Cataract Research Articles

Retropupillary sulcus gas migration after retinal detachment repair surgery.

To elucidate etiology and management of retropupillary sulcus migration of intravitreal gas after uneventful retinal detachment repair surgery. 70 year old Caucasian man presented with a temporal macula-off rhegmatogenous retinal detachment. 25-gauge (25G) pars plana vitrectomy was performed with cryopexy to retinal tear and 12% C3F8 gas tamponade under sub-Tenon's anaesthesia. At one week review, there was an elevated IOP of 28mmHg with migration of gas to the retropupillary space. Superiorly, iris was displaced anteriorly causing iridocorneal touch. There was no phacodonesis nor subluxation and retina was attached with a cryopexy scar under a 80% vitreous cavity gas fill. On treatment with topical IOP-lowering agents until two-week review, IOP had normalised to 18mmHg with persistent 50% gas fill in the retropupillary sulcus and superior iridocorneal touch.Retropupillary gas resorbed at week four with normalisation of IOP, a localised superior anterior subcapsular cataract with associated posterior synechiae, and no iridocorneal touch. Best-corrected visual acuity was 6/12 Snellen following resorption of vitreous cavity gas. Medical management may be adequate if there is no complete pupil block and adequate posterior gas fill. With complete pupil block, refractory IOP elevation, or inadequate posterior tamponade resulting in failure of retinal attachment, surgical intervention would be required.

Causal linkage of Graves’ disease with aging: Mendelian randomization analysis of telomere length and age-related phenotypes

BackgroundAging is an irreversible progressive decline in physical function. Graves’ disease (GD) is a common cause of hyperthyroidism and is characterized by elevated levels of the thyroid hormone (TH). High TH levels are associated with aging and a shortened lifespan. The causal relationship between GD and aging has yet to be investigated.MethodsWe used genome-wide association study (GWAS) datasets and Mendelian randomization (MR) analysis to explore the causal link between GD and aging. To assess the statistical power of instrumental variables (IVs), F-statistics and R2 were used. MR analysis was conducted using inverse-variance weighting (IVW), MR-Egger, weighted median, and weighted mode. The odds ratio (OR) and 95% CI were calculated to estimate the relative risk of GD to the outcomes. The Cochran Q test, I2, MR-PRESSO test, and MR-Egger regression intercept were calculated using statistical and leave-one-out analyses to test the heterogeneity, horizontal pleiotropy, and stability of the IVs on the outcomes.ResultsF-statistics of the five IVs were greater than 10, and the R2 values ranged from 0.033 to 0.156 (R2 > 0.01). According to the results of the IVW analysis, GD had no causal effect on facial aging (p = 0.189), age-related macular degeneration (p = 0.346), and Alzheimer’s disease (p = 0.479). There was a causal effect of GD on the remaining outcomes: telomere length (TL) (OR = 0.982; 95%CI:0.969–0.994; p = 0.004), senile cataract (OR = 1.031; 95%CI:1.002–1.060; p = 0.033), age-related hearing impairment (OR = 1.009; 95%CI:1.004–1.014; p = 0.001), chronic obstructive pulmonary disease (COPD) (OR = 1.055; 95%CI:1.008–1.103; p = 0.020), and sarcopenia (OR = 1.027; 95%CI:1.009–1.046; p = 0.004).ConclusionsGD accelerates the occurrence of age-related phenotypes including TL, senile cataracts, age-related hearing impairment, COPD, and sarcopenia. In contrast, there are no causal linkages between GD and facial aging, age-related macular degeneration, or Alzheimer’s disease. Further experimental studies could be conducted to elucidate the mechanisms by which GD facilitates aging, which could help slow down the progress of aging.

Changes in corneal curvature and astigmatism in senile cataract patients after phacoemulsification

PurposeAnalysis of changes in corneal curvature and astigmatism after phacoemulsification for senile cataracts.MethodsRetrospective collection of clinical data from patients who underwent uncomplicated phacoemulsification at the First Affiliated Hospital of Soochow University. The changes in total corneal curvature, anterior surface curvature, posterior surface curvature, and astigmatism were measured by the Sirius system. The axial length was measured by Lenstar 900.ResultsThe total corneal curvature and anterior surface curvature at 3 months were all larger than those before phacoemulsification, and the difference was statistically significant (p < 0.05). Compared with preoperative results, there was no significant change in corneal posterior surface curvature and astigmatism 3 months after surgery (p > 0.05). Changes in corneal curvature and astigmatism were not significantly correlated with age at 3 months after surgery (p > 0.05). Postoperative astigmatism was increased with the growth of axial length, while corneal curvature was decreased (p < 0.05).ConclusionPhacoemulsification can lead to increased postoperative corneal curvature in elderly cataract patients, and with the growth of the axial length, the corneal astigmatism was increased.

Diplopia and Work: A Case Report

Diplopia is a frequent symptom in ophthalmology and has many causes. It may be binocular or monocular, the latter reflecting ocular damage. The study of the interaction between diplopia and the workstation is often neglected in therapeutic management; however, diplopia at work can have consequences for the health and safety of the worker concerned and therefore for clinical and socio-professional prognosis. We report a case of monocular diplopia due caused by a nuclear cataract in a radiologist. The purpose is to illustrate and explain the interaction between diplopia and work and the repercussions on fitness for work. This case underscores the need for effective, multidisciplinary medical and occupational strategies to manage diplopia in the workplace.

The Association between Vitamin D3 Deficiency and Cataract Formation in Baghdad Al-Karkh

Background: Visual impairment is a global issue that is particularly problematic for poor nations. It is linked to diminished physical activity, social isolation, reliance on everyday tasks, and even death. The clouding of the lens inside the eye is called a cataract. It is one of the main causes of blindness and visual impairment in the world. Because of its anti-inflammatory and antioxidant properties, vitamin D, a prohormone in the blood, is crucial to the pathophysiology of many ocular illnesses. Given that oxidative stress and inflammation are significant contributors to the development of cataracts, a number of research have evaluated the relationship between vitamin D3 deficiency and cataract formation. Objective: Determine whether a vitamin D3 deficiency and cataracts are related. Patients and Methods: A cross-sectional study that was carried out included a total of 100 cataract patients who are 60 years of age or younger from September 2023 to March 2024 in the Ophthalmology Department of Imamein Kadhimein Medical City, Baghdad, Iraq. Questionnaire form was used which consist of sociodemographic information, socioeconomic status, dietary sources of vitamin D3, sun exposure, anthropometric measures and ophthalmic examination. Vitamin D3 level had been investigated in laboratory of the hospital. Results: Thirty percent of patients had cortical cataracts, 57% had nuclear cataracts, and 13% had posterior subcapsular cataracts. Sixty-nine percent of patients had a vitamin D3 level that is less than 20 ng/ml. Of the patients, 13% had a vitamin D3 level between 20 and 30 ng/ml, while 18% had a level greater than 30 ng/ml. There is a significant association between the level of vitamin D3 and the type of cataract (p-value = 0.013). Sixty-nine percent of patients with deficient vitamin D3 levels had 9% posterior subcapsular cataracts, 36% cortical cataracts, and 55% nuclear cataracts. Patients with insufficient vitamin D3 levels had 8% posterior subcapsular cataracts, 8% cortical cataracts, and 84% nuclear cataracts. While patients with sufficient vitamin D3 levels had 33% posterior subcapsular cataracts, 22% cortical cataracts, and 45% nuclear cataracts. The body mass index and vitamin D3 level were significantly associated (p-value = 0.003). Patients with a vitamin D3 level less than 20 ng/ml comprised 31% overweight patients, 26% class I obese patients, 26% class II obese patients, and 4% class III obese patients. Thirteen percent of these patients had normal weights. Patients with a vitamin D3 level 20-30 ng/ml comprised 46% overweight patients, 23% class II obese patients, and 31% with normal weight. While patients with a vitamin D3 level more than 30 ng/ml comprised 33% normal weight patients and 67% overweight. Conclusion: Vitamin D3 deficiency has a significant association with cataract formation, especially nuclear and cortical types, sun exposure, educational level, socioeconomic status, and obesity.

Secondary acute angle closure glaucoma after 25-gauge pars plana vitrectomy for a macular hole: a case report

BackgroundPosterior synechiae of the iris rarely cause secondary angle-closure glaucoma after pars plana vitrectomy, mainly reported in cases with high postoperative inflammation. The face-down position with gas tamponade can cause acute angle-closure glaucoma in phakic eyes owing to relative pupillary block. This report presents a rare case of pseudophakic eye with secondary acute angle-closure glaucoma after 25-gauge pars plana vitrectomy and long-term vitreous gas tamponade for a macular hole.Case presentationA 61-year-old Japanese female patient presented with a chief complaint of right-sided visual impairment that had persisted for several months. Slit-lamp examination revealed deep anterior chamber and moderate nuclear sclerotic cataracts in both eyes. The axial length of the eye was 23.53 mm right eye and 24.05 mm left eye, and the fundus examination revealed a full-thickness macular hole (stage 3) in the right eye. The patient underwent simultaneous cataract surgery and pars plana vitrectomy with 7-mm diameter 3-piece monofocal intraocular lens implantation, internal limiting membrane peeling, and air tamponade. There were no complications during surgery. Due to non-closure of the macular hole, a second pars plana vitrectomy with internal limiting membrane inverted flap and SF6 gas tamponade was performed 13 days later. The patient maintained face-down position after both surgeries, and 6 days after the second surgery, intraocular pressure was elevated to 53 mmHg, and acute angle-closure glaucoma with iris bombe was diagnosed in the right eye. A laser peripheral iridotomy was performed, resulting in a deepened anterior chamber, normalized intraocular pressure, and a closed macular hole.ConclusionsThis case presents a rare occurrence of secondary acute angle-closure glaucoma in a pseudophakic eye after 25-gauge minimally invasive pars plana vitrectomy and SF6 gas tamponade for macular hole. The cause was presumed to be posterior synechiae of the iris or relative pupillary block due to forward pushing of the intracapsular intraocular lens by vitreous gas. In cases where surgery is repeated without achieving macular hole closure, necessitating long-term face-down position, where vitreous gas is retained for an extended period, or when a large-diameter intraocular lens is implanted, secondary acute angle-closure glaucoma should be considered. This applies even when the 25-gauge pars plana vitrectomy is performed not for a highly invasive proliferative diabetic retinopathy but for macular hole repair, especially if the patient has a pseudophakic eye.

Causal relationship between hyperthyroidism and cataracts: a two-sample bi-directional mendelian randomization study

Clinical studies and meta-analyses have suggested a link between thyroid dysfunction and lens opacification. The objective of this study is to investigate the causal relationship between hyperthyroidism and the development of cataracts using the Mendelian randomization approach, with the aim of filling the gap in knowledge about the systemic effects of hyperthyroidism on ocular health. Leveraging genetic variants as instrumental variables, the analysis used extensive datasets from the UK Biobank and the FinnGen Database and employed three common approaches for causal inference (the Inverse Variance Weighted method, a regression based method the Weighted Median estimator, and MR-Egger regression) and accompanying sensitivity analyses to ensure robustness. The results demonstrate that there is a strong likely causal relationship, with hyperthyroidism increasing the risk of developing senile cataracts (OR = 361.09, 95%CI 5.024 to 2.60 × 104, P = 0.007). A sensitivity analysis provided no evidence of horizontal pleiotropy and no significant outliers, suggesting the results are robust. In conclusion, our study established a significant causal relationship between hyperthyroidism and increased risk of cataract development, underscoring the importance of considering the systemic effects of hyperthyroidism in clinical and public health interventions and policies. Future research should focus on elucidating the molecular mechanisms underlying this association, exploring the potential benefits of early intervention in hyperthyroidism to prevent cataract development, and investigating whether these findings translate across different ethnic populations. Additionally, further GWAS studies aimed at identifying genetic variants associated with both hyperthyroidism and cataracts are warranted to confirm and expand upon our results.

Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways

Fibrotic cataracts, the most frequent complications after phacoemulsification, cannot be cured by drugs in clinic. The primary mechanism underlying the disease is the epithelial-mesenchymal transition (EMT). Cimifugin is a natural monomer component of traditional Chinese medicines. Previous researches have demonstrated the effect of cimifugin inhibiting EMT in the lung. The purpose of this work is to evaluate the impact of cimifugin on EMT in the lens and elucidate its precise mechanism. The pathogenesis of fibrotic cataracts was simulated using TGFβ2-induced cell model of EMT and the injury-induced anterior subcapsular cataract animal model. Through H&E staining and immunofluorescence of mice eyeballs, we discovered that cimifugin can inhibit the expansion of fibrotic lesions in vivo. Furthermore, at mRNA and protein levels, we confirmed that cimifugin can allay EMT of lens epithelial cells (LECs) in vitro and in vivo. Additionally, the inhibition of cimifugin on the activation of TGFβ-related signaling pathways was certified by immunoblot. HSP90β, the target of cimifugin, was predicted by network pharmacology and verified by drug affinity responsive target stability, the cellular thermal shift assay, and microscale thermophoresis. Moreover, co-immunoprecipitation revealed the interaction between HSP90β and TGFβRII. Together, our findings showed that by weakening the binding of HSP90β and TGFβRII, cimifugin suppressed the TGFβ signaling pathways to alleviate fibrotic cataracts. Cimifugin is a promising medication for the treatment of fibrotic cataracts.

Vitamin D levels and risk of ocular disorders: insights from bidirectional and multivariable Mendelian randomization analysis.

This study aimed to assess the causal relationships between vitamin D levels and ocular disorders. Independent genetic variables were obtained from genome-wide association studies (GWAS) and publicly available databases. The summary statistics for 25-hydroxyvitamin D (25(OH)D) were obtained from two large-scale GWAS studies, with sample sizes of 324,105 and 417,580 European individuals. The genetic variants of myopia, primary open angle glaucoma (POAG), anterior iridocyclitis, senile cataract, diabetic retinopathy (DR), retinal vein occlusion (RVO), wet age-related macular degeneration (WAMD) and optic neuritis were extracted from the latest release of FinnGen consortium, which contains genome data from Finnish participants. Subsequently, Mendelian randomization (MR) analyses were conducted to obtain effect estimates. Additionally, we performed multivariable MR analysis and mediation analysis to validate the results. In the discovery dataset, genetically predicted vitamin D concentration was found to be causally associated with an increased risk of WAMD, (odd ratio (OR) = 1.35, 95% confidence interval (CI) = 1.09-1.67, P IVW = 0.005). However, no causal effects of genetically predisposed vitamin D levels on the risk of most types of ocular disorders were observed. Reverse MR revealed no causal relationships between the ocular diseases and vitamin D concentrations. The MR analyses of the validation dataset yielded consistent results. Additionally, the causal effect of vitamin D levels on the risk of WAMD remained significant after adjusting for potential confounders in the multivariable MR analysis (OR = 1.86, 95% CI = 1.26-2.73, P IVW = 0.002). Our MR analysis results provide robust evidence of a causal relationship between genetically predicted 25(OH)D levels and an increased risk of WAMD in European population. These findings offer important insights into the management and control of ocular disorders.

Macular changes after cataract surgery.

This article aims to highlight if the central macular retina suffers changes after cataract surgery, and to evaluate the eventually discovered changes regarding persistence. This retrospective study, which lasted over three years (2021-2023), included patients who underwent cataract surgery performed by one surgeon. Spectral-domain optical coherence tomography (SD-OCT) imaging assessed macular changes and measured the central macular thickness. A total of 240 eyes with diagnosed senile cataract were included in this study. The mean age was 66 years ± 4 years. Preoperative central foveal thickness was 210 ± 27.3 µm, the postoperative thickness on day 1 was 234.3 ± 40.2 µm, at 6 months 230.5 ± 35.2 µm, and the 1-year follow-up 229.2 ± 30.3 µm. Macular changes after cataract surgery are easily confirmed by SD-OCT. The evaluation and monitoring of macular changes can be done by using central macular thickness assessment. The study provides data from a Romanian pool of patients. The values correlated well with those from similar studies of SD-OCT examinations, but differences were still observed, as there were different devices for performing SD-OCTs.

Changes in Lens Structure in Pathological Myopia, Cataract Surgery and Special Situations

Pathological myopia is a major cause of low vision and blindness worldwide. In patients with pathological myopia, there are changes such as thinning of the lens and increase in equatorial diameter. In various population and clinic-based cohort, case-control and cross-sectional studies, it has been reported that myopic patients have a higher risk of posterior subcapsular cataract, cortical and nuclear cataract. It is known that the modern technique of phacoemulsification and intraocular lens implantation is effective in highly myopic eyes and provides significant improvement in visual acuity. However, complications related to phacoemulsification such as posterior capsule rupture, retinal detachment, progression of existing maculopathy, capsular phimosis, late lens dislocation and transient intraocular pressure elevation occur more frequently in highly myopic patients. As a result, it is extremely important that cataract surgeries of these patients are performed by experienced surgeons and that attention is paid to perioperative and postoperative complications.

Evaluation of antioxidant status of lens epithelial cells in cataract patients.

The main factor that causes cataracts is the increased oxidative stress and imbalance of an antioxidant defense mechanism, which leads to significant changes in the lens microarchitecture. Senile cataract is the most common type of acquired cataracts due to aging. We carried out a case-control study in the biochemistry department to examine the antioxidant status (catalase and total antioxidant capacity [TAC]) and lipid peroxidation marker, that is, malondialdehyde (MDA) in human lens epithelial cells (HLECs) of different grades of senile cortical, nuclear, and posterior subcapsular cataracts. We collected 150 samples from patients aged 50-90 years. These included 50 samples of cortical cataracts, 50 of nuclear cataracts, and 50 samples of posterior subcapsular cataracts. We measured catalase activity by the Beer method, TAC by the Benzie and Strain method, and protein by the Bradford method. We also estimated TAC in the aqueous extract of HLECs by the ferric reducing ability of plasma (FRAP) method and MDA by the thiobarbituric acid assay method. The results of this study showed that the level of catalase enzyme was higher in the first grade of nuclear, posterior subcapsular, and cortical cataracts than in other grades. This suggests that the catalase enzyme activity drops sharply in the second and third grades of these types of cataracts. The same pattern was observed for TAC, which was higher in the first grade of nuclear, posterior subcapsular, and cortical cataracts than in other grades. There were significant differences between catalase and TAC in different grades of cataracts, indicating that as the grading increases, both catalase and TAC decrease. The results of this study showed that the levels of MDA were higher and the levels of catalase and TAC were lower in patients with more severe cataracts compared to the healthy controls.

Delayed-onset spontaneous bilateral Descemet’s membrane detachment after uneventful phacoemulsification

A 69-year-old male presented with defective vision in both eyes. Best corrected visual acuity (BCVA) was 6/6 p with anterior cortical and posterior subcapsular cataracts in both eyes. Fundus examination was normal. He underwent successful phacoemulsification with intraocular lens implantation in the left eye, improving BCVA to 6/6. Two months later, BCVA in the right eye decreased to 6/12p; cataract progression was noted. Phacoemulsification in the right eye restored BCVA to 6/6. Four months post-left eye surgery, he developed corneal edema with descemet membrane detachment (DMD). Multiple descemetopexies with SF6 led to reattachment. Right eye also developed DMD which reattached with SF6 descemetopexy. Final visual acuity was 6/6 in the right eye and 6/6 partial in the left eye.

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.

Pinpointing Novel Plasma and Brain Proteins for Common Ocular Diseases: A Comprehensive Cross-Omics Integration Analysis.

The pathogenesis of ocular diseases (ODs) remains unclear, although genome-wide association studies (GWAS) have identified numerous associated genetic risk loci. We integrated protein quantitative trait loci (pQTL) datasets and five large-scale GWAS summary statistics of ODs under a cutting-edge systematic analytic framework. Proteome-wide association studies (PWAS) identified plasma and brain proteins associated with ODs, and 11 plasma proteins were identified by Mendelian randomization (MR) and colocalization (COLOC) analyses as being potentially causally associated with ODs. Five of these proteins (protein-coding genes ECI1, LCT, and NPTXR for glaucoma, WARS1 for age-related macular degeneration (AMD), and SIGLEC14 for diabetic retinopathy (DR)) are newly reported. Twenty brain-protein-OD pairs were identified by COLOC analysis. Eight pairs (protein-coding genes TOM1L2, MXRA7, RHPN2, and HINT1 for senile cataract, WARS1 and TDRD7 for AMD, STAT6 for myopia, and TPPP3 for DR) are newly reported in this study. Phenotype-disease mapping analysis revealed 10 genes related to the eye/vision phenotype or ODs. Combined with a drug exploration analysis, we found that the drugs related to C3 and TXN have been used for the treatment of ODs, and another eight genes (GSTM3 for senile cataract, IGFBP7 and CFHR1 for AMD, PTPMT1 for glaucoma, EFEMP1 and ACP1 for myopia, SIRPG and CTSH for DR) are promising targets for pharmacological interventions. Our study highlights the role played by proteins in ODs, in which brain proteins were taken into account due to the deepening of eye-brain connection studies. The potential pathogenic proteins finally identified provide a more reliable reference range for subsequent medical studies.

Организационно-финансовые аспекты выбора интраокулярных линз при хирургии катаракты в условиях ценностно-ориентированной системы здравоохранения.

Relevance. In modern conditions, value-based healthcare provides for the provision by medical organizations of medical care of appropriate quality with mandatory control of its cost. Treatment outcomes that are important to the patient become no less significant than clinical performance indicators and payment for medical services, regardless of the profile of medical care. The gradual change in paradigms of healthcare systems from a paternalistic to a person-centric model required changes in organizational, legislative and financial approaches when introducing health-saving healthcare technologies. Purpose of the study: analysis of the current organizational, legal, financial and clinical models of surgical treatment of patients with age-related cataracts, astigmatism and development of proposals for the implementation of the patient’s right to choose intraocular lenses, taking into account his modern expectations from the results of treatment. Materials and methods. Statistical and analytical methods were used (content analysis methods, expert assessment methods, analysis and synthesis methods). Results. An analysis of the legislation in organizing the provision and financing of medical care to the adult population in the field of ophthalmology is presented, and state guarantees for the use of medical products – types of intraocular lenses implanted into the human body for the surgical treatment of senile cataracts and astigmatism – are considered. Clinical models of the disease are systematized, taking into account the frequency and frequency of provision of medical services and the list of medical devices implanted into the human body, professional, medico-economic, medico-legal and reputational risks are described when exercising the patient’s right to choose intraocular lenses in the treatment of ophthalmological pathology. Proposals have been developed to change clinical recommendations, standards of medical care for senile cataracts and astigmatism, and improve payment for ophthalmological care. Conclusions. The transition to value-based healthcare requires the consolidation of the efforts of all structures of the healthcare industry to achieve the best results in the treatment of ophthalmic diseases and increase the clinical effectiveness associated with the choice of intraocular lenses in the surgical treatment of adults in the field of ophthalmology.

Corneal Endothelial Cell Loss During Uneventful Cataract Surgery in Hispanics Versus Non-Hispanics.

Limited information exists on the possible effects of ethnicity on corneal endothelial cell parameters and their changes during cataract surgery. Thus, we evaluated corneal endothelial cell density (ECD) and endothelial cell loss (ECL) during surgery for senile cataract in Hispanic and non-Hispanic White adults. This retrospective study included 312 eyes of 227 patients ≥50 years who underwent phacoemulsification with intraocular lens implantation for senile cataract. Preoperatively and 1 to 2 months after surgery, specular microscopy was performed to measure ECD, coefficient of variation (CV), and hexagonal cell percentage (HEX). Regression analysis was used to compare baseline values as well as surgery-related changes in corneal endothelial cell parameters between Hispanic and non-Hispanic patients considering demographics, biometric parameters, and intraoperative cumulative dissipated energy (CDE). There were 109 Hispanics and 118 non-Hispanics. Anterior chamber depth (ACD) was significantly lower in Hispanics (3.12±0.36 mm) compared with non-Hispanics (3.25±0.37 mm, P=0.009). There were no significant differences in baseline ECD between Hispanics (2,547±365 cells/mm2) and non-Hispanics (2,483±380 cells/mm2, P=0.17). There were also no significant differences in ECL (16.8%±17.0% vs. 17.4%±18.1%, P=0.46), increase in CV (3.8%±20.7% vs. 1.5%±21.6%, P=0.51), and decrease in HEX (-2.7%±8.5% vs. -1.8%±7.0%, P=0.33) between these two groups. Regression analysis showed that ECL was associated with a shallower ACD (P=0.003), a higher CDE (P<0.001), but not with ethnicity (P=0.46). There are no significant differences in ECD and ECL between Hispanics and non-Hispanics undergoing cataract surgery. Although Hispanics have a shallower ACD, the ethnic difference seems to be clinically insignificant.

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.

A study to compare the prevalence of posterior capsular opacity between patients implanted with hydrophobic acrylic intra ocular lens (IOL) versus hydrophilic acrylic intra ocular lens (IOL) in the diabetic and non-diabetic group following cataract surgery: A hospital based prospective study

: To study and compare the prevalence of posterior capsular opacity between patients implanted with hydrophobic acrylic IOL versus hydrophilic acrylic IOL in the diabetic and non diabetic group following cataract surgery. All patients with senile cataracts, whether they had diabetes or not, who visited a tertiary care hospital in Tamil Nadu between 2020 and 2022 were enrolled in this study after signing a written consent form. In this study, 200 patients underwent screening and were split into 4 equal groups.The PCO observation of patients in all 4 groups in the current study showed that Groups 3 and 4 with hydrophilic IOL found higher incidences of PCO than Groups 1 and 2 with hydrophobic IOL. In our study, more PCO was reported with hydrophilic IOL with known (Group 3) and unknown (Group 4) cases of diabetes. Regardless of the patient's level of diabetes during the course of a year-long follow-up, hydrophobic acrylic IOLs showed a greater decrease in PCO rates than hydrophilic acrylic IOLs.

A clinical study on evaluation of risk factors and visual outcome after phacoemulsification in presenile cataract patients

To evaluate the risk factors, types of pre senile cataract and to assess the visual outcome after phacoemulsification and intraocular lens implantation in pre senile cataract.This was a hospital based cross sectional study of 90 patients who presented to Ophthalmology OPD of a tertiary care hospital and was diagnosed to have pre senile cataract. The study was done from June 2020 to November 2021. Patients who gave written informed consent were included in the study. Detailed history was taken regarding the age, gender, risk factors such as diabetes mellitus, myopia, occupation, smoking, corticosteroid use, dermatological disease etc. All the patients were subjected to routine ophthalmological evaluation. All the patients underwent phacoemulsification and IOL implantation. Visual acuity was noted before and after the surgery. The risk factors for pre senile cataract and visual acuity before and after cataract surgery was statistically analysed.Out of 90 patients included in the study, 60% were females Mean age at presentation was 42.94 ±5.93 years. Most common cause of pre senile cataract was diabetes mellitus (42.2%) followed by tobacco consumption (20%) and dermatological diseases (15.6%). Posterior subcapsular cataract was the most common type of cataract seen among young population and it has been significantly associated with diabetes mellitus. 87.8% had a best corrected visual acuity of 6/6-6/9 after phacoemulsification surgery. In this study diabetes mellitus and tobacco consumption are the two strongest modifiable risk factors for cataractogenesis in younger working population which is mainly because of the lifestyle changes. Majority of the patients attained a good visual acuity post phacoemulsification and IOL implantation surgery.