Mature Cataract Research Articles

ODP246 The Content of Blood Chemokine Fractalkine in Patients with Type 2 Diabetes and Diabetic Macular Edema Depending on The Type of Glucose Lowering Therapy

Abstract Relevance. Diabetic macular edema (DME) remains one of the most widespread diabetic complications. Complications associated with DME include microglial activation, dysfunction of neurons, their dystrophy and apoptosis. One of the important modern chemokines involved in the functioning of the eye neurovascular unit is fractalkine (CX3CL1). The current literature has demonstrated a positive and significant relationship between fraktalkine aqueous humor levels and central macular thickness after intravitreal injection of aflibercept in patients with DME [Rodolfo Mastropasqua et al., 2018]. Goal. To evaluate the content of blood plasmachemokine fractalkine in patients with type 2 diabetes (T2D) and DME depending on the type of glucose lowering therapy (GLT). Material and methods. This study was conducted in 82 patients (male and female) with T2D and DME. The average age of patients was 65.25 ± 10.85 years (±SD), the average duration of diabetes was 14. 0 ± 7. 05 years(±SD), the average level of HbA1c was 8.40 ± 1.58% (±SD). The inclusion criteria in this open study were voluntary informed consent, age 18 years old and more, the presence of DME according to the classification of American Academy of Ophthalmology (2014) and non-proliferative diabetic retinopathy (DR) according to the simplified version of the ETDRS. Exclusion criteria were others endocrine diseases, acute infectious diseases, cancer, decompensation of comorbid pathology, mental disorders, proteinuria, T1D, were vitreo-retinal interface diseases, damage of the optic nerve, inflammatory eye diseases, glaucoma and mature cataracts, retinal vascular diseases. Plasma fractalkine concentration was determined by «RayBio®Human Fractalkine ELISA Kit Protocol» (USA). All patients enrolled in this study were diagnosed assessing DR using color fundus photography, fluorescein angiography, spectral optical coherence tomography and were evaluated with a comprehensive ophthalmologic examination. 43 patients received oral glucose lowering drugs (OGLD), 39– metformin plus insulin. Statistical analysis of the results of the current study included one-way ANOVA analysis. Results A study of content of blood plasma fractalkine showed its dependence from the type of GLT. So comparison of mean values of blood plasma fractalkine in patients with DME revealed the following differences: OGLD 1,81±0,09ng/ml [95%CІ 1.67 - 1,94ng/ml], insulin therapy 2,11±0,08ng/ml [95%CІ 1,98-2,23 ng/ml] (р=0,02). Discussion An increase in the concentration of fractalkine in blood plasma for a certain time can serve as an indicator of an active nonspecific inflammatory process in the neuroglia, the presence of edema and a harbinger of the death of ganglion cells and vision loss. That is why fractalkine, apparently, has a promising prognostic potential for its use in evaluating the effectiveness of treatment of DME and T2D in patients receiving various types of GLT. Conclusion In patients undergoing insulin therapy, the content of fractalkine in blood plasma is statistically significantly (p = 0. 02) higher than in patients receiving OGLD. Presentation: No date and time listed

Evolution of manual small-incision cataract surgery from 8 mm to 2 mm - A comprehensive review.

Cataract is the most common cause of reversible blindness worldwide, accounting for approximately 50% of blindness worldwide. Cataract surgery is the most common surgical procedure performed in routine ophthalmic practice. It has undergone tremendous evolution, and the incision size has progressively reduced from 10-12 mm in extracapsular cataract surgery (ECCE) to 6-8 mm for manual small-incision cataract surgery (MSICS) and 2.2-2.8 mm in phacoemulsification. In a developing country like India, with a massive backlog of cataract, everyone cannot afford private surgery like phacoemulsification. Moreover, annual maintenance of the machine, cost of foldable IOLs, need for greater skill, learning curve, and difficulty in performing the surgery in mature and brown cataracts are other barriers. Due to these factors, MSICS is the surgery of choice in the developing world, with profound societal and economic benefits and similar visual recovery compared to phacoemulsification. During the last two decades, MSICS gained popularity in developing countries and has undergone tremendous advances. This article aims to review the various techniques of MSICS and how the surgery has evolved over the years, particularly focusing on the current technique of 2-mm MSICS.

Preferred practice of cataract surgery in brown cataract: A questionnaire-based survey among Indian ophthalmic surgeons.

To determine the most preferred method of operating brown cataracts among ophthalmologists in India. A cross-sectional, questionnaire-based study was conducted among ophthalmologists all over India through electronic and social media from May 1 to June 15, 2022. All single, voluntary entries within the stipulated time period were accepted for analysis. A total of 230 ophthalmologists participated in the study among which 198 (86%) preferred Manual small-incision cataract surgery (mSICS) as the first option. This was preferred due to the high risk of complications associated (40, 33.6%) as well as endothelial damage due to increased Phaco power (53, 47.9%). The majority of the surgeons (162, 70.4%) preferred a superior tunnel for SICS, and 51.7% (119) performed continuous curvilinear capsulorhexis in 100% of their cases. The most common complication encountered was posterior capsular rupture (PCR) (66%), followed by zonular dialysis (ZD) (18.7%), whole bag removal (8.3%), and Descemet's membrane detachment (7%). Despite diverse recent new modalities of Femto Laser assisted cataract surgery (FLACS). Phakonit, and Smart Intraocular Lens (IOLs), the majority of ophthalmologists still find the manual small-incision cataract surgery (mSICS) procedure a safe surgery for mature brown cataracts.

A-Scan Parameters and the Risk of Phacomorphic Glaucoma in the Kazakh Population.

Background and Objectives: The aim of our study was to identify risk factors associated with phacomorphic glaucoma (PG) by comparing the biometric parameters of contralateral eyes of patients with PG with the eyes of patients with a mature cataract. Methods: This retrospective case-control study included 71 eyes affected with PG, 311 eyes of control participants, and 71 contralateral eyes of patients with PG. All participants were ethnically Kazakh. Axial lengths (AL), anterior chamber depths (ACD), and lens thicknesses (LT) were measured using A-scan ultrasound biometry. To determine the threshold value of the A-scan parameters associated with PG, we performed ROC analysis. Results: The eyes with PG had smaller AL and ACD values and larger LT values, followed by the fellow eyes with PG and the control eyes. There were no differences in age and sex between patients with PG and mature cataracts. After adjustment for age and other A-scan parameters, continuous measures of ACD and LT were associated with PG (OR 0.57, 95% CI 0.38-0.73, p < 0.001; OR 3.36, 95% CI 1.64-6.912, p = 0.001). When A-scan parameters were dichotomized according to the identified threshold, an ACD of less than 2.5 mm (OR 3.113, 95% CI 1.562-6.204, p = 0.001) and an LT thicker than 4.75 mm (OR 26.368, 95% CI 9.130-76.158, p < 0.001) were found to be related to PG. Conclusions: We found that a thicker lens and, possibly, a shallow ACD are risk factors for PG.

Outcomes of cataract surgery in patients with Human Immunodeficiency Virus infection in a developing country.

To report the outcomes of cataract surgery in patients with Human Immunodeficiency Virus (HIV) infection. Setting Tertiary care ophthalmic hospital DESIGN: Retrospective study METHODS: This study included all eyes of patients with known HIV infection undergoing cataract surgery with a minimum follow-up of 6 months between January 2017 and December 2020. Patients who underwent combined surgeries and pediatric patients were excluded from analysis. Data were retrieved from electronic medical records and we documented demographics, history, detailed anterior and posterior segment examination, pre-operative grade and type of cataract, type of surgery done, its complication and post-operative course. All these parameters were recorded at the baseline visit and at 1 month and 6 months postoperatively. One hundred and twenty nine eyes of 107 HIV infected patients that underwent cataract surgery were evaluated. Mature cataract was seen in 31% of the eyes. Features of HIV related uveitis/retinitis were seen in 21 (16.2%) eyes. Phacoemulsification was performed in 44 (34.1%) eyes while manual small incision cataract surgery (MSICS) was done in 85 (65.9%) eyes. Intra-operative complications were encountered in 4 (3.1%) eyes. At the final follow-up, there was a significant improvement in median corrected distance visual acuity (CDVA) from LogMAR 1.08 (5/60) at baseline to LogMAR 0 (6/6) at 6 months follow-up. Patients with HIV infection usually present early and with advanced cataracts. Visual outcomes after cataract surgery are generally good but affected by presence of prior HIV related uveitis or retinitis.

DIABETIC CATARACT IN DOGS: COMPLICATIONS, TREATMENT, OUTCOMES

Diabetic cataracts are common in diabetic dogs and lead to blindness and lens-induced uveitis, the complications of which may lead to the need to remove the eyeball. The objectives of this study were to provide a clinical and ophthalmological characteristics of diabetic cataract in dogs, to describe pre-, intra- and postoperative complications of diabetic cataract phacoemulsification in dogs, and to identify relationships between different parameters of phacoemulsification, types of complications, and outcomes of treatment for diabetic cataract in dogs. The study included 22 dogs of various breeds with diabetes mellitus complicated by bilateral mature cataract, all animals underwent a complete ophthalmological examination, including biomicroscopy, ophthalmotonometry, examination of chromatic pupillary reflexes, ultrasound examination of the eyeball, and uni- or bilateral cataract phacoemulsification. In the course of the study, it was found that diabetic cataract in dogs develops on average 3.4 ± 2.9 months from the moment the patient has diabetes mellitus, is characterized by the formation of cracks in the anterior lens suture (77%), the average lens thickness is 0.82 ±0.16 cm, lens -induced uveitis. Preoperative complications included: aqueous flare, posterior capsular rupture, capsular fibrosis, and lens subluxation. Intraoperative complications: the release of liquefied cortex into capsulorhexis, are widespread (75%). The most common postoperative complications of diabetic cataract include POH (16.7%) and corneal dystrophy (13.9%). Correlation analysis revealed the relationship between the time to surgery, various parameters of the operation and types of complications, preoperative complications, in particular, spontaneous rupture of the posterior capsule, small lens thickness, and intraoperative complications are associated in this study with a negative outcome in terms of vision.

Eye ball deviation patterns in traumatic cataract among children in Uttar Pradesh of India

Paediatric cataract is an important cause of treatable childhood blindness, provided it is recognized and managed early. Timely diagnosis, management, and visual rehabilitation of a child with a paediatric cataract are crucial determinants of a favourable prognosis. This particular topic, study of pattern of deviation of eye ball after traumatic cataract in children was selected because of the difference between the firm literature of Keith Lyle and the clinical observations. This study includes analysis of 25 patients. The key findings of this study were: Maximum incidence of traumatic cataract was seen in 6-10 years of age group, that too more commonly in boys and it was 2.5 times more than that of girls. lncidence of perforating injuries leading to cataract was 1.5 times more common than blunt trauma. In paediatrics cataract, the Diminution of vision in cases of traumatic cataract is usually at the level of mature or hypermature cataract. 40% of cases showed deviation in the range of 11-20° (irrespective to divergence or convergence). There was higher incidence of Exotropia than esotropia. Originally eye was divergent as per evolution of binocular vision in primates & our study also came out with a conclusion that when there is no force or compulsion of binocular Vision, most of the eyes tended to be Divergent in children after traumatic cataract.

Усовершенствованная технология факоэмульсификации набухающей катаракты с фемтолазерным сопровождением

Purpose. To optimize the technology of femtolaser-assisted intumescent cataract phacoemulsification. Material and methods. Group I included 29 patients (30 eyes) with intumescent mature cataract, who underwent femtolaser-assisted phacoemulsification using a new, advanced technology. Group II included 20 patients (20 eyes), in whom the femtolaser stage was performed using standard technology. In all preoperative parameters, patients in groups I and II were almost identical. The advanced femtocapsulorexis technology included: preoperative assessment of intralenticular pressure, staining of the anterior capsule of the swelling lens with trypan blue, introduction of a high molecular weight viscoelastic into the anterior chamber to balance intraocular and intralenticular pressure, increasing the laser energy up to 10 mJ when performing anterior capsulorhexis. Results. In group I, in 2 eyes there was a non-penetration of the anterior capsule, in one eye in the 30° sector, in the second – in the 45° sector. The leakage of the lens material into the anterior chamber and the floating anterior capsule were not observed in patients of group I. In group II, non-penetration of the anterior capsule was observed in 6 eyes, in the 140–150° sector – in 2 eyes, in the 90° sector – in 3 eyes, in the 180° sector – in 1 eye. A floating anterior capsule was observed in 5 cases. The leakage of the lens material into the anterior chamber was observed in 9 eyes. Conclusion. The advanced technology of femtolaser-assisted intumescent cataract phacoemulsification excludes the leakage of lens material into the anterior chamber and allows performing the anterior capsulorhexis of a given size and shape. Keywords: intumescent cataract, phacoemulsification, femtolaser-assisted, anterior apsulorhexis.

Особенности строения хрусталика при набухающей катаракте

Purpose. To study the structure of the swelling lens, the dependence of its anatomical parameters on the nucleus sizes and density, patients' age. Material and methods. 64 patients with intumescent mature cataract were examined. All patients underwent phacoemulsification with a two-stage continuous circular capsulorhexis. After the 2–2.5 mm capsulorhexis had been created, the liquid lenticular masses were removed from the anterior and posterior lens compartment with the aspiration/irrigation system. Visually we determined the size of the nucleus, its color and density according to Buratto's classification. Results. When performing this work four types of the swelling lens structure were detected. Type I – a small emerging white nucleus with large amount of liquid lenticular masses in the anterior and posterior lens compartment, II degree of density according to Buratto's classification. The mean age was 49.12 ± 3.11 years old. The related ophthalmic diseases accounted for 36.4 %. Type II – a large white nucleus with the presence of liquefied lenticular masses in the anterior and posterior lens compartment. III degree of density according to Buratto's classification. The mean age was 71.15 ± 5.07 years old. Associated diseases – 65 %. Type III – a large brown nucleus with the presence of liquefied lenticular masses in the anterior and posterior lens compartment. IV degree of density according to Buratto's classification. The mean age was 75.87 ± 1.48 years old. Associated diseases – 79 %. Type IV – a small, very dense, brown nucleus with liquid lenticular masses. V degree of density according to Buratto's classification. The mean age was 77.34 0 ±2.47 years old. Associated diseases – 100 %. Conclusion. Four types of lens structure in intumescent cataract were described depending on the nucleus size, density, the amount of the lenticular masses. By means of UBM it was shown that intumescent cataract was accompanied by the alterations of the ocular anterior segment parameters, which depended on the type of lens structure. It was revealed that the types of swelling lens structure were directly connected to the patients' age: mean age of patients with type I – 49.12 ± 3.11 years old, with type II – 71.15 ± 5.07, with type III – 75.87 ± 1.48, with type IV – 77.34 ± 2.47 years old. Keywords: ophthalmology, intumescent cataract, types of lens structure.

Femtosecond Laser Assisted Cataract Surgery in a Patient with Anterior Chamber Phakic IOL in situ

Introduction: Conventional phacoemulsification and intraocular lens (IOL) implantation for patients who already have a phakic IOL (PIOL) in situ can present challenges in IOL power calculation and the surgical procedure. Here we report a case of phacoemulsification with IOL implantation without removing the anterior toric PIOL. Patient and Clinical Findings: This 45-year-old male was referred to our clinic with mature cataract in the right eye, and a history of multiple corneal surgical procedures including radial keratotomy, LASIK, corneal cross-linking, and Artiflex toric PIOL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity were 20/2000. Diagnosis, Intervention, and Outcomes: Since CDVA was 20/25 after toric PIOL implantation and prior to the development of cataract, and the cornea was compromised, the toric PIOL was not removed. Using femtosecond laser assisted cataract surgery (FLACS) through the toric PIOL, capsulotomy and lens fragmentation were completed without modifying the device setting, and an IOL was inserted in the bag. At one year after surgery, right eye UDVA, CDVA, and refraction were 20/32, 20/25, and +1.25/-1.00*120ᵒ. Conclusion: In this case, FLACS was a successful technique for preserving the toric PIOL, and results were stable during the one year of postoperative follow up.

Biometry and intraocular power calculation using a swept-source optical coherence tomography: A repeatability and agreement study.

To evaluate the repeatability of biometry and intraocular lens (IOL) power using Galilei G6 and to determine the agreement of its measurements with those of IOL Master 700 and IOL Master 500. Hundred mature cataract eyes were examined twice with Galilei G6 and the results were compared with those of other two devices. Axial length (AL), minimum (K1), maximum (K2), and mean keratometry, anterior chamber depth (ACD), white-to-white (WTW) diameter, lens thickness (LT), and the calculated IOL power were the studied parameters. The correlation coefficient, within-subject standard deviation (Sw), Bland-Altman method, and 95% limits of agreement (LoA) were used for statistical analysis. The intraclass correlation coefficient (ICC) was above 0.9 for all indices, and the LoA ranged from a minimum of 0.08 mm for AL to a maximum of 0.50 D for K1. Sw also ranged between a minimum of 0.02 for AL, ACD, and WTW and a maximum of 0.13 for K1. In the Galilei G6-IOL Master 700 pair, the narrowest and widest LoA were calculated for AL (0.07 mm) and K2 (0.49 D), respectively. In the Galilei G6-IOL Master 500 pair, the narrowest and widest widths of LoA were calculated for AL (0.17 mm) and K2 (0.92 D), respectively. In the first pair, the LoA of IOL power (0.57 D) were the best for Haigis formula and in the second pair, the best agreement (LoA: 0.35 D) was observed for Holladay-1. Galilei G6 provided repeatable biometric measurements. The agreement between biometry and IOL power calculation was better in the Galilei G6-IOL Master 700 pair compared to the Galilei G6-IOL Master 500.

Incidence and risk factors for vitreous loss in residents performing manual small-incision cataract surgery

To assess the incidence of vitreous loss and associated risk factors in residents performing manual small-incision cataract surgery (MSICS). The present retrospective record review study was performed on 490 patients who underwent MSICS performed between November 2018 and December 2019 by 7 third-year postgraduate residents. The study group comprised of patients having intraoperative vitreous prolapse. All the surgeries were performed under supervision of a trained assistant. The mean age of the participants at the time of surgery was 68.42±2.05y. Of the 490 patients, 250 patients were male, and 240 patients were female (P=0.23). A total of 215 (43.9%) eyes had mature white cataract, 185 (37.8%) eyes had brown cataract, and 90 (18.3%) eyes had immature senile cataract. The incidence of intraoperative vitreous loss among residents was 2% (10/490). Vitreous loss occurred during hydrodissection [1/10 (10%)], nucleus delivery [3/10 (30%)], irrigation and aspiration [5/10 (50%)], and intraocular lens insertion [1/10 (10%)]. Multivariate stepwise Logistic regression analysis confirmed immature senile cataract [odds ratio (OR)=3.99; P=0.02], irrigation and aspiration of cortical material (OR=3.07; P=0.03), and anterior capsular extension (OR=3.22, P=0.03) as independent risk factors for vitreous loss. Immature senile cataract, irrigation and aspiration of cortical material, and anterior capsular extension are independent risk factors for vitreous loss. Our findings may serve as a guide for future trainers or residents learning MSICS.

Retrospective evaluation of pre-surgical electroretinography results in a mixed-breed canine population presented for cataract removal surgery.

Electroretinography (ERG) is used prior to cataract removal surgery to assess retinal function. We aimed to replicate and improve upon previous studies by performing a full ECVO protocol and by examining the retina post-surgery in all patients. One hundred twenty-seven eyes from 67 dogs were included in the study. A full ECVO protocol electroretinography, which includes extensive rod and cone analysis, was performed on all dogs presenting for cataract surgery. Our main findings were that amplitudes, but not implicit times of rod responses decreased with advanced cataracts. Amplitudes of the single flash rod and rod flicker responses were significantly lower in eyes with mature cataracts, and the former also decreased in hypermature cataracts. Cone flicker amplitude responses were also significantly lower in eyes with mature and hypermature cataracts. However, mixed single flash rod-cone and cone responses, with the exception of the mixed rod-cone a-wave amplitude in eyes with hypermature cataracts, were unaffected by cataract stage. The b-wave amplitude of the scotopic, mixed rod-cone, and photopic cone responses were affected by age and decreased by an average of 2.9, 7.5, and 1.5μV/year, retrospectively (p < 0.01). Lower ERG amplitudes in canine cataract patients may result from aging or the presence of advanced cataracts and may not indicate the presence of retinal disease.

Reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic.

Purpose:To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic.Methods:This was a prospective, cross-sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID-19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed.Results:One thousand four hundred seventy two patients were recruited with advanced cataracts. Absence of ophthalmic care nearby (44.2%), lack of awareness regarding elective surgeries (42.6%), lack of public transportation (37%), fear of contracting COVID-19 (23.4%), and waiting for outreach camps (20.4%) were found to be the reasons behind the delay in cataract surgery. 53.7% of the patients had worsening of defective vision and 55.3% of them had difficulty in carrying out activities of family living. 30.8% of the patients faced difficulty in commuting and 8.4% of the patients suffered a fall during this pandemic due to worsening of the visual acuity.Conclusion:The lockdown imposed during the pandemic has created a significant backlog of patients who are progressing to advanced cataracts due to lack of ophthalmic care nearby, lack of awareness regarding elective surgeries, lack of public transportation, and no outreach camps. Proactive measures to deal with this backlog are of utmost need to prevent blindness due to cataract.

Association of systemic cellullar immunity with the development of cataract

Among the causes of visual impairment, cataract occupies a significant proportion, which indicates a need for studying the causes of its development. Over recent years, an important role has been given to impaired immunoregulatory reactions in its genesis. So far, however, participation of systemic cellular immunity in occurence of different clinical types of cataract remains poorly known. The aim of the present study was to assess association between parameters of systemic cellular immunity and development of mature nuclear cataract. On the basis of IRTC “S.N. Fedorov Eye Microsurgery Center” (Tambov Branch), a study of major immune cells subpopulations in peripheral blood was performed over 2019-2020 in 63 patients aged 60-84 years, suffering from mature nuclear cataract (the study group). The control group consisted of 47 patients aged 60 to 84 years without ocular disorders in the history and at the time of examination. The evaluation of differentiated cell clusters was carried out with BD FACS Canto II flow cytometer. As a result, a statistically significant decrease in the absolute number of CD19+to 0.18±0.003 × 109/L was revealed in the patients from the main group versus 0.42±0.05 × 109/L in controls; the relative number of CD19+was decreased to 8.36±1.1% versus 19.64±1.3%, respectively, along with absolute content of CD3+cells of 0.92±0.08 × 109/L versus 1.57±0.06 × 109/L in controls. On the contrary, the absolute number of CD56+in the patients with mature nuclear cataract was significantly increased to 0.27±0.02×109/L compared to 0.15±0.03 × 109/L in the age control group. The relative risk values are statistically significant, and the highest levels were found for CD19+ and CD3+cell clusters, which were 3.237 and 2.954 for the absolute number, and 1.952 and 2.748, for the relative number, respectively. These findings suggest that development of a mature nuclear cataract is associated primarily with a decrease in absolute and relative contents of B and T lymphocytes at the systemic level, which may be of practical importance when used as immunological markers of nuclear cataract.

Convolutional Neural Network for Cataract Maturity Classification Based LeNet

The eyes are one of the vital organs owned by humans. One of the common eye diseases is cataracts. This disease is characterized by clouding of the lens of the eye and can interfere with vision. Worst case, sufferers can experience blindness. Cataract maturity can be divided into four categories, namely incipient, immature, mature, and hypermature. Cataracts can be removed through surgery when the cataract is in the mature or hypermature phase. Cataract examination is usually done using a slit lamp. The lack of hospitals that have this equipment can cause delays in the healing process for cataract sufferers. This study created an image processing algorithm for the maturity classification process of cataracts using the Convolutional Neural Network method with LeNet network architecture. The algorithm that has been built is capable of classifying the maturity of cataracts with an accuracy rate of 93.33%

Psychosocioeconomic Determinants of Complicated and Uncomplicated Mature Cataracts in Hong Kong

Objective: Blindness caused by mature cataract is reversible with timely cataract extraction surgery, however neglecting it could complicate with phacomorphic glaucoma. This study aims to investigate the psych socioeconomic determinants of phacomorphic glaucoma complicated and uncomplicated mature cataracts in Hong Kong. Participants and Methods: Retrospective review of cataract surgery records from 2013 - 2018 in a tertiary public emergency hospital’s ophthalmology unit in Hong Kong was done to identify phacomorphic glaucoma and uncomplicated mature cataract patients as case and control respectively. Data on demographics, psychiatric diseases, social and economic factors were extracted and analyzed. Results: 36 cases and 39 controls were included, with similar age (p = 0.73) and sex (p = 0.99). Presence of psychiatric diseases (p = 0.02) and absence of spouse (p = 0.008) were associated with phacomorphic glaucoma in univariate logistic regression analysis. Intention to private healthcare service usage (p = 0.002, p = 0.006) and living out of public rental housing (p = 0.002, p = 0.004) were associated with phacomorphic glaucoma in both the univariate and multivariate logistic regression analysis. Conclusion: Attention to screening of mature cataract before complication of phacomorphic glaucoma occurs should target the single elderly households, psychiatric patients, and the non-public housing population.

Analysis of postoperative intraocular pathologies in patients with mature cataracts.

To examine the prevalence and risk factors of intraocular pathologies after mature cataract surgery. The medical records of 115 patients (115 eyes) diagnosed with brunescent or white cataracts, who underwent surgery at a single primary center between January 2018 and August 2021 were retrospectively reviewed. Dense cataracts precluded preoperative fundus examination in all eyes; however, patients with fundus examination results within 3 months after cataract surgery were included. Logistic regression analyses were performed to identify factors associated with intraocular pathologies. Intraocular pathologies were observed in 37 eyes (32.2%) 11.8 ± 13.9 days postoperatively. The most common abnormalities were drusen (6.1%), myopic degeneration (5.2%) and diabetic retinopathy (4.3%). Intraocular pathology in the fellow eye was associated with posterior segment pathology in mature cataract eyes (odds ratio, 47.72; P < 0.001). The prevalence of each intraocular pathology found after mature cataract surgery was unremarkable. This study provides clinically useful evidence for clinicians to explain the risk of posterior segment pathology in patients with mature cataracts.

Strikingly High Myopia in Aland Island Eye Disease

A 48-year-old myopic white man presented with poor vision, nyctalopia, and photophobia in both eyes since childhood. Best corrected visual acuity was 20/150 in the right eye and counting fingers in the left eye, refracting –26 diopters (D) with axial length of 35 mm in both eyes. Both eyes showed nystagmus, mature cataracts, vitreous syneresis, hypopigmented myopic degeneration, foveal hypoplasia, extensive multilayered lattice with holes (Fig A-B), and marked staphylomas. Prophylactic barricade laser around the lattice was performed before cataract surgery.

Impact of Covid-19 on the Morphology of Cataract

Objective: To see the impact of Covid-19 on the morphology of cataract during lockdown. Study Design: Observational and interventional study. Place and Duration of Study: Department of Ophthalmology, Niazi Medical and Dental College from 1st April 2020 to 30th September 2020. Methodology: All the patients of eye related complaints were referred to eye department from emergency of hospital after screening them for Covid-19 suspected symptoms as well as patients coming directly to eye OPD from reception. Patients suffering from phacomorphic, phacolytic glaucoma and cataract of every type except traumatic type were included. Results: The ratio of males and females patients was almost equal because cataract is a common age related problem in both sexes. Due to lock down there is a significant increase in the number of mature cataract as well as phacomorpic and phacolytic glaucoma which was decreased for last many years .Although the awareness increased regarding cataract surgery but due to stop of elective work like other specialties and COVID 19 become the focus point the morphology of cataract changed (mature and hypermature), complicated cataract (phacomorphic, phacolytic glaucoma) irrespective of socioeconomic status of patients. Conclusion: During lockdown period there is increase in the maturity of cataracts and secondary glaucoma (phacolytic, phacomorphic). Although this pattern of cataract presentation has been decreased for last many years but due to covid 19 strong lock down occur and this pattern was again observed. Keywords: Covid-19. Phacolytic glaucoma, Phacomorphic glauco