Treatment Of Cataract Research Articles

Clinical study of functional visual recovery following phacoemulsification with IOL implantation

Aim To evaluate the functional visual recovery following phacoemulsification cataract surgery with foldable intraocular lens implantation through a temporal clear corneal incision. Methodology This prospective study was conducted at a tertiary health care centre in Western Maharashtra over a period of 2 years. Detailed history was taken and thorough ocular examination of was done. Visual Acuity, Color vision, Contrast sensitivity, Binocular vision was noted. Visual Fields were examined and Glare Disability was assessed. All patients underwent temporal clear corneal Phacoemulsification surgery through a 3.2 mm incision with implantation of an Aspheric Monofocal Foldable IOL under LA. All patients were started on tapering dose of antibiotic − steroid over 6 weeks and followed up post operatively on day 1, week 1, week 2, 6 weeks, 3months and at 6 months. Results 50 eyes of 46 patients with immature cataract aged between 40 to 80 years were included. At the end of 24 weeks the Distance Vision was ≥ 6/9 in 31 eyes, 6/18–6/12 in 17 eyes and < 6/18 in 2 eyes. It was a statistically significant difference (P<0.0001). No significant difference in near vision was seen at the end of 6 months. The difference in astigmatism post operatively in all 50 eyes was not statistically significant at the end of 6 months (P<0.05). Significant improvement in contrast sensitivity was seen post operatively (P<0.0001). The mean glare disability was 14.06 s at 24 weeks. No significant difference was seen (P>0.05). Colour vision and Field of vision were similar postoperatively. All the patients maintained grade 3 binocular vision at end of the study. Conclusion Phacoemulsification with monofocal foldable intraocular lenses can be the choice of technique in treatment of cataract as being able to provide excellent visual results and also being cost effective.

AQP5 deficiency promotes the senescence of lens epithelial cells through mitochondrial dysfunction

Cataract is lens opacity, which is a common blinding eye disease worldwide. Aquaporin 5 (AQP5) is expressed in the human and mouse lenses. This study aimed to investigate the underlying mechanisms of AQP5 in the senescence of lens epithelial cells (LECs). Primary LECs were isolated and cultured from Aqp5+/+ and Aqp5−/− mice. Western blot or immunofluorescence staining of p16, Ki67, MitoSOX, JC-1 and phalloidin was used in the experiments to evaluate the changes in the primary LECs. The primary Aqp5−/− LECs showed increased p16 expression and mitochondrial reactive oxygen species, decreased mitochondrial membrane potential and activity, and cytoskeletal disorders. When the cells were pretreated with Mito-TEMPO, the Aqp5−/− mice showed decreased p16 expression, reduced mitochondrial dysfunction and cytoskeletal disorders. Our results revealed that AQP5 deficiency promotes the senescence of primary LECs through mitochondrial dysfunction. This provides a new perspective for the treatment of cataracts by regulating AQP5 expression.

Клинические случаи хирургического лечения катаракты при амиодароновой кератопатии

Amiodarone-induced keratopathy occurs against the background of systemic use of the antiarrhythmic drug amiodarone, due to deposition of iodine molecules in the lysosomes of corneal cell elements. Amiodaronic keratopathy is not a contraindication to the surgical treatment of cataract. In LLC “Tri-Z”, Moscow branch 2 patients were operated for cataracts on the background of stage 2 amiodarone keratopathy. High functional results were obtained: Visus = 0.9–1.0. Considering the possibility of progressing corneal changes with subsequent transition to the projection area of the pupil against the background of taking this drug, a consultation with a arrhythmologist was recommended in order to resolve the issue of replacing amiodarone with another antiarrhythmic drug. Key words: amiodarone; keratopathy; cataract surgery.

Challenges of refractive cataract surgery in the era of myopia epidemic: a mini-review.

Myopia is the leading cause of visual impairment in the world. With ever-increasing prevalence in these years, it creates an alarming global epidemic. In addition to the difficulty in seeing distant objects, myopia also increases the risk of cataract and advances its onset, greatly affecting the productivity of myopes of working age. Cataract management in myopic eyes, especially highly myopic eyes is originally more complicated than that in normal eyes, whereas the growing population of cataract with myopia, increasing popularity of corneal and lens based refractive surgery, and rising demand for spectacle independence after cataract surgery all further pose unprecedented challenges to ophthalmologists. Previous history of corneal refractive surgery and existence of implantable collamer lens will both affect the accuracy of biometry including measurement of corneal curvature and axial length before cataract surgery, which may result in larger intraocular lens (IOL) power prediction errors and a compromise in the surgical outcome especially in a refractive cataract surgery. A prudent choice of formula for cataract patients with different characteristics is essential in improving this condition. Besides, the characteristics of myopic eyes might affect the long-term stability of IOL, which is important for the maintenance of visual outcomes especially after the implantation of premium IOLs, thus a proper selection of IOL accordingly is crucial. In this mini-review, we provide an overview of the impact of myopia epidemic on treatment for cataract and to discuss new challenges that surgeons may encounter in the foreseeable future when planning refractive cataract surgery for myopic patients.

Combination phacoemulsification and pars plana vitrectomy for retinal reattachment surgery in the Siberian Husky breed.

To report the success rate and complications of combined phacoemulsification and pars plana vitrectomy (PPV) for treatment of cataracts and retinal detachment in the Siberian Husky breed. Client-owned Siberian Husky dogs that underwent combined phacoemulsification and PPV at two veterinary referral centers. Retrospective study of 16 Siberian Husky dogs that underwent combined phacoemulsification and PPV with a minimum 3-month postoperative follow-up. Signalment and preoperative ophthalmic examination findings, intraoperative findings, and postoperative visual status and complications were recorded. Functional success was defined as the maintenance or restoration of vision. Seventeen eyes of 16 dogs were evaluated. Immediate postoperative anatomic success was achieved in all 17 eyes (100%), with functional success through the last known follow-up examination achieved in 88.2% of operated eyes (15/17). The most common postoperative complication was silicone oil migration into the anterior chamber (AC-SiO migration), occurring in 47.1% of eyes (8/17), followed by corneal endothelial decompensation and glaucoma each occurring in 17.6% of eyes (3/17). Combined phacoemulsification and PPV is a viable option in Siberian Husky dogs with cataracts and preoperative retinal detachment. Visual success was achieved in 88.2% of eyes, with the most common postoperative complication being AC-SiO migration.

Hydrophilic Versus Hydrophobic Acrylic Intraocular Lens Implantation in Paediatric Cataract Surgery

Introduction: The selection of intraocular lens is still debatable in paediatric eye. Due to low cost and fewer intra-operative complication hydrophilic acrylic intraocular lens are implanted in volume in low income countries. There is lack of comparative study of this type of lens with hydrophobic lens in paediatric population.
 Aims: To compare the outcomes of hydrophilic acrylic lens and hydrophobic acrylic lens in paediatric cataract surgery.
 Methods: Out of 48 eyes included in the study, the Group A (n =24) eyes were implanted with acrylic hydrophilic intraocular lens, and the Group B (n =24) were implanted with acrylic hydrophobic intraocular lens. The children were evaluated pre, intra and postoperatively for different parameter.
 Results: The mean age was 6.6±2.7 years at the time of surgery. The most common type of cataract was zonular (58% in Group A and 50% in Group B). Postoperatively, corneal edema was seen in 7(29%) eyes in group A and in 2(8%) eyes in group B. The mean follow-up was 16.9±2.9 months. At one year, the position of the intraocular lens was in the capsular bag in 20 eyes (88.33%) and 24 eyes (100 %) in the group A and B, respectively. Clear visual axis was present in 22 eyes in Group A and 24 eyes in Group B. Posterior capsule opacification occurred in 12(50%) eyes in Group A and 6(25%) eyes in Group B. Two (8.3%) eyes in group A underwent surgical membranectomy due to visual axis opacification. The mean LogMAR visual acuity was 0.56 and 0.52 in group A and B respectively at one year.
 Conclusion: Hydrophilic acrylic intraocular lens are good alternative to hydrophobic intraocular lens in Nepal in the treatment of paediatric cataract.

Astaxanthin ameliorates oxidative stress in lens epithelial cells by regulating GPX4 and ferroptosis

Ferroptosis is a form of regulated cell death closely associated with oxidative stress and mitochondrial dysfunction and is characterised by the accumulation of reactive oxygen species (ROS) and lipid species and iron overload. Damage to human lens epithelial cells (LECs) is associated with age-related cataract progression. Astaxanthin (ATX), a carotenoid with natural antioxidant properties, counteracts ferroptosis in the treatment of various degenerative diseases. However, this mechanism has not been reported with respect to cataract treatment. In this study, the differential expression levels of glutathione peroxidase 4 (GPX4) in the lens of young and aged mice were analysed. Continuous ATX supplementation for 8 months upregulated GPX4 expression in the mouse LECs and delayed the progression of ferroptosis. Upon treatment with erastin, ROS and malondialdehyde accumulated and the mitochondrial membrane potential decreased. At the same time, the expressions of GPX4, SLC7A11, and ferritin were suppressed in human LECs. All of these phenomena were partially reversed by ATX and Fer-1, a ferroptosis inhibitor. This study confirmed that the ATX-mediated targeting of GPX4 might alleviate human LECs damage by inhibiting ferroptosis and ameliorating oxidative stress and that this could represent a promising therapeutic approach for age-related cataract.

Attenuation of epithelial-mesenchymal transition via SGLT2 inhibition and diabetic cataract suppression by dapagliflozin nanoparticles treatment

AimsChronic hyperglycemia triggers overproduction of AKR1B1 (aldo-keto reductase family 1 member B) and receptor for advanced glycation end product (RAGE), which causes epithelial-mesenchymal transition (EMT) in the lens epithelial cells (LECs) of diabetic mellitus (DM) cataracts. However, it is unclear whether EMT in LECs is related to abnormal increase of SGLT2. Sodium glucose cotransporter 2 (SGLT2) inhibitor, also known as dapagliflozin (Dapa) can be used to treat diabetes. Here, we examined how Dapa or nano eye-drops (DapaN) reduce EMT in LECs of DM cataracts. The nano eye-drop provides an ophthalmic treatment that suppressed diabetic cataract progression and improved potency with reduced side effects. Main methodsSD rats were injected with streptozocin (STZ) (65 mg/kg, ip), nano-Dapa drops (0.456 mg/10 ml/eye) or Dapa (1.2 mg/kg/day) treatment for 6–12 weeks. Immunofluorescence staining was used for protein quantification of RAGE, SGLT2, N-cadherin and E-cadherin in the LECs of rats. Key findingsIn this study, Dapa applies nanotechnology-based delivery system and it contains polyvinylpyrrolidone (PVP) and HPBCD. Dapa showed therapeutic effect on DM cataracts, wherein it targeted EMT biomarker, E-cadherin. The nano-Dapa drops or oral Dapa inhibited SGLT2, suppressed AKR1B1 expression, decreased AcSOD2- and RAGE-induced EMT in diabetic cataracts. Our findings suggest that nanotechnology-based Dapa eye drops (Dapa-PVP-HPBCD) can effectively improve solubility of Dapa in aqueous solution. SignificanceTaken together, results suggest that the SGLT2-mediated DM cataract therapy may involve the AKR1B1-RAGE-AcSOD2-EMT pathway. The nano eye drops and Dapa show potential beneficial effects for cataract prevention. This study conveys new insights into cataract treatment and supplementation of nano-Dapa drops shows promising result in preventing diabetic cataracts.

Assessment of Visual Habituation Measured With the Halo & Glare Simulator and Its Impact on Patient Satisfaction Following Quadrifocal IOL Implantation.

To evaluate the levels of habituation and its influence on outcome satisfaction in patients who underwent bilateral multifocal intraocular lens (IOL) implantation. A total of 24 patients underwent bilateral multifocal IOL implantation surgery with the AcrySof IQ PanOptix trifocal diffractive IOL (Alcon Laboratories, Inc) following cataract extraction or for refractive purposes. Data were collected 3 and 6 months after surgery, which included subjective refraction, corrected and uncorrected visual acuity (distance, intermediate, near), a contrast sensitivity test, simulation with the Halo & Glare Simulator (Carl Zeiss Meditec AG), two visual quality surveys, and a slit-lamp examination by an ophthalmologist. All patients were spectacle independent for distance vision and 92% (n = 22) needed no visual aid for near vision. Minor visual acuity improvement was detected between both examinations at monocular uncorrected distance visual acuity (P = .025). Improvements of presence, size, and intensity of visual disturbances were not statistically significant, but overall patient satisfaction (P = .009) and Weber-Contrast sensitivity under mesopic conditions (P = .029) increased significantly. Diffractive multifocal IOLs are a stable treatment for presbyopia and/or cataract with a high spectacle independence rate. Visual disturbances caused by their optics do not decrease significantly between 3 and 6 months after surgery. Habituation and neuroadaptation play a significant role in patient satisfaction and contrast sensitivity during and possibly beyond that period. [J Refract Surg. 2023;39(8):510-517.].

Обзор нормативной базы в отношении применения мультифокальных ИОЛ при хирургическом лечении катаракты.

Considering the increasing requirements for the quality of postoperative vision, the number of requests from patients for the implantation of a multifocal IOL is increasing, which makes it relevant to analyze the existing regulatory framework for the possibility and obligation to use this medical device in the provision of specialized medical care – surgical treatment of cataract within the framework of the state guarantees program. An analysis of the current regulatory framework showed that the existing regulatory framework allows the use of multifocal IOLs in the provision of medical services under the state guarantees program, however, it does not give the patient the right to choose, and makes considering the patient’s desire to implant this particular type of medical device is not mandatory when planning surgery. Considering the requirements of mandatory informed voluntary consent when receiving a medical service, the patient must be informed about the implantation or refusal to implant this type of medical device when providing him with specialized medical care. Most of the analyzed medical devices – IOLs with multifocal properties – are registered in the Russian Federation as “Intraocular lens for the posterior chamber of the eye, pseudophakic”, and not “Intraocular lens for the posterior chamber of the eye, pseudophakic, with increased depth of focus”. There is both a clinical need for changes (Clinical guidelines), and an organizational need to identify a group of operations, including with the application of additional coefficients to the tariff as part of the payment for medical services included in the program of state guarantees.

The ideal lens for cataract patients in Thi-Qar Province

Cataract is a common age-related eye condition that affects millions of people worldwide, leading to impaired vision and decreased quality of life. The standard treatment for cataracts involves surgical removal of the cloudy lens and replacement with an intraocular lens (IOL). In recent years, significant advancements have been made in the development of ideal lenses for cataract patients, aiming to improve visual outcomes and address various visual challenges that patients may encounter post-surgery. Monofocal lenses provide excellent visual clarity at a fixed distance, either for near or distance vision, necessitating the use of glasses for other distances. Multifocal lenses, on the other hand, incorporate multiple focal points, reducing the dependency on glasses for various distances. However, they may introduce visual artifacts and reduce contrast sensitivity. EDOF lenses attempt to strike a balance, providing enhanced depth of focus while minimizing visual disturbances. Additionally, advancements in materials and technology have enabled the integration of premium features in these lenses, such as blue-light filtering, astigmatism correction, and enhanced durability, further enhancing patient satisfaction and long-term outcomes. This article also discusses the importance of personalized patient selection for specific IOL types, as individual visual needs and lifestyle preferences play a crucial role in determining the most suitable lens. Moreover, post-operative management and patient counseling are essential to manage patient expectations and maximize satisfaction with the chosen lens.

Estimation of the full shape of the crystalline lens from OCT: validation using stretched donor lenses.

Quantifying human crystalline lens geometry as a function of age and accommodation is important for improved cataract and presbyopia treatments. In previous works we presented eigenlenses as a basis of 3-D functions to represent the full shape of the crystalline lens ex vivo. Also, we presented the application of eigenlenses to estimate the full shape of the lens in vivo from 3-D optical coherence tomography (OCT) images, where only the central part of the lens -visible through the pupil- is available. The current work presents a validation of the use of eigenlenses to estimate in vivo the full shape of dis-accommodated lenses. We used 14 ex vivo crystalline lenses from donor eyes (11-54 y/o) mounted in a lens stretcher, and measured the geometry and the power of the lenses using a combined OCT and ray tracing aberrometry system. Ex vivo, the full extent of the lens is accessible from OCT because the incident light is not blocked by the iris. We measured in non-stretched (fully accommodated) and stretched (mimicking in vivo dis-accommodated lenses) conditions. Then, we simulated computationally in vivo conditions on the obtained ex vivo lenses geometry (assuming that just the portion of the lens within a given pupil is available), and estimated the full shape using eigenlenses. The mean absolute error (MAE) between estimated and measured lens' diameters and volumes were MAE = 0.26 ± 0.18 mm and MAE = 7.0 ± 4.5 mm3, respectively. Furthermore, we concluded that the estimation error between measured and estimated lenses did not depend on the accommodative state (change in power due to stretching), and thus eigenlenses are also useful for the full shape estimation of in vivo dis-accommodated lenses.

Electroretinography, Ocular Ultrasonography, and Phacoemulsification of Bilateral Cataracts in Two Juvenile Loggerhead Sea Turtles (Caretta caretta) of the Mediterranean Region.

Bilateral cataracts were diagnosed in two rescued juvenile, immature loggerhead sea turtles (Caretta caretta), weighing 1.65 and 1.7 kg. Both animals showed vision impairment and difficulty in feeding without assistance. In fact, they did not notice the presence of the food in the tank unless it was brought close to touching the mouth. Ocular ultrasonography and electroretinography showed no lesions of the vitreal body and retinal layer, therefore, both animals were candidates for bilateral cataract surgery. Topical administration of tropicamide + phenylephrine alternating with rocuronium resulted in only minimal mydriasis. Administration of intracameral rocuronium did not improve mydriasis. Phacoemulsification using a one-handed technique was performed bilaterally with a phacoemulsification device (Sovereign, AMO (Abbott Medical Optics®). After surgery, the systemic anti-inflammatory drug (dexamethasone 0.2 mg/kg, IM daily for one week) and antibiotics (enrofloxacin 10 mg/kg IM q 72 h, for 4 weeks; ceftazidime 20 mg/kg IM q 72 h for 3 weeks) were administered. Topical ofloxacin, flurbiprofen and tobramycin/dexamethasone were instilled TID for 4 weeks. Both turtles regained vision in both eyes. Results at a 10-month follow-up were satisfactory. This is the first report of cataracts in turtles rescued in the Mediterranean Sea and the first description of surgical treatment of cataracts in loggerhead turtles so young.

An Epidemiological Study of Cataract among Elderly Patients Attending in Eye Camps Arranged by Al-Basar International Foundation in Bangladesh

Background: Cataract is a common cause of visual impairment in the elderly and the leading cause of blindness worldwide. Bangladesh is not exception of this. Though cataract treatment is available across the country but there is no nationwide strategy to prevent this disease. Therefore, this study tried to explore the distribution of this diseases among the elderly patients in Bangladesh to provide some insights about the prevention strategies of cataract. Methodology: This descriptive cross-sectional study was conducted among conveniently selected 1020 cataract patients attending in two eye camps of Bagura and Jaypurhat districts in Bangladesh. Face to face interview was taken by using a structured validated questionnaire. Descriptive statistics such as frequency, percentage, mean, median, and standard deviation as well as inferential analysis were used for both categorical and continuous variables with the application of Statistical Package for Social Sciences (SPSS) version 26. Results: Out of 1020 cataract patients, male and female were 53.5% and 46.5%, respectively where 69.5% were in the age group of 15-64 years. Approximately 50% of participants were illiterate and 70.6% had family history of cataract. About 42.8% of respondents had identified age as the cause of disease and almost 50.8% were suffered from 1.1 to 3 years. 39.4% had delayed in receiving treatment for having financial issues. Age and gender had statistical significant association (p<.05) with the cataract. Conclusion: Age and gender based prevention strategies should be planned and implemented as cataract is found to be prevalent on these variables in this study.

Protective Effects of Different Doses of Ginsenoside-Rb1 Experimental Cataract Model That in Chick Embryos

Purpose There has been increased interest in phytochemical antioxidants to prevent protein damage and aggregate formation in cataract treatment. In this study, the protective effect of different doses of Rb1 (GRb1), one of the ginsenosides of Panax Ginseng, in the experimental cataract model formed in chick embryos was investigated. Methods Five different experimental groups were formed with 100 SPF fertilized eggs: Control (0.9% NaCl to physiological saline), hydrocortisone hemisuccinate sodium (HC), low dose (HC + L-GRb1 (1 mg/kg)), medium dose (HC+). M-GRb1 (2.5 mg/kg)), and high dose (HC + H-GRb1 (5 mg/kg)). All solutions were given to air sack at 15 days of incubation. On the 17th day, the bulbous oculi of the chick embryos were dissected. Cataract formations of the lenses, glutathione (GSH), malondialdehyde (MDA), total antioxidant (TAS), total oxidant (TOS) levels, Caspase-3 H-score, and TUNEL index were determined. In addition, crystalline alpha A (CRYAA) gene expression was evaluated. Results Cataracts were observed in the control, HC, HC + L-GRb1, HC + M-GRb1, and HC + H-GRb1 groups with a frequency of 0%, 100%, 75%, 56.25%, and 100%, respectively. There were statistically significant differences between the control and HC groups in terms of TAS, TOS, MDA, GSH, Caspase-3 H-score, and TUNEL index (p < .05). When the therapeutic effect of the GRb1 groups was evaluated, the HC group showed significant differences with the HC + L-GRb1 and HC + M-GRb1 groups in almost all parameters (p < .05), while there was no statistical difference with the HC + H-GRb1 group (p > .05). In addition, gene expression levels differed between the groups, although not statistically significant (p > .05). Conclusion 1 mg/kg and 2.5 mg/kg GRb1 applications show therapeutic properties on the HC-induced cataract model. This effect is more pronounced at 2.5 mg/kg.

Cataract and Homoeopathy: Review Article

Crystallin proteins in the lens partially unfurl and clump to cause age-related cataracts. Medical professionals and conventional healers have studied pharmacological cataract treatment for hundreds of years. Surgery is the only viable treatment at the moment. However, numerous homoeopathic and complementary treatments have been advocated as cataract treatments. This article explores homoeopathic treatments that are allegedly effective in treating cataract while also reviewing the state of knowledge regarding cataract. Keywords: Homoeopathy, Eye, Cataract, Symptomatic.

Changes in corneal endothelium and risk factors for surgical treatment of cataracts in the presence of pseudoexfoliation syndrome

Changes in corneal endothelium and risk factors for surgical treatment of cataracts in the presence of pseudoexfoliation syndrome

Phacoemulsification associated with loss of endothelial cells in cataract surgery: a systematic review of main surgical techniques

Introduction: Phacoemulsification (PE) cataract surgery is the gold standard in ophthalmology, being effective in improving vision in more than 90.0% of patients. In this context, authors found that PE was associated with 16.67% of endothelial cell loss, which correlated with the degree of trauma during surgery. Endothelial changes are considered an important parameter for assessing trauma and for estimating the safety of a surgical technique. In this sense, more modern PE machines are capable of removing cataracts using optimized parameters such as high vacuum, aspiration flow, and low amount of ultrasonic energy. Objective: It was to present and discuss the main phacoemulsification techniques for optimizing the treatment of cataracts, in an attempt to reduce the loss of corneal endothelial cells. Methods: Experimental and clinical studies were included (case reports, retrospective, prospective, and randomized studies) with qualitative and/or quantitative analysis. Initially, the keywords were determined by searching the DeCS tool (Descriptors in Health Sciences, BIREME base) and later verified and validated by MeSH Terms. The search literature was carried out from January to April 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Results: A total of 122 articles involving phacoemulsification and endothelial cells were found. Initially, the existing title and duplications were excluded according to the interest described in this work. After this process, the abstracts were evaluated and a new exclusion was performed. A total of 80 articles were evaluated in full and 59 were included and discussed in this study. At the beginning of treatment with PE, without the endothelial protection of viscoelastic agents and the use of ultrasound in the anterior chamber, the endothelial loss was greater than in extracapsular cataract extraction. With the modernization of PE, the use of viscoelastic agents, the emergence of techniques for fracture of the nucleus within the capsular bag, and the use of ultrasound in the posterior chamber, the loss of endothelial cells reduced from 7 to 12% on average. Conclusion: Endothelial changes are considered an important parameter to assess trauma and estimate the safety of a surgical technique. Highlighted, the main predictors associated with the loss of corneal endothelial cells are the duration of the ultrasound used in the surgery, the turbulence of the liquid in the anterior chamber, and the mechanical trauma.

Anti-Amyloid-Β Monoclonal Antibodies against Alzheimer's Disease may be a Potential Breakthrough for Cataract Treatment

The opacification of the lens, called cataracts, is responsible for degrading visual acuity as a consequence of scattering the light as it passes through the lens. The ocular lens plays a pivotal part in focusing the light onto the retina, and its clarity is essential for visual acuity. In 2020, the prevalence of cataracts had been 15.2 million cases among over 50 years globally. It has been estimated by the year 2050, approximately 50 million people in the united states will suffer from cataracts. According to statistics, cataracts will increase with passing years.

Efficacy of Endotrabeculectomy (Trabecula Ablation Ab Interno with the Forceps) for Open-angle Glaucoma.

To investigate the efficacy of endotrabeculectomy (ETE) performed either alone or combined with phacoemulsification (phaco) in patients with primary open-angle glaucoma (POAG). Investigations were done in two groups. The first group (38 patients, 38 eyes) with POAG underwent ETE, and the second group of 126 patients (126 eyes) with POAG and cataracts underwent ETE and phaco. The hypotensive effect of the surgery was evaluated. In the ETE group, the mean intraocular pressure (IOP) was reduced from 20.25 ± 3.30 to 14.94 ± 1.95 mm Hg (26.2% reduction, p < 0.001) at 12 months. The number of medications was reduced from 2.8 ± 1.0 to 1.5 ± 1.0 (p < 0.001) at 12 months after the surgery. In the phaco-ETE group, the mean IOP was reduced from 18.24 ± 3.20 to 14.83 ± 1.71 mm Hg (18.7% reduction, p < 0.001) at 12 months. The mean number of medications was reduced from 2.2 ± 1.1 to 1.0 ± 1.0 (p < 0.001) at 12 months after the surgery. The success rate defined as a final IOP of <16 mm Hg using the Kaplan-Meier curve at 12 months was 73.8%. There were no complications that led to a constant visual decrease. Our study shows that ETE is technically simple, gives the ability to remove trabecula in any quadrant, and effectively reduces IOP in patients with POAG. Endotrabeculectomy (ETE) is a safe and relatively simple procedure that significantly reduces IOP. The minimally invasive nature of the ETE allows expanding indications for combined treatment of glaucoma and cataract. Novytskyy IY, Novytskyy MI. Efficacy of Endotrabeculectomy (Trabecula Ablation Ab Interno with the Forceps) for Open-angle Glaucoma. J Curr Glaucoma Pract 2023;17(1):15-21.