Common Type Of Cataract Research Articles

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.

STUDY OF CLINICAL PROFILE OF PSEUDO-EXFOLIATION SYNDROME AND PSEUDO-EXFOLIATION CATARACT IN A TERTIARY HEALTH CARE HOSPITAL IN WESTERN ODISHA

Objective: The pseudo-exfoliation (PEX) syndrome is a complex disorder characterized by the deposition of fibrillary materials around the blood vessels of organs. This study was conducted with the aim of knowing the actual prevalence of PEX in Western Odisha and the characteristics of cataracts in those PEX patients. Methods: This cross-sectional study included 340 OPD patients and was conducted between January 1, 2021, and December 31, 2022, at Hitech Medical College and Hospital. The prevalence of PEX and cataracts was studied. The data was analyzed using basic descriptive statistics and reported in frequencies and percentages. Results: The study showed 74 patients out of 340 were diagnosed with pseudoexfoliation syndrome, with a prevalence of 23%. 42 patients (58%) were male and 32 (42%) were female, with a M: F ratio of 1.3:1. The mean age of presentation was 67 y (range 51–84 y), and the majority of patients (41%) were in the age group of 61–70 y. The increased intraocular pressure was noticed in 11 cases (15%) in our study. Two patients each had open-angle glaucoma and lens-induced glaucoma. Nuclear cataract was the most common type of cataract observed in 27% of the study group, followed by cortical cataract with nuclear sclerosis in 19% of cases. Conclusion: It is concluded that pseudo-exfoliation syndrome is more common in males than in females, with a higher number of patients in the age group of 81 y and older. Therefore, it can be assumed that it is associated with the age factor. Nuclear cataract was the most common type of cataract observed in our study population.

Optical Biometry versus Ultrasound A-scan in Measuring Anterior Chamber Depth, Axial Length, and Lens Thickness in Patients Undergoing Cataract Surgery

Ocular biometry measurements use ultrasonography and optical biometry, offering high precision for noninvasive intraocular distance measurement in cataract surgery. This study aims to Compare agreement values between an optical biometry machine and an ocular ultrasound-based biometry device for axial length, anterior chamber depth, and lens thickness measurements. A study enrolled 64 eyes of 42 patients scheduled for cataract surgery at Benghazi Teaching Eye Hospital, Libya, from January 1st to February 1st, 2024. Patients' medical and ocular histories were taken, and slit lamp examinations were conducted. All eyes with visual impairment and good fixation were included. Axial length, anterior chamber depth, and lens thickness were measured using Aladdin optical biometer and an ellex eye-cubed ultrasonic contact biometer. The study involved 64 eyes with a mean age of 64.36 years, The most common type of cataract was posterior subcapsular cataract [46.9%], nuclear cataract [14.1%], and cortical cataract [14.1%]. Combined cataracts were also present in 31.3% of the participants. The ICC analysis showed a strong agreement [0.976] between the two measurement devices in assessing axial length. difference in measurements of the mean anterior chamber depth. ICC showed a high level of agreement between the two methods [0.545]. There was no significant difference in lens thickness as measured by optical biometry and A-scan ultrasound, with a medium positive correlation between lens thickness measurement by the two devices [P<0.001]. The interclass correlation further supported these findings, with a strong correlation between lens thickness and cataract development [r = 0.753]. The study reveals consistency in the measurements between optical and ultrasound biometry, highlighting the need for future research, to address limitations like small sample size and potential biases.

Ocular characteristics and outcomes of phacoemulsification in patients with cataract after renal transplantation.

To explore ocular characteristics of patients with cataracts after renal transplantation and analyze the results of phacoemulsification combined with intraocular lens (IOL) implantation. Patients with cataracts after renal transplantation and control patients who underwent phacoemulsification combined with IOL implantation were enrolled. All patients underwent phacoemulsification combined with IOL implantation. Visual acuity, intraocular pressure, type of lens opacity, corneal endothelial cell density, and ocular biological parameters were evaluated before surgery. Visual prognosis, dry eye, and postoperative complications were monitored for 6months after phacoemulsification. We analyzed 25 eyes of 16 patients after renal transplantation and 30 eyes of 21 control patients. The most common type of cataract of renal transplantation group was posterior subcapsular, while the most common type of cataract of control group was cortical. Significant differences in corneal astigmatism, white-to-white ratio, and keratometry values were observed between the groups. The postoperative visual acuity of both groups significantly improved following surgery. Postoperative complications, such as the degree of anterior and posterior capsule opacification and the incidence of a requirement of neodymium-doped yttrium aluminum garnet laser capsulotomy, were significantly lower in the renal transplantation group. Moreover, secondary glaucoma occurred in two eyes in the renal transplantation group. This study showed that cataracts after renal transplantation were mostly posterior subcapsular. Postoperative visual acuity recovered well in most patients, with reduced incidence of postoperative complications. This study suggested that phacoemulsification combined with IOL implantation was safe and effective, providing a reference for multi-focal IOL implantation in kidney transplant recipients.

Characterization of mechanical stress in the occurrence of cortical opacification in age-related cataracts using three-dimensional finite element model of the human lens and RNA-seq

Cataract is the leading cause of blindness across the world. Age-related cataract (ARC) is the most common type of cataract, but its pathogenesis is not fully understood. Using three-dimensional finite element modeling combining experimental biotechnology, our study demonstrates that external forces during accommodation cause mechanical stress predominantly in lens cortex, basically matching the localization of opacities in cortical ARCs. We identified the cellular senescence and upregulation of PIEZO1 mRNA in HLECs under mechanical stretch. This mechano-induced senescence in HLECs might be mediated by PIEZO1-related pathways, portraying a potential biomechanical cause of cortical ARCs. Our study updates the fundamental insight towards cataractogenesis, paving the way for further exploration of ARCs pathogenesis and nonsurgical treatment.

Epidemiology of childhood cataracts

Aims: The aim of the study was to investigate the epidemiologic characteristics of pediatric patients with cataracts and to make a statistical comparison. Methods: The study included 25 eyes of 19 children aged 16 years and younger who presented to Kırıkkale University, Faculty of Medicine, Department of Ophthalmology with visual complaints between April 2018 and November 2023. The information about the patients was obtained and recorded by scanning the patient files. The patient data included age, gender, cataract type, trauma history, medical history, family history, and surgical intervention. Results: In the study, 25 eyes of 19 children were examined. Eleven (57.9%) of the patients were girls, and eight (42.1%) were boys, with a mean age of 4.74±4.22 years (0.2-14). When all age groups were compared, there was no statistically significant difference between boys and girls in the incidence of childhood cataracts (p=0.532). Both eyes were affected in 5 children (26.3%), the right eye in 8 (42.1%), and the left eye in 6 (31.6%). Regarding etiology, 5 were idiopathic, 4 were genetic, 2 were metabolic syndrome, 2 were steroid-induced, and 6 were traumatic. Conclusion: Congenital cataracts are the most common type of cataract seen in early childhood. Routine ophthalmologic examinations for chronic drug use and raising awareness among families in cases of childhood trauma are important.

A Transformer-Based Knowledge Distillation Network for Cortical Cataract Grading.

Cortical cataract, a common type of cataract, is particularly difficult to be diagnosed automatically due to the complex features of the lesions. Recently, many methods based on edge detection or deep learning were proposed for automatic cataract grading. However, these methods suffer a large performance drop in cortical cataract grading due to the more complex cortical opacities and uncertain data. In this paper, we propose a novel Transformer-based Knowledge Distillation Network, called TKD-Net, for cortical cataract grading. To tackle the complex opacity problem, we first devise a zone decomposition strategy to extract more refined features and introduce special sub-scores to consider critical factors of clinical cortical opacity assessment (location, area, density) for comprehensive quantification. Next, we develop a multi-modal mix-attention Transformer to efficiently fuse sub-scores and image modality for complex feature learning. However, obtaining the sub-score modality is a challenge in the clinic, which could cause the modality missing problem instead. To simultaneously alleviate the issues of modality missing and uncertain data, we further design a Transformer-based knowledge distillation method, which uses a teacher model with perfect data to guide a student model with modality-missing and uncertain data. We conduct extensive experiments on a dataset of commonly-used slit-lamp images annotated by the LOCS III grading system to demonstrate that our TKD-Net outperforms state-of-the-art methods, as well as the effectiveness of its key components. Codes are available at https://github.com/wjh892521292/Cataract_TKD-Net.

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.

Infective Etiologies in Patients with Bilateral Congenital Cataract

Objective: To determine the frequency of positive Toxoplasma, Rubella, Cytomegalovirus, Herpes Simplex virus and Syphilis serology in patients with bilateral congenital cataract and their correlation with different type of cataracts and age groups.
 Study Design: Cross sectional study.
 Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from May to Dec 2022.
 Methodology: Data was collected by a single investigator on Microsoft Excel sheet including patient’s age, gender, mode of delivery, consanguinity of parents, and type of congenital cataract, results of TORCH Screening and Presence or absence of amblyopia. TORCHS screening comprised of serum IgM and IgG levels for Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex virus and Syphilis. 
 Results: A total of 134 patients reported to our institute with bilateral congenital cataract during the study period. Out of them 56 patients had positive results of TORCH screening (41.7%) Out of total 56 patients with bilateral congenital cataract testing positive for TORCH, 30(53.6%) were male while 26(46.4%) were female. Age range was from 1-17 months (9.2±4.2 months).Lamellar cataract was the most common cataract type in our study sample 16(28.6%).
 Conclusion: In patients with bilateral congenital cataract positive TORCHS serology was most frequent. Serum Rubella IgM followed by Rubella IgG was positive in most cases. Most common age of presentation in our study was from 4-7 months. Furthermore, lamellar cataract followed by nuclear cataract was the commonest cataract type.

Comparison of the reverse chopper-assisted prechop and phaco-chop nucleotomy techniques during phacoemulsification for cataracts with grade III nuclei: a randomized controlled trial.

Phacoemulsification surgery is the standard treatment for cataract. However, excessive ultrasound (US) energy may cause injury to the corneal endothelium and other ocular tissues. Recently, a new prechop technique assisted with the reverse chopper is showed to be more efficient and safe, by splitting the nuclei in situ without using any US energy. However, it is verified only in treating some kinds of complex cataracts such as grade IV hard nuclei cataract, small-pupil cataract, and ultra-high myopia cataract. Since grade III nuclei cataract is the most common type of cataract, it is necessary to evaluate the efficacy and safety of prechop technique with reverse chopper in routine cataract surgery. This prospective, two-parallel, randomized controlled trial was conducted in Beijing Tongren Hospital from January 2022 to September 2022. A total of 89 cataract patients (89 eyes) were enrolled and then randomly assigned to either the reverse chopper-assisted prechop group (n=45) or the phaco-chop group (n=44). The patients were followed for 3 months postoperatively. The best-corrected visual acuity (BCVA), cumulative dissipated energy (CDE), corneal endothelial cell loss (ECL), and degree of corneal edema were evaluated and compared between these 2 groups. Data were analyzed using SPSS 23.0 and GraphPad Prism 8.0. The CDE of the reverse chopper-assisted prechop group was significantly less than that of the phaco-chop group (P=0.011). Compared with the phaco-chop group, the corneal edema in the reverse chopper-assisted prechop group was milder (P=0.026) and the BCVA was better (P=0.0012) at 1 day after surgery. No significant difference was found in the count or rate of corneal ECL between the 2 groups at 1 month after surgery (corneal ECL count: P=0.090; corneal ECL rate: P=0.053). The BCVA of the 2 groups at 1 week, 1 month, and 3 months after surgery was equivalent (P=0.052, 0.26, and 0.41, respectively). The prechop technique assisted with the reverse chopper in treating cataract with grade III nuclei enables less phaco energy consumption, milder ocular structural damage, and faster recovery of vision, compared with traditional phaco-chop technique.

Prospective clinical study of ocular manifestations in patients with type 2 diabetes mellitus

Purpose: The purpose of this study is to determine the common ocular manifestations in diabetes and their relation to the duration and severity of the diabetes. Methodology: This is a prospective, observational study of patients attending the outpatient department and those referred to the tertiary eye care hospital in Bagalkote district of Karnataka from October 2012 to March 2014. Type 2 diabetic patients were recruited on the basis of history, clinical examination, and blood investigations. Along with detailed demographic history, all participants underwent complete slit-lamp anterior segment, posterior segment examination and intraocular pressure measurement was done. Estimation of random blood sugar at admission and fasting blood sugar and postprandial blood sugar second day of admission along with urine sugar, albumin, and microscopy. If necessary based on the indication, fundus fluorescein angiography was also performed. Results: Out of 350 patients evaluated, 211 were male (60.3%) and 139 (39.7%) were female. Diabetic retinopathy (DR) was the most common complication (36.8%), followed by cataract 35.4%, glaucoma (4.6%), and other pathologies such as conjunctivitis, recurrent hordeolum, and dacrocystitis. The strongest predictor for the prevalence of retinopathy in persons with Type 2 diabetes is the duration of diabetes and was proven statistically significant. Both prevalence and severity of retinopathy correlate with HBA1C level in our study group. The most common type of cataract found was cortical type (41.2%) followed by senile posterior cortical (29.8%). Diabetes predisposes to infection in different body parts, and ocular structures are not an exception. Conclusion: DR was the most common ocular complication of diabetes, followed by cataract and primary open angle glaucoma. The prevalence and severity of DR were higher in patients with the longer duration of diabetes.

Phacoemulsification under Topical Anesthesia in a Tertiary Care Hospital

Introduction: The use of topical anaesthesia for cataract surgery dates back to 1884 when Knapp used 5% cocaine to anaesthetize cornea. The advancement in cataract surgery techniques like small stepped, self-sealing corneal incisions, phacoemulsification and advanced intraocular lenses has allowed the use of topical anaesthesia thus reducing surgical time and need of akinesia. Materials and Methods: Prospective non-comparative evaluation of patients’ and surgeon’s satisfaction under topical anaesthesia. All patients received topical anesthesia with proparacaine 0.5%. A 10-point visual analogue scale was given to patients to rate the level of pain felt during the operation. Also, the level of patient satisfaction, the need for supplemental anaesthesia, level of ocular motility, surgical complications and postoperative visual acuity were recorded. Results: Total number of cases were 156 out of which 86 (55.1%) were males and 70 (44.9%) were females. Nuclear sclerosis was most common type of cataract followed by mixed opacities. Majority of patients had no intraoperative movement and 30.8% of patients had some movement. Surgeon was dissatisfied in only 12.2% cases who had disturbing movements during surgery. Although majority of patients felt no pain (68%) or mild pain (23.7%) during surgery 8.3% cases had moderate to severe pain which required supplemental intracameral lidocaine. Conclusion: Topical anaesthesia is cost effective, provides high patient comfort during surgery, is less stressful for the patient, saves considerable time and complications compared to regional anaesthesia. Keywords: topical anaesthesia, phacoemulsification, pain assessment, surgeon`s satisfaction.

Risk Factors and Types of Presenile Cataract in Patients Attending a Tertiary Care Hospital in Kerala- A Retrospective Study

Background: Cataract is a major cause of blindness worldwide with a greater prevalence in developing countries like India. Presenile cataract refers to an onset of this disease below 50 years of age. Objectives: To study the factors associated with development of presenile cataract among the total cataract patients who attended out-patient clinic of Ophthalmology department from January 2016 to July 2017 and to find out the proportion of different types of presenile cataract. Method: The study includes patients who had undergone cataract surgery in the Department of Ophthalmology Government Medical College, Ernakulam from January 2016 and June 2017. Data was retrospectively entered and analysed. Results: There were 100 (49 males and 51 females) patients between the age 30 and 50 years. Around 70 study participants had co-morbidities. The average axial length was 22.5532mm, the average haemoglobin content was 13.01 g/dL, average total count was 8590.85, average BL urea was 22.755 mg/dL, average serum creatinine concentration was 0.9611 mg/dL and average GRBS concentration was 131.43 mg/dL. Drug history of 69 patients was observed in the current study. Conclusion: The most common type of cataract seen was posterior subcapsular cataract followed by mature cataract. Diabetes mellitus was the predominant risk factor in posterior subcapsular cataract. Keywords: Presenile cataract; Risk factors; Posterior subcapsular cataract.

Analysis of visual outcome following cataract surgery in axial myopic patients

Aim: The primary outcome is to assess visual outcomes following cataract surgery in axial myopic patients. The secondary outcome assessed is perioperative complications rate due to high axial length. Materials and Methods: Type of study: It was a retrospective, noncomparative case series study. Inclusion criteria: Patients with axial length more than or equal to 25 mm with visually significant cataract in one or both eyes were recruited for the study. Patients with pathological myopia were also included – visual recovery was assessed in conjunction with the preoperative best-corrected visual acuity. Exclusion criteria: Myopic patients with cataract with other causes of visual loss such as macular scar, diabetic retinopathy, age-related macular degeneration, disc edema, vein occlusion, and epiretinal membrane were excluded from the study. Sample Size: The sample size of the study was 32 patients (49 eyes). All patients recruited for the study underwent complete anterior segment examination in slit lamp with due importance to the type of cataract, visual acuity examination, and refraction to assess preoperative best-corrected visual acuity and posterior segment examination with 90 D lens. If the posterior segment was not visualized, B-scan was done. Blood investigations include complete blood count, random blood sugar, HIV, hepatitis B virus surface antigen, and urine albumin/sugar. With the test results and electrocardiogram, anesthetist fitness was obtained. Duct patency and intraocular pressure (IOP) were measured. Automated keratometry and axial length were measured by immersion technique done to calculate intraocular lens (IOL) power. IOL power calculation was performed using the SRK/T which was found to be reliable in axial lengths above 25 mm. Anterior chamber depth and lens thickness were also measured. All patients underwent phacoemulsification with IOL implantation by experienced single surgeon. The main outcomes measured were visual acuity after cataract surgery with implantation of zero or negative or very low IOL power at 1-month postoperative period and intraoperative and postoperative complications. The method of surgery did not influence the visual outcome. Results: The mean age of the patient operated on was about 61.9 years. In our study, the most common type of cataract was nuclear cataract (63.2%). Only 4.1% had previous refractive surgery. About 65.3% had 6/6 vision postcataract surgery with axial myopia. About 51.1% of axial myopic patients' fundus changes before cataract surgery which could be one of the causes for poor visual acuity. No significant perioperative complications were observed. Conclusion: Good postoperative outcomes following cataract surgery were observed in patients with cataract and high myopia. Refractive error is a potential complication as the hyperopic error appears to increase with axial length, especially in patients receiving negative power lens. If a sulcus IOL is inserted, it is more likely to be unstable or decenter because of the larger sulcus size. The need for Nd: YAG capsulotomy for posterior capsular opacity was found to be more common in myopes with high axial length compared to the general population. IOP reduction is slower and unstable for the first 30 days of postcataract surgery in highly myopic eyes.

Impact of Rashtriya Bal Swasthya Karyakram, in management of childhood cataract, at a tertiary eye care center of Eastern Uttar Pradesh

Background: Cataracts in children are rare, accounting 7.4-15.3% of pediatric blindness. Pediatric cataract is a treatable leading cause of childhood blindness. Rashtriya bal swasthya karyakram (RBSK) is an important initiative aiming at early identification and early intervention for children from birth to 18 years. The objective of our study was to know the impact of RBSK, in management of childhood cataract, at a tertiary eye care center.Methods: This was a hospital based retrospective study, done from December 2018 to December 2019. This study included all patients of congenital and developmental cataract during this study period. The patients aged less than or equal to 18 years were included. All statistical analyses were done at 5% (p<0.05) significance using Graph Pad instat version 3.0 and Microsoft excel 2019.Results: During a study period of thirteen months, 357 eyes of 210 patients with congenital or development cataract were included. There were 142 (67.61%) male patients and 68 (32.38%) were female. The maximum number of patients were seen in the age group of 4-6 years 52 (24.7%), followed by the age group of 7-9 years 48 (22.8%). Bilateral cataracts were seen in 148 (70.4%) patients and unilateral cataract in 61 (29.0%) patients. The most common type of cataract was lamellar cataract seen in 150 (42%) eyes.Conclusions: RBSK is changing the lives of children and their families by reducing the burden of childhood blindness due to cataract and improving the quality of the life, especially in financially underprivileged families.

Observational study on ocular manifestations in type 2 diabetes patients attending the ophthalmology department, at RVM hospital, South India

Introduction: India is infamously known as the Diabetes capital of the world. The national wide prevalence of diabetes in India now is 9%. By 2030, India will have 100 million people with type 2 Diabetes. Methodology: Cross sectional observational study, Study was conducted in ophthalmology department at RVM Hospital, Siddipet District, and Telangana State. The study was conducted in April 2018 to December 2019.The Sample Size is 300. Results: 188(63%) were males and 112(37%) are females. Among both sexes, age groups between 51 to 60 years had maximum number of patients (34%).33 patients had some lid lesions, out of which 12 had stye followed by 10 had Xanthelasma Conjunctival lesions found were pterygium 13(4.33%) and conjunctivitis 6(2%).6 patients had corneal ulceration (2%), 3 had reduced corneal sensation (1.0%) while 1 patient had perforation (0.33%). 11.5% people are affected by mild NPDR within 5 years, which increases significantly to 26.6% in 10 years. Conclusion: Thus both prevalence and severity of retinopathy correlates with HbA1C levels in this study group. The most common type of cataract found was cortical type (39.13%) followed by senile posterior cortical cataract (32.60%). In general, the visual prognosis following cataract surgery in diabetic patients is favourable. The prevalence of Primary open angle glaucoma was 2.33% and 2.0% had neo-vascular glaucoma. Diabetes predisposes to infection in different body parts, and ocular structures are not an exception.

Visual outcome and prognostic factors in cataract surgery in ocular tuberculosis.

Purpose:To analyze the outcome of cataract surgery in patients with ocular tuberculosis (OTB).Methods:Medical records of patients with OTB who underwent cataract surgery between 2005 and 2018 were retrospectively reviewed. The primary outcome measure was corrected distant visual acuity (CDVA), and a good outcome was defined as CDVA 20/40 or better.Results:There were 35 patients (41 eyes), of whom 13 (37.1%) were males and 22 (62.9%) were females. The mean age was 41.6 ± 13.8 (range 18–65) years. Anterior uveitis was present in 24 (58.5%) eyes, intermediate uveitis in 5 (12.2%) eyes, posterior uveitis in 6 (14.6%) eyes, and panuveitis in 6 (14.6%) eyes. Posterior sub-capsular cataract (51.2%) was the most common type of cataract. Total cataract was present in 9 (22%) eyes. The two most common ocular comorbidities were small pupil (85.4%) and glaucoma (17.1%). Phacoemulsification was performed in 36 (87.8%) eyes and ECCE was performed in 5 (12.2%) eyes. Intraoperatively the pupil was mechanically dilated in 36 (87.8%) eyes. Overall 26 (63.4%) and 23 (56.1%) eyes achieved CDVA 20/40 or better at 1- and 6-month follow-up visit, respectively. The mean preoperative LogMAR CDVA significantly improved from 1.28 ± 0.57 to 0.38 ± 0.36 at 1-month (P < 0.0001). One eye had fibrinous anterior chamber reaction and 24 (58.5%) eyes had 1 or more episodes of reactivation of uveitis in the follow-up period. The three commonest complications were glaucoma (26.8%), posterior capsule opacification (19.5%), and epiretinal membrane (17.1%). Postoperative posterior segment complications like epiretinal membrane formation, vitreous inflammation and cystoid macular edema affected final visual acuity (P < 0.002).Conclusion:The visual outcome after cataract surgery in OTB was satisfactory as significant number of patients achieved a good final visual acuity.

A study of risk factors and epidemiologic profile of posterior polar cataract/posterior subcapsular cataract in Northwest Rajasthan

Background: In India, cataract is the foremost cause of blindness, leading to the mild-to-severe morbidity. Objective: The objective of the study was to find out the epidemiologic profile and risk factors of posterior polar cataract/posterior subcapsular cataract. Materials and Methods: A prospective non-comparative observational study involving 50 patients having posterior polar cataracts attending our outpatient department was selected and was questioned about their locality, systemic diseases, ocular disease, and use of steroid in any form which were included in the study. Results: Of the 50 patients, 30 were male and 20 females, most patients were in the age group of 61–70 years. About 66% of the patient belongs to the rural locality. Most of the females were homemaker, 24% were farmer, 8% were shopkeeper, and 6% retired persons while 2% each of electrician, computer programmer, and bus driver. About 48% had bilateral cataracts, 42% (21) were pseudophakic in one eye, and 1% (5) unilateral cataract. About 24% of patients had hypertension, 18% of patients had of asthma/chronic obstructive pulmonary disease, 16% of patients had diabetes mellitus, 2% of patients had h/o arthritis, 8% had skin disease, 6% had h/o injudicious use of over-the-counter topical drops while 4% of patients of thyroid disease were noted and 34% of patients had h/o steroid use. The most common type of cataract seen Grade I (52%, 26 patients), followed by Grade II (36%, 18 patients), Grade III (8%, 4 patients), and Grade IV (4%, 2 patients). Conclusion: With increasing injudicious use of steroid can result in formation of posterior polar/posterior subcapsular cataract in young age and professional office class workers who are seeking medical help at early stage. An ultrasound should be done to rule out posterior capsular defect if suspected and the patient should be counseled well about the complication prior taking into surgery.

Frequency of Cataract in Diabetic Verses Non-Diabetic Patients

Purpose: To determine the frequency of cataract in diabetic verses non-diabetic patients.&#x0D; Study Design: Descriptive cross-sectional study.&#x0D; Place and Duration of Study: Eye Outpatients Department of Fatima Memorial Hospital Lahore from December to March 2018.&#x0D; Material and Methods: Patients between 20-50 years of age with and without diabetes were included in the study. The diabetic patients included in the study had diabetes for at least 6-7 years. Patients with any other systemic disease and patients &lt;20 years and &gt; 50 years were excluded from the study. All patients underwent a complete eye examination including uncorrected and best corrected visual acuity, refraction, dilated slit lamp and fundus examination.&#x0D; Results: A total of 194 patients were examined. Average duration of diabetes was 6-7 years with age groups 20-35 years (34.02%) and 35-50 years (65.97%). There were 79 (79.79%) patients with diabetes who had cataract while only 13 (13.68%) non- diabetic patients had cataract. Most common type of cataract in diabetic patients was posterior subcapsular cataract (PSCC) 43 (54.43%). This was followed by nuclear cataract in 17 (21.51%) and cortical cataract in 14 (17.72%) patients. While in non-diabetic patients nuclear cataract was seen in 6 (46.15%) patients and cortical and PSCC were the same percentage 3 (23.07%). Cataract frequently developed in the age group of 35-50 years in diabetic patients.&#x0D; Conclusion: Diabetic patients should be screened for cataract early as PSCC can cause significant deterioration of vision between 35-50 years.&#x0D; Keywords: Cataract, Diabetes Mellitus (DM), Posterior Sub Capsular Cataract (PSCC), Nuclear Cataract (NC) and Cortical Cataract (CC).

Presenile cataract and its risk factors: A case control study.

Purpose:Early onset opacification of the lens (cataract) has been observed to be on the rise globally. This study was conducted to determine the various types of presenile cataract and to determine the probable risk factors associated with the occurrence of presenile cataract.Materials and Methods:Patients in the age group of 18–40 years attending the Out-Patient Clinic of the Ophthalmology Department who were found to have presenile cataract were recruited as cases. An equal number of consecutive patients of the same age group were included in the control group. Those who gave consent to participate in the study were interviewed through a preformed questionnaire and underwent a complete ocular examination and set of blood investigations. The type of cataract was noted, data obtained were compiled, and examination and investigations done were documented and analyzed using frequency distribution and Chi-squared test.Results:In total, 90 cases and 90 controls that fulfilled the inclusion criteria were recruited. Most common type of cataract was found to be posterior subcapsular cataract. Presenile cataract was observed to be significantly associated with tobacco intake (P = 0.035), hypercholesterolemia (P = 0.002), fuel exposure (P = 0.004), and lower socioeconomic status (P = <0.001).Conclusions:Tobacco chewing, hypercholesterolemia, and excessive fuel exposure are risk factors for early development of cataract.