Secondary Cataract Research Articles

Expression Profiles of Inflammatory Cytokines in the Aqueous Humor of Children after Congenital Cataract Extraction.

PurposeTo investigate the change in cytokine microenvironment of the aqueous humor (AH) after surgery in children with congenital or developmental cataracts.MethodsAH samples were obtained from 59 eyes diagnosed with a congenital or developmental cataract. Thirty-three of these eyes were aphakic following previous cataract surgery and were scheduled for secondary intraocular lens (IOL) implantation. Additionally, AH samples from 26 eyes that had not undergone surgery were taken. AH samples were then analyzed for 16 different inflammatory immune mediators using multiplex bead immunoassays and enzyme-linked immunosorbent assay (ELISA).ResultsThe mean interval between secondary IOL implantation and original cataract surgery was 24.85 months (range, 9–60 months). Levels of IL-6, IP-10 (CXCL10), MCP-1 (CCL2), and IL-2 were significantly elevated in the AH of eyes after surgery compared to eyes that did not undergo surgery (P < 0.001, P = 0.047, P = 0.006, P = 0.012, respectively). There was significant correlation between the levels of TGF-β2 and intraocular pressure (IOP) in postsurgical and nonsurgical eyes (r = 0.532, P = 0.006; r = 0.57, P = 0.001). Postsurgical outcomes, such as iris adhesions, capsular fibrosis, and capsular contraction, were found not to be significantly associated with cytokine levels in the AH after surgery; however, IL-6 levels in capsular exposure eyes were significantly higher than those in cortical closure eyes (P = 0.023).ConclusionsTo our knowledge, this is the first study to report significantly increased proinflammatory cytokine levels in the AH after congenital cataract extraction in children. Our study also suggests that this proinflammatory state may be maintained for a prolonged period of time. Overall, these results give us insight into the relationship between the inflammatory cytokine microenvironment of the aqueous humor and potential long-term complications following congenital cataract surgery.Translational RelevanceThe inflammatory cytokine microenvironment of the aqueous humor might help explain potential long-term complications after surgery in patients with congenital or developmental cataracts.

Successful treatment of ciliary body medulloepithelioma with intraocular melphalan chemotherapy: a case report

BackgroundIntraocular medulloepithelioma is commonly treated with primary enucleation. Conservative treatment options include brachytherapy, local resection and/or cryotherapy in selected cases. We report for the first time the use of targeted chemotherapy to treat a ciliary body medulloepithelioma with aqueous and vitreous seeding.Case presentationA 17-month-old boy with a diagnosis of ciliary body medulloepithelioma with concomitant seeding and neovascular glaucoma in the right eye was seen for a second opinion after parental refusal of enucleation. Examination under anesthesia showed multiple free-floating cysts in the pupillary area associated with iris neovascularization and a subluxated and notched lens. Ultrasound biomicroscopy revealed a partially cystic mass adjacent to the ciliary body between the 5 and 9 o’clock meridians as well as multiple nodules in the posterior chamber invading the anterior vitreous inferiorly. Fluorescein angiography demonstrated peripheral retinal ischemia. Left eye was unremarkable. Diagnosis of intraocular medulloepithelioma with no extraocular invasion was confirmed and conservative treatment initiated with combined intracameral and intravitreal melphalan injections given according to the previously described safety-enhanced technique. Ciliary tumor and seeding totally regressed after a total of 3 combined intracameral (total dose 8.1 μg) and intravitreal (total dose 70 μg) melphalan injections given every 7–10 days. Ischemic retina was treated with cryoablation as necessary. Three years later, ab interno trabeculotomy followed by 360° gonioscopy-assisted transluminal trabeculotomy 6 months later was performed for uncontrolled intraocular pressure despite antihypertensive drugs combined to cyclophotocoagulation and 7 intravitreal anti-VEGF injections for recurrent iris neovascularization. Cataract was removed at the same operative time. The child has remained disease- and metastasis-free at a 5-year follow-up since the last melphalan injection (25-month follow-up after the combined lensectomy-trabeculotomy) with a controlled intraocular pressure under topical quadritherapy and a best corrected Snellen visual acuity of 0.08.ConclusionsWe report for the first time complete regression of a non-infiltrating ciliary body medulloepithelioma with seeding achieved with only a small number of intracameral and intravitreal melphalan injections. Concomitant secondary neovascular glaucoma and cataract needed appropriate management to allow long-term eye and vision preservation.

Atypical ophthalmic manifestations of disseminated intravascular coagulation in a newborn

Ophthalmic manifestations of disseminated intravascular coagulation (DIC) in a newborn are rare. Ocular involvement typically involves the posterior segment bilaterally and manifests as choroidal and/or retinal hemorrhages associated with fibrin thrombi in the choriocapillaris. We present the case of a newborn girl with DIC secondary to sepsis who subsequently developed nonclearing hyphema, related secondary cataract, 360° posterior synechiae, and nonclearing vitreous hemorrhage in the right eye and diffuse retinal hemorrhage in the left eye. The right fundus was not visible because of intraocular bleeding. The patient underwent cataract surgery at 39days of life and was left aphakic. Two weeks later, she required subsequent vitrectomy because of a nonclearing vitreous hemorrhage. She developed amblyopia of the right eye and a right esotropia that required strabismus surgery. At 7years of age, the patient's visual acuity was 20/50 in the right eye and 20/20 in the left eye.

Extended Release of Doxorubicin-Loaded 3DNA Nanocarriers from In-Situ Forming, Self-Assembled Hydrogels.

Purpose: Cataracts are the leading cause of blindness worldwide, resulting in over 30 million surgeries each year. These cases are expected to double within the next 10 years. About 25% of all patients develop secondary cataracts or posterior capsule opacification (PCO) postsurgery. PCO is a vision impairment disorder that develops from myofibroblasts migration and contraction that deforms the capsule surrounding the lens. Currently, Nd:YAG laser therapy is used to treat PCO; however, laser is not available worldwide and adverse side effects may arise. Thus, there is a considerable unmet need for more efficacious and convenient preventive treatments for PCO. Our work focuses on engineering an innovative, prophylactic sustained release platform for DNA-based nanocarriers to further reduce the incidence of PCO. Methods: Novel, optically clear, self-assembled poly(d,l-lactic-co-glycolic acid)-b-poly(ethylene glycol) (PLGA-PEG) triblock copolymer hydrogels were used for the sustained release of the DNA-based nanocarriers (3DNA®) loaded with cytotoxic doxorubicin (DOX) and targeted with a monoclonal antibody called G8 (3DNA:DOX:G8), which is specific to cells responsible for PCO. Results: The 29 (w/v)% polymer hydrogels with the 3DNA nanocarriers presented over 80% of light transmittance, soft mechanical properties (<350 Pa), and sustained release for 1 month. Conclusions: In this work, we show for the first time that the hydrophobic PLGA-PEG-PLGA hydrogels can be used as platforms for sustained delivery of nucleic acid-based nanocarriers. This work demonstrates that polymeric formulations can be used for the extended delivery of ocular therapeutics and other macromolecules to treat a variety of ocular conditions.

Concurrent Phacoemulsification and Encircling for Hypotony Maculopathy after Blunt Trauma

A 37-year-old Japanese man had his right eye hit by a fist. His right eye developed hypotony maculopathy and secondary cataract, and his visual acuity decreased to 20/200 with an intraocular pressure of 4 mmHg. He underwent phacoemulsification and aspiration, implantation of the intraocular lens, and encircling with a silicone tire. His visual acuity improved to 20/20 and stable for more than one year postoperatively. The intraocular pressure in his right eye increased to 12 mmHg, and maculopathy was resolved entirely. It was suggested that an encircling buckle obstructed the uveoscleral outflow through the cyclodialysis and increased intraocular pressure. Concurrent cataract surgery and encircling was sufficient to improve the vision.

Изучение частоты и структуры формирования вторичной катаракты при различных типах интерфейса «интраокулярная линза – задняя капсула хрусталика» в отдаленные сроки после факоэмульсификации возрастной катаракты

Изучение частоты и структуры формирования вторичной катаракты при различных типах интерфейса «интраокулярная линза – задняя капсула хрусталика» в отдаленные сроки после факоэмульсификации возрастной катаракты

Electrolyte, Nitric Oxide and Oxidative Stress Levels of Aqueous Humor in Patients with Retinal Detachment and Silicone Oil Tamponade

ABSTRACT Purpose: To enlighten the pathogenesis of silicone oil (SiO)-related complications via measuring aqueous humor levels of electrolytes, nitric oxide (NO), and oxidative stress in SiO, retinal detachment (RD), and control groups. Materials and Methods: In this prospective study, 56 patients were grouped as SiO (n = 29), RD (n = 12), and control (n = 15). The results of pre- and post-operative ophthalmological examinations, aqueous humor electrolyte and NO levels, total antioxidant and oxidant status (TAS, TOS) and oxidative stress index (OSI) were analyzed. Results: SiO group had a higher mean Na+ level compared to controls (144.77 ± 11.48 vs 137.56 ± 6.57 mmol/kg, p = .02). Also, the mean Na+ and Cl− levels of RD group were higher than controls (149.04 ± 12.05 vs. 137.56 ± 6.57 mmol/kg, p = .02, 115.2 ± 7.79 vs 106.23 ± 8.99 mmol/kg, p = .031 for Na+ and Cl−, respectively). The mean NO level of RD group was higher than that of SiO group (51.07 ± 19.56 vs. 34.07 ± 13.84 μM, p = .009). The mean TAS and TOS were lower in SiO group compared to controls (1.92 ± 0.64 vs. 2.49 ± 0.56 μmolTroloxEqv./L, p = .021, 34.98 ± 26.55 vs. 61.46 ± 22.69 μmolH2O2Eqv./L, p = .004 for TAS and TOS, respectively). Intraocular retention time of SiO demonstrated positive correlation with post-operative visual acuity (logMAR) and negative correlation with TOS. Conclusions: Elevated aqueous humor Na+ and Cl− in RD patients might reflect abolished function of ion channels on detached retina. Increased Na+ and lack of NO response to elevated intraocular pressure in SiO-filled eyes might contribute to secondary cataract and glaucoma formation. SiO is associated with low levels of oxidative stress in aqueous humor; however, increased intraocular retention time of SiO is related to a poor visual outcome.

Future perspectives of the femtosecond laser in anterior segment surgery

Around 12years after its introduction laser cataract surgery (LCS) has enabled remarkable progress, such as extremely precise capsulotomy and lens fragmentation with reduced or no ultrasound energy at all (zero phako); however, another innovation push is necessary to bring this technology to its full potential. Among the many benefits that have not yet been fully explored are primary posterior laser capsulotomy (PPLC) and the use of the femtosecond laser in pediatric cataract patients. In the present collective of patients in whom a PPLC was carried out at the end of the operation, a clearly reduced prevalence of secondary cataract could be observed, whereas the short additional intervention was not associated with notable complications. The LCS in infants is best carried out as an off-label procedure, which has been rendered more precise by the Bochum formula. In the near future, postoperative laser fine tuning will enable the target refraction to be achieved in most patients. Laser-induced refractive index change (LIRIC) will enable very exact refraction alterations on an already implanted intraocular lens (IOL), on acontact lens and on atreatment native cornea. Anew version of the Scheimpflug camera will be used just prior to surgery to analyze the morphology and kernel density of the lens opacity and to carry out a real-time grading of lens hardness. Based on this categorization, where the system classifies the results into five different density grades, the surgeon is automatically provided with an individualized fragmentation pattern defined preoperatively by the operator. Afurther innovation of the same system involves microcorneal incisions for fine tuning of residual refractive deficits.

Eradication of Posterior Capsule Opacification: Documentation of a Marked Decrease in Nd:YAG Laser Posterior Capsulotomy Rates Noted in an Analysis of 5416 Pseudophakic Human Eyes Obtained Postmortem

(1) To report the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate (%) of eight rigid and foldable intraocular lens (IOL) designs in a series of 5416 pseudophakic human eyes obtained postmortem, accessioned in our center between January 1988 and January 2000. (2) To identify factors that are instrumental in reducing the incidence of posterior capsule opacification, (PCO, secondary cataract) and hence the need for Nd:YAG laser posterior capsulotomy. Comparative autopsy tissue analysis. A total of 5416 globes with posterior chamber intraocular lens (PC-IOLs) obtained postmortem received from Lions Eye Banks between 1988 and2000. Miyake-Apple posterior photographic technique. Special reference was given to the presence or absence of Nd:YAG laser posterior capsulotomy orifice on the posterior capsule of each eye. The Nd:YAG laser posterior capsulotomy rate (%) as of January 2000 was documented. In addition, the Nd:YAG laser posterior capsulotomy rate for each lens was plotted on a monthly basis for the same period, creating a computerized trend or "timeline" for each IOL style. Relatively high Nd:YAG laser posterior capsulotomy rates ranging from 20.3% to 33.4% were noted with four relatively older designs (high incidence of implantation between 1988 and the early 1990s). Four modern foldable lOLs manufactured from silicone and acrylic materials had significantly lower Nd:YAG laser posterior capsulotomy rates ranging from 0.9% (Alcon Acrysof) to 17.1%. The difference in Nd:YAG rates among the eight IOL designs was found to be significant (P < 0.0001, chi-square test). Comparing foldable versus rigid designs, the foldable IOLs were associated with a much lower Nd:YAG laser posterior capsulotomy rate (14.1% vs. 31.1%). By use of the six factors regarding surgical technique and IOL choice described in this article, we strongly believe that the overall incidence of PCO and hence the incidence of Nd:YAG laser posterior capsulotomy is now rapidly decreasing from rates as high as 50% in the 1980s to early 1990s. Surgical tools and IOLs are now available to bring these rates down to single digits. Careful application and use of these tools by surgeons can genuinely lead in the direction of virtual eradication of secondary cataract, the second most common cause of visual loss worldwide.

Estudio de la discapacidad visual por diabetes mellitus tipo 2 en el adulto mayor

La discapacidad visual afecta gran parte de la población adulta mayor. Se trata generalmente de patologías secundarias oculares primarias o sistémicas y congénitas o idiopáticas, incluyendo presbicia, cataratas, glaucoma, degeneración macular y retinopatía diabética (RD). El objetivo de este trabajo fue conocer cuáles son las experiencias, perspectivas y significados que tienen los adultos mayores con discapacidad visual por diabetes mellitus tipo 2 (DMT2). Utilizando una metodología cualitativa con muestreo intencionado, se realizaron entrevistas a profundidad, siguiendo los principios éticos para investigación en salud. El fenómeno de la discapacidad mostró cinco dimensiones: impacto económico por el diagnóstico, vivencias de duelo ante la DMT2, vivencias de autocuidado (tratamiento alternativo, tratamiento farmacológico y reflexiones sobre el valor del tratamiento), impacto (económico, emocional y social) y vivencias con la discapacidad y sentimientos de la dependencia vs. discapacidad. Estos aportaron los elementos necesarios para hacer una pauta en el cuidado integral brindado por profesionales del cuidado.

Construction Solutions to Prevent Development of Secondary Cataract After Intraocular Lenses Implantation

Background. The development of secondary cataract after implantation of an intraocular lens (IOL) as a result of migration and reproduction of residual epithelial cells after phacoemulsification occurs in 45–78% of patients. The currently used IOL models do not adequately protect the posterior part of the lens capsule and the front surface of the lens from the deposition of epithelial cells on them. Objective. The aims of the paper are as follows: (1) modeling the process of development of secondary cataract due to proliferation, migration and metaplasia of residual epithelial cells (E-LEC); (2) evaluation of existing technical solutions to combat clouding of the lens capsule (CLC), secondary cataract, after implantation of IOL; (3) development of original technical approach to solving the problem of CLC with next modeling; (4) conducting an experiment to study the movement of a dye solution in an extracted pig's eye lens, implanted with a Support OP lens based on the data obtained during simulation. Methods. To model the migration of epithelial cells, the COMSOL Multiphysics 5.4 software environment and the Fluid flow library were used. For computer analysis, IOL of our own design and the lens of an American company were taken. During the simulation, it was taken into account that cells of a polygonal or oval shape have sizes from 48 to 142 μm and a constant propagation velocity of 10 - 4 m/s. The main attention was paid to the spread of epithelial cells not only towards the posterior wall of the lens capsule, but also to the front surface of the lens itself. After carrying out computer modeling, the results of which have been repeatedly confirmed, an experiment was carried out in which a capsule bag of a pig's eye lens was implanted with an implanted IOL of its own design. An aqueous dye solution, applied under a pressure not exceeding the penetration strength of the lens capsule, imitated the movement of epithelial cells. The study was conducted in compliance with the ARRIVE guidelines. Results. The simulation showed that the use of the IOL sharp edge design just partially protects the back wall of the capsule from the growth of epithelial cells (E-cells) on it, despite the fact that the lens is made of hydrophobic acrylic. This IOL doesn’t tightly contact with the back wall of the capsule and therefore the migration of lens epithelial cells in this direction is possible. The front of the lens also remains vulnerable to fibrous hyperplasia, which leads not only to visual impairment, but also to its complete loss. The proposed volume-replacing IOL of its own design, which has a sharp edge, which provides close contact with the lens capsule, a groove-trap for migrating cells, and in the front of the elements for suture fixation. Conclusions. The study revealed a number of factors that need to be addressed to prevent the development of secondary cataract. The intraocular lens must be made of biocompatible material, for the full tension of lens capsule, it is necessary that the haptic is angulated, the optical part should include at least one of the elements (a sharp edge or a special side). Based on this, the proposed approach takes into account the problems described in the article and includes the above elements and a special groove-trap for epithelial cells. Modeling and experimental testing of the proposed option confirmed its effectiveness.

Genetic and clinical findings of panel-based targeted exome sequencing in a northeast Chinese cohort with retinitis pigmentosa.

BackgroundPanel‐based targeted exome sequencing was used to analyze the genetic and clinical findings of targeted genes in a cohort of northeast Chinese with retinitis pigmentosa.MethodsA total of 87 subjects, comprising 23 probands and their family members (total patients: 32) with confirmed retinitis pigmentosa were recruited in the study. Panel‐based targeted exome sequencing was used to sequence the patients and family members, all subjects with retinitis pigmentosa underwent a complete ophthalmologic examination.ResultsOf the 23 probands, the clinical manifestations include night blindness, narrowing of vision, secondary cataracts, choroidal atrophy, color blindness, and high myopia, the average age of onset of night blindness is 12.9 ± 14 (range, 0–65; median, 8). Posterior subcapsular opacities is the most common forms of secondary cataracts (nine cases, 39.1%), and peripheral choroidal atrophy is the most common form of secondary choroidal atrophy (12 cases, 52.2%). Of these probands with complication peripheral choroidal atrophy, there were eight probands (66.7%, 8/12) caused by the pathogenic variation in USH2A gene. A total of 17 genes and 45 variants were detected in 23 probands. Among these genes, the commonest genes were USH2A (40%; 18/45), RP1 (15.6%; 7/45), and EYS (8.9%; 4/45), and the top three genes account for 56.5% (13/23) of diagnostic probands. Among these variants, comprising 22 (48.9%) pathogenic variants, 14 (31%) likely pathogenic variants, and nine (20%) uncertain clinical significance variants, and 22 variants was discovered first time. Most of the mutations associated with RP were missense (53.3%, 24/45), and the remaining mutation types include frameshift (35.6%, 16/45), nonsense (6.7%, 3/45), and spliceSite (4.4%, 2/45). Among the probands with mutations detected, compound heterozygous forms was detected in 13 (56.5%, 13/23) probands, and digenic inheritance (DI) forms was detected in five (21.7%, 5/23) probands.ConclusionPanel‐based targeted exome sequencing revealed 23 novel mutations, recognized different combinations forms of variants, and extended the mutational spectrum of retinitis pigmentosa and depicted common variants in northeast China.

SURGICAL OUTCOMES OF 25-GAUGE PARS PLANA VITRECTOMY USING AIR AS AN INTERNAL TAMPONADE FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT.

To report surgical outcomes of 25-gauge pars plana vitrectomy using air as an internal tamponade for patients with primary rhegmatogenous retinal detachment (RRD). A retrospective clinical study of 59 eyes of 59 consecutive patients presented with primary RRD at the Beijing Tongren Eye Center in China. From August 2016 to May 2018, medical records of the patients who underwent 25-gauge pars plana vitrectomy with air tamponade for RRD were reviewed. The main outcome measures were primary and final anatomical success (retinal re-attachment) rates, and postoperative complications. Of the 59 patients, aged 54.47 ± 11.81 years, 31 (52.5%) were men. Vitrectomy was performed 3 to 40 (averaged 16.98 ± 10.17) days after the onset of symptoms, and the mean follow-up period was 12.90 ± 5.92 months (ranging 6.07-26.10 months). Forty-two eyes (71.2%) had RRD with retinal breaks in the superior half of the retina, and the mean number of retinal breaks was 1.75 ± 0.94. Three eyes (5.1%) had RRD with giant retinal tears. Of the 59 eyes, 35 (59.3%) had RRD with inferior quadrants involved. Proliferative vitreoretinopathy (PVR) gradings were C1 in 2 (3.4%) eyes and B or below in 57 (96.6%) eyes. The primary and final anatomical success rates were 94.9% (56/59) and 98.3% (58/59), respectively. Of the three eyes which developed re-detachment of the retina, one eye had postoperative progression of PVR and two eyes were RRD associated with macular hole in high myopia. Postoperative complications included 5 eyes (8.5%) with serous choroidal detachment within 3 days after surgery and 4 eyes (6.8%) with macular epiretinal membrane formation 1 to 8 months after surgery. Secondary cataract surgery was performed in 13 of the 53 phakic eyes (24.5%) during follow-up. Small-gauge pars plana vitrectomy with air tamponade may be effective in treating selected cases of relatively simple primary RRD. Additional studies are needed to verify the efficacy of this surgical approach for more complicated cases such as those with giant retinal tears.

Effects of laser operations in the iris-lens diaphragm area on the thickness of the macular region and peripapillary nerve fiber layer

To assess possible changes in the macular region of the retina and thickness of the peripapillary retinal nerve fiber layer (RNFL) according to the results of a dynamic study of OCT parameters after laser operations in the iris-lens diaphragm area. Optical coherence tomography (OCT) was performed on 34 pseudophakic patients (43 eyes) with clinical signs of secondary cataract with best corrected visual acuity (BCVA) of at least 0.3, and on 28 patients (38 eyes) with relative papillary block before laser intervention and 1 hour, 1 day, 3 days, 7 days, 1 and 6 months after surgery. The changes in the thickness of the retina in 9 standard ETDRS areas, and the thickness of the ganglion cells layer and peripapillary RNFL were analyzed. In both groups of patients during the entire observation period, there was no fundamental change in the thickness of the peripapillary RNFL and the ganglion cell complex (all p>0.05). According to OCT, retinal thickness in both groups significantly increased an hour after laser irradiation in 5 out of 9 ETDRS areas. The retinal thickness returned to preoperative values in the group of patients with Nd:YAG laser posterior capsulotomy on the 3rd day after surgery, and after 1 week in the group with Nd:YAG laser iridectomy. Retinal thickness in the macular area did not change significantly during the follow-up. Laser operations in the iris-lens diaphragm area have a negligible effect on the thickness of the retina, as measured by the OCT method, do not affect the thickness of the ganglion cells layer or peripapillary RNFL, and is safe for the central zone of the retina.

Early anterior capsular fibrosis and formation of secondary cataract with in.the.bag intraocular lens decentration in a patient with retinitis pigmentosa.

Early anterior capsular fibrosis and formation of secondary cataract with in.the.bag intraocular lens decentration in a patient with retinitis pigmentosa.

АНАЛІЗ ГАПТИЧНИХ ЕЛЕМЕНТІВ ІНТРАОКУЛЯРНИХ ЛІНЗ

After operations performed toremovecataracts, anintraocularlens (IOL) isimplanted into the humaneye. The IOL includes the optical part (thelens) and the haptic with whichitisproper lyplaced intheplace of the removed naturallens. Hapticelements mustper form a number of important functions: preventing the dislocation of the lens, providing the corrects hape of the capsulebag, protecting the capsule from the development of secondary cataracts. To ensurethese and other functions, fasteningelements (haptics) mustsatisfy the conditions of both physical and chemical properties. The article provide sananalysis of theexisting hapticintraocular lenses and the iropportunities

Clinical Characteristics of Behcet's Disease in 453 Egyptian Patients Suffering from Uveitis with Gender Comparison.

To describe the clinical features in patients with Behcet's disease suffering from uveitis in Egypt and to compare the findings between both genders. 453 subjects fulfilling the 1990 Classification criteria for Behcet's disease and with uveitis in at least one eye. Follow-up was done for two years. Oral ulcers and recurrent iridocyclitis occurred in all patients during their disease course. The prevalence of genital ulcers, erythema nodosum, and joint involvement were similar between both sexes. The prevalence of all ocular findings was higher in females except for retinal hemorrhages. The incidence of secondary cataract and glaucoma in addition to vitreous opacities was similar between both sexes. 13.7% of patients had GIT manifestations. Vascular complications were present in 128 (28.2%) patients. Aseptic meningitis and hemiplegia were only found in males. 1.7% of males and 3.2% of females suffered from brainstem involvement. Superior sagittal sinus thrombosis was present in females only. Acute phase reactants (ESR & CRP) were significantly higher in females (p<0.0001). The disease characteristics of BD patients with uveitis in Egypt might be different from the BD patients of other countries. The markers of inflammation were higher in females compared to males. The ocular manifestations were more common in females.

Clinical Experience of Using Intraocular Lenses

Aim: to analyze the data obtained from using of intraocular lenses — the hydrophobic IOL Citrin and a hydrophilic IOL Aquamarine, produced by Russian company — NanOptic. Materials and methods. A total of 56 IOLs, produced by NanOptic (38 hydrophobic IOLs Citrine and 18 hydrophilic IOLs Aquamarine) were implanted. The observation period was from 3 to 12 months. The indication for phacoemulsification was age cataract. The age of the patients was 54–85. Patients before the operation were conducted basic studies. The mean uncorrected visual acuity before the operation was (UCVA) 0.121 ± 0.120 (0.001–0.3), and the mean corrected visual acuity was (BCVA) 0.187 ± 0.140 (0.001–0.6). All patients underwent standard phacoemulsification. Results. The early postoperative period was without any complications. In the postoperative period the mean UCVA in patients with “Citrine” and “Aquamarine” was 0.90 ± 0.10 (0.7–1.0) and 0.96 ± 0.07 (0.8–1.0) accordingly, and the mean BCVA was 0.94 ± 0.07 (0.8–1.0) and 0.99 ± 0.02 (0.9–1.0) accordingly. In all cases, the refraction obtained was consistent with the prediction. The error in IOL calculation was minimal and permissible. There weren’t any case of secondary cataract in patients with hydrophobic IOLs, and 3 cases of lens posterior capsule fibrosis of 1 degree in patients with hydrophilic IOLs in 3–12 months observation. The position of IOL in capsule bag was stable. Conclusions. The results of implantation of new Russian-made IOLs on the given parameters appeared to be satisfactory, that allows to recommend them for implantation in cataract surgery.

Effect of YAG Laser Posterior Capsulotomy on Central Macular Thickness in Pseudophakic Patients

Background: posterior capsular opacification (PCO), also known as ‘secondary cataract’ or ‘after cataract’, develops a few months to a few years over the clear posterior capsule after an uncomplicated cataract surgery. Purpose: evaluation the impact of Neodymium-doped Yttrium Aluminum-Garnet (Nd: YAG) laser capsulotomy on central macular thickness (CMT) by optical coherence tomography (OCT). Patients and Methods: the present study examined 50 eyes (24 males, 26 females) with an average age of 63.58±7.7 which was pseudophakic and had PCO, preoperative evaluation included history taking, ophthalmological examination and OCT was done. All patients underwent YAG laser posterior capsulotomy and CMT assessed at 3 days, 1 week, 1 month and 3 months by OCT. Results: there was significant improvement of BCVA (LogMAR) post laser capsulotomy (P< 0.001), IOP statistically significant increased (P< 0.001) at the first postoperative 3 days, 1 week, 1 month with mean ±SD of 16.46±2.54 mmHg 17.50±2.67 mmHg ,15.50±2.39 mmHg respectively when compared to preoperative values 13.0±1.67 mmHg. At 3 months there was minimal change (P=0.02). As regard CMT values at 1 week post laser (mean ±SD of 270.92±24.88) was highly significant increased (P< 0.001) and values at 3 months (mean ±SD of 248.70±21.66) showed nonsignificant difference (P=0.285) when compared to pre laser values (mean ±SD of 245.58±23.30). Conclusion: typical treatment of the PCO is YAG laser capsulotomy, IOP elevation is the most prevalent complication so antiglaucoma drugs is recommended and IOP return to normal values in the follow up period.

Effect of Neodymium-YAG Laser Posterior Capsulotomy on Intraocular Pressure

Background: Posterior capsule opacification (PCO) also known as Secondary cataract is the most common complication following cataract surgery. It can occur between few months and many years after implantation of intraocular lenses (IOLs), with incidence figures ranging from <5% to as high as 50%. Objective: The aim of this study was to determine the frequency of intraocular pressure elevation after Nd: YAG laser posterior capsulotomy for treatment of PCO. Patients and Methods: A prospective non-randomized study that was conducted at Al Zahraa University Hospital. The study included a total of 40 eyes of 31 patients. All patients underwent Nd: YAG laser posterior capsulotomy. Patients were followed up at 4 hours, 1 day, 1 week and 1 month after laser capsulotomy. Nine cases were bilateral, 15 were males (48%) and 16 were females (52%). Results: The majority of patients (90%) showed significant improvement in visual acuity after capsulotomy and about 87.5% of patients had final BCVA of 6/6-6/12, visual acuity after 24 hours was 6/9 in 20 eyes (50%) and 20 eyes (30%) had VA of 6/12. All the 40 patients had visual acuity improvement of 1 or more lines after capsulotomy. No one had further decline in visual acuity after capsulotomy. Conclusion: The present study depicts the Nd: YAG laser capsulotomy as a good, successful treatment of PCO, because it was found to be modern, non-invasive, effective mode of treatment of PCO with lesser complications and it does not require hospitalization.