Cataract Research Articles

The relationship between different stages of diabetic retinopathy and levels of YKL-40 in aqueous humour and serum

ABSTRACT Clinical relevance Since inflammation plays an important role in the pathogenesis of diabetic retinopathy, serum biomarkers and retinal imaging aimed at evaluating the presence of inflammation have emerged as useful tools to monitor the appearance and progression of diabetic retinopathy. Background This study aims to investigate the value of YKL-40 levels in patients with diabetes mellitus with different stages of diabetic retinopathy and without diabetic retinopathy, and to compare those findings with results from healthy individuals without diabetes mellitus. Methods This prospective cross-sectional study included 67 diabetic patients with or without diabetic retinopathy who underwent cataract surgery and 23 patients (control group) having no ocular and systemic disease other than senile cataract. Participants with diabetes mellitus were separated into three subgroups: the first group consisted of 26 patients without diabetic retinopathy, the second group included 21 patients with non-proliferative diabetic retinopathy and the third group included 20 patients with proliferative diabetic retinopathy. Serum and aqueous humour YKL-40 levels were analysed and compared between the groups. Results The mean serum (p < 0.001) and aqueous humour (p < 0.001) YKL-40 levels were statistically significantly lower in control subjects compared to patients with diabetes mellitus. The aqueous humour YKL-40 levels showed statistically significant elevations with the progression of diabetic retinopathy. Duration of diabetes mellitus was significantly correlated with aqueous humour YKL-40 levels (p = 0.001, r = 0.384). Conclusion Both serum and aqueous humour YKL-40 levels are higher in patients with diabetes mellitus compared to healthy subjects. Levels of YKL-40 in aqueous humour increase with the progression of diabetic retinopathy.

The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study

This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. This retrospective case-control study, spanning 2001–2022, used electronic medical records from Clalit Health Services (CHS) in Israel. Patients diagnosed with involutional ectropion served as the case group, while two control groups were used for comparison: one comprising patients diagnosed with senile cataract and the other with various ophthalmic diseases. Matching for the control groups was performed at a 1:3 ratio based on year of birth, sex, and ethnicity. A total of 17,292 patients with involutional ectropion and 51,876 matched controls in each group were included. The average age of the patients with involutional ectropion was 78 ± 10 years and 58% were men. Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89 ) and pterygium (OR 2.48). Systemic diseases such as hypertension (OR 1.46), dyslipidemia (OR 1.45), and autoimmune rheumatic diseases (OR 1.43) were also associated with involutional ectropion. This study found that localized chronic inflammatory conditions affecting the periocular tissues and ocular surface are significantly associated with the development of involutional ectropion.

Effect of anterior chamber depth on corneal endothelium following phacoemulsification among patients with different axial lengths.

To assess the effect of anterior chamber depth on corneal endothelium using specular microscopy following uneventful phacoemulsification among cataract patients with different axial lengths. The study was conducted in a quasi-experimental design including 300 eyes of 300 patients with grade three age-related nuclear cataract distributed equally based on their axial length into three equal groups. All eyes had grade three nuclear cataract. All patients underwent phacoemulsification using the same settings. They were assessed preoperatively and postoperatively at one week, one month and three months using specular microscopy. Outcome measures included endothelial cell density, axial length (AL), anterior chamber depth (ACD), ultrasound time (UST), cumulative dissipated energy (CDE) and intraoperative balanced salt solution (BSS) volume. There were no significant differences (p > 0.05) between study groups regarding age, cataract density, UST, CDE and BSS volume. The endothelial cell density decreased significant (p < 0.001) postoperatively in all groups through the follow up period. However, the amount of change decreased as the end of follow up was approached. A significant negative correlation was found between amount of endothelial cell loss and ACD. However, no significant correlation existed between AL and ACD or ECL. Endothelial cell density changes were significant following phacoemulsification. These changes were more in patients with shallow anterior chamber regardless of the axial length. Surgeons should adjust their surgical pattern considering our results.

Preliminary Diagnostic System for the Classification of Senile Cataract Using Convolutional Neural Networks

Preliminary Diagnostic System for the Classification of Senile Cataract Using Convolutional Neural Networks

The Effect of Cataract Surgery on Stereoacuity, Balance, and Falls in Patients With Senile Cataract.

To investigate the effect of cataract surgery on visual acuity, stereoacuity, balance, and falls in patients with senile cataract. Prospective, cross-sectional study. The patients were divided into group 1 if the first surgery was performed on the dominant eye and group 2 on the nondominant eye. After a complete ophthalmologic examination, all patients underwent stereoacuity tests (Titmus and TNO test); Berg Balance Scale and the number of falls in the last 36 months were recorded. All assessments were performed at three time points: the preoperative period, 6 months after the first surgery (primary endpoint), and 24 months after the second surgery (secondary endpoint). The mean number of falls was 4.95±2.6/year in the preoperative period and 1.43±0.59/year in the postoperative period. The incidence of falls after the second surgery decreased by 53.15% compared with the preoperative period. The number of falls and preoperative stereoacuity were negatively and moderately correlated (r=-0.546) (P=0.033). In univariate and multivariate analysis, only low preoperative corrected distance visual acuity in the dominant eye was associated with poor stereoacuity (P=0.001) and a high number of falls (P<0.001) in the preoperative period. Cataract surgery in patients with senile cataracts not only improves visual acuity but also increases stereoacuity level, improves balance, and decreases falls. These effects should be further studied in multicenter, large-participant studies.

Analysis of the rate and changes in the incidence of age-related diseases (by medical care uptake) in 2018–2022 (through the example of a municipal hospital in Saint Petersburg)

The aim was to study the rate and changes in the incidence (by uptake) of age-related diseases (ARDs) in 2018– 2022 through the example of a municipal hospital in Saint Petersburg.Materials and methods. The study was carried out on the basis of records and reports for the period of 2018–2022 for the main statistical age groups (adult population (AP), working age population (WAP), persons over working age (POWA)). The incidence was analyzed for the most common ARDs (hypertensive diseases; coronary heart disease; type 2 diabetes mellitus; senile cataract, and glaucoma). The assessment of the incidence rate was carried out both for ARDs in general and for particular diseases.Results. A long-term observation revealed that the incidence of ARDs has been increasing. In WAP, the rate of the increase in the incidence of ARDs was more pronounced compared to the same indicator in the general population surveyed (16.1 versus 5.4%). Moreover, in the post-COVID period, the incidence rate of a number of ARDs increased. In addition, a regular sequence was found in the manifestation of ARDs: hypertensive diseases, coronary heart disease, type 2 diabetes mellitus, senile cataract, glaucoma.Conclusion. The incidence rate of age-related diseases has been increasing, which is especially pronounced among WAP. In the post-COVID period, these diseases were found to develop much faster. ARDs are characterized by a sequence of manifestations as patients get older, which in the future will allow to develop clearer approaches to the prevention, diagnosis, and treatment of ARDs depending on the age of the patient.

Mortality and ocular parameters and diseases.

To assess associations between mortality and major ocular parameters and diseases. The population-based Ural Eye and Medical Study (UEMS) and Ural Very Old Study (UVOS) included 5899 individuals (age: 40+ years) and 1526 individuals (age: 85+ years), respectively. Cause-specific mortality was determined using the government regional information and analytical system. In the UEMS, 689 (11.7%) participants had died during the follow-up of 7.0 ± 0.4 years (median: 6.9 years). Higher death occurrence was associated (multivariable analysis) with lower best corrected visual acuity (OR: 1.86; 95%CI:1.10, 2.68) and higher prevalence of diabetic retinopathy (OR: 2.97; 95%CI: 1.68, 5.26), with adjusting for older age (OR: 1.08), male sex (OR: 4.18), higher waist-hip ratio (OR: 5.53), current smoking (OR: 2.25), history of cancer (OR: 1.93) and dementia (OR: 2.54), higher serum concentration of glucose (OR: 1.13) and lower serum concentration of high-density lipoproteins (OR: 0.89) and haemoglobin (OR: 0.99), higher leucocyte count (OR: 1.07), higher prevalence of chronic obstructive pulmonary disease (OR: 1.67), higher stage of arterial hypertension (OR: 1.15), and higher depression score (OR: 1.04). Death occurrence was not significantly associated with prevalence of age-related macular degeneration (P = 0.90), macular reticular pseudodrusen (P = 0.90), open-angle glaucoma (P = 0.11), angle-closure glaucoma (P = 0.98), nuclear cataract (P = 0.07), cortical cataract (P = 0.46), axial length (P = 0.44) and intraocular pressure (P = 0.87). In the UVOS, 791 (51.9%) participants had died during the follow-up of 4.8 ± 1.0 years (median: 5.2 years). None of the ophthalmological parameters was significantly associated with death occurrence. Diabetic retinopathy was the only major ophthalmic disease or parameter, in addition to vision impairment, which was associated with an increased death risk.

Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery

This study aims to characterize the conjunctival flora of patients scheduled for cataract surgery and determine the susceptibility profile of isolated bacteria to several commonly used topical antibiotics. Conjunctival swabs were taken from 44 consecutive patients (25 males, 19 females; mean age of 75.0 ± 12.6 years) who were scheduled for senile cataract surgery at two Italian centers before starting any prophylactic preoperative treatment. Swabs were processed for the detection of the microbial growth and for species identification. Selective culture media were used, and bacteria were identified using the MicroScan Specialty ID Panels (Beckman Coulter®, Brea, CA, USA). Antimicrobial susceptibility for the following antibiotics (netilmicin, tobramycin, ofloxacin, oxacillin, levofloxacin, moxifloxacin, chloramphenicol, cefuroxime, and azithromycin) were assessed using the Kirby–Bauer disk diffusion method. Susceptibility for oxacillin was useful to identify methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE). Among the swabs analyzed, 61.4% showed only saprophytic flora, 30.7% showed only potential pathogenic flora, and 8.0% showed mixed flora. S. epidermidis (20.5%), S. intermedius (18.2%), and S. aureus (14.8%) were the most frequent isolates; MRSA and MRSE accounted for 8.0% and 6.8% of isolates. Less frequently (9%), Gram-negative bacteria such as Pseudomonas fluorescent, Serratia marcescens, Moraxella lacunata, Morganella morgani, and Stenotrophomonas maltophila were detected. All isolated organisms showed an excellent sensitivity to moxifloxacin and chloramphenicol (range 83–100%, range 67–100%, Gram-positive sensitivity for moxifloxacin and chloramphenicol, respectively; 100% Gram-negative sensitivity for both). A significant percentage of the eyes of candidates for surgery presented potential pathogenic flora alone or in association with saprophytic organisms. Staphylococci were the most frequently isolated bacteria. Tobramycin and Ofloxacin, widely used in the ophthalmic field, are confirmed to have a reduced sensitivity in vitro.

Double-layer sign of the anterior lens capsule during cataract surgery: A case report.

The double-layer sign of the anterior lens capsule during continuous curvilinear capsulorrhexis (CCC) in cataract surgery is a rare phenomenon. This case report highlights the occurrence of this sign and provides a practical technique for managing it. A 55-year-old Chinese woman presented with blurred vision in her left eye. She had a history of nuclear sclerotic cataracts, but no abnormalities of the anterior capsule were noted in her preoperative evaluation. Nuclear sclerotic cataract in the left eye with no preoperative abnormalities of the anterior lens capsule. During CCC, a double-layer sign of the anterior lens capsule was identified. The surgeon successfully managed the double-layer sign by simultaneously grasping both layers with capsulorhexis forceps to complete CCC without complications. Postoperatively, the patient achieved 20/20 vision in the treated eye, and no complications were observed. The double-layer sign of the anterior lens capsule is a rare finding during cataract surgery. Although its exact cause remains unclear, the technique described offers a practical approach to manage this intraoperative challenge effectively.

Comparative study of serum albumin, serum cholestrol and liver enzymes in individuals having senile cataract versus normal individuals

Abstract Background: One of the often-seen consequences of the aging process is the development of senile cataracts, a disease that affects one of our most precious gifts, that of sight. Many factors such as aging, changes in blood electrolyte levels, and possibly family history are involved in senile cataract formation. Changes in serum electrolyte levels can induce changes in aqueous electrolyte levels and affect lens metabolism and probably cataract formation. Aims: We aimed to measure the level of serum albumin, serum cholesterol, and liver enzymes in senile cataractous lens and normal crystalline lens. To analyze the correlation of serum albumin, serum cholesterol, and liver enzymes with cataractogenesis. Materials and Methods: This prospective case–control study was performed on 160 patients who presented to the Ophthalmology Outpatient Department of Jawaharlal Nehru Medical College and Hospital in collaboration with the Department of Biochemistry, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, over 2 years (from December 2016 to December 2018), study group comprised of 100 patients and the control group comprised of 60 patients. Statistical Package for Social Sciences software was used for data analysis. Results: The two groups were comparable concerning age. There were no significant statistical differences between the groups in terms of age. However, there was a statistically significant difference in intraocular pressure (IOP) and visual acuity (P &lt; 0.05) in IOP and a highly significant difference (P &lt; 0.001) in best corrected visual acuity (BCVA right eye), BCVA (left eye) between the study group and control group, though IOP was within the normal limit in both the groups. Conclusion: This study demonstrates that deranged liver enzymes have some role in cataract formation, and are associated with decreased serum albumin levels and it increases the chances of cortical cataract followed by nuclear cataract. Increased serum cholesterol levels are also associated with increased chances of mixed cataracts followed by cortical cataracts.

The use of the smart eye camera device for cataract screening in the endocrine and ophthalmology clinics in a general hospital in Jordan

Aims/Purpose: To asses the usefuleness of the Smart Eye Camera (SEC) slit light device by OUI Inc. in comparing the prevalence of cataract in diabetic and non‐diabetic patients in an outpatient setting in a general hospital in Jordan. The study aims also to delineate risk factors for the development of cataract in diabetic patients.Methods: 207 patients (414 eyes) were examined using the SEC device which captures videos of the anterior segment similar to a slit lamp exam. After completion of data collection, web‐saved videos were reviewed and grades of cataract or each eye were recorded using a modified LOCS III (lens opacity classification system). The assigned observer recorded nuclear, cortical and posterior subcapsular grades for each eye from 0 to 5.Results: Mean age was 55 (range 40‐85). After exclusion of 19 pseudophakic eyes and 3 low quality images, 204 patients (392 eyes, 198 right (OD) and 194 OS (left) eyes) were analyzed. Nuclear cataract was found in 114 eyes (29%), cortical cataract in 104 eyes (27%) and posterior subcapsuar in 77 eyes (20%). Overall, odds ratio for developing cataract in diabetes in this study population was 1.606, with a p‐value of 0.09. Also the relative risk of developing cataract in diabetes was 1.123. A second and third observer independently evaluated the SEC videos and recorded their findings. Interobserver agreement kappa value was fair to moderate especially for nuclear cataract. Posterior subcapsular cataract was difficult to assess with no means of retroillumination on the device. Additionally, we looked into possible assosiations between DM control, comorbidities and medciations used by diabetic patients and the development of cataract, especially hypertension, thyroid disease and hyperlipidemia. All diabetic patients were type 2 with 34.2% having a Hba1c &gt; 7.5Conclusions: The Smart Eye Camera is a small, fast and accurate tool for the diagnosis and grading of cataract in the outpatient setting and would be very helpful on a national scale for cataract screening, especially in the rural areas and in clinical trials. Moreover, cataract tends to be more common in diabetic patients in Jordan probably through multifactorial mechanisms.References Evaluation of Nuclear Cataract with Smartphone‐Attachable Slit‐Lamp Device by Hiroyuki Yazu et al in Diagnostics 2020, 10, 576

The use of the smart eye camera device for cataract screening in the endocrine and ophthalmology clinics in a general hospital in Jordan

Aims/Purpose: To asses the usefuleness of the Smart Eye Camera (SEC) slit light device by OUI Inc. in comparing the prevalence of cataract in diabetic and non‐diabetic patients in an outpatient setting in a general hospital in Jordan. The study aims also to delineate risk factors for the development of cataract in diabetic patients.Methods: 207 patients (414 eyes) were examined using the SEC device which captures videos of the anterior segment similar to a slit lamp exam. After completion of data collection, web‐saved videos were reviewed and grades of cataract or each eye were recorded using a modified LOCS III (lens opacity classification system). The assigned observer recorded nuclear, cortical and posterior subcapsular grades for each eye from 0 to 5.Results: Mean age was 55 (range 40‐85). After exclusion of 19 pseudophakic eyes and 3 low quality images, 204 patients (392 eyes, 198 right (OD) and 194 OS (left) eyes) were analyzed. Nuclear cataract was found in 114 eyes (29%), cortical cataract in 104 eyes (27%) and posterior subcapsuar in 77 eyes (20%). Overall, odds ratio for developing cataract in diabetes in this study population was 1.606, with a p‐value of 0.09. Also the relative risk of developing cataract in diabetes was 1.123. A second and third observer independently evaluated the SEC videos and recorded their findings. Interobserver agreement kappa value was fair to moderate especially for nuclear cataract. Posterior subcapsular cataract was difficult to assess with no means of retroillumination on the device. Additionally, we looked into possible assosiations between DM control, comorbidities and medciations used by diabetic patients and the development of cataract, especially hypertension, thyroid disease and hyperlipidemia. All diabetic patients were type 2 with 34.2% having a Hba1c &gt; 7.5Conclusions: The Smart Eye Camera is a small, fast and accurate tool for the diagnosis and grading of cataract in the outpatient setting and would be very helpful on a national scale for cataract screening, especially in the rural areas and in clinical trials. Moreover, cataract tends to be more common in diabetic patients in Jordan probably through multifactorial mechanisms.References Evaluation of Nuclear Cataract with Smartphone‐Attachable Slit‐Lamp Device by Hiroyuki Yazu et al in Diagnostics 2020, 10, 576

A case report of Cerebrotendinous Xanthomatosis: Progressive gait difficulties and juvenile cataracts in a 33-year-old male.

A case report of Cerebrotendinous Xanthomatosis: Progressive gait difficulties and juvenile cataracts in a 33-year-old male.

Challenges and outcomes of cataract surgery after vitrectomy.

This review examines the challenges and outcomes of cataract surgery after pars plana vitrectomy (PPV), focusing on surgical techniques, timing, and complication management. Cataract formation remains the primary complication post-PPV, affecting approximately 80-100% of patients within two years. Nuclear sclerotic cataracts are most common, occurring in 60-100% of patients over 50, followed by posterior subcapsular cataracts (4-34%), which primarily affect younger and diabetic patients. PPV disrupts the normal oxygen gradient in the vitreous, resulting in a more uniform oxygen distribution and accelerating cataract formation.Post-PPV eyes present unique surgical challenges due to anatomical alterations, including zonular instability and capsular changes characterized by increased fragility, the potential for tears, and altered elasticity. Newer intraocular lens power calculations show promise, but unexpected refractive outcomes may occur. The choice between combined phacovitrectomy and sequential surgeries remains debated, with patient-specific factors guiding the approach. Visual outcomes vary depending on preexisting vitreoretinal pathologies and baseline vision before PPV. Further randomized controlled trials are needed to establish treatment guidelines and improve predictive models. Post-PPV cataract surgery presents unique challenges, including anatomical alterations and an increased risk of capsular complications. These necessitate careful consideration of the surgical approach and highlight the need for further research to optimize outcomes and establish treatment guidelines.

Phacolytic glaucoma: About a case report

Aims/Purpose: We report the case of a 70‐year‐old patient with chronic renal failure secondary to amyloidosis of undetermined etiology as well as multiple episodes of red eye with notion of self‐medication for 2 years consulting for an episode of red eye painful for 3 days.Methods: The ophthalmic examination revealed a best corrected visual acuity at counting fingers at 1 meter and light perception respectively in OD and in OS.Examination of the anterior segment showed a calm anterior segment in OD with normal ocular tonus and a grade 3 nuclear cataract and in OS a slight conjunctival hyperemia, ocular tonus at 30 mmHg, a 1+ flare and a dense morganian cataract.The ocular fundus was inaccessible in both eyes.The ocular ultrasound found a normal posterior segment in both eyes.Results: A phacolytic glaucoma diagnosis has been made and the patient was started on local steroid therapy and local and systemic antiglaucoma treatment and then benefited 3 days later from cataract surgery which took place without notable incident.The post‐operative period was marked by an improvement in visual acuity and a reduction in intraocular inflammation. Phacolytic glaucoma occurs mainly in the context of hypermature or even Morgagnian senile cataract. Over time, the cortical fibers of the lens degenerate into water‐soluble protein aggregates. These high molecular weight lens proteins escape through a grossly intact lens capsule into the anterior chamber, where they induce intense macrophage activity.Conclusions: Although curable, cataract remain the most significant cause of blindness in developing countries, mainly affecting the elderly.Delayed treatment leads to serious complications such as lens induced glaucoma, which can lead to irreversible vision loss. Cataract surgery is the most effective treatment for lowering IOP and restoring vision in these patients if undertaken early enough.References Macovei ML, Canache M, Neagoe BM. Phacolytic glaucoma ‐ case report. Rom J Ophthalmol. 2021 Apr‐Jun;65(2):191‐195. doi: 10.22336/rjo.2021.38. PMID: 34179587; PMCID: PMC8207859.

Semantic And Scientific Differences Between Al-A’mā, Al-Akmah, And Ibyadhādh Al-‘Ain In The Qur’an Al-Karīm

Blindness is a medical disease characterised by the partial or complete loss of vision, known as visual impairment or absolute blindness, respectively. The phenomenon of blindness is also mentioned in the Qur'an in several words, including: Al-A'maa, al-Akmah, and Ibyadhadh al-'Ain. This research intends to analyze the differences between al-A'maa, al-Akmah, and Ibyadhadh al-'Ain linguistically and scientifically. This study employs a library research methodology that utilises a descriptive and analytical technique to examine the linguistic and scientific distinctions among the three terms for blindness in the Qur'an. Several linguistic and scientific distinctions may be seen between the three terms of blindness that are found in the Qur'an, as shown by the findings of this research.: First, al-A'maa has two meanings, namely the ultimate meaning and majazi meaning. The connotation of the essential meaning of al-A'maa means total blindness, while the majazi meaning is related to disbelief and misguidance. Second, al-Akmah has three connotations of meanings: ophthalmic genetic, epiphora, and nyctalopia. Third, Ibyadhadh al-'Ain, which happened to the prophet Jacob As, is a cataract disease caused by traumatic and senile cataracts.

Evaluation of change in the contact of IOL with the posterior capsule with respect to the orientation of haptics of the IOL using intraoperative spectral domain optical coherence tomography.

To study change in the contact of intraocular lens (IOL) with the posterior capsule with respect to the vertical versus horizontal orientation of the haptic-optic junction of the IOL using intraoperative spectral domain optical coherence tomography (SD-OCT). Fifty eyes of 50 patients with senile immature cataract underwent topical phacoemulsification procedure with implantation of a monofocal IOL by a single experienced surgeon. The Rescan 700 SD-OCT system was used for intraoperative imaging. These patients were imaged using intraoperative SD-OCT after implantation of IOL, with the haptics oriented horizontally and then vertically. The vertical height between the posterior surface of the lens capsule and the posterior surface of IOL reduced significantly when the haptics were oriented vertically compared to horizontal orientation. This difference was found on analyzing both vertical as well as horizontal axis scans. We found a greater contact between the posterior capsule and the posterior surface of IOL, with the haptic optic junction of the IOL oriented vertically. This study also suggests the need for newer toric IOL designs which allow vertical orientation of haptics, leading to better contact between IOL and the bag.

Through a Hazy Lens: A Teen’s Surprising Struggle with Juvenile Cataracts

A juvenile cataract is a condition in which the eye's lens gets cloudy, affecting children and teenagers and considerably impairing vision. It accounts for approximately 5% to 20% of childhood blindness worldwide. A 16-year-old male patient came with his parents to the Pediatric Ophthalmology and Strabismus Department of RSUD dr. Zainoel Abidin with complaints of blurred vision in both eyes. The patient admitted that his visual acuity was deteriorating, and he had difficulty seeing the blackboard when the teacher explained it at school. There were no factors that aggravated or relieved the patient's complaints. The ophthalmologic examination showed the visual acuity of both eyes was 6/30, and the bilateral lenses were opaque. The patient was diagnosed with juvenile cataract oculi dextra et sinistra. Subsequently, the patient was planned for aspiration irrigation with intraocular lens (IOL) insertion in both eyes, membranectomy, primary posterior capsulectomy (PPC), and anterior vitrectomy (AV). Following the surgery, the visual acuity of both his eyes was improved to 6/7 and 6/10. The patient was also prescribed oral and topical antibiotics and topical anti-inflammatories to prevent infection and persistent inflammation after surgery. After surgery, the patient was also planned for optical rehabilitation one month postoperatively by being prescribed glasses with the best correction of 6/6 in both eyes.

Age-Related Viability of Patients with Ophthalmopathology Depending on Age Dissociation

Diabetic retinopathy and senile cataracts cause not only a significant impairment of visual functions, but also can affect the psychological and emotional status of patients and their age-related viability, which has not been practically studied in patients with the abovementioned ophthalmological diseases.The purpose: to study age–related viability in patients with ophthalmopathology depending on age dissociation. Age viability was studied among 135 patients aged 60–74 years with diabetic retinopathy and cataract with coincidence of calendar and biological age and 142 patients aged 60–74 years with diabetic retinopathy and cataract with accelerated biological age. It was found that diabetic retinopathy and cataract cause a more significant decrease in age viability in patients with an excess of the biological age of the chronological age to 60,1 ± 1,7 points versus 76,4 ± 1,5 points (p &lt; 0,001) in diabetic retinopathy and cataract with the coincidence of biological and calendar age. A similar effect was found for the somatic component of age-related viability, which in patients with diabetic retinopathy and cataract with an excess of the biological age of the chronological value was 4,2 ± 0,5 points relative to 2,2 ± 0,4 points (p &lt; 0,01) in patients with diabetic retinopathy and cataract, who had a coincidence of biological and calendar age. Diabetic retinopathy and cataracts are most affected when the biological age of the calendar value is exceeded among the subdomains of age viability, such as relationship security and positivity of accepted changes, resistance to adverse influences and trust in personal instincts with a significant difference between groups. Diabetic retinopathy and cataracts in patients with exceeding the biological age of the calendar significantly reduce age viability.

Study of Influence of Various Methods of Intraoperative Keratoprotection in Phacoemulsification of Senile Cataract on Morphological and Functional State of Ocular Surface Structures in Late Postoperative Period

Purpose: to study the effect of various methods of intraoperative keratoprotection in phacoemulsification (PE) of senile cataract (SC) on morphological and functional state of the ocular surface structures (OSS) in the late postoperative period.Patients and methods. 240 patients (240 eyes) who applied for surgical treatment of SC. Age: 65 ± 4 years. 109 men, 131 women. All patients were divided into three observation groups according to the method of intraoperative keratoprotection: 1st group — 60 patients, corneal irrigation with balanced solution; 2nd group — 60 patients, ophthalmic viscosurgical device was applied to the cornea; 3rd group: 3a subgroup — 60 patients, soft contact lens (SCL) was applied to the cornea; subgroup 3b — 60 patients, SCL impregnated with riboflavin solution was applied to the cornea. In addition to the standard ophthalmological examination, Schirmer I test, OCT-scanning were performed, and tear breakup time (TBUT) was determined.Results. The lowest indicator of Schirmer I test was detected in the 1st group a month after the operation. The indicators did not change 2 months after the operation. There were no significant intergroup differences in the final observation period. The TBUT index in all groups decreased. 3 months after the operation, TBUT in the eyes of 3b subgroup was significantly higher in comparison to other groups. The best state of corneal epithelium thickness (CET) occurred in 3a and 3b subgroups. During the epithelium analysis according to OCT-mapping of the cornea, it was noted that the maximum decrease of CET and the number of defects was detected in the 1st and 2nd groups, and the minimum — in 3a and 3b subgroups at all follow-up periods after surgery. There were no significant intergroup differences in preoperative tear osmolarity. 3 months after surgery, tear osmolarity in patients of 3a and 3b subgroups was significantly lower than in patients of the 1st and 2nd groups. OSDI scores in all groups before surgery were comparable. 3 months after the operation, the minimum OSDI values were 3a and 3b in subgroups. Iatrogenic dry eye syndrome (DES) in patients of 3b subgroup was significantly lower than in patients of other groups.Conclusion. In all the studied groups, the standard postoperative dynamics of OSS and TBUT and changes in CET were revealed, with the least variability in 3b subgroup. The use of SCL saturated with riboflavin showed the highest keratoprotective efficacy in PE SC, as it allowed a statistically significant reduction in the incidence of DES in patients after PE in SC (p &lt; 0.05) in comparison with other methods. The developed method for predicting iatrogenic DES in patients after PE in SC is highly informative, because the number of patients in the 1st group with DES was within the expected range of error.