Age-related Cataract Research Articles

Глаукома псевдофакичного глаза

Relevance. Currently, there is a steady increase in the age-associated eye diseases worldwide. First of all, this applies to such ocular diseases as age-related maculodegeneration (AMD), glaucoma and cataracts. Despite the development and standardization of surgical techniques, the widespread introduction of cataract phacoemulsification, appearance of many modifications of anti-glaucomatous surgery, and the active use of angiogenesis inhibitors used to treat AMD, these diseases continue to occupy a leading position in the causes of low vision and blindness. Purpose. To reveal the problem of the development of pseudophakic glaucoma in patients who underwent surgical treatment for cataracts. Material and methods.To complete this review, we searched for literature sources on the PubMed and Scopus abstract databases for the period up to 2021 inclusive. In total, 53 articles related to the topic of the review were selected. The beginning of publications on this topic dates back to 1963. Results. At risk are patients with pseudoexfoliative syndrome, high-grade myopia, traumatic, diabetic and uveal cataracts. Pseudophakic glaucoma can also be caused by intraoperative (iris damage, vitreous prolapse, implantation of an intraocular lens outside the capsular bag, incomplete viscoelastic washout) and postoperative complications (inflammatory process, hyphema, dislocation of the artificial lens, pupillary block or Ellingson syndrome). Conclusion. Pseudophakic glaucoma, although rare, is quite formidable, which can reduce result of cataract surgery. Key words: pseudophakic glaucoma, glaucoma, cataract, ophthalmohypertension, complications of phacoemulsification

The impact of preloaded intraocular lens implantation system (TECNIS iTec®) in routine cataract surgery in China: a time-motion analysis

ObjectiveTo evaluate the impact on surgical efficiency and labor time cost of preloaded intraocular lens (IOL) implantation system compared with manual IOL implantation system in age-related cataract surgery in China.MethodsThis study was an observational, multicenter, prospective time-motion analysis. IOL preparation time, operation time, cleaning time, number and cost of cataract surgeries in eight participating hospitals were collected. The linear mixed model was used to explore factors associated with the difference in operation time between the preloaded IOL implantation system and the manual IOL implantation system. A time-motion model was constructed to convert the operation time cost saved by using preloaded IOL into economic benefits from hospital and social perspective, respectively.ResultsThere were 2,591 cases included in the study (preloaded IOL: 1,591 cases; manual IOL: 1,000 cases). The preloaded IOL implantation system was significant time-saving in both preparation time and operation time compared to the manual IOL implantation system (25.48s vs. 47.04s, P < 0.001 and 353.84s vs. 367.46s, P = 0.004, respectively). An average total of 35.18s can be saved by using preloaded IOL per procedure. The results of linear mixed model showed that the type of IOL was the main factor leading to the difference in preparation time between preloaded IOL and manual IOL implantation system. By switching from manual IOL to preloaded IOL, the model projected additional 392 surgeries can be performed each year and an increase in revenue of $565,282 per hospital, a 9% increase from hospital perspective. And the annual productivity loss saved by using preloaded IOL was $3,006 in eight hospitals from perspective of society.ConclusionCompared with manual IOL implantation system, the preloaded IOL implantation system reduces lens preparation time and operation time, which increases potential surgical volume and revenue, and reduces the loss of work productivity. This study provides real-world evidence to support the advantages of the preloaded IOL implantation system in improving efficiency of ophthalmic surgery in China.

CeRNA network construction and identification of hub genes as novel therapeutic targets for age-related cataracts using bioinformatics.

The aim of this study is to investigate the genetic and epigenetic mechanisms involved in the pathogenesis of age-related cataract (ARC). We obtained the transcriptome datafile of th ree ARC samples and three healthy, age-matched samples and used differential expression analyses to identify the differentially expressed genes (DEGs). The differential lncRNA-associated competing endogenous (ceRNA) network, and the protein-protein network (PPI) were constructed using Cytoscape and STRING. Cluster analyses were performed to identify the underlying molecular mechanisms of the hub genes affecting ARC progression. To verify the immune status of the ARC patients, immune-associated analyses were also conducted. The PPI network identified the FOXO1 gene as the hub gene with the highest score, as calculated by the Maximal Clique Centrality (MCC) algorithm. The ceRNA network identified lncRNAs H19, XIST, TTTY14, and MEG3 and hub genes FOXO1, NOTCH3, CDK6, SPRY2, and CA2 as playing key roles in regulating the pathogenesis of ARC. Additionally, the identified hub genes showed no significant correlation with an immune response but were highly correlated with cell metabolism, including cysteine, methionine, and galactose. The findings of this study may provide clues toward ARC pathogenic mechanisms and may be of significance for future therapeutic research.

Systemic treatment with cigarette smoke extract affects zebrafish visual behaviour, intraocular vasculature morphology and outer segment phagocytosis

Introduction: Cigarette smoking adversely affects multiple aspects of human health including eye disorders such as age-related macular degeneration, cataracts and dry eye disease. However, there remains a knowledge gap in how constituents of cigarette smoke affect vision and retinal biology. We used zebrafish to assess effects of short-term acute exposure to cigarette smoke extract (CSE) on visual behaviour and retinal biology. Methods: Zebrafish larvae with a developed visual system at three days post-fertilization (dpf) were exposed to CSE for 4, 24 or 48 hours. Visual behaviour, hyaloid vasculature morphology, retinal histology, oxidative stress gene expression and outer segment phagocytosis were investigated using visual behavioural optokinetic and visual motor response assays (OKR and VMR), microscopy (light, fluorescence and transmission electron microscopy), and real-time PCR. Results: In zebrafish larvae, 48 hours of CSE treatment resulted in significantly reduced visual behaviour. Larvae treated with 10, 15 or 20 μg/mL CSE showed an average of 13.7, 10.7 or 9.4 saccades per minute, respectively, significantly lower compared with 0.05% DMSO controls (p=0.0093, p=0.0004 and p&lt;0.0001, respectively) that exhibited 19.7 saccades per minute. The diameter of intraocular vessels increased from 4.12 μm in 0.05% DMSO controls to 5.69 μm in the 20 μg/mL CSE-treated larvae (p≤0.0001). Biometry analysis highlighted a significant axial length elongation in 20 μg/mL CSE-treated larvae (216.9 μm, p&lt;0.0001) compared to 0.05% dimethyl sulfoxide (DMSO) controls (205.1 μm). Larvae exposed to 20 μg/mL CSE had significantly (p=0.0002) higher numbers of RPE phagosomes compared to vehicle controls (0.1425 and 0.093 phagosomes/μm RPE, respectively). Conclusions: Zebrafish larvae with a developed visual system display apparent defects in visual behaviour and retinal biology after acute exposure to CSE, establishing a valuable in vivo model to investigate ocular disorders related to cigarette smoke.

Bleach-Associated Uveitis: A Case Report

Introduction: Chemical ocular injuries represent ophthalmologic emergencies with potentially blinding complications. Burns with alkalis tend to be more serious due to deeper tissue penetration as a result of colliquative necrosis. Uveitis is usually observed in higher grades of burns with significant alterations in the anterior segment of the eye. This study aimed to report a case of late-onset unilateral uveitis following a mild alkali burns with sodium hypochlorite (bleach).&#x0D; Case presentation: A 64-year-old Caucasian woman reported that 3 weeks ago, she had an accident with bleach coming in contact with both eyes. At that time, she had emergency ocular irrigation with saline to both eyes, and she had also used artificial tears for about a week. Besides bilateral conjunctival hyperaemia and punctate corneal epithelial erosions, no other complications had been noted. Her symptoms had subsided in several days. Upon presentation to the clinic, reduced best-corrected visual acuity was observed in both eyes to 20/30, which was attributed to age-related cataracts, normal intraocular pressure, normal conjunctiva in both eyes, the clear cornea in the right eye (OD) and several white, round, middle-sized granulomatous keratic precipitates in the left eye (OS), without epithelial and stromal alterations. The anterior chamber of OS demonstrated a 0.5+ cellular reaction. The remaining ocular status was normal.&#x0D; Conclusion: Based on the history of chemical ocular injury, the lack of systemic diseases and the mild form of ocular inflammation, no additional diagnostic tests were offered. The patient was started on topical dexamethasone phosphate for 1 month with an initial dose of one drop four times daily, which led to remission.

Aberrant expression of COL4A1 in age-related cataract and its effect on cell proliferation, apoptosis and gene expression changes

To evaluate the regulation of the aberrant expression of collagen type IV alpha 1 chain (COL4A1) in the development of age-related cataract (ARC). Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot analysis were employed to evaluate the expression of COL4A1 in ARC patients and healthy controls. The proliferation, apoptosis, cell cycle and epithelial-mesenchymal transition (EMT) of human lens epithelial cell (HLE-B3) were further analyzed under the condition of COL4A1 gene silence. Alteration of gene expression at mRNA level after knockdown COL4A1 were also evaluated by qRT-PCR on HLE-B3 cells. The aberrant expression of COL4A1 was identified a clinically associated with the ARC. Silencing of COL4A1 promoted the apoptosis and inhibited the proliferation of HLE-B3 by blocking the cell cycle. Moreover, COL4A1 gene silence didn't affect the cytoskeleton of HLE-B3 but down-regulated the Collagen type IV Alpha 2 Chain (COL4A2), paired box 6 (PAX6), procollagen-lysine 2-oxoglutarate 5-dioxygenases 1 (PLOD1) and procollagen-lysine 2-oxoglutarate 5-dioxygenases 2 (PLOD2) expression levels in HLE-B3 cells. Silencing the COL4A1 gene induced EMT of the HLE-B3 cells by promoting the transforming growth factor beta (TGF-β) expression. Silencing of COL4A1 induces S-phase arrest, also inhibits the proliferation and enhance HLE-B3 apoptosis and EMT, and down-regulates the expression of COL4A2, PAX6, PLOD1 and PLOD2. Thus, the expression alteration of COL4A1 may play a critical role in the pathogenesis of ARC.

Genome-wide analysis of genetic pleiotropy and causal genes across three age-related ocular disorders

Age-related macular degeneration (AMD), cataract, and glaucoma are leading causes of blindness worldwide. Previous genome-wide association studies (GWASs) have revealed a variety of susceptible loci associated with age-related ocular disorders, yet the genetic pleiotropy and causal genes across these diseases remain poorly understood. By leveraging large-scale genetic and observational data from ocular disease GWASs and UK Biobank (UKBB), we found significant pairwise genetic correlations and consistent epidemiological associations among these ocular disorders. Cross-disease meta-analysis uncovered seven pleiotropic loci, three of which were replicated in an additional cohort. Integration of variants in pleiotropic loci and multiple single-cell omics data identified that Müller cells and astrocytes were likely trait-related cell types underlying ocular comorbidity. In addition, we comprehensively integrated eye-specific gene expression quantitative loci (eQTLs), epigenomic profiling, and 3D genome data to prioritize causal pleiotropic genes. We found that pleiotropic genes were essential in nerve development and eye pigmentation, and targetable by aflibercept and pilocarpine for the treatment of AMD and glaucoma. These findings will not only facilitate the mechanistic research of ocular comorbidities but also benefit the therapeutic optimization of age-related ocular diseases.

Whole-exome sequencing prioritizes candidate genes for hereditary cataract in the Emory mouse mutant.

The Emory cataract (Em) mouse mutant has long been proposed as an animal model for age-related or senile cataract in humans-a leading cause of visual impairment. However, the genetic defect(s) underlying the autosomal dominant Em phenotype remains elusive. Here, we confirmed development of the cataract phenotype in commercially available Em/J mice [but not ancestral Carworth Farms White (CFW) mice] at 6-8 months of age and undertook whole-exome sequencing of candidate genes for Em. Analysis of coding and splice-site variants did not identify any disease-causing/associated mutations in over 450 genes known to underlie inherited and age-related forms of cataract and other lens disorders in humans and mice, including genes for lens crystallins, membrane/cytoskeleton proteins, DNA/RNA-binding proteins, and those associated with syndromic/systemic forms of cataract. However, we identified three cataract/lens-associated genes each with one novel homozygous variant including predicted missense substitutions in Prx (p.R167C) and Adamts10 (p.P761L) and a disruptive in-frame deletion variant (predicted missense) in Abhd12 (p.L30_A32delinsS) that were absent in CFW and over 35 other mouse strains. In silico analysis predicted that the missense substitutions in Prx and Adamts10 were borderline neutral/damaging and neutral, respectively, at the protein function level, whereas, that in Abhd12 was functionally damaging. Both the human counterparts of Adamts10 and Abhd12 are clinically associated with syndromic forms of cataract known as Weil-Marchesani syndrome 1 and polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and cataract syndrome, respectively. Overall, while we cannot exclude Prx and Adamts10, our data suggest that Abhd12 is a promising candidate gene for cataract in the Em/J mouse.

Effects of visual restoration on gait performance and kinematics of lower extremities in patients with age-related cataract.

Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly; however, the mechanism needs to be explored intensively. The present study assessed the gait pattern after cataract surgery to investigate the effects of visual restoration on locomotion. The prospective study recruited 32 patients (70.1 ± 5.2 years) with bilateral age-related cataracts in the Department of Ophthalmology at Peking University Third Hospital from October 2016 to December 2019. The temporal-spatial gait parameters and kinematic parameters were measured by the Footscan system and inertial measurement units. Paired t -test was employed to compare data normally distributed and Wilcoxon rank-sum test for non-normally distributed. After visual restoration, the walking speed increased by 9.3% (1.19 ± 0.40 m/s vs. 1.09 ± 0.34 m/s, P =0.008) and exhibited an efficient gait pattern with significant decrease in gait cycle (1.02 ± 0.08 s vs. 1.04 ± 0.07 s, P =0.012), stance time (0.66 ± 0.06 s vs. 0.68 ± 0.06 s, P =0.045), and single support time (0.36 ± 0.03 s vs. 0.37 ± 0.02 s, P =0.011). High amplitude of joint motion was detected in the sagittal plane in the left hip (37.6° ± 5.3° vs. 35.5° ± 6.2°, P =0.014), left thigh (38.0° ± 5.2° vs. 36.4° ± 5.8°, P =0.026), left shank (71.9° ± 5.7° vs. 70.1° ± 5.6°, P =0.031), and right knee (59.1° ± 4.8° vs. 56.4° ± 4.8°, P =0.001). The motor symmetry of thigh improved from 8.35 ± 5.30% to 6.30 ± 4.73% ( P =0.042). The accelerated gait in response to visual restoration is characterized by decreased stance time and increased range of joint motion. Training programs for improving muscle strength of lower extremities might be helpful to facilitate the adaptation to these changes in gait.

METTL3-mediated m6A modification of has_circ_0007905 promotes age-related cataract progression through miR-6749-3p/EIF4EBP1.

Many cases of blindness are caused by age-related cataracts (ARCs). N6-methyladenosine (m6A)-modified circRNA widely participates in disease progression. However, the role of m6A modification of circRNA in ARC is unclear. We mined and elucidated the functions and mechanisms of key circRNAs with m6A modification involved in ARC progression. The GSE153722 dataset was used to mine m6A-mediated key circRNA. Loss-of-function assays and rescue assays were used to explore the effect and mechanism of circRNA on ARC cell proliferation and apoptosis. Has_circ_0007905 was a hypermethylated and upregulated expression in the ARC group relative to the control group both in vivo and in vitro. Silencing of has_circ_0007905 promoted proliferation and inhibited the apoptosis of HLE-B3 cells. METTL3 was upregulated in HLE-B3 cells after ARC modeling and had four binding sites with has_circ_0007905 and a mediated m6A modification of has_circ_0007905. Proliferation was significantly inhibited and apoptosis of HLE-B3 cells was facilitated by METTL3 overexpression, whereas these effects were prevented by has_circ_0007905 silencing. Silencing of has_circ_0007905 led to an alteration in the transcriptome landscape. Differentially expressed genes were mainly involved in immune-related processes and pathways. EIF4EBP1 overexpression promoted apoptosis and suppressed proliferation, and also significantly reversed effects of has_circ_0007905 silencing. Moreover, miR-6749-3p significantly decreased the luciferase activities of wild type plasmids with both of has_circ_0007905 and EIF4EBP1. MiR-6749-3p inhibitor blocked elevation in proliferation and reduced EIF4EBP1 expression and apoptosis conferred by has_circ_0007905 silencing. We reveal for the first time that the commitment of ARC progression is guided by METTL3/has_circ_0007905/miR-6749-3p/EIF4EBP1 axis, and the results provide new insights into ARC pathology.

Comparison of 30-day planned and unplanned readmissions in a tertiary teaching hospital in China

PurposeThe purpose of this study was to analyze and compare the clinical characteristics of patients with 30-day planned and unplanned readmissions and to identify patients at high risk for unplanned readmissions. This will facilitate a better understanding of these readmissions and improve and optimize resource utilization for this patient population.MethodsA retrospective cohort descriptive study was conducted at the West China Hospital (WCH), Sichuan University from January 1, 2015, to December 31, 2020. Discharged patients (≥ 18 years old) were divided into unplanned readmission and planned readmission groups according to 30-day readmission status. Demographic and related information was collected for each patient. Logistic regression analysis was used to assess the association between unplanned patient characteristics and the risk of readmission.ResultsWe identified 1,118,437 patients from 1,242,496 discharged patients, including 74,494 (6.7%) 30-day planned readmissions and 9,895 (0.9%) unplanned readmissions. The most common diseases of planned readmissions were antineoplastic chemotherapy (62,756/177,749; 35.3%), radiotherapy sessions for malignancy (919/8,229; 11.2%), and systemic lupus erythematosus (607/4,620; 13.1%). The most common diseases of unplanned readmissions were antineoplastic chemotherapy (2038/177,747; 1.1%), age-related cataract (1061/21,255; 5.0%), and unspecified disorder of refraction (544/5,134; 10.6%). There were statistically significant differences between planned and unplanned readmissions in terms of patient sex, marital status, age, length of initial stay, the time between discharge, ICU stay, surgery, and health insurance.ConclusionAccurate information on 30-day planned and unplanned readmissions facilitates effective planning of healthcare resource allocation. Identifying risk factors for 30-day unplanned readmissions can help develop interventions to reduce readmission rates.

Age-related cataract: GSTP1 ubiquitination and degradation by Parkin inhibits its anti-apoptosis in lens epithelial cells

PurposeOxidative stress-induced apoptosis of lens epithelial cells (LECs) contributes to the pathogenesis of age-related cataract (ARC). The purpose of this research is to underlie the potential mechanism of E3 ligase Parkin and its oxidative stress-associated substrate in cataractogenesis. MethodsThe central anterior capsules were obtained from patients with ARC, Emory mice, and corresponding controls. SRA01/04 cells were exposed to H2O2 combined with cycloheximide (a translational inhibitor), MG-132 (a proteasome inhibitor), chloroquine (an autophagy inhibitor), Mdivi-1 (a mitochondrial division inhibitor), respectively. Co-immunoprecipitation was employed to detect protein-protein interactions and ubiquitin-tagged protein products. Levels of proteins and mRNA were evaluated by western blotting and quantitative RT-PCR assays. ResultsGlutathione-S-transferase P1 (GSTP1) was identified as a novel Parkin substrate. Compared with corresponding controls, GSTP1 was significantly decreased in the anterior lens capsules obtained from human cataracts and Emory mice. Similarly, GSTP1 was declined in H2O2-stimulated SRA01/04 cells. Ectopic expression of GSTP1 mitigated H2O2-induced apoptosis, whereas silencing GSTP1 aggregated apoptosis. In addition, H2O2 stimulation and Parkin overexpression could promote the degradation of GSTP1 through the ubiquitin-proteasome system, autophagy-lysosome pathway, and mitophagy. After co-transfection with Parkin, the non-ubiquitinatable GSTP1 mutant maintained its anti-apoptotic function, while wildtype GSTP1 failed. Mechanistically, GSTP1 might promote mitochondrial fusion through upregulating Mitofusins 1/2 (MFN1/2). ConclusionOxidative stress induces LECs apoptosis via Parkin-regulated degradation of GSTP1, which may provide potential targets for ARC therapy.

Thioredoxin-1 regulates the autophagy induced by oxidative stress through LC3-II in human lens epithelial cells.

Oxidative stress plays a major role in age-related cataract development. The cellular antioxidant protein thioredoxin-1 (Trx-1) and its negative regulator, thioredoxin binding protein-2 (TBP-2), are pivotal in the cellular redox balance during oxidative stress. The aim of this study is to investigate the effect of Trx-1 and TBP-2 on LC3 I/LC3 II in oxidative stress-induced autophagy in human lens epithelial cells (LECs). In our study, LECs were treated with 50 μM H2 O2 for different durations, and the expression of Trx-1 and TBP-2 were measured by RT-PCR and Western blot. Trx-1 activity was evaluated by the thioredoxin activity fluorescent assay. The subcellular localization of Trx-1 and TBP-2 was evaluated by cellular immunofluorescence. The interaction between Trx-1 and TBP-2 was examined by co-immunoprecipitation. The cell viability was detected using CCK-8, and the expression of LC3-II/LC3-I was detected to evaluate the autophagy. The results showed that the mRNA levels of the Trx-1 and TBP-2 were kinetically changed after treatment with H2 O2 for different durations. Exposure to H2 O2 increased the expression of TBP-2 but not Trx-1, while the exposure inhibited Trx-1 activity. TBP-2 was co-localized with Trx-1, and exposure to H2 O2 increased the interaction between TBP-2 and Trx-1. Trx-1 overexpression enhanced the autophagic response under normal circumstances and it might regulate autophagy in the initial phase. This study demonstrates the differential role of Trx-1 in cellular oxidative stress response, oxidative stress increased Trx-1 interaction with TBP-2, and Trx-1/TBP-2 regulated the autophagic response in the initial phase through LC3-II.

Comparison of Frequency of Pseudo-Exfoliation Syndrome in Patients Undergoing Cataract Surgery in Different Regional Hospitals of Pakistan

Objective: To compare the frequency of Pseudo-Exfoliation Syndrome (PXS) in patients undergoing cataract surgery in different regional hospitals in Pakistan.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Three Tertiary Care Hospitals of Karachi, Rawalakot and Skardu Pakistan, from Sep 2017 to May 2020.&#x0D; Methodology: Patients aged 45 years and more undergoing age-related cataract surgery were evaluated for Pseudo-Exfoliation Syndrome. Initially, each patient underwent a complete outpatient ophthalmological workup. Demographic details like age and gender were noted. All the patients were screened for hypertension and diabetes mellitus. In addition, patients were screened for pseudo-exfoliation syndrome. Congenital, developmental, secondary and traumatic cataracts were excluded.&#x0D; Results: A total of 1882 patients were included in the study. Pseudo-exfoliation was carried out in 249(13.23%) patients. In Hospital-A, 23(3.23%); in Hospital-B, 145(14.92%) and Hospital-C, 81(40.70%) of the patients had pseudo-exfoliation. The frequency of pseudo-exfoliation syndrome was significantly more in Hospital-C and then in Hospital-B and least in HospitalA (p&lt;0.01).&#x0D; Conclusion: Pseudo-exfoliation syndrome was significantly more common in Skardu and then in Rawalakot and least in Malir, which in the same order have more latitude away from the equator, have less average annual temperature and are situated at higher altitudes.

Effect of larger corneal spherical aberration in improving the near visual acuity of eyes implanted with the TECNIS Symfony.

To explore the effect of corneal spherical aberration on the visual acuity and visual quality of eyes implanted with the TECNIS Symfony intraocular lens (IOL). A total of 43 patients with age-related cataract (60 eyes) undergoing phacoemulsification and TECNIS Symfony IOL implantation were enrolled in this study. The uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, and ocular spherical aberration were recorded 3 months after surgery. Preoperative and postoperative corneal spherical aberration were also measured using the iTrace device. Objective scattering index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) were measured by the Optical Quality Analyzing System. Catquest-9SF questionnaire were applied too. Spearman's correlation analysis was used to evaluate the relationship between spherical aberration and visual quality parameters. Patients were satisfied with their postoperatively visual quality. And the postoperative logMAR UDVA, UIVA, UNVA, and CDVA was 0.05 ± 0.07, 0.04 ± 0.06, 0.15 ± 0.07, and 0.03 ± 0.05, respectively. The mean preoperative corneal spherical aberration was 0.24 ± 0.10 μm, which is the only factor influencing postoperatively UNVA, and it was negatively correlated with UNVA and glare contrast sensitivity under 18 cpd (cycle/degree, cpd) spatial frequency (r = -0.403, -0.300, -0.360; all P < 0.05). Additionally, the greater the residual spherical aberration of the cornea, the better the near vision after operation. The mean postoperative ocular spherical aberration was -0.03 ± 0.07 μm, it was not correlated with visual acuity, contrast sensitivity, and visual quality (all P > 0.05). Preoperative positive spherical aberration can benefit near vision while decrease contrast sensitivities at high spatial frequencies when implanted with the TECNIS Symfony IOL.

Concentrations of glucose metabolites in the aqueous humour of diabetic cataract eyes.

Glucose metabolism underpins diabetic cataracts (DCs), but the relationship between the two remains unclear. Here, we tested the aqueous humour (AH) of patients with DCs to elucidate glucose metabolite levels. In this study, aqueous humour (AH) samples were collected preoperatively from DC eyes (n = 37) and age-related cataract eyes (n = 37) from 74 patients (74 eyes) undergoing uncomplicated cataract surgery. The content of glucose, pyruvate, L-lactate were detected by biochemical methods and advanced glycation end-products (AGEs) was detemined using enzyme-linked immunosorbent assay (ELISA) technique. Furthermore, the ratios of glucose/pyruvate and L-lactate/pyruvate in the AH were calculated. In addition, we calculated the correlation between glucose levels and AGEs in the AH. The concentrations of glucose, pyruvate and AGEs in the DC group were higher than those in the control group. Significantly lower levels of L-lactate in the AH were found in the DC group. We calculated the glucose/pyruvate ratio and the L-lactate/pyruvate ratio in the AH, which showed that glucose metabolism was changed in the AH from DC patients. Interestingly, we observed that AGEs in the AH were significantly correlated with increased anterior chamber glucose permeability. A stronger correlation was found in the subgroups of male patients, younger patients, and patients with poor glycaemic control status. Comparison of the levels of glucose metabolism-related products in the AH in the DC group highlight a potential pathological mechanism for DC from a glucose metabolism perspective. The findings indicated an alteration in the metabolic pathways of energy metabolism and amino acids in the AH of DC patients.

Surgery of age-related cataract: epidemiological nuances

AIM: To perform the analysis of the age composition of patients with a planned in-patient surgical procedure cataract phacoemulsification.&#x0D; MATERIALS AND METHODS: Three cohorts of patients diagnosed with age-related senile cataract were analyzed for the periods 20002003 (n = 6737), 20072009 (n = 13,015), and 20152017 (n = 1363) on the basis of age at the time of planned surgery in the ophthalmology hospital S.V. Belyaev Kuzbass Clinical Hospital. Persons with a diagnosis of congenital, complicated, traumatic cataract and persons operated as out-patients were excluded from all samples.&#x0D; RESULTS: At the first stage, the average age of patients at the time of surgical treatment of patients diagnosed with senile cataract was calculated. At the second stage, the age of operated patients was analyzed by decades of human life. At the third stage, the assessment of the judgment about the rejuvenation of the age of operated patients with incipient cataract according to professional indications was carried out.&#x0D; CONCLUSIONS: The average age of patients operated on with senile cataract during a fifteen-year period is a stable value in the range of 6668 years. In the dynamics from 2000 to 2017, there was a redistribution of patients with senile cataract within the cohort by age. Rejuvenation of the age composition of persons with cataracts occurred due to an increase in patients aged 5160 years by 2 times and a decrease in patients aged 7180 years by 1.6 times. The proportion of patients undergoing surgical treatment for senile cataract in a hospital setting with visual acuity of 0.1 or less is stable and amounts to 78.487.5 %.

Analysis of the Dysfunctional Lens Index as a Novel Criterion for Surgical Decision-Making in Age-Related Cataracts

ABSTRACT Background The dysfunctional lens index (DLI) provided by a ray-tracing aberrometry system is an objective index in cataract assessment. The purpose of this study is to evaluate correlations among Lens Opacities Classification System III (LOCS III) grades, Catquest 9SF scores, and the (DLI) and the DLI’s role in surgical decision-making in age-related mixed cataract. Methods This trial was registered at NIH (clinicaltrial.gov) on January 5, 2021 (NCT04711395). In this prospective cross-sectional study, age-related mixed cataract patients were recruited. One high-volume and two low-volume surgeons made surgical decisions based on corrected distance visual acuity (CDVA), LOCS III graded photographs, and Catquest 9SF scores. Their decision-making agreement was evaluated with Cohen’s kappa coefficient. Correlations among the parameters were analyzed. The optimal cut-off DLI was calculated using a receiver operating characteristic curve. Results Overall, 106 patients (106 eyes) were included. Very good agreement levels were noted among the high- and low-volume surgeons (Cohen’s kappa coefficient, 0.848) (95% CI, 0.748–0.948). The DLI had the strongest correlation with Catquest 9SF scores (R2 = 0.566), followed by with posterior subcapsular (R2 = 0.418), nuclear opalescence (R2 = 0.388), and cortical (R2 = 0.333, all P < .0001) cataract LOCS III grades. Catquest 9SF scores were correlated with cortical (R2 = 0.249), nuclear opalescence (R2 = 0.278), and posterior subcapsular (R2 = 0.235, all P < .0001) cataract LOCS III grades. A cut-off DLI of 5.36 was identified as a surgical criterion (specificity, 86.9%; sensitivity, 93.3%). Conclusions The DLI is valuable for objectively assessing patient complaints and lens opacity severity. LOCS III remains effective and economical in assessing early cortical cataracts with relatively clear central lenses. A cut-off DLI ≤5.36 could be a criterion for preoperative decision-making.

The Effect of Psychological Intervention on the Visual Quality of Patients with a Diffractive Multifocal Intraocular Lens Implant.

This study aimed to investigate the effect of psychological intervention on the visual quality of patients with a diffractive multifocal intraocular lens implant and its possible mechanism. Eighty-nine patients undergoing age-related cataract surgery were enrolled in the study at the Affiliated Hospital of Southwest Medical University between December 2015 and July 2017. They were randomly divided into two groups: multiple focus M1 group (n = 45) and multiple focus M2 group (n = 40). The M1 group was only given routine preoperative health education, treatment, and evaluation, while the M2 group also received psychological intervention. After treatment, there was no statistical difference in the uncorrected distance and near visual acuity, corrected distance and near visual acuity, or the vision and near removal rate in either of the two groups (p > 0.05). However, postoperative glare was lower in the M2 group (p < 0.05), and patient satisfaction was higher in the M2 group (p < 0.05). The M2 group had a more obvious improvement in the Symptom Checklist-90 score (p < 0.05), the serum interleukin-6 (IL-6) was lower, and the serum brain-derived neurotrophic factor (BDNF) was higher in the M2 group (p < 0.05). In addition, serum IL-6 had a negative correlation with the depression score, and serum BDNF also showed a negative correlation with the anxiety score (p < 0.05). Psychological intervention improved the stress state of patients with age-related cataracts and diffractive multifocal intraocular lens implants, reduced the level of inflammatory factors in the body, improved the level of BDNF, reduced postoperative visual interference, and improved postoperative satisfaction.

Relationship between expression levels of TDRD7 and CRYBB3 and development of age-related cortico-nuclear cataracts

BackgroundThe human lens develops age-related cataracts (ARCs) because of the complicated effects of aging and stressful conditions. Under conditions involving oxidative stress, cells form stress granules (SGs). TDRD7 has been identified as an RNA granule component and an important component of SGs. TDRD7 plays a role in the post-transcriptional expression of genes, such as the crystallin gene CRYBB3. Therefore, the present study investigated TDRD7 and CRYBB3 mRNA expressions in relation to age-related cortico-nuclear cataracts.MethodsQuantitative real-time PCR was used to determine the expression levels of TDRD7 and CRYBB3 in 52 patients with ARC and 52 healthy controls. Anterior lens capsules and peripheral blood samples from patients with ARC were included in the patient group, and peripheral blood samples from healthy subjects and human lens epithelial cells (HLE-B3) were included in the control group. Gene expression levels in the different age groups were compared. Correlation analysis was used to assess the gene expression levels and age.ResultsThe expression of TDRD7 and CRYBB3 was significantly up-regulated (P < 0.0001) in anterior lens capsules compared to that in HLE-B3 cells. Similarly, the expression of TDRD7 (P = 0.0004) and CRYBB3 (P < 0.0001) was higher in the peripheral blood samples of patients with ARC than in those of healthy subjects. Significant upregulation (P < 0.05) was observed in the 71–81-year age group of patients. No correlation was found between gene expression levels and age.ConclusionSignificantly higher expression levels of TDRD7 and CRYBB3 in patients with ARC than in controls suggest that TDRD7 and CRYBB3 are associated with the development of age-related cortico-nuclear cataracts and the aging process under chronic stress.