Cataract Research Articles

Transzonular moxifloxacin and dexamethasone delivery in phacoemulsification: A novel dropless regimen.

To assess the safety and efficacy of transzonular moxifloxacin and dexamethasone versus standard postoperative topical drug regimen in phacoemulsification. Nonrandomized prospective study. The study included 100 eyes of 100 age and gender-matched individuals with senile cataract undergoing routine phacoemulsification. The patients were consecutively divided into transzonular (TZ = 50) and topical (TP = 50) groups. Both the groups were followed up for 4 weeks and assessed for intraocular inflammation, visual acuity, changes in intraocular pressure (IOP), and any adverse events. The grades of inflammation were significantly lower in TZ as compared to the TP group ( P < 0.001). The IOP remained normal and comparable in both the groups. Most of the patients in the two groups attained a visual acuity of 0.2 or better at the end of the follow-up. No adverse effects and increased rate of endophthalmitis were noted in TZ group. A one-time peroperative TZ moxifloxacin and dexamethasone combination is a safe and effective method to control postoperative inflammation after cataract surgery. A word of caution though, due precautions to be exercised to prevent the risk of inflammation and endophthalmitis.

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.

Comparison of SRK/T with Kane formula for prediction of refractive outcome after phacoemulsification: Insights from a South Asian patient group

BackgroundPhacoemulsification stands as the most commonly conducted ocular procedure. Biometry represents an art with numerous generations of formulas introduced to enhance refractive prediction accuracy. The Sanders Retzlaff Kraff theoretical (SRK/T), a third-generation formula that merges linear regression and a theoretical eye model, and the Kane formula, a fourth-generation formula incorporating theoretical optics, regression, and artificial intelligence, embody our focal points. Our aim is to compare post-operative refractive outcomes utilizing SRK/T and Kane formulae for calculating intraocular lens (IOL) power in senile cataract patients undergoing phacoemulsification featuring a hydrophilic acrylic, monofocal IOL. MethodsThis prospective, interventional institutional study engaged 70 patients, totaling 74 eyes. They were categorized into two groups: Group A employed the SRK/T for IOL power calculation, while Group B used the Kane formula. Quantel Medical® A-scan biometer was employed. A comparison was drawn between both formulae in terms of mean absolute error (MAE) and median absolute error (MedAE), with the utilization of IBM SPSS 20 and a significance level of p < 0.05. ResultsThe MAE for the SRK/T and Kane formulae stood at 0.18 ± 0.82 D and 0.24 ± 0.94 D, respectively, while the MedAE recorded values of 0.16 D and 0.155 D, correspondingly (p < 0.05). ConclusionWithin this South Asian cohort of senile cataract patients, the SRK/T formula demonstrated a marginally improved refractive outcome, evidenced by a reduced mean absolute error.

Aqueous humor perturbations in chronic smokers: a proteomic study

The detrimental effects of smoking are multisystemic and its effects on the eye health are significant. Smoking is a strong risk factor for age-related nuclear cataract, age-related macular degeneration, glaucoma, delayed corneal epithelial healing and increased risk of cystoid macular edema in patients with intermediate uveitis among others. We aimed to characterize the aqueous humor (AH) proteome in chronic smokers to gain insight into its perturbations and to identify potential biomarkers for smoking-associated ocular pathologies. Compared to the control group, chronic smokers displayed 67 (37 upregulated, 30 downregulated) differentially expressed proteins (DEPs). Analysis of DEPs from the biological point of view revealed that they were proteins involved in complement activation, lymphocyte mediated immunity, innate immune response, cellular oxidant detoxification, bicarbonate transport and platelet degranulation. From the molecular function point of view, DEPs were involved in oxygen binding, oxygen carrier activity, hemoglobin binding, peptidase/endopeptidase/cysteine-type endopeptidase inhibitory activity. Several of the upregulated proteins were acute phase reactant proteins such as clusterin, alpha-2-HS-glycoprotein, fibrinogen, alpha-1-antitrypsin, C4b-binding protein and serum amyloid A-2. Further research should confirm if these proteins might serve as biomarkers or therapeutic target for smoking-associated ocular diseases.

A study of clinical profile in patients of cataracts with pseudoexfoliation in rural populations of central India

Background Ophthalmologists deal with daily pseudoexfoliation (PXF) due to severe secondary glaucoma, which arises after cataract surgery. Cataracts with pseudoexfoliation are age-related and are associated with open-angle glaucoma. Therefore, pseudoexfoliation is expected to occur more frequently. Pseudoexfoliation is occasionally associated with the development of thick nuclear cataracts, which may make surgery challenging. risks of cataract extraction in patients with pseudoexfoliation include zonular weakness and inadequate pupillary dilation. This may cause vitreous loss, and intraoperative or postoperative lens displacement. It could also lead to a rise in postoperative intraocular pressure (IOP), progressing to long-term inflammation, phimosis of the capsular tissue, glaucoma, and surgical corneal decompensation. Recurrent secondary cataracts are typically caused by some remaining cortical tissue and decreased zonular support, which may lead to lens epithelial cell migration. Surgery for glaucoma and cataracts is complicated by the presence of pseudoexfoliative debris. Objectives To determine the prevalence of pseudoexfoliation in cataract patients visiting the ophthalmic OPD, AVBRH hospital, to locate patients with pseudoexfoliative cataracts, to evaluate their likelihood of progressing to open-angle glaucoma, and to examine the various ocular characteristics of these patients. Methodology The study participants will undergo ophthalmological examination after considering the inclusion and exclusion criteria. This examination will include sac syringing on the lacrimal gland, estimation of the highest corrected visual acuity, slit-lamp examination, application tonometer assessment of intraocular pressure (IOP), and fundus examination using an indirect ophthalmoscope. All individuals with cataracts visiting the ophthalmology department of AVBRH will be examined under a slit-lamp to determine the presence of pseudoexfoliation in the operating eye. Expected Results Hospital statistics from India indicated that the percentage of patients with pseudoexfoliation, in addition to cataracts, ranges from 1.87% to 13.5%.

Clinical study on the influence of phacoemulsification on retinal structure of senile cataract based on data mining.

With the improvement of the level of science and technology, diagnosis and treatment technology of ophthalmology has continuously improved, especially with the rise of optical coherence tomography. Alternative methods have enabled clinicians to obtain more information and make greater breakthroughs in the occurrence and development of many ophthalmic diseases. To investigate changes in retinal structure in the macular area of senile diabetic cataract patients undergoing cataract phacoemulsification. This was a prospective cohort study. A total of 68 cataract patients (78 eyes) who voluntarily received phacoemulsification combined with intraocular lens implantation in the Department of Ophthalmology of our hospital from December 2018 to December 2021 were selected. They were divided into A (diabetic) and B (non-diabetic) according to whether they were complicated with diabetes. There were 24 cases (28 eyes) in A and 44 cases (50 eyes) in B. Cataract patients were collected before and after surgery. Day, 1 week, and 1 month, data on the average thickness of the fovea retina and thickness of the retinal nerve fiber layer around the optic disc (average thickness, nasal thickness, topic side thickness, upper thickness, and lower thickness) were statistically analyzed analyze. The average retinal thickness of the macular fovea in Group A was found to be greater than that of Group B, however, there was no statistically significant difference between the two groups. At week one and week thirty, Group A's layer of retinal nerve fibers surrounding the optic disc thickened; there was no discernible difference between the two groups. One week and one month following surgery, however, showed a one-week difference in upper thickness compared to preoperative days. There was no discernible change between the preoperative and 1-day times. Both diabetic cataract patients and simple age-related cataract patients will have different degrees of increased foveal retinal thickness after surgery. However, the foveal retinal thickness of patients with diabetes increases more.

Based on the relationship between anxiety of existential meaninglessness, hope level, and fear of progression, explored the effect of preoperative nursing with Orem theory in the senile cataract population.

Cataracts, characterized by a decrease in vision due to the clouding of the lens, can progress to blindness in advanced stages. The rising incidence of cataract cases has led to a significant number of patients experiencing negative emotions associated with vision loss, thereby diminishing their quality of life. In clinical practice, it is imperative for healthcare professionals to consider the psychological well-being of cataract patients. Currently, there is a scarcity of research focusing on psychological evaluations, such as assessing feelings of meaninglessness among individuals with cataracts. This study aims to investigate the factors influencing the anxiety of existential meaninglessness and to explore the relationships among existential anxiety, Herth hope index levels and fear of progression in the elderly cataract-affected population. Additionally, it evaluates the effectiveness of Orem's nursing care strategies. Utilizing a sociodemographic questionnaire, the Existential Meaninglessness Anxiety Scale (EM-A), Herth Hope Index Level Scale, and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), this research employed convenience sampling for a cross-sectional and intervention study. The retrospective study sample comprised 1,029 individuals, while the intervention study included 317. The intervention design assessed psychological changes in existential meaninglessness following Orem's preoperative nursing interventions. Multiple linear regression analysis was employed to ascertain the determinants of EM-A within the population of elderly patients with senile cataracts. Pearson correlation analysis elucidated the relationship between EM-A, levels of hope, and the FoP-Q-SF among this demographic. Subsequent investigations, utilizing a t-test, evaluated the effects by comparing the data before and after the implementation of the interventions. The correlation between EM-A, hope levels, and FoP-Q-SF was statistically significant (p < 0.05). Factors such as age, education level, alcohol consumption habits, hope levels, and FoP-Q-SF scores significantly affected EM-A scores (p < 0.05). Orem's nursing framework significantly reduced existential anxiety (p < 0.05). Among elderly patients with cataracts, existential anxiety was generally moderate. Hope levels and fear of progression were closely associated with the EM-A. The novel Orem preoperative care model effectively addresses clinical issues. In clinical practice, it is crucial to address psychological problems and enhance patients' quality of life.

Analysis after posterior chamber phakic intraocular lens implantation: 17- to 19-year follow-up study.

To evaluate the clinical outcomes of the Visian implantable collamer lens (ICL) in eyes with ≥17 years of follow-up. Single-center. Retrospective observational study. 70 eyes from 38 patients who underwent surgery between 2002 and 2006 with V4 ICL implantation were analyzed. Preintervention data included corrected distance visual acuity (CDVA), refraction, and intraocular pressure (IOP). At the 19-year mark, CDVA, refraction, IOP, endothelial count, and vault were measured using Tomey Casia 2 anterior pole tomography, along with recording long-term events. The operated patients had a spherical correction between -4 diopters (D) and -21 D and a cylinder up to 7.5 D. The mean CDVA (decimal) at the 17-year check-up was 0.89 ± 0.18, with a spherical equivalent of -1.05 ± 1.36 D. IOP has remained stable because mean measurements before surgery and currently were 15.16 ± 2.54 mm Hg and 16.19 ± 3.29 mm Hg, respectively. The endothelial cell count showed values of 2191 ± 386 cells/mm2, with a maximum of 2804 cells and a minimum of 1125 cells. Finally, the vault obtained was 348.53 ± 234.58 mm. Over the years, 2 eyes developed angle-closure glaucoma and 9 eyes were operated on for the development of anterior subcapsular cataracts. Visian ICL implantation demonstrated long-term visual and refractive stability, indicating it as a low-risk procedure. The ICL V4 model yielded satisfactory results for myopia and astigmatism correction after 17 years.

Prevalence and Associated Factors of Cataract, Cataract Surgery and Postoperative Outcome in an Old Population in Russia: The Ural Very Old Study

PurposeTo assess prevalence of cataract and cataract surgery in a very old population in Russia. DesignPopulation-based study. ParticipantsThe Ural Very Old Study included 1526 (81.1%) participants out of 1882 eligible individuals aged 85+ years. MethodsBased on anterior and posterior segment imaging, we assessed the prevalence of cataract, cataract surgery and other ocular disorders affecting best corrected visual acuity (BCVA). Main outcome measuresPrevalence of cataract and cataract surgery. ResultsThe study included 1163 (76.3%) individuals with lens information. Cataract surgery had been performed in 469 right eyes (41.0%;95%CI:38.1,43.9) (92.1% with posterior chamber IOL; 4.7% with multifocal IOL) and 479 left eyes (41.6%;95%CI:38.7,44.4) (92.7% with posterior chamber IOL; 4.2% with multifocal IOL). Among the 1163 study participants, 610 (52.5%) individuals had undergone cataract surgery in at least one eye. Higher prevalence of previous cataract surgery correlated (multivariable analysis) with lower IOP (OR:0.92;95%CI:0.88,0.95;P<0.001), glaucomatous optic nerve damage stage (OR:1.20;95%CI:1.05,1.36;P=0.006), and better visual acuity (OR:0.67;95%CI:0.51,0.89;P=0.005). Postoperative BCVA (mean:0.83±1.43logMAR) was reduced to moderate-to-severe vision impairment (MSVI) in 202 eyes (44.6%;95%CI:40.0,49.2) and to blindness in 53 eyes (11.7%;95%CI:8.7,14.7). Causes of postoperative MSVI were age-related macular degeneration (AMD) (34.2%), glaucoma (13.9%), and secondary cataract (5.4%). Causes for blindness were AMD (24.5%), glaucoma (18.9%), corneal opacifications (15.8%) and myopic macular degeneration (11.3%). YAG-laser capsulotomy had been performed in 6 (1.3%) out 469 right eyes after cataract surgery and in 12 (2.5%) out of 479 left eyes after cataract surgery. Prevalence of nuclear cataract and cortical cataract was 604/671 (90.0% in phakic eyes 51.9% in the whole study population) and 97.9% eyes (48.4% in total study population). Cataract caused bilateral MSVI and blindness in 28.2% (95%CI:25.6,30) and 2.9% (95%CI:1.9,3.9), respectively, of all study participants. ConclusionsDespite a relatively high prevalence of cataract surgery, this multiethnic cohort aged 85+ years from Russia showed a high prevalence of cataract-related MSVI and blindness, due to the old age of the participants. After cataract surgery, main causes for MSVI (prevalence:44.6%) and blindness (prevalence:11.7%) were AMD, glaucoma, corneal opacifications, and myopic macular degeneration. Almost all individuals aged 85+ years need cataract surgery, despite limited chance of postoperative good vision.

Impact of Physical Activity Frequency, Duration, and Intensity on Senile Cataract Risk: A Mendelian Randomization Study.

We aimed to determine the causal effects of physical activities with different frequencies, durations, and intensities on the risk of senile cataracts using Mendelian randomization (MR). A bidirectional two-sample MR approach was used to determine the association between physical activity and senile cataract risk. Our primary analysis used the inverse variance weighted method, and secondary analyses included MR-Egger regression, MR-PRESSO, and Cochran's Q statistic to evaluate heterogeneity and pleiotropy. Causal estimates were presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). Genetically predicted moderate physical activity ≥ 10 min/wk (OR = 0.765, 95% CI = 0.627-0.936, P = 8.73E-03), vigorous physical activity ≥ 10 min/wk (OR = 0.691, 95% CI = 0.521-0.917, P = 1.04E-02), moderate-to-vigorous physical activity levels (OR = 0.552, 95% CI = 0.369-0.823, P = 3.75E-03), and overall acceleration average (OR = 0.952, 95% CI = 0.926-0.978, P = 3.80E-04) were associated with a decreased risk of senile cataract while walking ≥ 10 min/wk (OR = 0.972, 95% CI = 0.741-1.275, P = 8.36E-01) had no significant correlation. The reverse MR analysis showed no reversal causality from senile cataract to physical activity except for walking ≥ 10 min/wk (OR = 0.951, 95% CI = 0.923-0.979, P = 7.30E-04). Our findings suggest that moderate to vigorous physical activity with higher frequency and longer duration will causally reduce the risk of senile cataracts, and there is no reverse causal relationship. These findings underscore the potential of incorporating physical activity into preventive health strategies for senile cataracts.

Corneal morphology following use of Malyugin versus B-hex pupil expansion rings in small pupil phacoemulsification

Aim: The aim of the study is to evaluate changes in corneal parameters following the use of the Malyugin ring (MR) and B-Hex ring (BhR) in small pupil phacoemulsification. Methods: A prospective cross-sectional study. 51 eyes with small pupil underwent phacoemulsification with the use of MR and BhR as pupil expansion techniques. Best-corrected visual acuity (BCVA), endothelial cell counts density (ECD), coefficient-of-variation (CV), hexagonality, central corneal thickness (CCT), and intraocular pressure (IOP) were recorded on preoperative day and postoperative day 1 and day 30. Results: Mean age at presentation was 70.9 ± 4.1 years. The most common cause for small pupils was alpha-blockers used in benign prostate hypertrophy, followed by diabetes mellitus and pseudo-exfoliation syndrome. Mean preoperative BCVA (3/60–6/12), IOP (17.12 ± 2.81 mmHg), CCT (530.96 ± 44.47 μ), ECD (2347.96 ± 298.09 cells/mm2), 6A (48.92% ± 6.34%) and CV (39.50 ± 3.49) changed to BCVA (6/9–6/6), IOP (18.69 ± 1.91 mm of Hg), CCT (536.04 ± 37.61 μ), endothelial cell count (2201.15 ± 276.75 cells/mm2), 6A (45.12% ±4.99%), and CV (37.57 ± 3.37) at day 30 postoperatively after use of MR. Similarly, mean preoperative BCVA (3/60–6/12), IOP (16.40 ± 2.42 mmHg), CCT (532.40 ± 36.14 μ), ECD (2433.68 ± 162.01 cells/mm2), 6A (48.84% ± 3.73%), and CV (39.36 ± 3.915) changed to BCVA (6/9–6/6), IOP (17.68 ± 2.75 mmHg), CCT (546.88 ± 31.25 μ), ECD (2322.08 ± 167.97 cells/mm2), 6A (46.36% ± 3.25%) and CV (38.96 ± 4.43) at day 30 post-operatively after use of BhR. The average change was clinically insignificant at day 30. Conclusion: MR and BhRs are safe pupil expansion devices and the corneal parameters are in the acceptable range of any routine phacoemulsification for senile cataracts. Nevertheless, B-hR shows relatively less alteration in corneal parameters, when compared to MR.

The Protective Effect of Rho-Associated Kinase Inhibitor Eye Drops (Ripasudil) on Corneal Endothelial Cells After Cataract Surgery: A Prospective Comparative Study.

Cataract surgery poses a risk to corneal endothelial cells. This study aimed to assess the protective effect of rho-associated kinase inhibitor eye drop (ripasudil) on corneal endothelial cells after cataract surgery over 12months. We conducted a prospective, non-randomized, non-blinded comparative study including 43 patients divided into two groups: the ripasudil group (22 patients, 23 eyes) and the control group (21 patients, 21 eyes). All patients had grade 3 nuclear cataract and underwent uneventful phacoemulsification with intraocular lens implantation. In the ripasudil group, one drop of ripasudil hydrochloride hydrate (Glanatec® ophthalmic solution 0.4%) was administered three times a day for 5days. Outcome measures included central corneal thickness (CCT) and endothelial cell density (ECD), which were evaluated preoperatively and 12months postoperatively. In the ripasudil group, the median ECD was 2398 (interquartile range [IQR] 410, 2201-2611) cells/mm2 at baseline and 2262 (IQR 298, 2195-2493) cells/mm2 at 12months postoperatively. In the control group, the median ECD was 2503 (IQR 390, 2340-2730) cells/mm2 at baseline and 2170 (IQR 324, 2049-2373) cells/mm2 at 12months postoperatively. Endothelial cell loss (ECL) was 12.8% in the control group, significantly reduced to 4.5% in the ripasudil group (p = 0.001*). CCT (p = 0.042), age (p = 0.383), sex (p = 0.944), and duration of surgery (p = 0.319) were not significant factors. No adverse effects were observed in either of the groups. Incorporating ripasudil into postoperative management could help maintain corneal endothelial cell integrity and reduce cell loss after cataract surgery, potentially decreasing the need for endothelial transplantation in patients who have undergone intraocular surgeries.

The effect of propofol-midazolam versus sevoflurane on bispectral index and eye position in pediatric cataract surgery: A randomized controlled study

ABSTRACT Background Cataract surgery is one of the infrequent ocular surgeries. The adequate ocular position with central alignment is the main prerequisite for good surgical technique. Propofol and sevoflurane are the common anesthetics drugs used during pediatric anesthesia. BIS monitor is one of the common intraoperative awareness monitors used. Aim To assess the efficacy of the bispectral index monitor in quantifying the depth of anesthesia and its correlation with ocular alignment during juvenile cataract surgery. Specifically, we will compare the use of sevoflurane anaesthesia with total intravenous anesthesia using a midazolam bolus and propofol infusion. Methods This study included 100 children scheduled for cataract surgery. The children were divided into two groups: group (S) included 50 children who were anesthetized using sevoflurane maintenance only and group (P) included 50 children who were anesthetized using continuous intravenous anesthesia (midazolam bolus plus propofol infusion) as maintenance after induction with sevoflurane anesthesia 8%. The bispectral index was recorded immediately after induction and after intubation and every 5 min later on until end of surgery. Results The eye position showed statistically significant central position among the propofol group with p value 0.02. An eye position-BIS value association was found statistically significant negative correlation in sevoflurane group while no statistically significant link was found in the propofol group. Conclusion Use of BIS monitor for making correlation between depth of anesthesia for prediction of ocular alignment was significant in sevoflurane group, but not in propofol group in pediatric patients and even with adequate depth of general anesthesia.

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.

Genetic correlation between circulating cytokines and risk of three ophthalmic diseases: a bidirectional two-sample Mendelian randomization study.

Pathogenesis and the associated risk factors of cataracts, glaucoma, and age-related macular degeneration (AMD) remain unclear. We aimed to investigate causal relationships between circulating cytokine levels and the development of these diseases. Genetic instrumental variables for circulating cytokines were derived from a genome-wide association study of 8293 European participants. Summary-level data for AMD, glaucoma, and senile cataract were obtained from the FinnGen database. The inverse variance weighted (IVW) was the main Mendelian randomization (MR) analysis method. The Cochran's Q, MR-Egger regression, and MR pleiotropy residual sum and outlier test were used for sensitivity analysis. Based on the IVW method, MR analysis demonstrated five circulating cytokines suggestively associated with AMD (SCGF-β, 1.099 [95%CI, 1.037-1.166], P = 0.002; SCF, 1.155 [95%CI, 1.015-1.315], P = 0.029; MCP-1, 1.103 [95%CI, 1.012-1.202], P = 0.026; IL-10, 1.102 [95%CI, 1.012-1.200], P = 0.025; eotaxin, 1.086 [95%CI, 1.002-1.176], P = 0.044), five suggestively linked with glaucoma (MCP-1, 0.945 [95%CI, 0.894-0.999], P = 0.047; IL1ra, 0.886 [95%CI, 0.809-0.969], P = 0.008; IL-1β, 0.866 [95%CI, 0.762-0.983], P = 0.027; IL-9, 0.908 [95%CI, 0.841-0.980], P = 0.014; IL2ra, 1.065 [95%CI, 1.004-1.130], P = 0.035), and four suggestively associated with senile cataract (TRAIL, 1.043 [95%CI, 1.009-1.077], P = 0.011; IL-16, 1.032 [95%CI, 1.001-1.064], P = 0.046; IL1ra, 0.942 [95%CI, 0.887-0.999], P = 0.047; FGF-basic, 1.144 [95%CI, 1.052-1.244], P = 0.002). Furthermore, sensitivity analysis results supported the above associations. This study highlights the involvement of several circulating cytokines in the development ophthalmic diseases and holds potential as viable pharmacological targets for these diseases.

TO COMPARE KERATOMETRY ASTIGMATISM FROM TEMPORAL AND SUPERIOR CORNEAL INCISIONS DURING PHACOEMULSIFICATION

Objective: To examine the average change in keratometry’s medically produced astigmatism between lateral andphacoemulsification corneal incisions.Study Design: Randomized Controlled TrialStudy Duration and place of study: Department of Ophthalmology, Khyber Institute of Ophthalmic Sciences HMC,Peshawar. From 20-07- 2020 to 21-01-2021.Materials and Methods: A random allocation process divided 140 cataract patients into two groups. Phacoemulsification was performed using a superior corneal incision in group A and a temporal incision in group B. Baselineand follow-up keratometry readings were used to compute the average astigmatism change.Results: Patient age averaged 49.6 + 5.3 years throughout the research group. Group B patients averaged 50.4 +4.9 years old (p 0.04), whereas group A patients averaged 48.9 + 5.8 years. Group A included 82.9% males and17.1% women, whereas group B had 74.3% men and 25.7% women (p 0.217). Group A’s mean BMI was 24.9+ 3.8 kg/m2, whereas Group B’s was 25.2 + 3.7. A and B had mean baseline BCVAs of 0.8 + 0.2 and 0.8 +0.2, respectively (p 0.858). Keratometry showed group A’s mean baseline astigmatism was 0.2 + 0.06D and groupB’s 0.1 + 0.07 (p 0.614). Keratometry showed that group A’s mean follow-up astigmatism was 1.2 + 0.2D andgroup B’s 1.1 + 0.2 (p 0.836). According to keratometry, group A’s astigmatism changed by 1.0 + 0.17D andgroup B’s by 1.0 + 0.2 (p 0.707).Conclusion: We found no statistically significant difference in mean astigmatism before and after phacoemulsificationin corneal vs temporal incision groups. Our study had a limited sample size and did not account for effect modifiers, thuswe urge additional studies with higher sample sizes and accounting for confounders that may affect patients’ medicallyinduced astigmatism after phacoemulsification.Keywords: Senile Cataract, phacoemulsification, temporal incision superior corneal incision, astigmatism, keratometry.

Robust Analysis of the Influencing Factors for Hospitalization Costs of Senile Cataracts Patients in Chengdu Considering Different Types of Insurance

Chengdu is one of the earliest pilot cities for urban-rural basic medical insurance integration in China. This study aimed to analyze the influencing factors of hospitalization costs of senile cataract in a tertiary hospital in Chengdu by robust method, especially considering the influence of medical insurance type. A total of 1310 discharged patients from a tertiary hospital from January 2020 to June 2021 who were mainly diagnosed with senile cataracts were selected as the research subjects. Kruskal-Wallis H test and Spearman correlation analysis are used to conduct univariate statistical analysis. The robust multivariate linear regression model and a semi-parametric multivariate regression model are established to obtain the influencing factors for their hospitalization costs. The robust multivariate regression model results show that reimbursement ratio, number of surgeries, type of medical insurance, hospitalization days, number of additional diagnoses and material proportion have significant correlations with the response variable, i.e. total hospitalization costs of the senile cataract patients. In the robust multivariate regression analysis, the type of insurance is significantly associated with the hospitalization costs. Fixing other variables, the hospitalization costs of patients with UEBMI insurance were 7.6% higher than those with URRBMI insurance. Generalized additive model (GAM) can express the nonlinear relationship between explanatory variables and response variable. Because of the nonlinear part of the GAM, the interpretation and description of the model can provide more knowledge than the linear models. In the GAM model, the type of insurance is also significantly related to the total costs. According to the regression effects of reimbursement ratio, number of surgeries, type of medical insurance, hospitalization days, number of additional diagnoses and material proportion on total costs, the paper aims to provide some references for promoting the reform of the local medical system and improving the eye health status and quality of life of middle-aged and elderly groups.

Satisfaction with Teleophthalmology Services: Insights from Remote Areas of Taiwan.

During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6-90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project.

Oxidative stress as a marker of inflammation in cataracts

Introduction. Oxidative stress is an important pathogenetic factor of degenerative eye diseases. Oxidative stress can damage tissues, leading to changes in their structure and function, increased vascular permeability, microvascular abnormalities and neovascularization. In turn, these changes can cause damage to the eye; denaturation of the crystalline lens.&#x0D; The purpose of the study: according to modern literature, to study the role of oxidative stress and inflammation in the development of cataracts.&#x0D; The molecular mechanisms of cell damage under oxidative stress and the pathogenesis of cataracts caused by oxidative stress have been studied.&#x0D; Conclusion. Oxidative stress is an important pathogenetic mechanism of degenerative eye diseases. Oxidized phospholipids activate pro-inflammatory molecules and cause inflammation. Oxidative stress in the body is regulated by antioxidant mechanisms. An imbalance of antioxidants affects the lens and causes cataracts. The G/G genotype of SOD1-251 A/G polymorphism may lead to a higher risk of senile cataracts. The content of antioxidants depends on the density of the lens nuclei, on the type of cataract. Non-enzymatic antioxidants have a predominant effect in watery moisture, and enzymatic antioxidants in blood serum in patients with cataracts.

Correlation between Postoperative Visual Acuity and Patient-Related Outcomes in Senile Cataract

Aims: This study assessed visual function (VF) and quality of life (QOL) post cataract surgery and their relationship with post-operative presenting visual acuity (PVA) in patients operated for senile cataract in two hospitals in Jos, North-central Nigeria.&#x0D; Study Design: A retrospective, hospital-based, cross-sectional survey.&#x0D; Place and duration of study: The study took place in the Eye units of the Bingham University Teaching Hospital and the Faith Alive Foundation Hospital both in Jos, North-Central Nigeria between June and August 2021.&#x0D; Methodology: Patients aged 40 years and above, operated on for senile cataract within 18 months before the onset of the study were included. Sociodemographic data and surgical history were obtained from patients and their surgical records. Visual acuity at presentation was assessed at six weeks or more postoperative period with available correction using Snellen’s acuity and converted to the LogMAR scale. A trained research assistant administered the VF-14 item and QOL-12 item questionnaires and responses were scored using Fletcher’s guidelines. Data was analyzed with STATA version 16.0 using the geometric mean, range, percentages, and Spearman’s rank test.&#x0D; Results: Eighty-seven (69.6%) participants aged 40-104 years, mean of 67.2 ± 12.0 years with a male-to-female ratio of 1.1:1 were enrolled. Their mean PVA was 0.6LogMAR (6/24) which improved to 0.3LogMAR (6/12). The mean total VF and QOL were 87.1% and 97.5% respectively. Depth perception (99.6%), visual perception, and peripheral vision (94.2% each) scored the highest in the VF subscales. Mental well-being (97.9%) scored the highest in the QOL subscale, followed by social interaction (97.3%). There was a negative correlation between PVA and mean total VF (rs = -0.4, P&lt;0.0001) and QOL (rs = -0.3, P = 0.011).&#x0D; Conclusion: In this study population, VF and QOL scores improved with increasing PVA.