Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack o...Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.展开更多
Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this comb...Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.展开更多
Purpose. This paper studies the tumour necrosis factor (TNF) levels in aqueous humor after traumatic cataract extraction and posterior chamber (PC) intraocular lens (IOL) implantation in rabb...Purpose. This paper studies the tumour necrosis factor (TNF) levels in aqueous humor after traumatic cataract extraction and posterior chamber (PC) intraocular lens (IOL) implantation in rabbits,and discusses the effect of TNF on postoperative anterior ocular inflammation. Methods. Twenty seven pigmented rabbits were divided into three groups: for the first group, the IOL were placed in the capsular bag after traumatic cataract extraction; for the second, the Extracapsular cataract extraction without IOL implantation; and for the third, the control group without surgical intervention. On the 1st, 3rd, 7th and 14th day postoperatively, aqueous humor samples were obtained. A modified double antibodies indirect sandwich ELISA was used to detected for the presence of TNF. The data were studied by means of analysis of variance in SAS software. Result. The TNF level was increased in aqueous humor and reached its maximum on the 1st postoperative days after traumatic cataract extraction and PC IOLs implantation, and the TNF levels are significantly higher (P<0 05) on the 1st, 3rd, 7th and 14th day postoperatively in traumatic cataract extraction and PC IOL implanted group than that in the non surgical intervention group and extracapsular cataract extraction group. Conclusions. The increase of TNF levels had a close relationship with presence of the IOL itself which induces the secretion of TNF. This suggested that TNF as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after traumatic cataract extraction and IOL implantation.展开更多
The cell morphology of corneal endothelium in 84 mice with experimental traumatic cataract was investigated with stained corneal buttons. In the experimental group, the boundaries between adjacent corneal endothelial ...The cell morphology of corneal endothelium in 84 mice with experimental traumatic cataract was investigated with stained corneal buttons. In the experimental group, the boundaries between adjacent corneal endothelial cells were significantly distorted, some cell boundaries manifested degenerative changes that led to coalescence of the cells. The mean density and mean area of endothelial cells of the controls showed significant difference from those of the experimental group during the 12 weeks of observ...展开更多
Dear Editor,I am Dr.Zhi-Tao Su,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present a case of spontaneous resolution of a traumatic cataract resulted ...Dear Editor,I am Dr.Zhi-Tao Su,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present a case of spontaneous resolution of a traumatic cataract resulted in good visual rehabilitation after removal of a ferrous intravitreal foreign body(IVFB).展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Traumatic cataract is the leading cause of significant monocular </s...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Traumatic cataract is the leading cause of significant monocular </span><span style="font-family:""><span style="font-family:Verdana;">visual impairment in children. The cause of this type of cataract is preventable penetrating or blunt ocular injury. Lens extraction can improve the visual </span><span style="font-family:Verdana;">acuity but it also depends on the extent of the injury to other ocular struc</span><span style="font-family:Verdana;">ture</span></span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To describe the features of pediatric traumatic cataract presenting at a tertiary eye center in Indonesia. </span><b><span style="font-family:Verdana;">Methods:</span></b><i> </i><span style="font-family:Verdana;">This study is a descriptive study and the data w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> collected retrospectively from the medical records of the patients who were diagnosed as pediatric traumatic cataract over the period of January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2019 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2019. Demographic data, trauma characteristics, clinical features, management, and pre- and post-operative Best Corrected Visual Acuity (BCVA) were reviewed retrospectively. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 37 patients were diagnosed as pediatric traumatic cataract. Among these patients, 78.38% were boys, with the mean age of 9.14 </span></span><span style="font-family:""><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 3.77 years old. Open globe injury was the mechanism of injury for 54.05% patients. Besides lens aspiration, additional procedures were membranectomy, anterior vitrectomy, primary posterior capsulotomy, and synechiolysis. Eighty-one percent patients had unilateral blindness preoperatively and 23.80% patients still had unilateral blindness on three months of follow</span></span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;">up. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In pediatric patients, traumatic cataract occurred predominantly in boys while playing outside the house. The children who had ocular trauma still have the risk of blindness even after the surgery. Trauma prevention and avoidance by adult supervision when children engage in outdoor play activity </span></span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> necessary.展开更多
AIM: To review results of traumatic cataracts in children.METHODS: Only those pediatric patients who fitted in the definite inclusion criteria were considered for study enrollment. They were further examined for any k...AIM: To review results of traumatic cataracts in children.METHODS: Only those pediatric patients who fitted in the definite inclusion criteria were considered for study enrollment. They were further examined for any kind of co-morbidities because of trauma, operated upon for traumatic cataracts with intraocular lens implantation. Amblyopia if present was treated. All were re-examined at the culmination of six-week postoperative period.According to the Birmingham Eye Trauma Terminology System the traumatic cataract cases were divided into group 1(open globe) and group 2(closed globe), and then determinants of visual acuity were compared.RESULTS: There were 544 eyes in group 1 and 127 eyes in group 2 in our study of 671 eyes with pediatric traumatic cataracts. Visual acuity at the end of 6 wk after surgery in the operated eye was > 6/60 in 450(82.7%) and ≥ 6/12 in 215(39.4%) eyes in the open globe group and > 20/200 in 127(81.8%) and ≥ 6/12 in 36(28.4%) eyes in the closed globe group(P = 0.143), and the difference between the groups was not significant in children. Overall, 402(39.4%) eyes gained ≥ 6/60 and > 5/12 in 238(35.4%) cases. Surgical treatment caused a significant difference in visual outcome(P = 0.000). When we compared achieved visual outcome with ocular trauma score predicted vision, no significant difference was found.CONCLUSION: Traumatic cataracts in children may have better outcome and ocular trauma score is a useful predictive method for the ocular trauma in children.展开更多
Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications we...Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.展开更多
AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS: Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of inju...AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS: Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis. RESULTS: A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included in the study. The mean (SEM) age at diagnosis was (6.6 ±3.2) years (range, 1.3-13.8 years). Each cataract was categorized according to the type of trauma: closed-globe (n =26) or open-globe (n =91) injuries. The most common injuring objects were sharp metal objects (37.61%). The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs) were primarily implanted in 47 eyes (68.12%), whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%). The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision. CONCLUSION: Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.展开更多
Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery you...Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery younger than 15 years of age, without history of ocular trauma and with a minimum follow-up period of 6 months, were reviewed retrospectively. Results: The most common initial complaint was leukocoria. Thirty-nine patients (62.9%) had bilateral cataracts and 23 patients (37.1%) had unilateral cataracts. The most common type was posterior polar cataract (22%) in patients with unilateral cataracts, and total cataract (33%) in patients with bilateral cataracts. The overall prevalence of postoperative complications was 58%, visual axis opacification (VAO) being the most common one (39%). The incidence of VAO was significantly higher in eyes with intact posterior capsules. Secondary glaucoma occurred in 12 (12%) eyes. Thirty-one (50%) patients were orthophoria, 17 (27%) patients had esotropia, and 14 (23%) patients had exotropia. Additional surgery for all of these complications was performed in 53 (53%) eyes. Conclusions: Despite appropriate surgical treatment of nontraumatic pediatric cataracts, post-surgical complications including VAO, glaucoma, or strabismus remain an important cause of morbidity in these patients. Posterior capsulotomy and anterior vitrectomy must be performed in all children below 6 years to reduce the need for additional surgery for VAO.展开更多
Obese individuals who subsequently sustain a traumatic brain injury(TBI)exhibit worsened outcomes including longer periods of rehabilitation(Eagle et al.,2023).In obese individuals,prolonged symptomology is associated...Obese individuals who subsequently sustain a traumatic brain injury(TBI)exhibit worsened outcomes including longer periods of rehabilitation(Eagle et al.,2023).In obese individuals,prolonged symptomology is associated with increased levels of circulato ry pro-inflammatory marke rs up to 1 year postTBI(Eagle et al.,2023).展开更多
The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cel...The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cellular interactions and circuitry.Therapeutic interventions seek to modify some aspects of the injury course to enable the re-establishment of functional circuitry.Interventions often target one cell type(e.g.,promoting neuroprotection or neural regeneration)or one process(e.g.,modulating inflammation,affecting astrocytic,microglial,or macrophage responses.)Many axons in the spinal cord are myelinated,and after injury oligodendrocyte death causes demyelination.Promoting remyelination of spared or new axons to re-establish conduction seems a logical choice as a therapeutic target.展开更多
Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract...Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months.Results: All the lenses remained transparent. Postoperatively, 31 cases (72. 1%) achieved uncorrected visual acuities (V. A) over 0. 2, 32 cases (74. 4%) achieved corrected V. A over 0. 4. Most of the cases achieved the best preoperative corrected V. A with spectacles of less than 3 diopters. No severe complication occurred. Conclusion: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation. Eye Science 1997 ;展开更多
Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microgl...Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.展开更多
Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes.This review systematically analyzes the curr...Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes.This review systematically analyzes the current understanding of the bidirectional relationship between blood-brain barrier disruption and neuroinflammation in traumatic brain injury,along with emerging combination therapeutic strategies.Literature review indicates that blood-brain barrier disruption and neuroinflammatory responses are key pathological features following traumatic brain injury.In the acute phase after traumatic brain injury,the pathological characteristics include primary blood-brain barrier disruption and the activation of inflammatory cascades.In the subacute phase,the pathological features are characterized by repair mechanisms and inflammatory modulation.In the chronic phase,the pathological features show persistent low-grade inflammation and incomplete recovery of the blood-brain barrier.Various physiological changes,such as structural alterations of the blood-brain barrier,inflammatory cascades,and extracellular matrix remodeling,interact with each other and are influenced by genetic,age,sex,and environmental factors.The dynamic balance between blood-brain barrier permeability and neuroinflammation is regulated by hormones,particularly sex hormones and stress-related hormones.Additionally,the role of gastrointestinal hormones is receiving increasing attention.Current treatment strategies for traumatic brain injury include various methods such as conventional drug combinations,multimodality neuromonitoring,hyperbaric oxygen therapy,and non-invasive brain stimulation.Artificial intelligence also shows potential in treatment decision-making and personalized therapy.Emerging sequential combination strategies and precision medicine approaches can help improve treatment outcomes;however,challenges remain,such as inadequate research on the mechanisms of the chronic phase traumatic brain injury and difficulties with technology integration.Future research on traumatic brain injury should focus on personalized treatment strategies,the standardization of techniques,costeffectiveness evaluations,and addressing the needs of patients with comorbidities.A multidisciplinary approach should be used to enhance treatment and improve patient outcomes.展开更多
Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,...Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,2013).A major sequela of TBI is long-lasting white matter injury(WMI)which includes traumatic axonal injury and loss of myelination,resulting in cognitive,behavioral,and psychiatric deficits in survivors.展开更多
Cataract is the leading cause of reversible blindness worldwide,affecting millions,particularly the elderly.Over 65 million people suffer from significant visual impairment due to cataracts,with the burden being highe...Cataract is the leading cause of reversible blindness worldwide,affecting millions,particularly the elderly.Over 65 million people suffer from significant visual impairment due to cataracts,with the burden being highest in low-and middle-income countries where access to surgery is limited.Cataract surgery,one of the most commonly performed and cost-effective procedures,has evolved significantly.Traditional extracapsular cataract extraction(ECCE)has been largely replaced by phacoemulsifi cation,which uses ultrasonic energy through a small incision,reducing recovery time and complications.More recently,femtosecond laser-assisted cataract surgery(FLACS)has emerged,off ering enhanced precision but with ongoing evaluation of its cost-eff ectiveness.Intraocular lenses(IOLs)now allow for customized visual outcomes,addressing distance,near,and intermediate vision.Despite its safety,cataract surgery can still result in complications such as corneal edema and posterior capsular opacifi cation,requiring careful surgical management and patient education.展开更多
Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July ...Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July 2024 to July 2025 were selected and randomly divided into the experimental group and the control group,with 34 cases in each group.The control group received routine blood glucose management,while the experimental group,on this basis,implemented individualized intervention 3 days before the operation,real-time regulation during the operation,dynamic management 7 days after the operation,and self-management training.Result:The blood glucose control in the experimental group was more stable 7 days after the operation.The total incidence of complications(2.9%)was significantly lower than that in the control group(38.2%),and the average hospital stay(5.1±1.0 days)was shorter than that in the control group(7.3±1.4 days).One week after the operation,the proportions of uncorrected visual acuity and visual acuity≥0.6(67.6%)were both better than those of the control group(p<0.001).Conclusion:The whole-course management of perioperative blood glucose can enhance the stability of blood glucose control,reduce the risk of complications,shorten the length of hospital stay,promote visual recovery,and has high clinical promotion value.展开更多
AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and ...AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.展开更多
AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide asso...AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized.Obesity-related traits,including body mass index(BMI),waist-to-hip ratio(WHR),and waist circumference(WC).A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk,while potential mediators were identified from suitable genome-wide association studies(GWAS)datasets.Additionally,a metabolic pathway analysis was conducted.RESULTS:An increase of 1 standard deviation(SD)in BMI,WHR,and WC was associated with a significantly higher risk of cataract(BMI:odds ratio(OR)1.0017,95%confidence interval(CI):1.0001-1.0032,P=0.0320;WHR:OR 1.0029,95%CI:1.0006-1.0051,P=0.0129;WC:OR 1.0020,95%CI:1.0001-1.0038,P=0.0390].These associations remained robust after adjusting for confounding factors in multivariable MR analysis.Furthermore,a two-step MR analysis identified eight potential metabolic mediators,with one mediator showing a significant causal role in the relationship between obesity and cataract.CONCLUSION:This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts,particularly through metabolic pathways.展开更多
文摘Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.
文摘Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.
文摘Purpose. This paper studies the tumour necrosis factor (TNF) levels in aqueous humor after traumatic cataract extraction and posterior chamber (PC) intraocular lens (IOL) implantation in rabbits,and discusses the effect of TNF on postoperative anterior ocular inflammation. Methods. Twenty seven pigmented rabbits were divided into three groups: for the first group, the IOL were placed in the capsular bag after traumatic cataract extraction; for the second, the Extracapsular cataract extraction without IOL implantation; and for the third, the control group without surgical intervention. On the 1st, 3rd, 7th and 14th day postoperatively, aqueous humor samples were obtained. A modified double antibodies indirect sandwich ELISA was used to detected for the presence of TNF. The data were studied by means of analysis of variance in SAS software. Result. The TNF level was increased in aqueous humor and reached its maximum on the 1st postoperative days after traumatic cataract extraction and PC IOLs implantation, and the TNF levels are significantly higher (P<0 05) on the 1st, 3rd, 7th and 14th day postoperatively in traumatic cataract extraction and PC IOL implanted group than that in the non surgical intervention group and extracapsular cataract extraction group. Conclusions. The increase of TNF levels had a close relationship with presence of the IOL itself which induces the secretion of TNF. This suggested that TNF as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after traumatic cataract extraction and IOL implantation.
文摘The cell morphology of corneal endothelium in 84 mice with experimental traumatic cataract was investigated with stained corneal buttons. In the experimental group, the boundaries between adjacent corneal endothelial cells were significantly distorted, some cell boundaries manifested degenerative changes that led to coalescence of the cells. The mean density and mean area of endothelial cells of the controls showed significant difference from those of the experimental group during the 12 weeks of observ...
基金Supported by the National Natural Science Foundation of China(No.81800877)the Natural Science Foundation of Zhejiang Province(No.LY15H120001No.LQ17H120008)。
文摘Dear Editor,I am Dr.Zhi-Tao Su,from the Eye Center,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present a case of spontaneous resolution of a traumatic cataract resulted in good visual rehabilitation after removal of a ferrous intravitreal foreign body(IVFB).
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Traumatic cataract is the leading cause of significant monocular </span><span style="font-family:""><span style="font-family:Verdana;">visual impairment in children. The cause of this type of cataract is preventable penetrating or blunt ocular injury. Lens extraction can improve the visual </span><span style="font-family:Verdana;">acuity but it also depends on the extent of the injury to other ocular struc</span><span style="font-family:Verdana;">ture</span></span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To describe the features of pediatric traumatic cataract presenting at a tertiary eye center in Indonesia. </span><b><span style="font-family:Verdana;">Methods:</span></b><i> </i><span style="font-family:Verdana;">This study is a descriptive study and the data w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> collected retrospectively from the medical records of the patients who were diagnosed as pediatric traumatic cataract over the period of January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2019 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2019. Demographic data, trauma characteristics, clinical features, management, and pre- and post-operative Best Corrected Visual Acuity (BCVA) were reviewed retrospectively. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 37 patients were diagnosed as pediatric traumatic cataract. Among these patients, 78.38% were boys, with the mean age of 9.14 </span></span><span style="font-family:""><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> 3.77 years old. Open globe injury was the mechanism of injury for 54.05% patients. Besides lens aspiration, additional procedures were membranectomy, anterior vitrectomy, primary posterior capsulotomy, and synechiolysis. Eighty-one percent patients had unilateral blindness preoperatively and 23.80% patients still had unilateral blindness on three months of follow</span></span><span style="font-family:Verdana;">-</span><span style="font-family:""><span style="font-family:Verdana;">up. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In pediatric patients, traumatic cataract occurred predominantly in boys while playing outside the house. The children who had ocular trauma still have the risk of blindness even after the surgery. Trauma prevention and avoidance by adult supervision when children engage in outdoor play activity </span></span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> necessary.
文摘AIM: To review results of traumatic cataracts in children.METHODS: Only those pediatric patients who fitted in the definite inclusion criteria were considered for study enrollment. They were further examined for any kind of co-morbidities because of trauma, operated upon for traumatic cataracts with intraocular lens implantation. Amblyopia if present was treated. All were re-examined at the culmination of six-week postoperative period.According to the Birmingham Eye Trauma Terminology System the traumatic cataract cases were divided into group 1(open globe) and group 2(closed globe), and then determinants of visual acuity were compared.RESULTS: There were 544 eyes in group 1 and 127 eyes in group 2 in our study of 671 eyes with pediatric traumatic cataracts. Visual acuity at the end of 6 wk after surgery in the operated eye was > 6/60 in 450(82.7%) and ≥ 6/12 in 215(39.4%) eyes in the open globe group and > 20/200 in 127(81.8%) and ≥ 6/12 in 36(28.4%) eyes in the closed globe group(P = 0.143), and the difference between the groups was not significant in children. Overall, 402(39.4%) eyes gained ≥ 6/60 and > 5/12 in 238(35.4%) cases. Surgical treatment caused a significant difference in visual outcome(P = 0.000). When we compared achieved visual outcome with ocular trauma score predicted vision, no significant difference was found.CONCLUSION: Traumatic cataracts in children may have better outcome and ocular trauma score is a useful predictive method for the ocular trauma in children.
文摘Twenty-five cases of posterior chamber IOL implantation intraumatic cataract with complications associated with primary injury werereported.The operating methods were described and the post-operative com-plications were discussed.Seventy-two percent of patients have the correctvision over 20/40.It is suggested that the posterior chamber IOL can be im-planted in traumatic cataract with some injured complications.EYE SCIENCE1992;8:111-112.
文摘AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS: Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis. RESULTS: A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included in the study. The mean (SEM) age at diagnosis was (6.6 ±3.2) years (range, 1.3-13.8 years). Each cataract was categorized according to the type of trauma: closed-globe (n =26) or open-globe (n =91) injuries. The most common injuring objects were sharp metal objects (37.61%). The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs) were primarily implanted in 47 eyes (68.12%), whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%). The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision. CONCLUSION: Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.
文摘Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery younger than 15 years of age, without history of ocular trauma and with a minimum follow-up period of 6 months, were reviewed retrospectively. Results: The most common initial complaint was leukocoria. Thirty-nine patients (62.9%) had bilateral cataracts and 23 patients (37.1%) had unilateral cataracts. The most common type was posterior polar cataract (22%) in patients with unilateral cataracts, and total cataract (33%) in patients with bilateral cataracts. The overall prevalence of postoperative complications was 58%, visual axis opacification (VAO) being the most common one (39%). The incidence of VAO was significantly higher in eyes with intact posterior capsules. Secondary glaucoma occurred in 12 (12%) eyes. Thirty-one (50%) patients were orthophoria, 17 (27%) patients had esotropia, and 14 (23%) patients had exotropia. Additional surgery for all of these complications was performed in 53 (53%) eyes. Conclusions: Despite appropriate surgical treatment of nontraumatic pediatric cataracts, post-surgical complications including VAO, glaucoma, or strabismus remain an important cause of morbidity in these patients. Posterior capsulotomy and anterior vitrectomy must be performed in all children below 6 years to reduce the need for additional surgery for VAO.
文摘Obese individuals who subsequently sustain a traumatic brain injury(TBI)exhibit worsened outcomes including longer periods of rehabilitation(Eagle et al.,2023).In obese individuals,prolonged symptomology is associated with increased levels of circulato ry pro-inflammatory marke rs up to 1 year postTBI(Eagle et al.,2023).
基金supported by Grant 3195 from Paralyzed Veterans of America Research Foundation (to BRK)
文摘The inter-related pathological cascades following a traumatic spinal cord injury(tSCI)disrupt multiple cell types and physiological processes.Subsequently,motor and sensory functions are disrupted by breakdowns in cellular interactions and circuitry.Therapeutic interventions seek to modify some aspects of the injury course to enable the re-establishment of functional circuitry.Interventions often target one cell type(e.g.,promoting neuroprotection or neural regeneration)or one process(e.g.,modulating inflammation,affecting astrocytic,microglial,or macrophage responses.)Many axons in the spinal cord are myelinated,and after injury oligodendrocyte death causes demyelination.Promoting remyelination of spared or new axons to re-establish conduction seems a logical choice as a therapeutic target.
文摘Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months.Results: All the lenses remained transparent. Postoperatively, 31 cases (72. 1%) achieved uncorrected visual acuities (V. A) over 0. 2, 32 cases (74. 4%) achieved corrected V. A over 0. 4. Most of the cases achieved the best preoperative corrected V. A with spectacles of less than 3 diopters. No severe complication occurred. Conclusion: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation. Eye Science 1997 ;
基金supported by the Natural Science Foundation of Yunnan Province,No.202401AS070086(to ZW)the National Key Research and Development Program of China,No.2018YFA0801403(to ZW)+1 种基金Yunnan Science and Technology Talent and Platform Plan,No.202105AC160041(to ZW)the Natural Science Foundation of China,No.31960120(to ZW)。
文摘Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.
基金supported by Open Scientific Research Program of Military Logistics,No.BLB20J009(to YZhao).
文摘Blood-brain barrier disruption and the neuroinflammatory response are significant pathological features that critically influence disease progression and treatment outcomes.This review systematically analyzes the current understanding of the bidirectional relationship between blood-brain barrier disruption and neuroinflammation in traumatic brain injury,along with emerging combination therapeutic strategies.Literature review indicates that blood-brain barrier disruption and neuroinflammatory responses are key pathological features following traumatic brain injury.In the acute phase after traumatic brain injury,the pathological characteristics include primary blood-brain barrier disruption and the activation of inflammatory cascades.In the subacute phase,the pathological features are characterized by repair mechanisms and inflammatory modulation.In the chronic phase,the pathological features show persistent low-grade inflammation and incomplete recovery of the blood-brain barrier.Various physiological changes,such as structural alterations of the blood-brain barrier,inflammatory cascades,and extracellular matrix remodeling,interact with each other and are influenced by genetic,age,sex,and environmental factors.The dynamic balance between blood-brain barrier permeability and neuroinflammation is regulated by hormones,particularly sex hormones and stress-related hormones.Additionally,the role of gastrointestinal hormones is receiving increasing attention.Current treatment strategies for traumatic brain injury include various methods such as conventional drug combinations,multimodality neuromonitoring,hyperbaric oxygen therapy,and non-invasive brain stimulation.Artificial intelligence also shows potential in treatment decision-making and personalized therapy.Emerging sequential combination strategies and precision medicine approaches can help improve treatment outcomes;however,challenges remain,such as inadequate research on the mechanisms of the chronic phase traumatic brain injury and difficulties with technology integration.Future research on traumatic brain injury should focus on personalized treatment strategies,the standardization of techniques,costeffectiveness evaluations,and addressing the needs of patients with comorbidities.A multidisciplinary approach should be used to enhance treatment and improve patient outcomes.
文摘Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,2013).A major sequela of TBI is long-lasting white matter injury(WMI)which includes traumatic axonal injury and loss of myelination,resulting in cognitive,behavioral,and psychiatric deficits in survivors.
文摘Cataract is the leading cause of reversible blindness worldwide,affecting millions,particularly the elderly.Over 65 million people suffer from significant visual impairment due to cataracts,with the burden being highest in low-and middle-income countries where access to surgery is limited.Cataract surgery,one of the most commonly performed and cost-effective procedures,has evolved significantly.Traditional extracapsular cataract extraction(ECCE)has been largely replaced by phacoemulsifi cation,which uses ultrasonic energy through a small incision,reducing recovery time and complications.More recently,femtosecond laser-assisted cataract surgery(FLACS)has emerged,off ering enhanced precision but with ongoing evaluation of its cost-eff ectiveness.Intraocular lenses(IOLs)now allow for customized visual outcomes,addressing distance,near,and intermediate vision.Despite its safety,cataract surgery can still result in complications such as corneal edema and posterior capsular opacifi cation,requiring careful surgical management and patient education.
文摘Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July 2024 to July 2025 were selected and randomly divided into the experimental group and the control group,with 34 cases in each group.The control group received routine blood glucose management,while the experimental group,on this basis,implemented individualized intervention 3 days before the operation,real-time regulation during the operation,dynamic management 7 days after the operation,and self-management training.Result:The blood glucose control in the experimental group was more stable 7 days after the operation.The total incidence of complications(2.9%)was significantly lower than that in the control group(38.2%),and the average hospital stay(5.1±1.0 days)was shorter than that in the control group(7.3±1.4 days).One week after the operation,the proportions of uncorrected visual acuity and visual acuity≥0.6(67.6%)were both better than those of the control group(p<0.001).Conclusion:The whole-course management of perioperative blood glucose can enhance the stability of blood glucose control,reduce the risk of complications,shorten the length of hospital stay,promote visual recovery,and has high clinical promotion value.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112).
文摘AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.
基金Supported by the National Natural Science Foundation of China(No.82501261)Medical Research Projects of the Jiangsu Provincial Health Commission(No.M2024041).
文摘AIM:To investigate the causal effect of obesity on cataract risk and explores the potential mediating roles of metabolites using Mendelian randomization(MR).METHODS:Summary-level data from large-scale genome-wide association studies to examine the relationship between obesity and cataract were utilized.Obesity-related traits,including body mass index(BMI),waist-to-hip ratio(WHR),and waist circumference(WC).A two-sample MR approach was employed to assess the causal effect of obesity on cataract risk,while potential mediators were identified from suitable genome-wide association studies(GWAS)datasets.Additionally,a metabolic pathway analysis was conducted.RESULTS:An increase of 1 standard deviation(SD)in BMI,WHR,and WC was associated with a significantly higher risk of cataract(BMI:odds ratio(OR)1.0017,95%confidence interval(CI):1.0001-1.0032,P=0.0320;WHR:OR 1.0029,95%CI:1.0006-1.0051,P=0.0129;WC:OR 1.0020,95%CI:1.0001-1.0038,P=0.0390].These associations remained robust after adjusting for confounding factors in multivariable MR analysis.Furthermore,a two-step MR analysis identified eight potential metabolic mediators,with one mediator showing a significant causal role in the relationship between obesity and cataract.CONCLUSION:This work highlights the importance of addressing obesity as a modifiable risk factor for cataracts,particularly through metabolic pathways.
