Early Cataract Research Articles

Widefield Retinal Imaging in Gyrate Atrophy: Correlation of Structural, Biochemical, and Functional Characteristics

ObjectivesTo profile a cohort of gyrate atrophy patients classified by widefield retinal imaging and correlate the structural, biochemical, and functional characteristics. DesignRetrospective observational cohort study. ParticipantsSixty-five patients (129 eyes) with gyrate atrophy. MethodsData of participants with a diagnosis of gyrate atrophy were retrieved from their electronic medical records (January 2015 to December 2023). Retinal involvement was classified into three zones using widefield retinal images. Zone 3 had atrophic patches in the area anterior to the equator; Zone 2 had involvement limited to the arcades but posterior to the equator; Zone 1 had involvement within the vascular arcades and/or peripapillary region, with or without any other zone involvement. Macular assessment was performed using swept-source OCT (n=104). Flash ERG was performed in 40 eyes. serum ornithine levels (n=35) were measured, and genetic analysis was conducted (n=18). Main Outcome MeasuresDemography, patient profile, zone of retina involved, macular features, and serum ornithine levels. ResultsThe average age at presentation was 26.4 (range: 5-67) years, majority were male. Nyctalopia (n=35, 53.8%) and blurred vision (n=29, 44.6%) were the most common symptoms. Positive family history was reported in 32.3% of patients. Most eyes were myopic (69.8%<-3 D). Posterior subcapsular cataracts were documented in 36.4% of eyes. The highest frequency of retinal area affected was Zone 1 (57.14%), followed by Zone 2 (33.33%) and Zone 3 (9.52%), correlating with age at presentation. Foveoschisis was observed in 57.7% of eyes, with a higher prevalence in eyes with Zone 1 disease. Elevated serum ornithine levels (>163 μmol/L) were found in 77.14% of patients. ERG showed non-recordable (n=32) or severely reduced (n=8) responses in scotopic and photopic phases. Genetic analysis of 18 patients identified mutations in the OAT gene, including a novel missense variant (c.290T>C). ConclusionsThis large cohort of patients with gyrate atrophy revealed symmetrical involvement, predominantly in Zone 1. Most patients presented between the first and third decades, experienced nyctalopia, vision reduction, early posterior subcapsular cataracts, and varying degrees of myopia. Zone 1 involvement was strongly associated with foveoschisis and visual compromise.

Dysfunctional lens syndrome: a literature review

Introduction. The term “Dysfunctional Lens Syndrome” (DLS) refers to age-related changes in the lens, including early cataracts and presbyopia, that do not significantly reduce visual acuity. This syndrome is characterized by a decrease in accommodative amplitude, an increase in light scattering, and a reduction in contrast sensitivity. With rising life expectancy, the prevalence of DLS is increasing, necessitating a more in-depth study of the pathogenic mechanisms underlying the syndrome and the refinement of its diagnostic criteria to establish standards for treatment correction. Aim: to summarize information on the pathogenesis of DLS, the potential for staging the syndrome using objective examination methods, and to provide treatment recommendations. Materials and methods. A bibliographic study of scientific publications was conducted using the Pubmed, ScienceDirect, and Cyberleninka databases. Literature sources were searched using the following keywords: dysfunctional lens syndrome (DLS), presbyopia correction, cataract, age-related lens changes. A total of 32 publications, primarily from the last 10 years, were included in the study from more than 100 viewed sources. Results. The DLS encompasses a wide range of conditions, from early stages characterized by a loss of accommodative amplitude and minor refractive anomalies to later stages involving a decrease in visual acuity and quality due to increased light scattering and aberrations. Currently, the evaluation of age-related lens changes involves assessing visual acuity and determining the degree of lens opacification using slit-lamp examination. Additionally, objective instrumental methods, such as optical coherence tomography and Scheimpflug imaging, can be used to assess the degree of lens opacification. Various methods are employed for the correction and treatment of DLS, ranging from glasses and contact lenses to surgical interventions, such as lens extraction and intraocular lens implantation. Research is also ongoing into drugs aimed at slowing the progression of lens changes. Conclusion. The term “Dysfunctional Lens Syndrome” is currently used to describe early cataracts and presbyopia, where the reduction in visual acuity is still minor, but patients experience visual complaints due to age-related lens changes. Further research is necessary to develop and standardize diagnostic criteria and to evaluate the effectiveness of new treatment methods and interventions in order to create the most effective and adequate approach to correcting DLS and alleviating the associated visual complaints.

An Automated Wavelet Scattering Network Classification Using Three Stages of Cataract Disease

إعتام عدسة العين وهو مرض يصيب العين حيث يسبب تشوهًا بصريًا ويمكن أن تؤدي المرحلة المتأخرة من هذا المرض إلى العمى. ويعتبر مرضًا صامتًا يمكن أن يحدث دون ظهور الأعراض. لذلك ، فإن الطريقة الأكثر فاعلية للكشف عن إعتام عدسة العين هي من خلال الكشف الدقيق في الوقت المناسب لمنع الأذى والعمى والعمليات المكلفة. ان الغرض من هذه البحث هو اقتراح نظام آلي يعتمد على شبكة نثر المويجات التي تصنف المرضى إلى أربع فئات: إعتام عدسة العين المبكر وإعتام عدسة العين المتوسط وإعتام عدسة العين المتأخر وعدم إعتام عدسة العين باستخدام 512 صورة لقاعدة البيانات ODIR (212 شخص مصاب و300 شخص غير مصاب). الخطوة الأولى في هذه التقنية هي خطوة المعالجة المسبقة لصورة الشبكية التي كانت عبارة عن مرشح المتوسط ، والذي تم استخدامه لتقليل ضوضاء الصورة. ثم بعد ذلك استخدام طريقة معادلة الرسم البياني التكيفية محدودة التباين (CLAHE) لتحسين مستوى عينات الصورة. بعد ذلك ، يمكن استخراج الخصائص منخفضة التباين من بيانات الصورة باستخدام شبكة تشتت المويجات لاستخدامها في تطبيقات التعلم العميق. في هذه الشبكة ، يتم استخدام مرشحات تحجيم تمرير منخفض وموجات موجية محددة مسبقًا. كان متوسط دقة الطريقة المقترحة 100٪ لأربع فئات (غير مصاب، مبكر، متوسط، شديد). علما ان النتائج موعودة مقارنة مع أعمال أخرى مماثلة.

Cataract and glaucoma detection based on Transfer Learning using MobileNet

A serious eye condition called cataracts can cause blindness. Early and accurate cataract detection is the most effective method for reducing risk and averting blindness. The optic nerve head is harmed by the neurodegenerative condition known as glaucoma. Machine learning and deep learning systems for glaucoma and cataract detection have recently received much attention in research. The automatic detection of these diseases also depends on deep learning transfer learning platforms like VeggNet, ResNet, and MobilNet. The authors proposed MobileNetV1 and MobileNetV2 based on an optimized architecture building lightweight deep neural networks using depth-wise separable convolutions. The experiments used publicly available data sets with both cataract & normal and glaucoma & normal images, and the results showed that the proposed model had the highest accuracy compared to the other models.

An Assessment of Contemporary Methods and Data-Enabled Approaches for Early Cataract Detection

Background: Cataracts are common causes of visual impairment. Preventing blindness requires an early and accurate diagnosis. This review examines current cataract diagnosis strategies, explores data-driven machine learning algorithms for early detection, investigates the use of artificial intelligence (AI) approaches, assesses improvements in cataract detection accuracy, identifies research gaps, and provides recommendations for future studies. Methods: We gathered labelled cataract and non-cataract fundus data from the Kaggle. Scholarly publications were sourced from reliable databases such as ProQuest, IEEE, ELSEVIER, Google Scholar, and PubMed. A detailed literature search with specific terms expanded the scope of this review. We included studies that used cataract and non-cataract fundus eye images from cross-sectional, retrospective, and prospective studies. The quality assessment used the AMSTAR tool, considering factors such as literature search comprehensiveness, study selection criteria, data extraction methodologies, and study validity (Table 1). Results: This study encompassed 130 research publications, focusing on machine learning models and clinical-based diagnostic approaches for early-stage cataract identification. The performance of machine-learning models is influenced by factors such as dataset noise and limited reliable data. Barriers to the successful implementation of AI for cataract diagnosis were identified. Conclusions: This review emphasises the obstacles hindering the broad application of AI in cataract diagnosis. Addressing these findings is vital for developing strategies to overcome these challenges and enhance cataract detection systems. To achieve improved accuracy and efficiency in cataract diagnosis, future research should prioritise efforts to enhance dataset availability and quality, reduce data noise, and refine machine-learning algorithms. Unlocking the full potential of AI and/or machine learning can lead to significant breakthroughs in cataract diagnosis, ultimately resulting in better patient outcomes and reduced visual impairments.

Importance of Early Intervention of Traumatic Cataract in Children

Aim: To evaluate the intraoperative complications &amp; post- operative outcome of early intervention of traumatic cataract in children due to open globe injuries.  Materials and Methods: 40 cases of unilateral cataract having repair of open globe injuries previously were included in this prospective study. Primary repair of corneal injuries were done with 10-0 Nylon under general anesthesia. Secondary intervention with IOL implantation were done within 4 weeks of primary repair. Age range was 4-14 years and minimum follow up 3 months. Intraoperative and postoperative complications and final best-corrected visual outcome were recorded.  Results: All cases had pre-existing anterior capsular tear and flocculent lens matter in anterior chamber. IOL were implanted in the bag in 90% cases. Intra-operatively 4 cases revealed pre-existing posterior capsular hole and IOL were implanted in the sulcus. Synechiolysis was done in 3 cases. There was no iatrogenic PC rent. Postoperatively no cases showed synechiae formation, pupil capture and IOL displacement. Visual acuity was 6/9 to 6/60 in all cases and intraocular pressures were digitally normal. No optic atrophy and RD were noticed at last follow up. Most common causes of decreased vision were corneal scar and astigmatism.  Conclusion: Early cataract surgery with IOL implantation after repair of open globe injuries carries favorable intraoperative and postoperative outcome.

Design of A Cataract Detection System based on The Convolutional Neural Network

Cataract, a condition characterized by clouding of the eye's lens, leads to decreased vision and potentially blindness. In Indonesia, it is the predominant cause of blindness, accounting for 81.2% of cases. Given the rising life expectancy, the incidence of degenerative diseases like cataracts is expected to increase. This research aims to develop a cataract detection system capable of classifying eye images as either indicative of cataracts or normal. Utilizing Convolutional Neural Networks (CNN) and RGB-based image processing—including edge detection techniques such as Canny and Prewitt—the system identifies eye contours. This facilitates image segmentation to ascertain the eye's condition. Therefore, image collection and processing models play a crucial role in this study. The research findings indicate that the system functions effectively, with a 98% success rate in accurately processing normal eye images through the CNN model without detecting cataracts. When tested using grayscale imaging, cataract-afflicted eyes—characterized by red spots in the images—were also successfully identified by the CNN model. These test results demonstrate that the designed cataract detection system can accurately classify images into normal or cataract-afflicted eyes with high precision. This system shows promise for use in early cataract detection, potentially helping to reduce the prevalence of cataract-related blindness in Indonesia.

Enhancing Cataract Detection through Hybrid CNN Approach and Image Quadration: A Solution for Precise Diagnosis and Improved Patient Care

Cataracts, characterized by lens opacity, pose a significant global health concern, leading to blurred vision and potential blindness. Timely detection is crucial, particularly in regions with a shortage of ophthalmologists, where manual diagnosis is time-consuming. While deep learning and convolutional neural networks (CNNs) offer promising solutions, existing models often struggle with diverse datasets. This study introduces a hybrid CNN approach, training on both full retinal fundus images and quadrated parts (i.e., the fundus images divided into four segments). Majority voting is utilized to enhance accuracy, resulting in a superior performance of 97.12%, representing a 1.44% improvement. The hybrid model facilitates early cataract detection, aiding in preventing vision impairment. Integrated into applications, it supports ophthalmologists by providing rapid, cost-efficient predictions. Beyond cataract detection, this research addresses broader computer vision challenges, contributing to various applications. In conclusion, our proposed approach, combining CNNs and image quadration enhances cataract detection’s accuracy, robustness, and generalization. This innovation holds promise for improving patient care and aiding ophthalmologists in precise cataract diagnosis.

Phacoemulsification in angle-closure glaucoma: A 360° evaluation.

To evaluate the effect of phacoemulsification on intraocular pressure (IOP) and anterior chamber angle (ACA) morphology in primary angle-closure glaucoma (PACG). A hospital-based, prospective pre- and post-interventional study was carried out in 40 PAC and PACG eyes post patent PI with visually significant cataracts. All patients underwent phacoemulsification and were evaluated for IOP control, ACA widening, and disease progression for a minimum of 6 months. Failure was defined as an IOP of >21 mmHg necessitating another intervention, including trabeculectomy and/or an increase in the required number of antiglaucoma medications (AGMs) by >1. A highly statistically significant reduction of IOP ( P < 0.0001) was seen with an overall reduction of 42.2% over 6 months and a mean reduction of 8.9 ± 3.59 mmHg, with the requirement of AGMs reducing from 39/40 patients preoperatively to 1/38 postoperatively. Success was seen in 95% of cases, with two patients not achieving target IOP and requiring trabeculectomy. Angle widening was documented in all cases by both gonioscopy and AS-OCT, and none of the patients showed any progression in disc damage and visual field changes. Early cataract surgery in ACG not only helps to control IOP and disease progression by widening angles and improving aqueous outflow but also improves visual acuity and reduces the economic burden of AGMs. It also helps in better evaluation of disease progression by both structural and functional analysis, as was documented by the improved and more reliable visual field indices.

B- Mode Ultrasonography of Ocular Abnormalities in Dogs

Background: Ultrasonography is a simple, safe and non-invasive method to examine the internal structures of eye in case of opacity of otherwise clear ocular medium like cornea, aqueous, lens, and vitreous. Methods: 123 dogs with ocular abnormalities from March 2021 to October 2022, presented to the Division of Veterinary Surgery and Radiology were included in this study. All of the animals underwent a thorough ophthalmic examination along with B-scan ultrasonography of both the eyes using a 7.5 MHz linear probe. Result: Ultrasonography revealed thin hyperechoic lines and a thin hyperechoic rim of the lens, indicating early cataract changes and cortical cataract, respectively. Sixty-two dogs were found to be affected by cataract; 20 dogs were affected by the disease Phthisis bulbi; 16 dogs had a complete retinal detachment showing a typical “morning glory” sign; 10 dogs had vitreous haemorrhage; 6 dogs had a damaged eye with lens dislocation; and 5 dogs had choroidal melanoma and intraocular tumours in 4 dogs out of 123 observed dogs. Further, out of 62 cataract cases, 16 dogs were affected by cortical cataracts, 41 had nuclear cataracts, and 5 dogs were affected by morgagnian cataracts. Therefore, B-scan ultrasonography of the eye was a quick, safe, and accurate way to examine the pathology, especially when opaque media inhibit direct examination or when exophthalmos is evident and the normal anatomy of the eye.

TRPM3-mediated inhibition of active Na-K transport by the ocular lens epithelium

Purpose: The TRPM3 channel is selectively expressed in the lens epithelium, a monolayer at the anterior lens surface, but undetectable in fiber cells that make up the lens bulk. A point mutation in TRPM3 gene (substitution of isoleucine by methionine at codon 65; I65M) causes early onset autosomal dominant cataract in humans and in mice. From studies on transgenic mice, it is apparent the I65M TRPM3 mutation disrupts lens Na-K homeostasis. However, the normal role of lens TRPM3 in the lens is currently unknown. Here, we explore the lens response to TRPM3 activation. Methods: Studies were carried out using intact mouse lenses, cultured mouse lens epithelial cells and a human lens epithelium cell line (HLEB3). Active Na-K transport was studied by using rubidium (Rb) as a tracer for potassium entry. Rb was detected by atomic absorption spectrophotometry. Intracellular calcium was measured in nonconfluent single cells by Fura-2 ratiometric imaging. Results: Rb uptake was measured over a period of 10 min in intact mouse lenses exposed to a TRPM3 agonist CIM0216 (10 μM). CIM0216 reduced the rate of Rb uptake by ~20% (Ctrl 6.4±0.4 vs CIM 4.5±0.4 mmoles/kg lens dry weight/10 min, n=7, p&lt;.01). The concentration dependence of the response to CIM0216 (1 to 50 μM) was examined in primary cultured mouse lens epithelium and Rb uptake was reduced by CIM0216 concentrations &gt; 10 μM. The TRPM3 agonist reduced Rb uptake to a similar extent (~20%) in mouse lens epithelium, HLEB3 cells and HLEB3 cells that had been stably transfected with the I65M mutant TRPM3. However, the mutant cells responded to CIM0216 at a 10-fold lower concentration than WT mouse and HLEB3 cells. The Rb uptake response to CIM0216 was significantly inhibited by a TRPM3 antagonist, primidone (50 μM), and was abolished when cells were bathed in calcium-free solution. To study calcium entry, Fura2-loaded mouse lens epithelial cells were exposed to the TRPM3 agonist pregnenolone (100 μM). Pregnenolone caused an immediate increase in cytoplasmic calcium that was inhibited by primidone (Peak calcium concentration Ctrl 201±37 vs primidone 137±8 nM, n=5, p&lt;.001). In cultures lens epithelium, agents that increase cellular cAMP, including IBMX, forskolin and 8p-CPT-cAMP, all caused a marked reduction of Rb uptake. Conclusions: TRPM3 activation causes a significant reduction in the rate of active Na-K transport and the response is associated with calcium entry. Because most lens Rb uptake is ouabain-sensitive, the response points to Na,K-ATPase inhibition. Studies are under way to test whether the Na-K transport response to TRPM3 activation involves cAMP signaling. This work was supported by NIH grants R01EY029171 and R01EY009532. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Immediate Sequential Bilateral Implantable Collamer Lens Surgery Is Safe and Effective.

To assess the clinical outcomes and safety profiles of patients who underwent immediate sequential bilateral phakic lens surgery. This retrospective multicenter study included 254 consecutive patients (508 eyes) who underwent bilateral same-day Implantable Collamer Lens (ICL) (STAAR Surgical) surgery. The authors focused on 1-year postoperative clinical outcomes and adverse events. In the initial cohort, 176 patients (352 eyes) met inclusion criteria. Of these, 335 eyes underwent myopic ICL placement, and 17 eyes received a hyperopic ICL. Notably, 87% of eyes achieved ±0.50 diopters (D) and 95% achieved ±1.00 D of the intended refraction. One year postoperatively, 78% of eyes demonstrated optimal vaulting (250 to 750 µm), with a significant 19% reduction in vaulting observed over the 12 months (P < .001). Only minor adverse events, including early cataract formation (1 case), secondary toric ICL rotation (3 cases), and ICL exchange due to inappropriate vaulting (6 cases), were noted. The findings corroborate the safety and efficacy of immediate sequential bilateral phakic lens surgery and indicate its potential as a treatment option. The low incidence of minor adverse events further reinforces its favorable safety profile. [J Refract Surg. 2024;40(5):e313-e320.].

Severely subluxated cataract

A 56-year-old man with a history of myopic LASIK presented with left eye gradual blurring of vision over 3 months. There was no history of trauma. His uncorrected visual acuities were 20/25 in the right eye and 20/400 in the left eye. The right eye was normal except for an early cataract. The left eye had a moderate cataract that was phacodonetic. Vitreous was present in the shallow anterior chamber (AC) (Figure 1 JOURNAL/jcrs/04.03/02158034-202405000-00018/figure1/v/2024-04-22T135154Z/r/image-tiff ). The fundus was normal. The intraocular pressures (IOPs) were 14 mm Hg in the right eye and 20 mm Hg in the left eye. Ultrasound biomicroscopy of the anterior segment in the left eye revealed near total zonular loss with few intact zonular strands at the 6 and 10 o'clock regions (Figure 2 JOURNAL/jcrs/04.03/02158034-202405000-00018/figure2/v/2024-04-22T135154Z/r/image-tiff ). Vitreous was observed in the AC, herniating mostly from the 3 o'clock region. The endothelial cell density and optical coherence tomography (OCT) of the macular and disc in both eyes were normal. Central corneal thickness was 527 µm in the right eye and 520 µm in the left eye. Describe how you would manage this case surgically. Optical biometry had been obtained, and the axial length in both eyes was similar. Discuss how you would select the monofocal intraocular lens (IOL) diopter (D) targeted for −1.50 D if the AC depth in the left eye was 2.48 mm and in the right eye was 3.25 mm.

Analysing the Evidence of the Effects of Climate Change, Air Pollutants, and Occupational Factors in the Appearance of Cataracts

Cataracts are ocular conditions characterized by the opacification of the natural lens within the eye, which develops gradually over time and can affect one or both eyes. This condition commonly results from age-related changes in the lens, but can also arise from various factors. Cataract surgeries are expensive, particularly in states such as Spain, where they receive full support from the Spanish social welfare system. Despite a significant body of research on cataracts, few studies address the social and environmental factors triggering their development or consider the spatiotemporal evolution of their impacts. We analysed the incidence of cataracts in a southern region of Spain, differentiating between senile cataracts (those over 60 years old) and early cataracts (those between 15 and 59 years old). Twenty-one socio-economic, climate, and air pollution variables were statistically analysed using bivariate correlation, cluster analysis, and Geographic Information Systems. Eleven years of observation show a decadal increase in annually averaged maximum temperature and a decrease in annual precipitation, partially explaining the rising incidence of operable cataracts in the following year (r = 0.77 and −0.84, respectively; p &lt; 0.05). Furthermore, early cataracts responded spatially to % agricultural employment (r = 0.85; p &lt; 0.05) and moderately to maximum temperatures, insolation, and various constituents.

Autosomal Dominant Retinitis Pigmentosa Secondary to TOPORS Mutations: A Report of a Novel Mutation and Clinical Findings.

Purpose: Mutations in Topoisomerase I-binding RS protein (TOPORS) have been previously documented and have been described to result in pathological autosomal dominant retinitis pigmentosa (adRP). In our study, we describe the various genotypes and clinical/phenotypic manifestations of TOPORS-related mutations of our unique patient population in Rural Appalachia. Methods: The medical records of 416 patients with inherited retinal disease at the West Virginia University Eye Institute who had undergone genetic testing between the years of 2015-2022 were reviewed. Patients found to have pathologic RP and mutations related to TOPORS were then analyzed. Results: In total, 7 patients (ages 12-70) were identified amongst three unique families. All patients were female in our study. The average follow-up period was 7.7 years. A mother (70 yr) and daughter (51 yr) had a novel heterozygous nonsense point mutation in TOPORS c.2431C > T, p.Gln811X (Exon 3) that led to premature termination of the desired protein resulting in early onset vision loss, cataract formation, and visual field restriction. The mother developed a full-thickness macular hole which was successfully repaired. Five other patients were found to have previously described TOPORS mutations. Visual field loss was progressive with age in both cohorts. Conclusions: Seven patients at our institution were identified to have mutations in TOPORS resulting in autosomal dominant retinitis pigmentosa. Two patients were found to have novel truncating mutations in the TOPORS gene resulting in profound night blindness and visual field loss, recurrent macular edema, and in one individual, epiretinal membrane formation leading to a macular hole which was able to be successfully repaired.

Cataract classification and grading in federated learning environment using CNN based Modified-ResNet-50

Cataract, a common eye disease, causes lens opacification, which can lead to blindness. Early cataract detection in a privacy-preserving approach has led us to investigate the concept of Federated Learning (FL) and its prominent technique, known as Federated Averaging (FedAVG). Federated learning has the potential to solve the privacy issues by allowing data servers to train their models natively and distribute them without invading patient confidentiality. This research introduces an interactive federated learning framework that permits multiple medical institutions to screen cataract from split lamp images utilising convolutional neural network (CNN) without sharing patient data, as well as grade normal, mild, moderate, and severe cataracts. The CNN is developed based on Modified-ResNet-50 and FedAVG technique could achieve relatively high accuracy. The experimental results demonstrate that the proposed modification reduces the processing time to a greater extent.

LASIK is associated with early cataract surgery in healthy patients.

To evaluate the association between LASIK and early cataract phacoemulsification surgery (PE). A matched case-control study was conducted. Cases were otherwise healthy adults with a history of LASIK. Groups were paired according to corrected-distance visual acuity (CDVA), axial length, and cataract grade. A total of 213 patients were included. 85 patients were classified as post-LASIK group and 128 as controls. The mean age at the time of LASIK was 42.32 ± 9.24years. The mean CDVA before PE was 0.29 ± 0.19 Log MAR in post-LASIK group and 0.34 ± 0.22 Log MAR in controls (p = 0.07). The mean axial length was 23.99 ± 1.78mm in post-LASIK group and 23.62 ± 0.98mm in controls (p = 0.085). The mean nuclear cataract grading was 1.36 in post-LASIK group and 1.47 in controls (p = 0.34). The mean age at the time of PE was 60.18 ± 7.46years in post-LASIK group and 67.35 ± 9.28 in controls (p < 0.0005). The difference between the mean age of LASIK and the mean age of PE was 17.85 ± 5.72years. There was a positive association between the post-LASIK group and the age of PE ≤ 55years (OR: 4.917, 95% CI: 2.21-10.90, p < 0.001). LASIK may be associated with early PE. Patients with LASIK had a 7-year earlier PE compared to a matched control group.

Early cataract surgery and affordable Sinskey hook goniotomy in Black and Afro-Latino glaucoma patients: a 6-month retrospective study.

The purpose of this study was to determine the real-world efficacy of early phacoemulsification cataract surgery and goniotomy with a Sinskey hook in patients with glaucoma. This study was conducted at Advanced Eye Care of New York, a private practice located in Manhattan, NY. This was a single-center, retrospective study of predominantly Black and Afro-Latino patients with glaucoma. These patients underwent early phacoemulsification cataract surgery and goniotomy using an affordable and reusable straight Sinskey hook (Ambler 200-μm tip). Patients who underwent the aforementioned procedure with 6 months of follow-up were included in this study. Investigated parameters were intraocular pressure, number of medications, mean deviation on visual field test, visual acuity, adverse events, and pre/postoperative spherical refractive error. Among all 38 eyes that were enrolled in the study and underwent surgery (goniotomy using a Sinskey hook with phacoemulsification), mean intraocular pressure was reduced from 16.45 mmHg at baseline to 13.24 mmHg at month 6, a 19.5% reduction. The mean number of topical intraocular pressure-lowering medications used was reduced from 1.81 at baseline to 0.52 at month 6, a 71% reduction in topical medications. Combined early cataract surgery and goniotomy performed with a Sinskey hook is an affordable microinvasive surgery and an effective way to reduce intraocular pressure and the number of ocular hypertensive medications used in Black and Afro-Latino patients with primary open-angle glaucoma.

Exome Sequencing Reveals Biallelic Mutations in MBTPS1 Gene in a Girl with a Very Rare Skeletal Dysplasia

The Kondo-Fu type of spondyloepiphyseal dysplasia (SEDKF) is a rare skeletal dysplasia caused by homozygous or compound heterozygous mutations in the MBTPS1 gene. The MBTPS1 gene encodes a protein that is involved in the regulation of cholesterol and fatty acid metabolism. Mutations in MBTPS1 can lead to reduced levels of these lipids, which can have a number of effects on development, including skeletal anomalies, growth retardation, and elevated levels of blood lysosomal enzymes. This work reports the case of a 5-year-old girl with SEDKF. The patient had a severely short stature and a number of skeletal anomalies, including kyphosis, pectus carinatum, and reduced bone mineral density. She also had early onset cataracts and inguinal hernias. Genetic testing revealed two novel compound heterozygous variants in the MBTPS1 gene. These variants are predicted to disrupt the function of the MBTPS1 protein, which is consistent with the patient’s clinical presentation. This case report adds to the growing body of evidence that mutations in the MBTPS1 gene are causal of SEDKF. We summarized the features of previous reported cases (with age ranges from 4 to 24 years) and identified that 80% had low stature, 70% low weight, 80% had bilateral cataracts and 70% showed Spondyloepiphyseal dysplasia on X-rays. The findings of this study suggest that SEDKF is a clinically heterogeneous disorder that can present with a variety of features. Further studies are needed to better understand the underlying mechanisms of SEDKF and to develop more effective treatments.

Tobacco smoking and early onset cataracts

Background and Hypothesis:Cataracts are among the leading causes of blindness in the world. Smoking tobacco has been linked to cataract formation in old age. However, its linkage in causing an earlier onset is much more questionable. Assessing this linkage can help identify risk factors and help understand the causes and pathogenesis in development of cataracts over time. This can help direct modifiable risk factors in patients to prevent early deterioration in health, finance, physical capabilities, and overall comfort. It is hypothesized that history and intensity of smoking tobacco correlates with earlier onset cataracts.&#x0D; Experimental Design or Project Methods:Patient data of patients aged 40-65 were gathered from the last two years of cataract surgeries from Deen-Gross Eye Centers EMR (n=718). Age at date of surgery was used as observed value for determining earlier onset, and pre-operation charts were used to collect patient data on smoking status (light, someday, every day, heavy, former, never), age, gender, hypertension, diabetes, number of eyes operated on, family history (cataracts/glaucoma), and glaucoma. Statistical analysis was performed among the gathered data.&#x0D; Results:Statistical analysis revealed no significant difference in the ages of cataract surgeries between smokers and non-smokers. Controlling for non-hypertensive and non-diabetic patients revealed a similar result. There was no significant difference in smoking status between ages 40-55 and ages 56-65 who underwent surgery. There was no significant difference in age of surgery among each of the individual types of smokers.&#x0D; Conclusion:No significant associations were found. This calls for further research to better understand the linkage between tobacco smoking and cataracts, as well as the pathogenesis of earlier onset cataracts. No modifications in directing patient care can be made yet.