pallvi; Syed Tariq
INTRODUCTION: Cataract is the leading cause of preventable blindness in India. Manual Small Incision Cataract Surgery is still the preferred method of cataract surgery because of its low cost and non-dependence on costly equipments. Postoperatively astigmatism is an important cause of poor uncorrected visual acuity after cataract surgery. Purpose: The purpose of this study was to assess corneal astigmatism in manual small incision cataract surgery in superior versus temporal ...
Bimanual microincisional cataract surgery has been introduced recently as a technique for cataract surgery and it is gaining interest of many cataract surgeons in the world. Over the last few years many changes were made in the phacoemulsification machines and the intraocular lenses design which allowed bimanual microincisional cataract surgery to be safer and more efficient. The purpose of this review is to introduce the technique of bimanual microincisional cataract surgery and to review al...
Purpose: The aim of this retrospective study was to evaluate cataract incidence in a homogeneously-treated group of patients after total-body irradiation (TBI) followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Methods and Materials: Between 1982 and 1994, a total of 260 patients received either autologous bone marrow or blood stem cell transplantation for hematological malignancy at the University of Heidelberg. Two hundred nine of these patients received TBI in our hospital. Radiotherapy was applied as hyperfractionated TBI, with a median dose of 14.4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 h. Photons with an energy of 23 MeV were used with a dose rate of 7-18 cGy/min. Ninety-six of the 209 irradiated patients were still alive in 1996; 86 of these patients (52 men, 33 women) answered a questionnaire and could be examined ophthalmologically. The median age at time of TBI was 38.5 years, with a range of 15-59 years. Results: The median follow-up is now 5.8 years, with a range of 1.7-13 years. Cataract occurred in 28/85 patients (32.9%) after a median of 47 months (1-104 months). In 6 of 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to TBI had been performed more often in the group of patients developing cataract (14.3%) versus 10.7% in the group of patients without cataract. However, there was no statistical difference (Chi-square, p > 0.05). Conclusion: Cataract is a common side effect of TBI. Cataract incidence found in our patients is comparable to results of other centers using a fractionated regimen for TBI. To assess the incidence of cataract after TBI, a long-term follow-up is required
Rahul Bhargava; Prachi Kumar; Hafsa Bashir; Shiv Kumar Sharma; Anurag Mishra
Purpose: The purpose of this study is to evaluate the outcome of manual small incision cataract surgery (SICS) in eyes with uveitic cataract. Setting: Medical college hospital of the subcontinent. Design: Retrospective case series. Materials and Methods: In this retrospective study, patients who underwent SICS with posterior chamber intraocular lens implantation for uveitic cataract from 2006 to 2009 were evaluated. Patients with less than 3 months follow-up were excluded. Post-opera...
Abdullah Al-Mujaini; Wali, Upender K.
Purpose/Objective: To report the best corrected visual acuity, at the end of one year, in 33 patients (35 eyes), who underwent extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens implantation (PC-IOL) for mature and hypermature cataracts, with pseudoexfoliation (PEX). Design: Retrospective, non-comparative, single-institutional (Sultan Qaboos University Hospital) study. Participants: Thirty-three patients with mature and hypermature cataracts, with PEX opera...
Snellingen, T; Shrestha, B.; Gharti, M; Shrestha, J.; Upadhyay, M; Pokhrel, R
BACKGROUND—Previous studies have shown that, despite an increasing availability of cataract surgery, important socioeconomic barriers exist in the acceptance of surgery in many rural areas of south Asia. Nepal has developed a comprehensive national network of eye hospitals but the surgical coverage for the treatment of cataract blind is still low. AIMS—To determine the utilisation of cataract surgery and the level of physical and psychosocial impairment and the socioeconomic barriers to surge...
Full Text Available Introduction. Cataracts cause about 50% of world blindness. There is little likelihood of effective prevention becoming available in the next few years and so the only treatment will remain surgical. For many of the other major causes of world blindness, like trachoma, xerophthalmia and onchocerciasis, the remedy is community-based, not hospital-based, and requires prevention rather than treatment. The prevalence of blinding cataract will only increase as people live longer, so cataract will continue to be, by far, the most important treatable cause of blindness.
Antunes, A; Barros, P S M; Morelhao, S L; Antunes, Andrea; Safatle, Angelica M.V.; Barros, Paulo S.M.; Morelhao, Sergio L.
This work reports the exploitation of diffraction enhanced X-ray imaging (DEI) for studying cataract in addition to the finding of heavy scattering centers of light, probably Ca-rich precipitates in cataractous lenses. DEI selectively probes diffuse-scattering, refraction, and absorption properties of features in the lenses. Fiber cell compaction areas and dilute distribution of precipitates are identifiable, as well as highly absorbing aggregations providing contrast even in the conventional radiography setup. This finding opens new opportunities for clinical diagnosis, for understaning the causes of cataract, and in developing medicines for this disease.
Jones, Jeffrey A.; McCarten, M.; Manuel, K.; Djojonegoro, B.; Murray, J.; Cucinotta, F.; Feiversen, A.; Wear, M.
Induction of cataracts by occupational exposure in flight crew has been an important topic of interest in aerospace medicine in the past five years, in association with numerous reports of flight-associated disease incidences. Due to numerous confounding variables, it has been difficult to determine if there is increased cataract risk directly caused by interaction with the flight environment, specifically associated with added radiation exposure during flight. Military aviator records from the United States Air Force (USAF) and Navy (USN) and US astronauts at the National Aeronautics and Space Administration (NASA)/Lyndon B. Johnson Space Center (JSC) were evaluated for the presence, location and age of diagnosis of cataracts. Military aviators were found to have a statistically significant younger average age of onset of their cataracts compared with astronauts, however the incidence density of cataracts was found to be statistically higher in astronauts than in military aviators. USAF and USN aviator s cataracts were most commonly located in the posterior subcapsular region of the lens while astronauts cataracts were most likely to originate generally in the cortical zone. A prospective clinical trial which controls for confounding variables in examination technique, cataract classification, diet, exposure, and pharmacological intervention is needed to determine what percentage of the risk for cataracts are due to radiation, and how to best develop countermeasures to protect flight crews from radiation bioeffects in the future.
Mahmoodreza Panahi Bazaz
Full Text Available Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS in children under age of 15 Methods: This prospective cohort (since 2006 consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24 months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year months in non-glaucomatous group (p<0.001. All glaucoma patients had the operation under two years of age. In group 1, 9 (60% and in group 2, 24 (30% patients were female (p=0.001. In group 1, 17 eyes (60.7% and in the group 2, 41 eyes (30.8% were aphakic (p=0.001. Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days. Mean follow-up time was 3.1 years (range, 1-6 years. In 22 (78.6% eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82% and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.
This investigation was conducted to ascertain whether cellular hypersensitivity to radiation may be identified as a possible cause of cataract in persons exposed to low levels of radiation. Patients were studied in whom posterior subcapsular cataract (PSC) had followed probable exposure to low levels of radiation or in whom PSC had developed before the age of 60 without known exposure. Patients with cataract were compared with age and sex matched controls. Radiation sensitivity was estimated by measuring clonal growth of skin fibroblasts and peripheral blood lymphocytes after exposure to graded doses of radiation and by measuring postirradiation reconstruction of separated nuclear material from lymphocytes. Results show variations in radiation sensitivity between patients, without significant differences from the controls. It is concluded that radiation hypersensitivity is not normally associated with development of posterior subcapsular cataract. (author)
Full Text Available Phycocyanin is a biliprotein pigment found in blue-green algae Spirulina platensis, which have attracted attention because of their nutritional value and medicinal properties. This pigment has antioxidant, anti-inflammatory and hepatoprotective activity in different experimental models. This data supports the view that phycocyanin may prevent cataract progression. Cataract preventive action of phycocyanin was evaluated against naphthalene and galactose induced cataract experimental models in wistar rats at dose 200 mg/kg/day p.o and vitamin E was used as a reference standard. Phycocyanin treated animals showed no opacification in the lens and they also showed significantly increased level of glutathione (GSH, soluble proteins and water content as compared to positive control group in the lens in both the experimental models. Cataract preventive action of phycocyanin may be due to is antioxidant and free radical scavenging activity.
Chiseliţă, D; Vancea, P P; Filimon, O; Brănişteanu, D; Bredetean, M; Poiata, I
The retrospective analysis of the postoperative course in 204 traumatic cataracts (140 isolated, simple cataracts and 64 aggravated ones) showed an apparent functional improvement in the simple cases (preoperative and postoperative visual acuity 0.0139 and 0.8520, respectively); the incidence of postoperative detachment of retina was of 4.9%, that of postoperative endophthalmitis that of cystoid macular edema of 3.2%; complications more commonly occurred in aggravated traumatic cataracts and partially accounted for the poorer functional results. During the investigated interval (1988-1992) a rapid shift to extracapsular cataract extraction and posterior chamber lens implants was made. The crystalline grafts preserved binocular vision in 92% of the cases and contact lens in 50% of the cases. Lens implant remains a matchless solution for the visual rehabilitation of the patients with aphakia. PMID:7654673
Roszkowska, A. M.; Torrisi, L.
The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.
Kirkpatrick, J N; Cook, S D
A case of planned routine extracapsular cataract extraction is described where surgery was complicated peroperatively by fracture of the posterior chamber lens implant. The technique of lens implantation is discussed.
The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.
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Investment by organizations and agencies has led to a growing body of evidence and information to assist ophthalmologists and others to meet the needs of children with cataract in Africa. The geographic distribution of research, training, and programme development across Africa has been uneven; investment has been greatest in eastern and southern Africa. Population based surveys (using key informants) suggest that 15–35% of childhood blindness is due to congenital or developmental cataract. T...
Wan-Chen Ku; Lan-Hsin Chuang; Chi-Chun Lai
Background: According to the high prevalence of myopia in Taiwan, we analyze theadopted cataract extractions, identify predicting factors for postoperativevision, and to assess the incidence of retinal complications after Nd: YAGlaser capsulotomy in high myopic eyes.Methods: One hundred and twenty-five eyes, which the axial lengths were longer than26 mm, following cataract extraction were enrolled. Surgeries adoptedincluded phacoemulsification with intraocular lens implantation, extracapsular...
Kelley, J S; Doxanas, M T
PURPOSE: To estimate the incidence of retinal detachment after cataract surgery with capsulorhexis. METHODS: A consecutive series of 2,150 cataract operations were followed for incidence of retinal detachment. A series of 1,000 patients from this group were analyzed for high risk factors: myopia, age, sex, operative complications and capsulotomy. RESULTS: With minimum one year follow up in 90% of patients the incidence of retinal detachment was 0.25% (5 cases). CONCLUSION: The true incidence ...
Hamid Fesharaki; Hasan Razmjoo; Masoud Aghajani
BACKGROUND: Complaining of tearing was found in some of our patients after phacoemulsification surgery for senile cataract. Secondary acquired lacrimal drainage obstruction has been proposed to happen due to different causes. This study was performed at Feiz hospital in Isfahan, Iran from September to December of 2004 to evaluate the effects of phacoemulsification surgery on tear drainage in eyes with senile cataract. METHODS: This cohort study was performed on 110 patients with senile catara...
Extracapsular cataract extraction with lens implant under local anaesthesia consisting of amethocaine drops followed by a simple subconjunctival injection in the upper part of the globe but without a retrobulbar injection was carried out in 175 eyes of 165 patients. The purpose of the study was to establish the feasibility of this type of anaesthesia in cataract surgery with the principal object of avoiding the possibility of retrobulbar haemorrhage and the other, rarer, complications of retr...
Hodgkins, P R; Luff, A J; Morrell, A. J.; Botchway, L. T.; Featherston, T. J.; Fielder, A R
A questionnaire regarding preferred methods of cataract extraction and anaesthesia was sent to 456 consultant ophthalmologists in England and Wales. Replies were received from 86% (n = 392), 83% (n = 380) having completed the questionnaire in full. The most frequently employed surgical approach was non-automated extracapsular cataract extraction. Only 2% of surgeons (n = 8) used phacoemulsification routinely and 2% (n = 7) used intracapsular extraction. Intraocular lens implantation was the s...
Pollack, A; Dotan, S.; Oliver, M.
The course of diabetic retinopathy following cataract extraction was studied retrospectively in 89 patients (89 eyes). Cataract extraction was extracapsular in 12 eyes (13.5%), extracapsular with intraocular lens implantation in 37 (41.6%), and intracapsular in 40 (45%). In 55 eyes (61.8%) there was no change in the retinal status after surgery, and in 34 (38.2%) there was progression of diabetic retinopathy. In the eyes showing progression there was appearance or aggravation of non-prolifera...
Harding, J J
Cataract is the major cause of blindness and of visual impairment worldwide, so its prevention is of the greatest importance. At present no drug therapy is licensed for use in the UK or the US, so the only treatment for cataract is by surgery, which is expensive and has adverse effects. This article reviews research on prevention of cataract by a variety of agents, including micronutrients as well as drugs. Benefits have been claimed for many compounds or mixtures and this review concentrates on those most extensively studied. Information on possible benefits of putative anticataract agents comes from a variety of approaches, from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients. Sorbitol-lowering drugs were the first to be examined systematically and progressed to clinical trials which were disappointing, and now the entire rationale for their use in prevention of cataract is questionable. Micronutrients showed little promise in animals but came to clinical trial in patients with cataract without the publication of any major benefit. Pantethine showed more promise in animal studies but the only clinical trial was abandoned early. A variety of laboratory and epidemiological evidence supports the benefits of aspirin-like drugs but there has been no trial specifically in patients with cataract. Add-on studies to trials of aspirin for other indications have not been encouraging. Research into other compounds is interesting but less advanced. PMID:11482741
Purpose: Aim of this retrospective study was to evaluate cataract incidence in a homogeneous group of patients after total-body irradiation followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Method and Materials: Between 11/1982 and 6/1994 in total 260 patients received in our hospital total-body irradiation for treatment of haematological malignancy. In 1996-96 patients out of these 260 patients were still alive. 85 from these still living patients (52 men, 33 women) answered evaluable on a questionnaire and could be examined ophthalmologically. Median age of these patients was 38,5 years (15 - 59 years) at time of total-body irradiation. Radiotherapy was applied as hyperfractionated total-body irradiation with a median dose of 14,4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 hours, photons with a energy of 23 MeV were used, and the dose rate was 7 - 18 cGy/min. Results: Median follow-up is now 5,8 years (1,7 - 13 years). Cataract occurred in (28(85)) patients after a median time of 47 months (1 - 104 months). In 6 out of these 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to total-body irradiation was more often in the group of patients developing a cataract (14,3%) vs. 10,7% in the group of patients without cataract. Conclusion: Cataract is a common side effect of total-body irradiation. Cataract incidence found in our patients is comparable to results of other centres using a fractionated regimen for total-body irradiation. The hyperfractionated regimen used in our hospital does obviously not result in a even lower cataract incidence. In contrast to acute and late toxicity in other organ/organsystems, hyperfractionation of total-body irradiation does not further reduce toxicity for the eye-lens. Dose rate may have more influence on cataract incidence
Lim, Julie C; Umapathy, Ankita; Donaldson, Paul J
Cataract is the leading cause of blindness worldwide and accounts for approximately half of all forms of vision loss. Currently, the only way to treat cataracts is by surgery. However, with an ageing population, the demand for surgery and the need for cost effective alternative solutions grows exponentially. To reduce the need for cataract surgery, alternative medical therapies to delay cataracts are urgently required. However, given the difficulty in accessing human cataract lenses, investigating the process of cataract formation and testing the efficacy of potential therapies in humans is problematic. Therefore, researchers have looked to create suitable animal models of cataractogenesis to identify therapeutic options. This review will provide an overview of the cataract specific changes previously reported in human cataract lenses, before focussing on the specific changes that occur in age related nuclear (ARN) cataract, the most common form of cataract in humans. This will be followed by a discussion of a range of existing animal cataract models and their respective suitability for mimicking the processes associated with the development of ARN cataract, and therefore their utility as models to test anti-cataract therapies for future use in humans. PMID:26391448
... cataracts occur naturally with age and cause the eye's lens to become cloudy. Cataracts can be removed but ... prevent oxidation that leads to clouding of the eye lens. A vitamin C-rich diet may boost the ...
Leffler, Christopher T; Wainsztein, Ricardo D
We strove to identify the earliest cataract surgeons in Latin America. Probably by 1611, the Genovese oculist Francisco Drago was couching cataracts in Mexico City. The surgeon Melchor Vásquez de Valenzuela probably performed cataract couching in Lima by 1697. Juan Peré of France demonstrated cataract couching in Veracruz and Mexico City between 1779 and 1784. Juan Ablanedo of Spain performed couching in Veracruz in 1791. Cataract extraction might have been performed in Havana and Caracas by 1793 and in Mexico by 1797. The earliest contemporaneously documented cataract extractions in Latin America were performed in Guatemala City by Narciso Esparragosa in 1797. In addition to Esparragosa, surgeons born in the New World who established the academic teaching of cataract surgery included José Miguel Muñoz in Mexico and José María Vargas in Caracas. Although cataract surgery came quite early to Latin America, its availability was initially inconsistent and limited. PMID:27143845
Draganić Vladimir; Vukosavljević Miroslav; Milivojević Milorad; Resan Mirko; Petrović Nenad
Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. ...
Singh, Ajay; Strauss, Glenn H.
The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-ba...
M. A. Kovalevskaya; N. V. Vedrintseva; L. A. Filina; T. Yu. Perova
Aim. To study immune and antioxidant status of diabetic cataract patients and to assess the efficacy of preoperative preparation for diabetic cataract surgery to prevent intra- and postoperative complications and the efficacy of cataract treatment in metabolic syndrome patients. Patients and methods. 136 cataract patients (272 eyes) were examined (mean age 62±3.2 years). Among these patients, women predominated (n = 74). Control group included 25 healthy volunteers (10 men and 15 women) aged ...
Sanjeev Kumar Puri; Suma Elangovan
Background: Cataract can cause visual dysfunction ranging from mild to severe loss of vision. The rate of development of senile cataract is generally slow and the vision loss is usually gradual but can result in blindness if treatment is delayed. The main objective was to study the awareness about cataract among students (non-medical). Methods: A questionnaire based study was conducted among 430 students (non-medical). The questions tested their awareness about cataract and also about the...
Onakpoya Oluwatoyin; Bekibele Charles; Adegbehingbe Stella
Purpose: To determine the visual outcome of cataract surgery in diabetes mellitus with advanced cataract in a tertiary institution in Nigeria. Design: A retrospective case control study conducted at the University College Hospital, Ibadan Nigeria. Subjects: Twenty three consecutive patients with diabetes and 23 age and sex matched non-diabetic control patients who had extracapsular cataract extraction for advanced cataract between 2002-2005. Main outcome: Mean post operative visual acu...
Mouse mutants affecting lens development are excellent models for corresponding human disorders. The mutant aphakia has been characterised by bilaterally aphakic eyes (Varnum and Stevens, J Hered 1968;59:147-50); the corresponding gene was mapped to chromosome 19 (Varnum and Stevens, Mouse News Lett 1975;53:35). Recent investigations in our laboratory refined the linkage of 0.6 cM proximal to the marker D19Mit10. Several candidate genes have been excluded (Chuk1, Fgf8, Lbp1, Npm3, Pax2, Pitx3). The Cat3 mutations are characterised by vacuolated lenses caused by alterations in the initial secondary lens fibre cell differentiation. Secondary malformations develop at the cornea and iris, but the retina remains unaffected. The mutation has been mapped to chromosome 10 close to the markers D10Mit41 and D10Mit95. Several candidate genes have been excluded (Dcn, Elk3, Ldc, Mell8, Tr2-11). The series of Cat2 mutations have been mapped close to the gamma-crystallin genes (Cryg; Löster et al., Genomics 1994;23:240-2). The Cat2nop mutation is characterised by a mutation in the third exon of Crygb leading to a truncated gamma B-crystallin and the termination of lens fibre cell differentiation. The Cat2 mutants are interesting models for human cataracts caused by mutations in the human CRYG genes at chromosome 2q32-35. PMID:10627821
Full Text Available BACKGROUND: Manual small incision cataract surgery (SICS has given visual results almost equivalent to Phacoemulsification but limited studies are available regarding the efficacy of small incision cataract surgery in phaco suitable immature cataracts. OBJECTIVE: To compare manual small incision cataract surgery and Phacoemulsification in immature cataracts. MATERIALS AND METHODS: A single blind randomized controlled trial was conducted with 105 eyes each for small incision cataract surgery and Phacoemulsification. RESULT: Mean IOL power was similar in both Phacoemulsifications as well as SICS. Four cases of posterior capsular rupture occurred in Phacoemulsification while one case of zonular dialysis occurred in SICS. Uncorrected visual acuity was good (6/6-6/18 in 80.0 % of the phaco and 93.33 % of the SICS group. CONCLUSION: SICS surgical technique resulted in significantly better visual acuity on the 1st postoperative day in comparison with phaco. Hence, SICS with rigid PMMA IOL implantation being a cheaper, faster and easier technique, may be recommended for immature cataract surgery in the developing countries
Hüseyin Bayramlar; Remzi Karadağ; Ünsal Sarı
Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91
Full Text Available Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91
Full Text Available The anterior lens epithelial cells undergo a variety of degenerative and proliferative changes during cataract formation. Acid phosphatase is primarily responsible for tissue regeneration and tissue repair. The lipid hydroperoxides that are obtained by lipid peroxidation of polysaturated or unsaturated fatty acids bring about deterioration of biological membranes at cellular and tissue levels. Acid phosphatase and lipid peroxidation activities were studied on the lens epithelial cells of nuclear cataract, posterior subcapsular cataract, mature cataract, and mixed cataract. Of these, mature cataractous lens epithelium showed maximum activity for acid phosphatase (516.83 moles of p-nitrophenol released/g lens epithelium and maximum levels of lipid peroxidation (86.29 O.D./min/g lens epithelium. In contrast, mixed cataractous lens epithelium showed minimum activity of acid phosphatase (222.61 moles of p-nitrophenol released/g lens epithelium and minimum levels of lipid peroxidation (54.23 O.D./min/g lens epithelium. From our study, we correlated the maximum activity of acid phosphatase in mature cataractous lens epithelium with the increased areas of superimposed cells associated with the formation of mature cataract. Likewise, the maximum levels of lipid peroxidation in mature cataractous lens epithelium was correlated with increased permeability of the plasma membrane. Conversely, the minimum levels of lipid peroxidation in mixed cataractous lens epithelium makes us presume that factors other than lipid peroxidation may also account for the formation of mixed type of cataract.
Reeta Gurung; Albrecht Hennig
Small incision cataract surgery (SICS) is one of the cataract surgical techniques commonly used in developing countries. This technique usually results in a good visual outcome and is useful for high-volume cataract surgery.1–3This article describes how to minimise surgical complications in SICS.
Zhang, Zong-Mei; Niu, Qing; Nie, Yan; Zhang, Jin
Objective: This study is to compare the efficacy of three different cataract surgeries in eyes with angle closure glaucoma (ACG) with concomitant cataract. Methods: A retrospective comparative analysis of 106 ACG patients (112 eyes) with concomitant cataract was conducted between February, 2012 and February, 2014. Clinical outcomes of ACG patients with concomitant cataract underwent phacoemulsification and intraocular lens implantation (group A, n = 34, 36 eyes, angle closure < 180°); combine...
Norregaard, J. C.; Thoning, H.; Andersen, T. F.; Bernth-Petersen, P.; Javitt, J C; Anderson, G F
AIMS: To estimate the risk of retinal detachment (RD) following cataract extraction in Denmark, and to compare the risk with that following cataract extraction in the USA, and with that in a sample of Danish patients who did not have ocular surgery. METHODS: A sample was created from the administrative Danish Hospital Register and included 19,252 patients who underwent first eye cataract surgery between 1985 and 1987, and who were 50 years of age or older. The patients were then followed for ...
Since the advent of medical radiations, the radiation injuries have been intensively studied, particularly the eye. Most of the previous investigation has concerned radiation cataractogenesis. There are a variety of opinions regarding the causes of the radiation cataract formation. In this investigation, I consider direct and indirect effects as two mechanisms for radiation induction of cataracts. It is shown that radiation cataracts in albino rabbits should be studied by reference to the alteration of the lens, dynamic study of the aqueous humor and microcirculation of the iris and ciliary body. Experimental evidence from this study supports the hypothesis that cataractogenesis may be caused by the circulatory insufficiency due to radiation damage of the fine vasculature supplying nutrition to the iris and ciliary body. However I can not perfectly deny that cataractogenesis may be caused by the direct radiation injury in this study. (author)
Tajunisah, I; Reddy, S C
Twenty two cases of dropped nucleus following 1,196 phacoemulsification procedures in cataract surgery were examined retrospectively to determine the incidence, predisposing factors and visual outcomes of this dreaded complication. All the cases underwent pars plana vitrectomy and the lens fragments were removed with phacofragmotome, vitrectomy cutter or delivered through limbus. The incidence of dropped nucleus was 1.84%. The predisposing factors were hard cataracts (13.6%), polar cataracts (9.1%), previously vitrectomized eyes (4.5%) and high myopia (4.5%). The final visual outcome was > or = 6/12 in 10 eyes (45.5%); complications were seen in 5 eyes (22.7%). The interval between initial surgery and vitrectomy, the method of fragment removal and the type of lens implanted, did not influence the final visual outcome. PMID:18705466
Ammar M Al Mahmood
Full Text Available Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature.
Pouw, C A M Karin; Zegers, Richard H C
Nowadays, cataract surgery is the most commonly performed surgical procedure in the Netherlands. This is due to the increasing incidence of cataracts, the changing indication for surgery in our society where good vision is becoming increasingly important, and the quality of the operation. How was this modern procedure developed? Cataracts were treated by couching until the middle of the 18th century. Since then, many discoveries by a number of doctors changed the procedure gradually from couching to lens extraction and through extracapsular to intracapsular extraction with the simultaneous implantation of an intraocular lens. This article outlines the development and also discusses some of the many inventions in the field of instrumentation and materials that have brought this intervention to its current high level; these include the cryo-probe, implantation of artificial lenses, the use of hyaluronic acid, phaco-emulsification, smaller incisions without sutures and the development of foldable intraocular lenses. PMID:23548190
Microwaves most commonly cause anterior and/or posterior subcapsular lenticular opacities in experimental animals and, as shown in epidemiologic studies and case reports, in human subjects. The formation of cataracts seems to be related directly to the power of the microwave and the duration of exposure. The mechanism of cataractogenesis includes deformation of heat-labile enzymes, such as glutathione peroxide, that ordinarily protect lens cell proteins and membrane lipids from oxidative damage. Oxidation of protein sulfhydryl groups and the formation of high-molecular-weight aggregates cause local variations in the orderly structure of the lens cells. An alternative mechanism is thermoelastic expansion through which pressure waves in the aqueous humor cause direct physical damage to the lens cells. Cataracts induced by ionizing radiation (e.g., X-rays and gamma rays) usually are observed in the posterior region of the lens, often in the form of a posterior subcapsular cataract. Increasing the dose of ionizing radiation causes increasing opacification of the lens, which appears after a decreasing latency period. Like cataract formation by microwaves, cataractogenesis induced by ionizing radiation is associated with damage to the lens cell membrane. Another possible mechanism is damage to lens cell DNA, with decreases in the production of protective enzymes and in sulfur-sulfur bond formation, and with altered protein concentrations. Until further definitive conclusions about the mechanisms of microwaves and ionizing radiation induced cataracts are reached, and alternative protective measures are found, one can only recommend mechanical shielding from these radiations to minimize the possibility of development of radiation-induced cataracts. 74 references
Since ancient times a grey or white pupil in an nearly blind eye was thought to be caused by a mucous substance in front of the lens. It was called "hypochysis" or "hypochyma" in Greece and "suffusio" in Rome. Later the term "cataract" (=waterfall) was the most popular denomination. A surgical method was tried very early with usually good effect, when with a thin needle, introduced into the eye, the opaque material was removed from the pupillary area. In the middle of the 17th century more careful investigations showed that there was no membrane in front of the lens, but the lens itself was opaque. The final proof was delivered when an extraction of the lens was performed with good effect. In ancient times incurable blindness, which was called glaucoma, was thought to be located to the lens, which probably had a very important role in the seeing process. The name (of Greek orgin) is translated "green" or "blue-green", which was sometimes notified to be the color of the lens, seen through the pupil, in these cases. A period of great confusion followed when the removal of this very important part of the eye did not lead to blindness but rather an improved vision. As there were significant difficulties in identifying the specific color of the pupil the name glaucoma seemed to be very inadequate. In the beginning of the 19th century a disease entity (which is to-day called acute closed-angle glaucoma) seemed to eventually fullfill the demand of a greenlooking pupil. The most characteristic symptoms are pain and a high intraocular pressure causing a corneal edema and a change of the blackness of the pupil to hazy grey (and maybe a little green?). PMID:11625470
Perkins, E. S.
A retrospective analysis of 388 records of patients undergoing surgery for cataract between the years 1968 and 1978 showed that more women than men were admitted. About 13.7% of the patients were diabetic, and there was a striking excess of women over men with diabetes and cataract. The diabetic patients required surgery at an earlier age than the non-diabetics. Patients who had been refracted at least 5 years before surgery showed an incidence of myopia of -1.00 D or more of 25.4%. In 34% of...
LOU Ding-hua; XU Ye-sheng; LI Yu-min
To evaluate the phacoemulsification and intraocular lens implantation in patients with sensory exotropia subsequent to senile cataract. The authors prospectively studied the role of phacoemulsification and intraocular lens implantation on 25 patients by observing visual acuity, ocular alignment, binocular vision and diplopia pre-, 1 month post- and 3 months post-operation. The patients underwent follow-up for three months. Postoperatively, one patient had a corrected visual acuity of 20/50, and 24 patients had 20/40 or better. The ocular alignment, binocular vision and diplopia were resolved spontaneously. Phacoemulsification and intraocular lens implantation performed together is effective on sensory exotropia subsequent to senile cataract.
Solborg Bjerrum, Søren; Kiilgaard, Jens F; Mikkelsen, Kim Lyngby; la Cour, Morten
To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk.......To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk....
Drexler, Wolfgang; Findl, Oliver; Menapace, Rupert; Hitzenberger, Christoph K.; Fercher, Adolf F.
In an earlier study we showed that precise axial eye length measurement on cataract eyes is possible with the dual beam partial coherence interferometry technique (PCI). A high correlation with the standard ultrasound technique has been obtained. Recently, in a prospective study, partially coherent interferometry and ultrasound biometry were compared in cataract surgery using the SRK II formula based on US applanation biometry. Three months after surgery PCI was repeated and refractive outcome was determined. The use of PCI would have improved refractive outcome by about 30%.
Chatterjee, A.; Milton, R C; Thyle, S
Three districts in the Punjab plains were surveyed in 1976-7 for senile cataract and potential risk factors. The prevalence of senile cataract was 15.3% among 1269 persons examined who were aged 30 ang older, and 4.3% for all ages. These figures confirmed previous reports of high prevalence. The prevalence was 1% for ages 30-49 and increased markedly in the sixth and seventh decades to 67% for ages 70 and older. Univariate age-adjusted analyses of selected socioeconomic, demographic, dietary,...
Full Text Available : In developing country like India, the primary goal is to provide all the benefits to common man at minimal possible cost in visual rehabilitation of cataract. In achieving this goal, the surgery (MICS described in this article can be extremely helpful. It has almost all the advantages of phacoemulsification, at the same time it is inexpensive. The wound construction, various techniques of nucleus delivery in MSICS are described precisely. This may stimulate the reader towards this surgery, which is the only way to tackle the huge backlog of cataract in developing countries, particularly in India, where 60% of rural people live in less than thirty rupees a day.
Singh, Ajay; Strauss, Glenn H
The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery. PMID:24996918
Liu, Y Z
Femtosecond laser-assisted cataract surgery (FLACS) is a novel technology and the biggest revolution in the field of cataract in the latest several years. However, increasing large-scale population randomized controlled trials (RCT) have demonstrated that FLACS does not provide significant advantages over conventional phacoemulsification cataract surgery (CPCS) for common cataract patients. Furthermore, the cost and space requirement of the femtosecond equipment are another two limitations for the universal application of FSL in cataract surgery. However, FLACS may be beneficial for complex cataract situations, such as lens dislocation, zonular laxity, traumatic cataract, low preoperative endothelial cell values, and significant corneal astigmatism. With the progress of science and technology, FLACS can be expected to achieve integration with phacoemulsification systems, and equipment costs can be reduced, making it more widely used in clinical practice in the future. (Chin J Ophthalmol, 2016, 52: 81-84). PMID:26906700
Shuttleworth, G.; Luhishi, E; Harrad, R
AIMS—To assess the benefits of cataract extraction in patients with age related maculopathy (ARM). METHODS—1073 randomly selected cataract operations were reviewed and 99 cases of preoperatively recognised ARM were identified for investigation. Data relating to visual function were retrieved from case notes, and patient responses to a questionnaire were analysed. RESULTS—98% had dry or unspecified ARM. Only 2% had exudative maculopathy. 81% of cases had an improvement in best distance acuity;...
The Search for Appropriate Sutureless Cataract Surgery. During the last decade, in industrialised countries phacoemulsification has largely replaced ab-externo extracapsular cataract extraction with posterior chamber intraocular lenses (ECCE/PC IOL) with sutures. The small self-sealing phaco incision provides rapid visual rehabilitation, and the surgery is increasingly done on an outpatient basis. However, in developing countries phacoemulsification is performed only on selected patients, usu...
Purpose: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract. Methods and Materials: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment. Results: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 x 8 or 2 x 5 Gy TBI, from patients receiving 2 x 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 x 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 x 6 Gy group might also
Mohd R.A. Manaf
Full Text Available A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE and phacoemulsification (PEA was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques and six months (for ECCE only. Effectiveness of cataract surgery was assessed using Visual Function 14 (VF-14, quality of life measurement specifically for vision. The cost analysis results from each 50 subjects of ECCE and PEA group showed that average cost for one ECCE after six months post-operation is USD 458 (± USD 72 and for PEA is USD 528 (± USD 125. VF-14 score showed a significant increased after a week, two months and six months post-operation compared to the score before operation for both techniques (p<0.001. However, there was no significant difference between them (p = 0.225. This study indicated that ECCE is more cost effective compared to PEA with cost per one unit increment of VF-14 score of USD 14 compared to USD 20 for PEA. (Med J Indones 2007; 16:25-31 Keywords: cataract, cost-effectiveness, extracapsular cataract extraction, phacoemulsification, visual function 14
Full Text Available Tien-En Tan,1,2 Jodhbir S Mehta2–4 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore National Eye Centre, Singapore; 3Singapore Eye Research Institute, Singapore; 4Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore Abstract: Intrastromal corneal inlays are an emerging treatment for presbyopic patients. The KAMRA™ small aperture inlay was the first such inlay to receive Conformité Européenne (CE marking in 2005. It has been shown to improve uncorrected near and intermediate visual acuity without adversely affecting uncorrected distance visual acuity. Due to the age of presbyopic patients, they may eventually develop cataracts. In two such cases, we found that cataract surgery with the KAMRA implant left in place was not technically more difficult, and that the surgical procedure could be improved by additional ocular rotations to improve visualization. Biometry readings were reliable, and it appeared that the SRK/T formula was accurate for calculation of intraocular lens power. Cataract surgery with the KAMRA implant left in situ is a viable option for patients. Keywords: cataract surgery, KAMRA, corneal inlay, AcuTarget, presbyopia
Cole, M D; Brown, R.; Ridgway, A. E.
Forty patients subjected to extracapsular cataract extraction with posterior chamber intraocular lens implantation in whom a sphincterotomy was required are reported on. This method was used to counter the problems created by a small pupil during surgery. The technique is described and results evaluated.
Full Text Available Background: According to the high prevalence of myopia in Taiwan, we analyze theadopted cataract extractions, identify predicting factors for postoperativevision, and to assess the incidence of retinal complications after Nd: YAGlaser capsulotomy in high myopic eyes.Methods: One hundred and twenty-five eyes, which the axial lengths were longer than26 mm, following cataract extraction were enrolled. Surgeries adoptedincluded phacoemulsification with intraocular lens implantation, extracapsularcataract extraction with intraocular lens implantation, phacoemulsification,and extracapsular cataract extraction. Logistic regression was utilizedto assess predictive factors for postoperative vision.Results: Postoperative vision of 41 eyes (32.8% of the 125 high myopic eyesimproved at least 4 lines of Snellen acuity. Thirty-two eyes (25.6%achieved good postoperative vision (BCVA≥20/40, and 26 eyes (20.8%demonstrated poor postoperative vision (BCVA<20/200. Younger age andshorter axial length were appreciated for better visual outcome ( p < 0.05.Nd: YAG laser capsulotomy is required for posterior capsular opacity. Threein 125 eyes (2.4% developed retinal complications and 2 of them had retinaldetachment subsequently within one month after Nd: YAG laser capsulotomy.Conclusion: Most high myopic patients achieved visual improvement after cataract surgeries.Age and axial length are the predictive factors in high myopicpatients. It is crucial to examine retina prior to Nd: YAG laser capsulotomyto prevent retinal complication.
Full Text Available Purpose: To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK, cataract removal and intraocular lens implantation (triple procedure, and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods: This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either opensky extracapsular cataract extraction (ECCE or phacoemulsification (PE. In the ECCE group, the posterior chamber intraocular lens (PCIOL was implanted in the ciliary sulcus, while in the PE group PCIOLs were fixated within the capsular bag. Outcome measures included best spectacle corrected visual acuity (BSCVA, refractive results, graft clarity and complications. Results: Seventy-six eyes of 69 consecutive patients with mean age of 61.4±14.2 years were enrolled. Mean follow-up period was 61.4±37.2 months over which mean BSCVA was significantly improved from 1.40±0.68 to 0.44±0.33 LogMAR (P<0.001. Mean postoperative spherical equivalent refractive error was -2.13±3.02 D, which significantly differed from the target refraction (-0.73±0.29 D, P=0.004. At final follow-up, 89.5% of the corneal grafts remained clear. Conclusion: The triple procedure is a safe and effective approach to restore vision in patients with coexisting corneal pathologies and cataracts. However, unacceptable postoperative refractive error can be anticipated.
Full Text Available ABSTRACT The Determination of the tactics for surgical cataract treatment in the fellow eye in patients with bilateral cataracts did not received any unambiguous solution till now and the periods of operation performance are interpreted differently. The authors analyzed the results of treatment in 486 patients with bilateral cataracts. The authors identified a possible favorable interval between first and second operations in case of bilateral cataract, which was based on the clinical, functional and immunological parameters. Phacoemulsifications with peri-operative antibiotic prophylaxis were carried out not later than 4 days after the operation on the first eye, if there were no complications intra-operatively and in post-operative period in the first eye. Recommended time of surgery in the fellow eye in 114 patients of the main group allowed to reveal high functional results (0.7-1.0 in 90.4% in the first eye and in 85.1% of cases in the fellow eye, that promoted the restoration of binocular functions in 98 % of cases after surgery in the shortest possible time. In all patients of the main group the clear vision at different distances were achieved after surgery with bilateral implantation of multifocal IOLs in both eyes in the maximum shortest time. Selected dates of cataract surgery in both eyes taking into account the general and associated ocular pathology allows to reduce the emotional cost, time and organizational problems in preparation for the operation, adding the benefits of quality of early rehabilitation after surgery in both eyes.
To determine the mean axial length and biometric measures in patients undergoing cataract surgery and further compare the variability of axial length between the gender and with age. Study Design: Cross-sectional observational study. Place and Duration of Study: Eye Unit I, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan from January 2010 to December 2012. Methodology: All patients referred for cataract surgery were assessed. The study included 886 eyes which were straightforward cataract cases with no other ocular problem. The data was collected for axial length, keratometric values and Intra-Ocular Lens (IOL) power prior to cataract surgery. The collected data was then analyzed using SPSS version 19 for windows software. Results: Gender based comparison showed significant difference in age, axial length, keratometric values and IOL power between the two groups (p=0.000). 86% of the eyes had an axial length between 21.00 mm and 23.99 mm. In univariate analysis there was significant (p=0.000) relation between overall age and axial length. The keratometric values ranged between 36.75 D and 52.50 D. Majority of the IOL powers ranged between 20.00 D and 23.00 D. Conclusion: The mean axial length of patients undergoing cataract surgery was 22.96 +- 1.04 mm, was comparable to Indian and Chinese population but shorter than the Western population. Females had shorter axial lengths, similar to other studies. Axial length was positively associated with age among the females, the cause of which is yet to be determined. (author)
Roseline Ekanem Duke
Full Text Available The key informant methodology for case finding for childhood cataract was utilized in a rural population in Nigeria to identify suitable children who would benefit surgically from intervene for cataract and restore vision such children. It was however noticed that some parents who had children with cataract did not bring their children to the primary health center for examination and recommendation. The purpose of this study is to investigate the benefits of using the theatre for development approach in childhood cataract case finding. The delay in identification and referral of children with cataract at an appropriate age for surgical intervention and optical rehabilitation is the main cause of poor vision following surgery for the condition as amblyopia results. Therefore early presentation, identification, referral and surgical intervention as well as appropriate optical rehabilitation is the key to successful surgical outcome of childhood cataract and good visual prognosis. The theater for development (TfD approach methodology was implemented in a community in Akpabuyo local government are of Cross River state, Nigeria as a means to enhance community participation, health promotion and education and to complement the key informant methodology in case finding for childhood cataract. Three children with cataracts were referred by the community following the TfD intervention, for cataract surgery and uptake of follow up care after surgery. The TfD approach appears to be a useful method for encouraging community participation in the case finding of childhood cataract.
... on. Feature: Treating Cataracts Cataracts and Other Common Eye Diseases Past Issues / Summer 2014 Table of Contents Click ... are more likely to develop a cataract. Diabetic Eye Disease Diabetic Retinopathy : A scene as it might be ...
Proton nuclear magnetic resonance (1H-NMR) is one of the most important methods for noninvasively evaluating the state of water in the biological system. It could be useful for evaluation of the early changes of cataract. In this study, in vivo magnetic resonance imaging (MRI) was applied to rat galactosemic cataract, which is a model of the human diabetic cataract, and compared with the histological findings. The relationship between the relaxation times (T1, T2) and the water contents were discussed. The T1 and T2 values were prolonged and the high intensity area of the lens cortex was enlarged from the early stage of the cataract (two days after the intake of galactose). These changes preceded the histological changes. This suggests that MRI is applicable for the evaluation of anti-cataract agents, for example aldose reductase inhibitors, against human diabetic cataract. (author)
Haargaard, Birgitte; Andersen, Elisabeth W; Oudin, Anna; Poulsen, Gry; Wohlfahrt, Jan; la Cour, Morten; Melbye, Mads
PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment. METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark...... was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3...... (16% [95% CI: 6%-24%]). CONCLUSIONS: The estimated overall risk of retinal detachment 20 years after pediatric cataract surgery was 7%, but only 3% for isolated cataract. Particularly high risks of retinal detachment after cataract surgery were associated with mental retardation and having other...
Full Text Available As we near the end of this century, refractive cataract surgery has become a reality through concerted contributions from ultrasonic phacoemulsification, foldable intraocular lens (IOL implantation technology and keratorefractive surgery. As we enter the new millennium, our sights are set on realizing another dream: accommodative IOL surgery. Towards achieving this goal, many advances have been made in both techniques and technology of cataract removal. Lasers in particular have been under investigation for cataract removal for nearly two decades. The technology has now reached a stage where cataract can indeed be removed entirely with laser alone. Neodymium:YAG and erbium:YAG are the laser sources currently utilized by manufacturers of laser phaco systems. Initial clinical experience reported in the literature has served to highlight the capabilities of lasers and the need for further refinement. Despite the excitement associated with the availability of this alluring new technology for cataract removal, it is necessary to develop more effective laser systems and innovative surgical techniques that optimize its capabilities if laser phaco surgery is to be a genuine improvement over current techniques.
Full Text Available The Search for Appropriate Sutureless Cataract Surgery. During the last decade, in industrialised countries phacoemulsification has largely replaced ab-externo extracapsular cataract extraction with posterior chamber intraocular lenses (ECCE/PC IOL with sutures. The small self-sealing phaco incision provides rapid visual rehabilitation, and the surgery is increasingly done on an outpatient basis. However, in developing countries phacoemulsification is performed only on selected patients, usually those able to pay high treatment charges. The reasons for this include the cost of a phaco machine and consumables such as foldable IOLs. Until now, phacoemulsification has played a very limited role in the reduction of cataract blindness in low income countries. Therefore, eye surgeons in developing countries are searching for alternatives to phacoemulsification. We need a surgical technique which is easy to learn, provides an immediate good uncorrected visual outcome, and is affordable to most cataract patients. Such a technique would advance cataract surgery in low income countries and contribute to reaching the goal of VISION 2020: The Right to Sight.
Full Text Available Aims: To report the technique and outcomes of sutureless manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts. Materials and Methods: This retrospective study comprised of 112 eyes of 83 patients with mature cataract who all had manual cataract extraction via a subconjunctival limbus oblique incision. A transconjunctival tunnel is fashioned with a 3.0 mm keratome, 0.5 mm behind the limbal vascular arcades. A limbal tunnel, with a transverse extent of 9 mm in the cornea and 7.0 mm in the limbus, is created beneath the conjunctival/Tenon′s tissue using an angled bevel-up crescent blade. Outcome measures included visual acuity, intraoperative complications, surgically induced astigmatism, endothelial cell loss rate and surgery time. Results: Self-sealing wound was achieved in 112 eyes (98.2%. The nucleus was delivered in whole in 108 eyes (96.4%. Intraoperative complications included hyphema in 3 eyes (2.7%, iridodialysis in 2 eyes 1.8%, posterior capsular rupture and zonular dialysis in 2 eyes (1.8%. At the 3-month follow-up, 91% patients achieved a best-corrected visual acuity of 20/20 or better, the mean of surgically induced astigmatism was -0.62 ± 0.41 Diopters and endothelial cell loss was 4.2%. Average surgical time was 3.75 min per case. Conclusion: This subconjunctival limbus oblique incision has the potential to serve as safe and effective technique for mature cataracts.
Isabel Signes-Soler; Jaime Javaloy; Gonzalo Munoz; Tomas Moya; Raul Montalban; Cesar Albarran
Purpose: To compare the safety and the visual outcomes of two experienced cataract surgeons who converted from extracapsular cataract extraction (ECCE) to manual small incision cataract surgery (MSICS) during a campaign for the prevention of blindness. Methods: Two surgeons used the ECCE technique (ECCE group) during a campaign in Burkina Faso on 93 consecutive cataract patients with a corrected distance visual acuity (CDVA)
Yeniad Baris; Corum Isik; Ozgun Cahit
Purpose: This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration. Materials and Methods: In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicated surgery subg...
Tseng, Victoria Li-Ting
Cataract surgery is the mainstay of treatment for visually significant cataract. Aside from vision improvement, one secondary benefit of cataract surgery that has been reported is the reduction of fracture risk. This dissertation examines associations between cataract surgery and factors related to fracture risk, including the association between cataract surgery and falls and the association between cataract surgery and long-term mortality. The first study of this dissertation uses data from...
An MR microscope (gradient strength, up to 100 gauss/cm; diameter, 7 mm; typical resolution, 20-40 μm) operating at 200 MHz is used to study cataract formation in a rat cataract model. Factors determining image intensity at 200 MHz such as T1, T2, and diffusion are discussed. In particular, these gradient strengths are typical for pulsed gradient diffusion experiments. The authors compare image intensity with the cellular changes accompanying cataract formation
Full Text Available A key issue in converting to sutureless cataract surgery is training. This article first describes the main surgical steps and complications of sutureless cataract extraction and their management. The second part reports on the training of 11 surgeons in sutureless cataract extraction at Sagarmatha Choudhary Eye Hospital, Lahan. The stepwise, supervised training is described and the learning curves of 11 surgeons analysed.
Braganza Andrew; Cheng Arthur; Thomas Ravi; Muliyil Jayaprakash
Intracapsular cataract extraction is still the most common type of operation performed in India, especially in eye camps, and most of these are done without magnification. To assess the surgical outcome of intracapsular cataract surgery in a rural hospital with various magnifying systems, 121 consecutive eyes (121 patients) with uncomplicated cataract were randomly allocated to surgery with the operating microscope, binocular loupe or unaided eye. The surgery was performed by either consultan...
Roseline Ekanem Duke
The key informant methodology for case finding for childhood cataract was utilized in a rural population in Nigeria to identify suitable children who would benefit surgically from intervene for cataract and restore vision such children. It was however noticed that some parents who had children with cataract did not bring their children to the primary health center for examination and recommendation. The purpose of this study is to investigate the benefits of using the theatre for developmen...
Leffler, Christopher T; Schwartz, Stephen G.; Grzybowski, Andrzej; Puneet S. Braich
We tried to identify the earliest cataract surgeons in the English-speaking areas of America. In 1751, couching was performed on the Caribbean island of Montserrat by John Morphy. William Stork of England, who couched cataracts, practiced in Jamaica in 1760 and then in cities from Annapolis to Boston between 1761 and 1764. Frederick William Jericho of Germany, upon completion of his training at Utrecht, published his 1767 treatise on his preferred surgical technique of extracapsular cataract ...
Redmond, R M; Dallas, N L
Day-case cataract surgery and the need for local anaesthesia are likely to increase. Retrobulbar (and peribulbar) anaesthetic injection is a common technique in cataract surgery, but serious complications are persistently reported. Subconjunctival injection is an alternative that avoids these risks. This retrospective study compares two groups of patients that underwent extracapsular cataract surgery under local anaesthetic. One group (retrobulbar) had uncomplicated retrobulbar injection with...
Gupta A; Ellwein Leon
Surgery for cataract blindness, a major health problem, is undergoing a rapid transition. This study characterizes cataract surgery in India in terms of practice setting and surgical procedure. A survey questionnaire was mailed in December 1992 to 4356 members of the All India Ophthalmological Society, resident in India, requesting data on cataract surgery cases within the past 12 months. Two thousand one hundred thirty-four (49%) ophthalmologists responded to the survey. Of the 1,023,...
Jacob, T J; Humphry, R. C.; Davies, E. G.; Thompson, G M
Simulated extracapsular cataract extractions on cadaver eyes were performed which demonstrated that the cells of the anterior capsule remain largely intact and that only a small amount of cortical lens matter remains postoperatively. Human lens epithelial cells from normal and cataractous lenses were grown in culture. There was no appreciable difference in growth rate between cells from normal and those from cataractous lenses or between equatorial and central capsule cells. The cells grew fr...
Donnelly, C.A; Seth, J; Clayton, R M; Phillips, C I; Cuthbert, J; Prescott, R J
AIMS--To look for differences between matched pairs of patients and controls in concentrations of various plasma constituents which might indicate dysfunctions associated with cataract. METHOD--One thousand patients were taken from the cataract waiting list of a specialist eye hospital. For each patient a matched control of the same sex and half-decade of age but without cataract was taken from the patient list of the family doctor of the patient; the control was the next alphabetically after...
Joyce, P W; Allarakhia, L
Intercapsular cataract extraction, a variation of extracapsular cataract extraction (ECCE), has recently become popular, particularly in Europe and Asia. It is gaining popularity in the United States among both phacoemulsification and planned ECCE surgeons. The initial steps in the intercapsular capsulotomy include either a linear or curvilinear opening. To facilitate anterior capsulotomy for intercapsular surgery, we developed a disposable 27-gauge cystotome with a specially designed curved configuration. This cystotome also facilitates capsulotomies in deep-set eyes, which may be difficult when standard cystotomes are used. The new cystotome has a conventional beveled tip with a 90-degree bend and a main shaft curved at a radius of 14.5 mm. When attached to a syringe this cystotome allows the surgeon a more comfortable holding position during the capsulotomy procedure. PMID:2355328
Full Text Available We propose the Maximal Mydriasis Test (MMT as a simple and safe means to provide the cataract surgeon with objective and dependable pre-operative information on the idiosyncratic mydriatic response of the pupil. The MMT results of a consecutive series of 165 eyes from 100 adults referred for cataract evaluation are presented to illustrate its practical applications and value. The results of the MMT allows the surgeon to anticipate problem eyes pre-operatively so that he can plan his surgical strategy more appropriately and effectively. Conversely, the surgeon can also appropriately and confidently plan surgical procedures where wide pupillary dilation is important. The MMT has also helped improve our cost-effectiveness by cutting down unnecessary delays in the operating room and enabling better utilisation of restricted costly resources.
The relationship between anisometropia and aniseikonia (ANK) is not well understood. Ametropic cataract patients provide a unique opportunity to study this relationship after undergoing emmetropizing lens extraction. Because light scatter may affect ANK measurement in cataract patients, its effect should also be evaluated. The Basic Aniseikonia Test (BAT) was evaluated using afocal size lenses to produce specific changes in retinal height. Several light scattering devices were then evaluated to determine which produced effects most similar to cataract. Contrast sensitivity and visual acuity (VA) losses were measured with each device and compared to those reported in cataract. After determining the most appropriate light scattering device, twenty healthy patients with normal visual function were recruited to perform the BAT using the filters to simulate cataract. Cataract patients were recruited from Vision America and the University of Alabama at Birmingham School of Optometry. Patients between 20 and 75 years of age with at least 20/80 VA in each eye, ≥ 2D ametropia, and normal binocular function were recruited. Stereopsis and ANK were tested and each patient completed a symptom questionnaire. ANK measurements using afocal size lenses indicated that the BAT underestimates ANK, although the effect was minimal for vertical targets and darkened surroundings, as previously reported. Based on VA and contrast sensitivity loss, Vistech scattering filters produced changes most similar to cataract. Results of the BAT using Vistech filters demonstrated that a moderate cataract but not a mild cataract may affect the ANK measurement. ANK measurements on cataract patients indicated that those with ≥ 2 D ametropia in each eye may suffer from induced ANK after the first cataract extraction. With upcoming healthcare reform, unilateral cataract extraction may be covered, but not necessarily bilateral, depending on patient VA in each eye. However, a questionnaire about symptoms
Full Text Available : INTRODUCTION: Ocular trauma is the leading cause of unilateral blindness all over the world. The incidence of ocular trauma varies in different parts of the world. From India, the reported incidence is 20.53%. Any strategy for prevention requires knowledge of the cause of injury, which may enable more appropriate targeting of resources towards preventing such injuries. Eye trauma represents a large, potentially preventable burden on both victims and society as a whole. Traumatic cataracts occur secondary to blunt or penetrating ocular trauma, Infrared energy (glass-blower's cataract, electric shock and ionizing radiation are other rare causes of traumatic cataracts. It form a separate category of cataracts as they present with other ocular morbidity like corneal tears, iris injury, vitreous hemorrhage and retinal tears; and they are to some extent, preventable. The methods used to evaluate the visual outcome in eyes managed for traumatic cataracts and senile cataracts are similar, but the damage to other ocular tissues owing to trauma may compromise the visual gain in eyes treated surgically for traumatic cataracts. Hence, the success rates may differ between eyes with these two types of cataract. The aim of this study was to evaluate the final visual outcome of a patient with surgical extraction of traumatic cataract along with demographic features and modes of trauma.
Full Text Available Cataractous-opacification of the lens is one of the leading causes of blindness in India. The situation can be managed by surgical removal of the cataractous lens. Various pharmacological strategies have been proposed for the prevention and treatment of cataract. Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo , to epidemiological studies in patients. This review deals with the various mechanisms, and possible pharmacological interventions for the prevention of cataract. The article also reviews research on potential anticataractous agents, including aldose reductase inhibitors, glutathione boosters, antiglycating agents, vitamins and various drugs from indigenous sources.
Wu, Chen; Liu, Chih-Hao; Raghunathan, Raksha; Singh, Manmohan; Li, Jiasong; Han, Zhaolong; Larin, Kirill V.
Cataract is one of the most common degenerative diseases that causes blindness. Careful quantification of lens biomechanical properties can greatly assist in early detection of the disease as well as personalization of treatment procedures. In this study, we utilize a phase-sensitive optical coherence elastography (OCE) system to assess the effects of the cold cataract on the biomechanical properties of porcine crystalline lens in vitro. Relaxation rates of air puff induced elastic waves were measured on the same crystalline lens with and without cold cataract. Results demonstrate that the relaxation rate and, thus, associated elasticity of the porcine lens, increased due to the presence of cold cataract.
Brown, N. A.; Sparrow, J M
A study is reported on cataract surgery, with intraocular lens implant, with measurement of the preoperative astigmatism and of the postoperative astigmatism over 28 weeks. Nine interrupted 10/0 nylon sutures are used to close a limbal section. Preoperative astigmatism is compensated for in the method of suturing by the placement of additional sutures. Postoperatively sutures are cut in line with the plus cylinder axis in eyes showing excessive astigmatism with the rule. Final postoperative a...
Lou, Ding-hua; Xu, Ye-sheng; Yu-min LI
To evaluate the phacoemulsification and intraocular lens implantation in patients with sensory exotropia subsequent to senile cataract. The authors prospectively studied the role of phacoemulsification and intraocular lens implantation on 25 patients by observing visual acuity, ocular alignment, binocular vision and diplopia pre-, 1 month post- and 3 months post-operation. The patients underwent follow-up for three months. Postoperatively, one patient had a corrected visual acuity of 20/50, a...
Boris Knyazer, Jaime Levy, Itamar Klemperer, Tova LifshitzDepartment of Ophthalmology, Soroka University Medical Center, Ben-Gurion, University of the Negev, Beer-Sheva, IsraelIntroduction: Intraocular eyelash is an uncommon complication after cataract surgery. We report a very rare case of corneal foreign body after uneventful phacoemulsification surgery. Methods: A 66-year-old man referred to our outpatient ophthalmology clinic for routine examination one week after uneventful phacoemulsifi...
Mishra,, A.N.; Manavalan; Ramya; Jeevitha; Vinnarasi; Latha; Sridevi; Parth
: In developing country like India, the primary goal is to provide all the benefits to common man at minimal possible cost in visual rehabilitation of cataract. In achieving this goal, the surgery (MICS) described in this article can be extremely helpful. It has almost all the advantages of phacoemulsification, at the same time it is inexpensive. The wound construction, various techniques of nucleus delivery in MSICS are described precisely. This may stimulate the reader towar...
Trokielewicz, Mateusz; Czajka, Adam; Maciejewicz, Piotr
This paper presents the experimental study revealing weaker performance of the automatic iris recognition methods for cataract-affected eyes when compared to healthy eyes. There is little research on the topic, mostly incorporating scarce databases that are often deficient in images representing more than one illness. We built our own database, acquiring 1288 eye images of 37 patients of the Medical University of Warsaw. Those images represent several common ocular diseases, such as cataract, along with less ordinary conditions, such as iris pattern alterations derived from illness or eye trauma. Images were captured in near-infrared light (used in biometrics) and for selected cases also in visible light (used in ophthalmological diagnosis). Since cataract is a disorder that is most populated by samples in the database, in this paper we focus solely on this illness. To assess the extent of the performance deterioration we use three iris recognition methodologies (commercial and academic solutions) to calculate genuine match scores for healthy eyes and those influenced by cataract. Results show a significant degradation in iris recognition reliability manifesting by worsening the genuine scores in all three matchers used in this study (12% of genuine score increase for an academic matcher, up to 175% of genuine score increase obtained for an example commercial matcher). This increase in genuine scores affected the final false non-match rate in two matchers. To our best knowledge this is the only study of such kind that employs more than one iris matcher, and analyzes the iris image segmentation as a potential source of decreased reliability
Regular serial refraction was used to determine the rate of stabilisation of refraction following routine extracapsular cataract surgery in 85 eyes. Patients were divided into four groups depending on wound closure technique: limbal section closed by interrupted 8-0 virgin silk, 9-0 polydioxanone or 10-0 nylon sutures, and corneal section closed by continuous 10-0 nylon suture. Stabilisation of refraction, sufficient to prescribe satisfactory glasses, occurred at three months except in the in...
Sherwood, D. R.; Rosenthal, A R
Eighteen eyes in 17 patients with Fuchs' heterochromic iridocyclitis underwent cataract extraction with or without intraocular lens implantation (17 extracapsular and one intracapsular). Intraoperative complications included hyphaema, poor pupillary dilatations, and localised zonule dehiscence with vitreous loss. Only four eyes developed a marked anterior uveitus (two pseudophakic and two aphakic) which resolved within 2 weeks with topical steroids. Three eyes developed a rise in intraocular ...
Craig J Brown,1 Faical Akaichi21The Eye Center, Fayetteville, AR, USA; 2Scotland’s Rural College, Edinburgh, UKPurpose: To evaluate risk factors associated with posterior subcapsular cataract (PSC) development and the relationship between vitamin D deficiency and etiology of PSC.Methods: Of 195 consecutive patients from a private ophthalmology practice, diagnosed with PSC, serum vitamin D3 (25-OH D) levels were obtained for 175, and associations among risk factors, comorbidities, an...
Brown CJ; Akaichi F
Craig J Brown,1 Faical Akaichi21The Eye Center, Fayetteville, AR, USA; 2Scotland’s Rural College, Edinburgh, UKPurpose: To evaluate risk factors associated with posterior subcapsular cataract (PSC) development and the relationship between vitamin D deficiency and etiology of PSC.Methods: Of 195 consecutive patients from a private ophthalmology practice, diagnosed with PSC, serum vitamin D3 (25-OH D) levels were obtained for 175, and associations among risk factors, comorbidities, and PS...
Pérez-Cambrodí, Rafael J; Ascaso, Francisco J; Diab, Fathi; Alzamora-Rodríguez, Antonio; Grzybowski, Andrzej
The dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community. PMID:26385516
Vajpayee, R B; Angra, S K; Honavar, S G; Katoch, S; Prasad, N; Bansal, A; Anand, J
We describe a modified surgical technique of anterior capsulotomy and phacoemulsification for use in hypermature cataracts. Surgical steps included inferior linear capsulotomy with aspiration of milky cortex, inflation of the capsular sac with viscoelastic, a reverse triangular anterior capsulotomy with Vannas scissors, and in-the-bag bimanual sculpting of the nucleus. An oval 5 mm x 6 mm posterior chamber intraocular lens was used with single horizontal or no-stitch wound closure. The technique was used successfully in 20 cases of hypermature cataract. The mean time required to perform phacoemulsification was 3.46 minutes (range 1.2 to 6.3 minutes), with a standard deviation of 1.29. Visual acuity on the first postoperative day ranged from 20/20 to 20/60 (median 20/40). At one week, the mean astigmatism was 1.01 diopters (range 0.25 to 2.75 diopters). The mean endothelial cell loss was 13% (range 3.6% to 26.0%). Based on our results, the modified phacoemulsification technique merits consideration for use in hypermature cataracts. PMID:8551435
Daien, Vincent; Le Pape, Annick; Hève, Didier; Carriere, Isabelle; Villain, Max
Objective: To report age- and sex-specific incidence rates of cataract surgery in France and evaluate the trends of cataract surgery from 2009 to 2012. Design: Cohort study Subjects: Data for all patients who underwent primary cataract surgery in France between January 2009 and December 2012 were collected from the national database. Methods: Annual incidence rates were calculated and adjusted to the corresponding-year national population data from the French national institute of statistics....
Yazici Ahmet; Kara Necip; Bozkurt Ercument; Cakir Mehmet; Goker Hasan; Demirok Ahmet; Yilmaz Omer
Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 28 patients underwent combine...
Conclusion: SICS with posterior chamber intraocular lens implantation is safe in most cataracts due to uveitis and improves BCVA at 6 months. Inflammation should be well-controlled pre-operatively for at least 3 months. Posterior capsule opacification, macular edema and persistent uveitis were the main factors affecting visual outcome. SICS requires minimal instrumentation, surgical time is short and can also be performed in rural clinics and eye-camps, where phacoemulsification machines are unavailable. SICS may be a more practical and cost-effective technique for uveitic cataract, in such circumstances.
Norregaard, J. C.; Thoning, H.; Bernth-Petersen, P.; Andersen, T. F.; Javitt, J.; G. Anderson
AIM—To estimate risk of infectious endophthalmitis after cataract extraction in Denmark and to compare results with the risk of this complication in the USA METHODS—In the national Danish administrative hospital register, 19 426 patients were identified who underwent first eye cataract surgery from 1985 to 1987 and who were 50 years of age or older. Of these, 61 patients had postoperative endophthalmitis. RESULTS—A 12 month cumulative risk of rehospitalisation for endophthalmitis was estimate...
Full Text Available Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms "barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC, and rapid assessment of avoidable blindness (RAAB." The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa.
To determine the role of free radicals and antioxidant enzymes in patients suffering from cataract due to aging and diabetes. The study was conducted on 80 cataract patients. Lens and plasma samples from senile and diabetic subjects suffering from cataract were analyzed and activity of Cu, Zn-superoxide dismutase (Cu, Zn-SOD) was measured using xanthine oxidase system. Catalase (CAT) activity was estimated. Levels of malondialdehyde (MDA) was measured by thiobarbituric acid reaction. Student's t- test was employed for analysis of results. Significant difference (p<0.001) was found in activity of Cu, Zn-SOD in cataract lenses from diabetic patients as compared to senile subjects, CAT activities was also lower (p<0.001) in lenses from diabetic cataract patients when compared to lenses from senile cataractous subjects. Lens MDA levels were significantly higher (p<0.001) in cataract lenses from diabetic patients than in senile subjects. Plasma MDA levels were lowest (p<0.001) in controls as compared to senile and diabetic cataractous patients. (author)
Magnusson, Gunilla; Bizjajeva, Svetlana; Haargaard, Birgitte; Lundström, Mats; Nyström, Alf; Tornqvist, Kristina
screening policy. Response frequency was 96% (122/127). Data were derived from The Pediatric Cataract Register, PECARE Sweden. All Swedish children diagnosed with congenital cataract and operated on before 1 year of age between January 2007 and December 2009 were included. Statistical comparison with...
Sakhnov, S. N.; Leksutkina, E. V.; Smolyanskaya, O. A.; Usov, A. V.; Parakhuda, S. E.; Grachev, Ya. V.; Kozlov, S. A.
We study the destructive action of femtosecond pulses (200 fs) on the human cataractous crystalline lens and the transmission of the cataractous lens in the terahertz spectral range of electromagnetic oscillations (0.2-1 THz) in relation to the density of the nucleus of the lens.
Leuenberger, P M
The possible effects of Quercetine, a potent inhibitor of aldose-reductase, on cataract formation and vascular permeability were investigated in streptozotocine-diabetic rats. Preliminary results after peroral administration of Quercetine did not allow to demonstrate a clear inhibitory effect on cataract formation. PMID:418268
N. Ya. Senchenko; K. A. Nagaeva; E. K. Ayuyeva1; T.N. Iureva
Different approaches to surgical and pleoptic treatment of congenital cataract and amblyopia of obscure origin in children are represented. Main tendencies that determine the indications to surgical procedures and their terms are described. Current techniques of aphakia correction, their advantages and disadvantages as well as pleoptic methods of visual system stimulation are discussed
Moisseiev, J; Bartov, E; Cahane, M; Blumenthal, M; Treister, G
A surgical technique for cataract extraction in eyes filled with silicone oil was developed that has two major objectives: removal of the entire cataractous lens and complete preservation of the silicone oil volume. A regular extracapsular cataract extraction or phacoemulsification is performed, and the incision is closed with the final sutures. All steps are performed under continuous positive pressure achieved with an anterior chamber maintainer connected to a bottle of balanced saline solution. An inferior basal iridectomy is created with a vitrectomy probe, and the posterior capsule is then slowly pulled out through the limbal incision with intraocular forceps, again under positive pressure, in an eye that is actually a closed system, without any loss of silicone. This step results in transformation of the extracapsular cataract extraction condition into an intracapsular cataract extraction condition. The described technique was successfully performed in nine eyes. In the younger patients, the whole procedure was completed through two very small limbal openings. PMID:1444927
Cataract surgery has tremendously evolved in recent years. Innovations include micro-incision cataract surgery through incisions smaller than 2mm, high-fluidics phacoaspiration and laser phacoemulsification to minimize or replace the use of ultrasound, the advent of femtolasers for high-precision incisions in the cornea, the lens capsule and the cataractous lens, aspheric intraocular lenses (IOLs) to enhance the quality and contrast of the image, multifocal and enhanced-depth-of-focus IOLs to correct presbyopia, advancements in biometry and IOL power calculation, prevention of secondary capsule opacification by improvements in the design and material of the IOLs and surgical techniques like capsule polishing and posterior capsulorhexis, and pharmacological prophylaxis and possible future treatment of the cataract itself. Finally, cost-effectiveness and future potential of same-session bilateral cataract surgery are discussed. PMID:26982642
Radiation-induced cataracts are predominantly of the posterior sub-capsular (PSC) type, whereas about 90% of age-related cataracts are of other types. Retired workers, likely to have transuranic body burdens, from three DOE-supported installations were questioned regarding their eye-care history and asked for permission to contact their eye-care providers regarding any cataracts. In 97 cases with lifetime exposure records 20 cases (20.6%) were reported to have PSC cataracts. However, of 24 individuals with recorded lifetime doses of 200-600 mSv, nine (37.5%) had PSC cataracts, compared with 15.1% of 73 cases with doses of less than 200 mSv. This difference is statistically significant at the 5% level. (authors)
Full Text Available Congenital cataracts are one of the most treatable causes of visual impairment and blindness during infancy, with an estimated prevalence of 1 to 6 cases per 10,000 live births. Approximately fifty percent of all congenital cataract cases may have a genetic cause. All three types of Mendelian inheritance have been reported for cataract; however, autosomal dominant transmission seems to be the most frequent. The transparency and high refractive index of the lens are achieved by the precise architecture of the fiber cells and the homeostasis of the lens proteins in terms of their concentration, stability, and supramolecular organization. Research on hereditary congenital cataract led to the identification of several classes of candidate genes that encode proteins such crystallins, lens specific connexins, aquaporine, cytoskeletal structural proteins, and developmental regulators. The purpose of this study was to review the literature on the recent advances made in understanding the molecular genetic basis of congenital cataracts.
Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid
Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. (Texas Retina Associates, Dallas (USA))
Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.
Makarenko, Nikolay; Liapidevskii, Valery; Morozov, Eugene; Tarakanov, Roman
We discuss some theoretical approaches, experimental results and field data concerning wave phenomena in ocean near-bottom stratified flows. Such strong flows of cold water form everywhere in the Atlantic abyssal channels, and these currents play significant role in the global water exchange. Most interesting wave structures arise in a powerful cataract flows near orographic obstacles which disturb gravity currents by forced lee waves, attached hydraulic jumps, mixing layers etc. All these effects were observed by the authors in the Romanche and Chain fracture zones of Atlantic Ocean during recent cruises of the R/V Akademik Ioffe and R/V Akademik Sergei Vavilov (Morozov et al., Dokl. Earth Sci., 2012, 446(2)). In a general way, deep-water cataract flows down the slope are similar to the stratified flows examined in laboratory experiments. Strong mixing in the sill region leads to the splitting of the gravity current into the layers having the fluids with different densities. Another peculiarity is the presence of critical layers in shear flows sustained over the sill. In the case under consideration, this critical level separates the flow of near-bottom cold water from opposite overflow. In accordance with known theoretical models and laboratory measurements, the critical layer can absorb and reflect internal waves generated by the topography, so the upward propagation of these perturbations is blocked from above. High velocity gradients were registered downstream in the vicinity of cataract and it indicates the existence of developed wave structures beyond the sill formed by intense internal waves. This work was supported by RFBR (grants No 12-01-00671-a, 12-08-10001-k and 13-08-10001-k).
K. B. Pershin
Full Text Available Purpose: To develop an uniform method of the treatment for patients with progressive keratoconus (stage 1‑2 and cataract. Patients and methods: 4 patients (5 eyes with cataract and progressive keratoconus stage 1‑2 were enrolled in the study. Mean age was 42 years. In all patients, standard ophthalmic examination as well corneal topography, anterior segment optical coherence tomography, biometry, and IOL power calculations using IOLMaster were performed. Mean uncorrected visual acuity (UCVA was 0.1 while mean best-corrected visual acuity (BCVA was 0.4. Surgical technique included two steps. The first step was the creation of corneal tunnels with femtosecond laser with subsequent phaco and monofocal aspheric IOL implantation. The second step (1‑2 weeks later was the implantation of intrastromal ring segments based on corneal topography and corneal crosslinking.Results: After the first step, all patients had myopic refraction (from –1.0 D to –2.5 D. Cylindrical component was almost unchanged. After the second step, the patients reported the vision improvement, mainly due to UCVA. Both spherical (myopic and cylindrical components decreased, mainly due to the steep meridian. After the treatment, optical power of the cornea decreased, mainly due to the steep meridian. UCVA was 0.6 or more in 60 % of cases, final BCVA was 0.8‑1.0 in 80 % of cases. Neither intraoperative nor postoperative (follow-up was 2 years complications were observed.Conclusions: Combined phaco and prior creation of corneal tunnels with subsequent intrastromal ring segment implantation and crosslinking in patients with cataract and progressive keratoconus stage 1‑2 is safe, provides good predictable outcome and significantly reduces rehabilitation period.
Full Text Available AIM: To assess the visual outcome following traumatic cataract surgery and to assess the predictors of better visual outcome STUDY SETUP AND DESIGN: This is a prospective case study made on consecutive series of patients with traumatic cataract who underwent surgery between November 2012 to July 2013 at Government Regional eye hospital, Andhra medical college, Visakhapatnam . METHODS: Study was made on 100 eyes of 100 patients. Patient’s detailed history, clinical features, pre - operative examination, surgical intervention, post - operative visual acuity and follow up refraction changes record. RESULTS: In total , 100 eyes of 100 patients were included . Out of 100 cases, 78 cases (78% were males and 22 cases (22% were females. Good visual acuity of 6/6 – 6/18 was achieved by 70 cases, (70% out of which 58 cases (58% are closed globe type and 12 cases ( 12% are open globe type. 4 cases ( 4% achieved visual acuity of 6/24 to 6/609 . ( 1 26 cases ( 26% achieved a poor visual outcome of < 6/60 out of which 22 cases (22% are open globe type and 4 cases 4% are closed globe type . ( 2 CONCLUSIONS: Closed globe injury has a favorable prognosis for a satisfactory better that 6/18 visual recovery after surgical management of traumatic cataract , compared to open globe type. In case of open globe injury . (3 prompt wound repair , proper use of drugs to reduce infection , inflammation followed by timely surgery may improve the visual prognosis if there is no other sight threatening injury.
Conclusion : Individuals with nuclear and PSC showed a significantly higher prevalence of myopia while the prevalence of hyperopia was lower in those with cataract. High myopia was seen in higher grades of nuclear cataract. The high percentage of hyperopia was also significant in patients with cortical cataract. More studies are necessary to clarify the correlation between cortical cataract and hyperopia.
Balaji, M.; K. Sasikala; Ravindran, T
The study was undertaken to determine the copper content in different human cataractous lenses. The level of copper increased with increasing age in nuclear brunescence and mixed cataractous lens and a low amount of copper was observed in the posterior subcapsular cataractous lens with increasing age. Cataractous lenses of females have greater amounts of copper compared with males.
Kang, Kui Dong; Yim, Hye Bin; Biglan, Albert W.
Purpose To investigate the causes and characteristics of glaucoma in children following cataract surgery. Methods Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in ...
Han-Han; Liu; Ying; Hu; Hong-Ping; Cui
In the past few years, 9 unique laser platforms have been brought to the market. As femtosecond(FS) laserassisted ophthalmic surgery potentially improves patient safety and visual outcomes, this new technology indeed provides ophthalmologists a reliable new option. But this new technology also poses a range of new clinical and financial challenges for surgeons. We provide an overview of the evolution of FS laser technology for use in refractive and cataract surgeries. This review describes the available laser platforms and mainly focuses on discussing the development of ophthalmic surgery technologies.
Liu, Xue; Wan, Xiuhua
With development of the technology of cataract surgery, combined phacoemulsification and intraocular lens implantation in cataract with high myopia has been widely carried out in clinical treatment. Due to the particularity of high myopia, phacoemulsification in patients with cataract and high myopia is difficult and has recently received a lot of attentions. In this paper, preoperative examinations, the selection of intraocular lenses, surgery methods and surgical complications of cataract surgery in patients with cataract and high myopia are briefly reviewed. PMID:26310259
Salz, James J.
A standard cataract extraction involves removal of the entire cataractous lens through a 12- to 13-mm incision with the aid of a cryoprobe while phacoemulsification consists of removing the cataract through a 3-mm incision by breaking the lens into small pieces with an ultrasonically vibrating needle which is then used to aspirate the fragmented cataract. Most ophthalmic surgeons choose to carry out the standard cataract extraction because although phacoemulsification offers a more rapid reha...
Robert Lindfield; Kalluru Vishwanath; Faustin Ngounou; Rohit C Khanna
Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income ...
Full text: The human lens biosynthesises UV filter compounds which effectively remove light in the 300-400nm band. These chemicals are present either as an aid to visual acuity, or to filter out damaging UV radiation. The primate UV filters are 3-hydroxykynurenine analogues derived from the metabolism of tryptophan. We have recently demonstrated that these endogenous UV filters are not innocuous, but are in fact capable of binding to proteins, including the crystalline proteins which make up the bulk of the lens. Thus, over time, the levels of protein - bound UV filters increase and this results in the human lens becoming progressively more yellow as we age. This colouration affects our colour vision and it may also be responsible for the brown colour of lenses which is the hallmark of age-related nuclear cataract. An understanding of the intrinsic instability of the endogenous UV filters, combined with changes in the internal transport of these and other small molecular weight compounds including antioxidants, such as glutathione, is allowing us to gain an insight into the processes responsible for the development of age-related cataract: the major cause of world blindness
Full Text Available Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to surgery, proper construction of wound, injectable intraocular lenses, use of prophylactic intracameral antibiotics or prophylactic subconjunctival antibiotic injection at the conclusion of cataract surgery, placing a patch after the surgery for at least 4 h and initiating topical antibiotics from the same day of surgery helps to lower the frequency of postoperative endophthalmitis. Intraoperative posterior capsule rupture and anterior vitrectomy are risk factors for acute endophthalmitis, and utmost care to prevent posterior capsular rent should be taken while performing cataract surgery. Also, in case of such complication, these patients should be closely monitored for early signs of endophthalmitis in the postoperative period. In the unfortunate event of endophthalmitis the diagnosis should be prompt and treatment must be initiated as early as possible.
Đurović Branislav M.
Full Text Available Cataract surgery is most common in human surgery and comprises 80% of eye surgery programs. Owing to sophisticated technologies, it has become a routine surgery with lowered complications rate; hence, the functional outcome is more conditioned by operative trauma. The aim of this study was to demonstrate the significance of specular microscopy in the evaluation of operative trauma during extra-capsular cataract extraction (ECCE and phacoemulsification (P, in a controlled environment. The study included 100 consecutive patients who met the established criteria, and groups were formed according to the type of surgery by the assignment of successive numbers from a random number table. Examination and photographs of the corneal endothelium, as well as pachymetry were performed on Keeler-Konan Poclington Specular Microscope (KSP. The obtained results revealed significant dissimilarity in endothelial cell reduction (9.17% in group E, and 4.72% in group P, which generated statistically significant correlation of pre-operative and post-operative pachymetry in the group E (p=0.0004. On the basis of the results obtained by specular microscopy, it was concluded that under the same conditions phacoemulsification caused reduced operative trauma of the corneal endothelium.
The objective of this study was determination of criteria for recognition of a pre senile cataract as a professional disease in health care personnel exposed to small doses of ionizing radiation. Method: The study included 3240 health workers in medical centers of Serbia in the period 1992-2002. A total of 1560 workers were employed in the zone (group A) and 1680 out of ionizing radiation zone (group B). Among group A, two groups had been selected: 1. Group A-1: Health workers in the ionizing radiation zone who contracted lens cataract during their years of service while dosimetry could not reveal higher absorbed dose (A-1=115); 2. Group A-2: Health workers in the ionizing radiation zone with higher incidence of chromosomal aberrations and without cataract (A-2=100). Results: More significant incidence of cataract was found in group A, χ2=65.92; p<0.01. Radiation risk was higher in health workers in radiation zone than in others, relative risk is 4, 6. Elevated blood sugar level was found in higher percentage with health workers working in radiation zone who developed cataract. Conclusion: Low doses of radiation are not the cause of occupational cataract as individual occupational disease. X-ray radiation may be a significant cofactor of cataract in radiological technicians. (author)
Full Text Available Abstract Background Cataract surgery remains a commonly performed elective surgical procedure in the aging and the elderly. The purpose of this study was to utilize time series methodology to determine the temporal and seasonal variations and the strength of the seasonality in age-related (senile cataract hospitalizations and phacoemulsification surgeries. Methods A retrospective, cross-sectional time series analysis was used to assess the presence and strength of seasonal and temporal patterns of age-related cataract hospitalizations and phacoemulsification surgeries from April 1, 1991 to March 31, 2002. Hospital admission rates for senile cataract (n = 70,281 and phacoemulsification (n = 556,431 were examined to determine monthly rates of hospitalization per 100,000 population. Time series methodology was then applied to the monthly aggregates. Results During the study period, age-related cataract hospitalizations in Ontario have declined from approximately 40 per 100,000 to only one per 100,000. Meanwhile, the use of phacoemulsification procedures has risen dramatically. The study found evidence of biannual peaks in both procedures during the spring and autumn months, and summer and winter troughs. Statistical analysis revealed significant overall seasonal patterns for both age-related cataract hospitalizations and phacoemulsifications (p Conclusion This study illustrates the decline in age-related cataract hospitalizations in Ontario resulting from the shift to outpatient phacoemulsification surgery, and demonstrates the presence of biannual peaks (a characteristic indicative of seasonality, in hospitalization and phacoemulsification during the spring and autumn throughout the study period.
Full Text Available Purpose. To determine how different grades of cataract affect sensitivity threshold and saccadic reaction time (SRT in eye movement perimetry (EMP. Methods. In EMP, the visual field is tested by assessing the saccades that a subject makes towards peripheral stimuli using an eye tracker. Forty-eight cataract patients underwent pre- and postoperative EMP examination in both eyes. The subjects had to fix a central stimulus presented on the eye tracker monitor and to look at any detected peripheral stimulus upon its appearance. A multilevel mixed model was used to determine the factors that affected the sensitivity threshold and the SRT as a function of cataract grade. Results. We found no effect of cataract severity (LOCS III grades I through IV on SRT and the sensitivity thresholds. In cataract of LOCS III grade V, however, we found an increase by 27% and 21% (p<0.001, respectively, compared to the SRT and the sensitivity threshold in LOCS III grade I. Eyes that underwent cataract surgery showed no change in mean SRTs and sensitivity thresholds after surgery in LOCS III grade IV and lower. Conclusion. The present study shows that EMP can be readily used in patients with cataract with LOCS III grade IV and below.
To study the effects of cataract surgery in lowering of intraocular pressure (IOP). Study Design: Retrospective study. Place and Duration of Study: The Department of Ophthalmology, Combined Military Hospital, Rawalpindi from January 2011 to December 2013. Patients and Methods: The study included a total of 250 patients; of which 100 cases had simple cataract with no coexisting disease, 100 cases had cataract with primary open angle glaucoma and 50 cases of cataract had accompanying pseudoexfoliation glaucoma. All patients were assessed and recorded preoperatively for their IOP, vision, depth of anterior chamber (ACD), angle of anterior chamber by gonioscopy and glaucoma medications being used. Cataract surgery was performed by phacoemulsification and IOL implantations in all cases. These patients were followed up for a period of six months. Results: The intraocular ressure of all these patients was recorded at monthly interval for six months. The IOP showed a significant decrease in all cases and remained constant till the end of the study. A marked improvement of vision was noted in all cases. The depth of the anterior chamber increased and the angle also widened in all cases. Discussion: Cataract surgery has been found to reduce IOP along with improvement in vision. Patients with glaucoma have a dual benefit of reduced IOP and visual improvement after cataract surgery. (author)
Full Text Available This article reviews the literature on manual small incision cataract surgery (MSICS and its complications. Various articles on MSICS published in indexed journals were reviewed, as well as the sections on complications of MSICS. The Pubmed search engine on the Internet was used to find out articles published since 1985 on MSICS in any language in indexed journals. Books published by Indian authors and the website of Indian Journal of Ophthalmology were also referred to. MSICS has become very popular technique of cataract surgery in India, and it is often used as an alternative to phacoemulsification. Studies on its efficacy and safety for cataract surgery show that, being a variant of extracapsular cataract surgery, MSICS also has similar intraoperative and postoperative complications. The considerable handling inside the anterior chamber during nucleus delivery increase the chances of iris injury, striate keratitis, and posterior capsular rupture. The surgeon has to be extra careful in the construction of the scleral tunnel and to achieve a good capsulorrhexis. Postoperative inflammation and corneal edema are rare if surgeons have the expertise and patience. The final astigmatism is less than that in the extracapsular cataract surgery and almost comparable to that in phacoemulsification. There is, however, a concern of posterior capsular opacification in the long term, which needs to be addressed. Although MSICS demands skill and patience from the cataract surgeon, it is a safe, effective, and economical alternative to competing techniques and can be the answer to tackle the large backlog of blindness due to cataract.
Roberts, Timothy V; Lawless, Michael; Chan, Colin Ck; Jacobs, Mark; Ng, David; Bali, Shveta J; Hodge, Chris; Sutton, Gerard
The recent introduction of femtosecond lasers to cataract surgery has generated much interest among ophthalmologists around the world. Laser cataract surgery integrates high-resolution anterior segment imaging systems with a femtosecond laser, allowing key steps of the procedure, including the primary and side-port corneal incisions, the anterior capsulotomy and fragmentation of the lens nucleus, to be performed with computer-guided laser precision. There is emerging evidence of reduced phacoemulsification time, better wound architecture and a more stable refractive result with femtosecond cataract surgery, as well as reports documenting an initial learning curve. This article will review the current state of technology and discuss our clinical experience. PMID:22788831
Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.
Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.
Varma, Shambhu D
Previous biochemical and morphological studies with animal experiments have demonstrated that caffeine given topically or orally to certain experimental animal models has significant inhibitory effect on cataract formation. The present studies were undertaken to examine if there is a correlation between coffee drinking and incidence of cataract blindness in human beings. That has been found to be the case. Incidence of cataract blindness was found to be significantly lower in groups consuming higher amounts of coffee in comparison to the groups with lower coffee intake. Mechanistically, the caffeine effect could be multifactorial, involving its antioxidant as well as its bioenergetic effects on the lens. PMID:26869755
Mehta, J; ADAMS, G
BACKGROUND—The use of recombinant tissue plasminogen activator (r-TPA) has been advocated in the treatment of postsurgical fibrinous membrane formation following cataract surgery in adults. Its use in paediatric cases is not well documented. METHOD—A retrospective review of paediatric cataract extractions performed at Moorfields Eye Hospital between 1 January 1997 and 4 April 1999 was carried out. RESULTS—Cataract extractions were performed in 37 patients, 22 in males 15 in females. Four (9.2...
Randomised, single-masked non-inferiority trial of femtosecond laser-assisted versus manual phacoemulsification cataract surgery for adults with visually significant cataract: the FACT trial protocol.
Day, A. C.; Burr, J.M.; Bunce, C; Doré, C J; Sylvestre, Y.; Wormald, R. P.; Round, J.; McCudden, V.; Rubin, G; Wilkins, M R
INTRODUCTION: Cataract is one of the leading causes of low vision in the westernised world, and cataract surgery is one of the most commonly performed operations. Laser platforms for cataract surgery are now available, the anticipated advantages of which are broad and may include better visual outcomes through greater precision and reproducibility, and improved safety. FACT is a randomised single masked non-inferiority trial to establish whether laser-assisted cataract surgery is as good as o...
Sri; Ganesh; Sheetal; Brar
<正>INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool for cataract surgery.Preliminary experience for femtosecond laser-assisted cataract surgery show appropriate safety and efficacy,and possible advantage over conventional cataract surgery[1-4].The ability of the femtosecond laser to fragment the lens results in the need for less ultrasound energy to be expended inside the eye.Several studies indicate that less effective phacoemulsification time is needed to emulsify the lens
Akshay Gopinathan Nair
Full Text Available A carotid-cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.