Cataract Severity Research Articles

Targeting PYK2, entrectinib allays anterior subcapsular cataracts in mice by regulating TGFβ2 signaling pathway

BackgroundFibrosis cataract occurs in patients receiving cataract extraction. Still, no medication that can cure the disease exists in clinical. This study aims to investigate the effects and mechanisms of Entrectinib on fibrotic cataract in vitro and in vivo.MethodsThe human lens cells line SRA 01/04 and C57BL/6J mice were applied in the study. Entrectinib was used in animals and cells. Cataract severity was assessed by slit lamp and Hematoxylin and Eosin staining. Expression of alpha-smooth muscle actin, fibronectin, and collagen I were examined by real-time quantitative PCR, western blotting, and immunofluorescence. Cell proliferation was evaluated by Cell Counting Kit-8. Cell migration was measured by wound healing and transwell assays. Molecular docking, Drug Affinity Responsive Target Stability, and Cellular Thermal Shift Assay were applied to seek and certify the target of Entrectinib treating fibrosis cataract.ResultsEntrectinib can ameliorate fibrotic cataract in vitro and in vivo. At the RNA and the protein levels, the expression of alpha-smooth muscle actin, collagen I, and fibronectin can be downgraded by Entrectinib, while E-cadherin can be upregulated. The migration and proliferation of cells were inhibited by Entrectinib. Mechanistically, Entrectinib obstructs TGFβ2/Smad and TGFβ2/non-Smad signaling pathways to hinder the fibrosis cataract by targeting PYK2 protein.ConclusionsTargeting with PYK2, Entrectinib can block TGF-β2/Smad and TGF-β2/non-Smad signaling pathways, lessen the activation of EMT, and alleviate fibrosis cataract. Entrectinib may be a potential treatment for fibrosis cataract in clinic.

Prospective Cytokine Profiling in Aqueous Humor Reveals a Proinflammatory Microenvironment in Highly Dense Nuclear Cataracts.

To investigate if the cytokine profile in the aqueous humor (AH) of cataract patients varies according to cataract type and severity. This prospective study included 397 eyes of 397 patients (median age, 76 years; range, 30-94 years) who underwent standard small-incision phacoemulsification surgery. Cataracts were graded using the LOCS III system: mild (≤3), moderate (3.5-5), and severe (≥5). Biometric measurements from the IOL master 700 (Zeiss, Oberkochen, Germany) were used to differentiate between thick (>4.5 mm) and thin lenses. Information about age, gender, and self-reported diseases was obtained from patient records. Eleven different proteins were measured in AH using a multiplex cytokine assay (AYOXXA Biosystems, Cologne, Germany), including IL- 6, IL-8, angiopoietin 2, C-reactive protein (CRP), vascular endothelial growth factor A (VEGF-A), platelet-derived growth factor BB, placental growth factor, CXCL12, CXCL13, and CXCL10. Statistical analysis was performed using R and included nonparametrical testing, linear regression, and k-means clustering. Higher nuclear LOCS grades correlated with increased levels of CCL2 (360 vs. 387 vs. 517 pg/mL, P < 0.001), VEGF-A (270 vs. 292 vs. 390 pg/mL, P = 0.012), IL-8 (3.1 vs. 4.2 vs. 5.7 pg/mL, P = 0.018), and CXCL10 (52 vs. 61 vs. 90 pg/mL, P = 0.003). No associations were observed for cortical and subcapsular cataracts. Thicker lenses were associated with significantly increased levels of CRP, CXCL10, CXCL12, IL-6, IL-8, and VEGF-A. The cytokine profile of AH varies based on cataract grading and lens thickness. In highly dense nuclear cataracts, CCL2, VEGF-A, IL-8, and CXCL10 were elevated.

Investigating the impact of OCT imaging of the crystalline lens on the accuracy and precision of cataract assessment.

To determine if supplementing standard clinical assessments with Optical Coherence Tomography (OCT) imaging of the crystalline lens improves the accuracy and precision of lens opacity assessment and associated clinical management decisions by optometrists. Fifty optometrists registered in the UK or Éire undertook a clinical vignette study where participants graded lens opacities and made associated clinical management decisions based on the image(s)/information displayed. Three forms of vignettes were presented: (1) Slit-lamp (SL) images of the lens, (2) SL and OCT images and (3) SL, OCT and visual function measures. Vignettes were constructed using anonymised data from 50 patients with varying cataract severity, each vignette being presented twice in a randomised order (total vignette presentations = 300). The accuracy of opacity and management decisions were evaluated using descriptive statistics and non-parametric Bland-Altman analysis where assessments from experienced clinicians were the reference. The precision of assessments was examined for each vignette form using non-parametric Bland-Altman analysis. All (n = 50) participants completed the study, with 36 working in primary eyecare (primary eyecare) settings and 14 in hospital eyecare services (HES). Agreement was highest where vignettes contained all clinical data (i.e., SL, OCT and visual function data-grading: 51.0%, management: 50.5%), and systematically reduced with decreasing vignette content (p < 0.001). A larger number of vignettes containing imaging and visual function measures exhibited below reference (i.e., less conservative) grading compared with vignettes containing imaging data alone (all p < 0.05). HES-based optometrists were more likely to grade lens opacities lower than clinicians working in primary eyecare (p < 0.001). Good measurement precision was evident for all vignettes, with a mean bias close to zero and limits of agreement below one grading step for all conditions. The addition of anterior segment OCT to SL images improved the accuracy of lens opacity grading. Structural assessment alone yielded more conservative decision making, which reversed once visual functional data was available.

Outcomes of cataract surgeries performed in 8 eyes of centenarians.

Cataract surgery outcomes in centenarian patients have not previously been explored. This study aimed to examine characteristics and report clinical results of people aged ≥100 years undergoing cataract surgery. This was a retrospective observational study, including patients aged ≥100 years who underwent cataract surgery between 2003 and 2021 at Miyata Eye Hospital in Japan. Medical charts were reviewed for information on cataract severity, surgery type, anesthesia, as well as ocular and medical comorbidities. Using Mann-Whitney test, visual acuity, intraocular pressure, and corneal endothelial cell density were compared before and after surgery. Eight eyes of 5 patients were included in the study (mean age, 101.5 ± 1.2 years). Seven of these eyes (87.5%) belonged to women. All surgeries were performed under topical anesthesia using phacoemulsification and insertion of the intraocular lens fixed in the bag. All patients had multiple preoperative medical comorbidities; however, there were no intraoperative, postoperative ocular, or general complications. The postoperative best-corrected visual acuity was significantly improved compared to that before surgery (1.18 ± 0.74 and 0.29 ± 0.52, respectively, P = .004). Neither intraocular pressure nor corneal endothelial cell density demonstrated a significant difference postoperatively. Cataract surgery can be safely performed under topical anesthesia in centenarians without complications using proper perioperative medical control and preparation.

NCME-Net: Nuclear cataract mask encoder network for intelligent grading using self-supervised learning from anterior segment photographs

Cataracts are a leading cause of blindness worldwide, making accurate diagnosis and effective surgical planning critical. However, grading the severity of the lens nucleus is challenging because deep learning (DL) models pretrained using ImageNet perform poorly when applied directly to medical data due to the limited availability of labeled medical images and high interclass similarity. Self-supervised pretraining offers a solution by circumventing the need for cost-intensive data annotations and bridging domain disparities. In this study, to address the challenges of intelligent grading, we proposed a hybrid model called nuclear cataract mask encoder network (NCME-Net), which utilizes self-supervised pretraining for the four-class analysis of nuclear cataract severity. A total of 792 images of nuclear cataracts were categorized into the training set (533 images), the validation set (139 images), and the test set (100 images). NCME-Net achieved a diagnostic accuracy of 91.0 % on the test set, a 5.0 % improvement over the best-performing DL model (ResNet50). Experimental results demonstrate NCME-Net's ability to distinguish between cataract severities, particularly in scenarios with limited samples, making it a valuable tool for intelligently diagnosing cataracts. In addition, the effect of different self-supervised tasks on the model's ability to capture the intrinsic structure of the data was studied. Findings indicate that image restoration tasks significantly enhance semantic information extraction.

Comparison of Age-Related Decline and Behavioral Validity in C57BL/6 and CB6F1 Mice.

Variability in physical resilience to aging prompts a comprehensive examination of underlying mechanisms across organs and individuals. We conducted a detailed exploration of behavioral and physiological differences between C57BL/6 and CB6F1 mice across various age groups. In behavioral assays, B6 mice displayed superior performance in rotarod tasks but higher anxiety while CB6F1 mice exhibited a decline in short-term memory with age. Grip strength, long-term memory, and voluntary wheel running declined similarly with age in both strains. Examining physiological phenotypes, B6 mice exhibited lower body fat percentages across ages compared to CB6F1 mice, though cataract severity worsened with age in both strains. Analysis of cardiac functions revealed differences between strains, with worsening left ventricular hypertrophy and structural heart abnormalities with age in CB6F1 mice along with higher blood pressure than B6. Lesion scores showed an age-related increase in heart, kidney, and liver lesions in both strains, while lung lesions worsened with age only in CB6F1 mice. This study underscores the validity of behavioral assays and geropathology assessment in reflecting age-related decline and emphasizes the importance of considering strain specificity when using mouse models to study human aging.

Feasibility of shear wave elastography for evaluating lens stiffness in patients with age-related cataracts: A quantitative analysis

BackgroundShear wave elastography (SWE) is a novel imaging technique that provides quantitative assessments of tissue stiffness. This non-invasive method offers real-time, quantitative measurements and has been widely applied to various tissues, providing valuable diagnostic insights. PurposeThis study aimed to investigate the feasibility of using SWE to evaluate the stiffness of the lens in patients with age-related cataracts. Materials and methodsA comparative analysis involving 92 patients diagnosed with age-related cataracts and 39 healthy controls was conducted. Lens stiffness was quantified using SWE measurements. The lens nucleus of all participants was graded based on the Lens Opacities Classification System II (LOCS II). Correlations between the stiffness of the lens and age were also analyzed. ResultsThe study indicates that both the stiffness of the lens and the lens nucleus were significantly higher in patients with age-related cataracts compared to healthy controls (P < 0.001). In patients with age-related cataracts, although lens nucleus stiffness variations across different grades of cataract severity were not statistically significant, all grades displayed increased stiffness relative to healthy controls. Additionally, a significant positive correlation between lens stiffness and age was observed in all participants (P < 0.001). ConclusionSWE appears to be a promising imaging technique for quantitatively assessing the mechanical characteristics of the lens in patients with age-related cataracts.

Trace Element Concentration in the Blood and Aqueous Humor of Subjects with Eye Cataract.

Cataract, characterized by the opacification of the lens, is the leading cause of reversible blindness and visual impairment globally. The study aims to investigate the role of trace elements such as Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, and Zn in the development and severity of cataract. Elements were quantified by inductively coupled plasma mass spectrometry in blood and aqueous humor of 32 cataract cases and 27 controls living in the Latium region, Italy. The association between element concentration in blood and aqueous humor and cataract severity, gender, and age of subjects were also assessed. Results showed Cr levels significantly elevated in both blood and aqueous humor of cataract cases, with concentrations that increased with cataract severity. In addition, blood Pb levels were significantly higher in older cases and positively correlated with the age of cataract cases, while blood Co and Cu levels negatively correlated with cataract severity, suggesting changes in the levels of these elements. In conclusion, this study provides evidence of the involvement of specific elements in cataract development and severity, and the findings highlighted important avenues for future research. Understanding the biological mechanism underlying element-induced cataract may contribute to preventing cataractogenesis and providing targeted interventions.

Fundus photograph-based cataract evaluation network using deep learning

Background: Our study aims to develop an artificial intelligence-based high-precision cataract classification and grading evaluation network using fundus images.Methods: We utilized 1,340 color fundus photographs from 875 participants (aged 50–91 years at image capture) from the Beijing Eye Study 2011. Four experienced and trained ophthalmologists performed the classification of these cases based on slit-lamp and retro-illuminated images. Cataracts were classified into three types based on the location of the lens opacity: cortical cataract, nuclear cataract, and posterior subcapsular cataract. We developed a Dual-Stream Cataract Evaluation Network (DCEN) that uses color photographs of cataract fundus to achieve simultaneous cataract type classification and severity grading. The accuracy of severity grading was enhanced by incorporating the results of type classification.Results: The DCEN method achieved an accuracy of 0.9762, a sensitivity of 0.9820, an F1 score of 0.9401, and a kappa coefficient of 0.8618 in the cataract classification task. By incorporating type features, the grading of cataract severity can be improved with an accuracy of 0.9703, a sensitivity of 0.9344, an F1 score of 0.9555, and a kappa coefficient of 0.9111. We utilized Grad-CAM visualization technology to analyze and summarize the fundus image features of different types of cataracts, and we verified our conclusions by examining the information entropy of the retinal vascular region.Conclusion: The proposed DCEN provides a reliable ability to comprehensively evaluate the condition of cataracts from fundus images. Applying deep learning to clinical cataract assessment has the advantages of simplicity, speed, and efficiency.

Femtofakoemulsyfikacja zaćmy – 10 lat doświadczeń

Femtosecond laser-assisted cataract surgery is a procedure known for more than a decade. The review compares this surgical technique with conventional cataract phacoemulsification – the most frequently performed operation of this type. The review took into account metanalysis, clinical trials and reports from the last 10 years to evaluate several aspects, including intraoperative parameters, surgical complications and advantages for patients. Femtosecond laser-assisted cataract surgery is the method with less effective phacoemulsification time, cumulative dissipate energy and better intraocular lens centration. Reduction of aberrations in presbyopia correcting intraocular lens is also noticeable. Best uncorrected and corrected visual acuity and postoperative predicted refraction are similar in both groups of patients. Surgical complications are comparable as well. Noteworthy is the fact that patients with hard nuclear cataracts have smaller endothelial cell loss. The results for low and medium severity of cataracts are mostly the same in laser-assisted surgery versus phacoemulsification. Femtosecond laser-assisted cataract surgery is a new solution for patients with low endothelial density or endothelial dystrophy, especially in advanced cataracts. The procedure is also recommended for surgery with presbyopia-correcting lens implantation due to better centration and smaller ocular aberrations. This whole new surgical technique requires greater financial outlay but provides some improvements in cataract surgery

A ranking-based multi-scale feature calibration network for nuclear cataract grading in AS-OCT images

Anterior Segment Optical Coherence Tomography (AS-OCT) is an important imaging technique for the grading of nuclear cataract. However, due to the complex interdependencies among 6 clinically-defined levels of cataract severity, it presents significant challenges to classify neighboring severity levels accurately and expeditiously, whether by human experts or computer-aided approaches. Existing deep learning-based models usually obtain 3 grades of nuclear cataract severity only, and often struggle to capture vital information related to the progression of neighboring severity levels, leading to inaccuracies in grading. In this paper, we introduce a novel method called Ranking-MFCNet, which utilizes both a ranking-based framework and a Multi-scale Feature Calibration network (MFCNet). To bolster the model’s capability for discriminating between neighboring severities that are prone to confusion, we treat the multi-category severity classification as a collection of distinct binary classification patterns. This strategy facilitates a systematic implementation of fine-grained nuclear cataract severity grading on an individual basis. Within each binary classification pattern, we propose an external attention-augmented Multi-scale Feature Calibration (eaMFC) module, which effectively captures the multi-scale characteristics inherent to the lens nucleus. Additionally, eaMFC allows for the calibration of shared attributes extracted by the external attention layer, thereby enhancing the model’s proficiency in modeling the distinctive traits related to opacity and sclerosis of the lens nucleus. We trained and validated our model on a dataset that contains 1608 AS-OCT images, and the extensive experiments have verified the effectiveness and superiority of our method over state-of-the-art cataract grading methods.

Evaluation of a mobile app for dark adaptation measurement in individuals with age-related macular degeneration

We present clinical evaluation of a mobile app for dark adaptation (DA) measurement in age-related macular degeneration (AMD) patients and in older adults (age > 50 years) without AMD or other retinal disorders (NV). The outcome measures were the area under dark adaptation curve (AUDAC) and the time for visual sensitivity to recover by 3 log units (TR). Larger AUDAC and TR values indicated worse DA response. The association of AUDAC with AMD was analyzed using linear regression, while time-to-event analysis was used for TR. 32 AMD patients (mean ± SD; age:72 ± 6.3 years, VA:0.09 ± 0.08 logMAR) and 25 NV subjects (mean ± sd; age:65 ± 8.7 years, VA:0.049 ± 0.07 logMAR) were measured with the app. Controlling for age, VA, and cataract severity, the AMD presence was significantly associated with higher AUDAC (β = 0.41, 95% CI 0.18–0.64, p = 0.001) and with slower sensitivity recovery (β = 0.32, 95% CI 0.15–0.69, p = 0.004). DA measurements with the app were highly correlated with those obtained with AdaptDx—an established clinical device (n = 18, ρ = 0.87, p < 0.001). AMD classification accuracy using the app was 72%, which was comparable to the 71% accuracy of AdaptDx. Our findings indicate that the mobile app provided reliable and clinically meaningful DA measurements that were strongly correlated with the current standard of care in AMD.

Through the Smoke: An In-Depth Review on Cigarette Smoking and Its Impact on Ocular Health.

Smoking is a widespread and pervasive habit, impacting health across various care settings, including acute care, subacute care, home-based care, and long-term care. Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. Cigarette smoke contains a complex mixture of harmful constituents, including nicotine and toxic chemicals, which permeate the bloodstream, affecting ocular tissues. The oxidative stress and inflammation induced by smoking are central to its detrimental effects on ocular health. Age-related macular degeneration (AMD), a leading cause of vision loss, exhibits a strong association with smoking. Research consistently demonstrates that smokers face a heightened risk of both early and advanced AMD. Cataracts, another prevalent ocular condition, develop earlier and progress more rapidly in smokers. The oxidative stress on the lens and reduced antioxidants among smokers contribute to the increased severity of cataracts. Moreover, thehealth of the eyes may be compromised by smoking-related chemicals that reduce blood flow and/or hasten thrombus formation in ocular capillaries thus increasing the chance of acquiringglaucoma, cataracts, AMD, and Graves' eye disease. Beyond individual health concerns, the societal implications of smoking on ocular health are substantial, including increased healthcare costs and diminished quality of life for affected individuals. Understanding the underlying mechanisms can provide insights into potential therapeutic interventions for preventing and managing smoking-related ocular damage. Given the global prevalence of smoking, raising awareness about the ocular risks associated with smoking is crucial for promoting eye health. The review underscores the urgent need for comprehensive anti-smoking initiatives and smoking cessation programs to alleviate the burden of ocular diseases associated with smoking.

SAT046 Canagliflozin Leads To Less Weight Gain, Confers Changes In The Gut Microbiota And Extends Life Span In Male C57BL6 Mice

Abstract Disclosure: E.E. Habeos: None. F. Filippopoulou: None. M. Kanakis: None. G.I. Habeos: None. N. Belmokhtar: None. P. Stathopoulou: None. G. Tsiamis: None. S. Taraviras: None. G. Lagoumintzis: None. D.V. Chartoumpekis: None. Introduction: SGLT2 inhibitors (SGLT2i) are widely prescribed drugs for the treatment of diabetes. Their beneficial health effects appear to be pleiotropic and are not limited to the amelioration of glycemic profile. The SGLT2i-induced glycosuria is suggested to provoke a metabolic shift that mimics the fasting response. Since calorie restriction has been shown to enhance longevity in mice, we hypothesized that treating mice with SGLT2i would also increase their life span. Methods: To this end, 4-months old male C57BL6 mice were fed with a standard chow diet (Control, n=83) or a diet supplemented with 200 mg/kg canagliflozin (Cana, n=92) and were observed up to the natural end of their life. Results: The canagliflozin-treated mice gained less weight over time. For instance, at the age of 10 months, the body weight of control mice was higher (means ± SEM: 33.1 ± 0.26 g) than the body weight of their canagliflozin-treated counterparts (means ± SEM: 31.4± 0.21 g; p&amp;lt;0.01). The development and severity of age-related cataracts were also examined at the age of 14 months, but no statistically significant difference was found in the severity score between the 2 groups. The survival curves of the control and the Cana mice diverged significantly, with the median survival of the control being 107.5 weeks versus 112.5 weeks of the Cana group (p=0.011). As the gut microbiome is known to change with age and be associated with the development of age-related diseases, feces were collected from 17-month-old mice (n=10 per group) and analysis of fecal bacterial 16S rRNA sequences was performed. Differences in beta diversity (diversity of bacterial species across samples) and relative abundance of bacterial species were noted between the Control and the Cana groups. Conclusions-Discussion: Our study highlights the effect of SGLT2i on longevity in a widely used mouse model (C57BL6). The underlying mechanisms leading to the enhancement of longevity are not clear yet. Some microbiota changes associated with the SGLT2i treatment, as described in other mouse models with enhanced longevity, warrant further investigation and analysis. It would be useful to extend these studies employing various SGLT2i with different potencies and selectivity against SGLT so as to determine if the observed effect on longevity is independent of the type of the drug. Presentation: Saturday, June 17, 2023

Incidence of cataract and glaucoma in children with nephrotic syndrome undergoing steroid treatment

Background Nephrotic syndrome (NS) is by far, the most common glomerular disease in childhood period and is considered as one of the main aetiologies of child exposure to systemic steroids. High-dose corticosteroids for NS, are usually prescribed by pediatrians for a long period. Posterior subcapsular cataract (PSC) and increased intraocular pressure (IOP) are the two most common ocular complications associated with steroid treatment. The exact incidence, prevalence, severity, and time of cataract and glaucoma onset in those childrens have not yet been thoroughly investigated. Aim Evaluating the incidence of cataract and glaucoma in children with NS receiving steroid treatment during and after treatment cessation. Patients and methods This cohort prospective study was done at the Pediatric Nephrology Clinic at Zagazig University Children’s Hospital in co-operation with the Department of Ophthalmology, Zagazig University, for detailed eye examination. Totally 48 children with primary NS who received corticosteroids either as a single treatment or with other treatment modalities for more than 3 months were included in our study. Clinical features plus laboratory tests confirmed by renal biopsy were the main parameters used in the diagnosis of NS. Results Posterior subcapsular cataracts (PSC) were observed in 14 patients (29.2%). All studied patients had normal intraocular pressure ranging between 10 and 20 mmHg in both eyes during the follow-up period with no glaucomatous optic disc changes observed. Conclusion A significant number of children with NS treated with steroids are liable to develop cataracts and glaucoma that may progress and need surgery to preserve vision, so they have to be well diagnosed and followed-up.

Effects of different feeding regimes on growth, cataract development, welfare, and histopathology of lumpfish (Cyclopterus lumpus L.)

To develop specific recommendations on the feeding strategies for farmed lumpfish, four duplicate groups (n = 70; N = 280) of lumpfish with a mean ± SD start weight of 30.4 ± 5.3 g were distributed among eight sea cages (5 × 5 × 5 m) each stocked with 220 one year old Atlantic salmon with a mean (± SD) weight of 1485.9 ± 213.2 g. The fish were fed either pelleted feed at 3% BW−1 or with feed blocks at 1.5%, 2% and 3% BW−1 respectively for 66 days. There were clear differences in growth performance between the four treatment groups with lumpfish fed with pelleted feed attaining the highest weight gain. There were only minor histopathological changes observed between the dietary treatments with mainly mild focal and multifocal inflammation observed in sampled tissues. There were no significant differences in liver vacuolisation between the dietary groups and baseline samples with most of the livers evaluated appeared to be vacuolized within what is regarded as normal range for all four treatment groups. Only minor differences in welfare score between the four treatment groups were found. The incidence of cataracts varied between the treatment groups and was correlated to differences observed in growth between the four groups. Lumpfish fed once daily from automatic feeders with pelleted feed had the highest incidence and severity of cataracts. This study suggests that feeding lumpfish with moderate amounts of feed blocks (≤ 2% BW−1) may be advantageous for maintaining slow growth and good welfare in salmon cages, and this should be further tested in large scale studies in commercial salmon farms.

Effect and Safety of Pressure Sensor-equipped Handpiece in Phacoemulsification System.

To evaluate the effect of the Active Sentry handpiece of the Centurion Vision System compared to the Centurion Ozil handpiece for phacoemulsification in cataract surgery. A retrospective study was conducted on 281 patients (449 eyes) who underwent cataract surgery between August 2020 and June 2021. Preoperative measurements, intraoperative parameters, complication rate, and postoperative outcomes were compared between the Active Sentry handpiece and the Centurion Ozil handpiece groups. Additionally, the parameters were compared in different cataract severity groups and multiple predictive factors for the number of active surge mitigation (ASM) actuations were assessed with the Active Sentry handpiece. There were 198 eyes in the Active Sentry group and 251 eyes in the Centurion Ozil group. There were no statistically significant differences between the two groups, as the cumulative dissipated energy in the Active Sentry and Centurion Ozil groups were 8.32 ± 7.74 and 7.87 ± 9.25 μJ, respectively (p = 0.576). Total surgery time, ultrasound usage time, aspiration time, amount of fluid aspirated, postoperative corrected distant visual acuity, and postoperative decrease in corneal endothelial cell density were comparable between the two groups. The significant contributors to the number of ASM actuations were age, preoperative corrected distant visual acuity, axial length, and total ultrasound time. There was no clear advantage of the Active Sentry handpiece compared to the Centurion Ozil handpiece. ASM actuation increases with age, poor visual acuity before surgery, short axial length, and prolonged ultrasound usage time. It is expected that in more severe and high-risk cataract surgery, the Active Sentry handpiece functions more effectively, possibly affecting the safety and prognosis.

Safety and effectiveness comparison of a new cohesive ophthalmic viscosurgical device.

Evaluation of the safety and effectiveness of a new cohesive OVD (StableVisc) compared to a marketed cohesive OVD (ProVisc) in patients undergoing cataract surgery. 22 sites in the United States. Prospective, multicenter, controlled, double-masked, and randomized 1:1 (StableVisc:ProVisc; stratified by site, age group, and cataract severity). Adults (≥45 years) with age-related non-complicated cataract considered amenable to treatment with standard phacoemulsification cataract extraction and IOL implantation were included. Patients were randomized to receive either StableVisc or ProVisc during standard cataract surgery. Postoperative visits occurred at 6 hours, 24 hours, 7 days, 1 month, and 3 months. The primary effectiveness outcome was the change in endothelial cell density (ECD) from baseline to 3 months. The primary safety endpoint was the proportion of patients who experienced at least one IOP measurement ≥30 mmHg at any follow-up visit. Noninferiority between the devices was tested. Inflammation and adverse events were evaluated. 390 patients were randomized; 187 patients with StableVisc and 193 patients with ProVisc completed the study. StableVisc was noninferior to ProVisc in mean ECD loss from baseline to 3 months (17.5% and 16.9%, respectively). StableVisc was noninferior to ProVisc in the proportion of patients with postoperative IOP ≥30 mmHg at any follow-up visit (5.2% and 8.2%, respectively). StableVisc cohesive OVD, which provides both mechanical and chemical protection, is safe and effective when used in cataract surgery and provides surgeons with a new cohesive OVD.

Dietary zinc, selenium and water temperature during early seawater phase influences the development of vertebral deformities and cataract in adult Atlantic salmon

The impact of dietary trace minerals (TM; zinc and selenium) and water temperature during early seawater phase on the development of vertebral deformities and cataracts in adult Atlantic salmon was studied. Two experimental feeds (control and High TM) and two water temperatures (12 and 16 °C) were designed in a 2 × 2 factorial arrangement. The Zn and Se levels in the control and high TM diet corresponded to 150 or 200 mg Zn/kg and 0.5 or 0.7 mg Se/kg diet, respectively. Atlantic salmon post-smolts (mean weight, 138 g) were distributed in 12 tanks and were randomly assigned to one of the treatments in triplicate groups. The experimental regime lasted for 12 weeks and thereafter the fish were sampled or transferred to three net pens comprising all four treatments in a common garden. The fish were further grown on a common commercial feed and assessed for vertebral deformities and cataracts as adults (4 to 4.5 kg). Atlantic salmon post-smolt fed the control diet or reared at 16 °C grew more than those fed the high TM diet or reared at 12 °C at the end of the 12-week experimental feeding period. Vertebral mineral density, concentration of Zn and Se in the whole body, plasma and bile were influenced by the dietary treatments. The fast growth rates observed in the control diet and 16 °C exposed fish were associated with increased risk of vertebral deformities and cataract at adult stage. The preventive effect of the high TM diet on incidence and severity of vertebral deformities and cataracts was highly effective if the fish were reared at 12 °C during early seawater phase, but was reduced or absent if reared at 16 °C. Cataract inducing effect of high temperature at 16 °C was much stronger than the cataract mitigating effect of high TM diet at 16 °C. Overall, feeding Atlantic salmon post-smolts a high TM diet (Zn: 200 mg/kg; Se: 0.7 mg/kg diet) during early seawater phase for 12 weeks reduced the incidence of vertebral deformity and cataracts in adult fish, albeit subject to water temperature.

Early OCT Angiography Variations in Macular and Peripapillary Area after Uncomplicated Cataract Surgery and Correlation with Intraoperative Parameters

Background: We evaluated changes in both macular and peripapillary vascular parameters, evaluated by OCT angiography (OCTA), after uncomplicated cataract surgery, as well as the influence of effective phacoemulsification time (EPT) and cumulative dissipated energy (CDE). Methods: This is prospective study on 130 eyes of 65 individuals who underwent unilateral phacoemulsification, with fellow eyes data taken as control group. We collected cataract grading, EPT and CDE. Best corrected visual acuity (BCVA), superficial vessel density, deep vessel density, foveal avascular zone (FAZ) parameters and peripapillary capillary density were measured at baseline, one week and one month following surgery. Results: When compared to baseline, there was a significant increase in both superficial and deep foveal density at last follow up (from 42.9 ± 4.2 and 37.3 ± 7.4 to 45.6 ± 5.4 and 43.7 ± 9.0%, p = 0.002 and p = 0.0001, respectively). Both foveal avascular zone’s area and perimeter showed a significant decrease compared to the preoperative value (p &lt; 0.05). On the other hand, peripapillary vascular density showed a significant increase at week one (from 49.6 ± 2.7 to 51.4 ± 4.6%, p = 0.01), which returned to preoperative values at last follow up (49.3 ± 4.0%, p = 0.95). We found no significant differences when dividing the cohort for cataract severity. Moreover, no significant effect of the EPT and CDE on vascular changes were reported. Conclusions: We found a significant increase in the vascular parameters of the macular area after cataract surgery, while peripapillary vascular density only experienced a transient increase, suggesting an adaptative metabolic mechanism in response to increased light exposure after surgery.