An Assessment of Cataract Severity Based on Antioxidant Status and Ascorbic Acid Levels in Aqueous Humor.

Yu-Ting Tsao,Yi-Jen Hsueh,Hung-Chi Chen,Chun-Fu Liu,Chao-Min Cheng,Kuan-Jen Chen,Wei-Chi Wu

doi:10.3390/antiox11020397

Abstract

Cataract is the leading cause of blindness throughout the world. Currently, the cataract severity evaluation is based on the subjective LOCS III guideline. To ameliorate the evaluation system and develop an objective and quantitative analysis, we investigated the relationships among aqueous humor total antioxidant capacity (AqTAC), ascorbic acid (AqAA) concentration, and cataract severity. In this study, we enrolled 130 cataract patients who underwent phacoemulsification between April 2019 and March 2020. The AqTAC and AqAA were measured by our own developed TAC assay and commercially available kit. Cataract severity was recorded by nuclear opalescence (NO) and cortical cataract (CC) degree according to LOCS III. Cumulative dissipated energy (CDE) during phacoemulsification was recorded to verify the severity of the cataract. As a result, we found a moderate correlation between AqTAC and CDE (p < 0.001). In addition, we found AqTAC independently associated with the CDE when analyzed by multivariate linear regression (p < 0.001). AqTAC also negatively correlated to cataract severity when measured by NO and CC (p = 0.012 in NO grade 3 vs. grade 1; p = 0.012 in CC grade 2 vs. grade 1; p < 0.001 in CC grade 3 vs. grade 1). We further found AqAA provided 71.9 ± 13.5% of AqTAC, and showed a high correlation (rho = 0.79, p < 0.001). In conclusion, we found a significant correlation between AqTAC/AqAA and cataract severity measured by CDE. The correlation was superior to the correlation between LOCS III and CDE. Aqueous humor TAC owns the potential to assess cataracts in an objective and quantitative way.

Highlights

Cataract is the leading cause of blindness and afflicts millions of people annually, with a worldwide prevalence rate of 17.2% [1]
We found that aqueous humor total antioxidant capacity (TAC) level provided a significant correlation to cataract severity, which is presented in the relation between aqueous humor TAC/acid concentration (AA) and cumulative dissipated energy (CDE)/LOCS III cataract severity of nuclear opalescence (NO) and CC
Our findings revealed no significant associations between aqueous humor TAC and the surgical efficacy or surgical safety evaluated by best-corrected visual acuity (BCVA) and intraocular pressure (IOP)

Summary

Introduction

Cataract is the leading cause of blindness and afflicts millions of people annually, with a worldwide prevalence rate of 17.2% [1]. Surgical intervention remains the primary means of treatment to restore vision; despite the presence of novel techniques and advanced instruments for phacoemulsification treatment, complications exist [2]. A comprehensive preoperative evaluation is important to determine treatment choices. In addition to the subjective symptom inquiry, an objective evaluation of cataract severity, which may directly affect surgical outcomes, is necessary to provide a suitably complete investigation. The Lens Opacities Classification System III (LOCS III) based on slit-lamp and retroillumination photography analysis is one of the most well-known cataract severity of Antioxidants 2022, 11, 397. Accumulative state-of-the-art evidence has emphasized the importance of ultrasonic energy expenditure during the phacoemulsification process [4,5,6,7,8]

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