Cataracts are the leading cause of blindness worldwide. Current methods for discriminating cataractous lenses from healthy lenses of Sprague-Dawley rats during preclinical studies are based on either histopathological...Cataracts are the leading cause of blindness worldwide. Current methods for discriminating cataractous lenses from healthy lenses of Sprague-Dawley rats during preclinical studies are based on either histopathological or clinical assessments which are weakened by subjectivity. In this work, both cataractous and healthy lens tissues of Sprague-Dawley rats were studied using multispectral imaging technique in combination with multivariate analysis. Multispectral images were captured in transmission, reflection and scattering modes. In all, five spectral bands were found to be markers for discriminating cataractous lenses from healthy lenses;470 nm and 625 nm discriminated in reflection mode whereas 435 nm, 590 nm and 700 nm discriminated in transmission mode. With Fisher’s Linear discriminant analysis, the midpoints for classifying cataractous from healthy lenses were found to be 14.718 × 10−14 and 3.2374 × 10−14 for the two spectra bands in the reflection mode and the three spectral bands in the transmission mode respectively. Images in scattering mode did not show significant discrimination. These spectral bands in reflection and transmission modes may offer potential diagnostic markers for discriminating cataractous lenses from healthy lenses thereby promising multispectral imaging applications for characterizing cataractous and healthy lenses.展开更多
AIM： To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population.METHODS： Human cataractous lenses...AIM： To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population.METHODS： Human cataractous lenses were collected from the patients who underwent extracapsular cataract extraction surgery; clear lenses were collected from the freshly donated eye bank eyes. Antioxidant molecules such as glutathione and thioltransferase enzyme activity were measured; simultaneously in these lenses a blue fluorophore argpyrimidine, an advanced glycation end（AGE） product level was assessed using high performance liquid chromatography（HPLC）.RESULTS： The protein concentration was found to be present at higher levels in the control lenses compared to cataract lenses. A significant decrease in the glutathione level was observed in the nuclear cataractous lenses compared to cortical cataractous（P=0.004） and clear lenses（P≤0.005）, but no significant change in the level of antioxidant enzyme thioltransferase was observed. Further, argpyrimidine a blue fluorophore（AGE） was found to be significantly higher in the nuclear cataract（P=0.013） compared to cortical cataract lenses.CONCLUSION： Antioxidants such as glutathione significantly decrease in age-related nuclear and cortical cataract and an AGE, argpyrimidine are present at significantly higher levels in nuclear cataract.展开更多
Cataracts were observed in the eye lenses of a group of Wistar rats that had been injected with Na2SeO3. The trace elemental analysis of their lenses was carried out by PIXE. The results showed that the variations of ...Cataracts were observed in the eye lenses of a group of Wistar rats that had been injected with Na2SeO3. The trace elemental analysis of their lenses was carried out by PIXE. The results showed that the variations of elemental contents were different between the injected rats and the controls. The elemental concentrations, which exhibited a certain regularity in their variations,could be related to the time of formation of cataract and to its state.展开更多
<strong>Background:</strong> Glaucoma is the leading cause of irreversible blindness worldwide. An appreciable proportion of glaucoma patients have been found to have hidden psychiatric disorders that ofte...<strong>Background:</strong> Glaucoma is the leading cause of irreversible blindness worldwide. An appreciable proportion of glaucoma patients have been found to have hidden psychiatric disorders that often go undetected. Anxiety and depression have been found to be major contributors to these psychological issues. This present study aims to compare the prevalence of anxiety and depression amongst glaucoma and cataract patients and to identify risk factors for anxiety and depression amongst these patients. <strong>Materials and Methods:</strong> A comparative crossectional study was carried out among 197 Primary Open Angle Glaucoma (POAG) patients and 197 controls (non-POAG patients that have no ocular disorder other than cataract) attending Deseret Community Vision Institute, Ijebu Imushin, Ogun state from 1st of April to 31st May 2014. POAG was defined as patients with open anterior chamber angles based on gonioscopy, pale and cupped discs (Cup: Disc ratio ≥ 0.4), and corresponding visual field defects with or without an elevated intraocular pressure. Cataract was defined as patients with opacification of the crystalline lens in either or both eyes. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among the participants. Data were analyzed using SPSS Version 20 using Chi-square, Independent student T-test and Logistic regression. <strong>Results:</strong> The mean age of glaucoma subjects was 62.24 years and the cataract subjects was 64.2 years. There was a male preponderance with a male: female ratio of 1.5:1. Anxiety as defined by the HADS was seen in 35.5% of glaucoma patients and 21.8% of the cataract patients but there was no statistically significant difference after controlling for sociodermographic and clinical characteristics on logistic regression. The risk factors for anxiety among the glaucoma participants were those younger than 60 (OR 2.9, 95% CI: 1.3 - 6.5 p = 0.009) and those with severe glaucoma (OR 9.5, 95% CI: 1.7 - 54.4 p = 0.011). The risk factors for anxiety among cataract patients were sociodermographic factors. Those employed (OR 6.4. 95% CI: 2.1 - 20.0 p = 0.001) and those separated and divorced (OR 10.3, 95% CI: 1.4 - 78.4 p = 0.002). Visual status was not a risk factor amongst the cataract participants. Depression as defined by HADS was seen in 24.4% of glaucoma participants and 3.6% of cataract participants. Glaucoma participants were four times more likely to be depressed than the cataract participants after controlling for clinical and sociodermographic variables (OR 4.0, 95% CI: 1.5 - 10.8 p = 0.007). The risk factors for depression among the glaucoma participants were those younger than 60 (OR 4.7, 95% CI: 1.7 - 13.5 p = 0.004), those with primary (OR 6.6, 95% CI: 1.5 - 28.4) p = 0.010) and secondary education (OR 8.0, 95% CI: 2.1 - 29.9 p = 0.002) as compared to those with tertiary education, those unemployed (OR 2.0, 95% CI: 1.0 - 7.2 p = 0.042) as compared to those employed. Those blind (OR 10.8. 95% CI: 2.8 - 42.4 p = 0.001) as compared to those without visual impairment and those that had had surgery (OR 3.7, 95% CI: 1.4 - 10.0 p = 0.011). <strong>Conclusion:</strong> Anxiety and Depression were found in 35.5% and 24.4% of glaucoma patients as compared to 21.8% and 3.6% of cataract patients respectively. Glaucoma patients were 4 times more likely to be depressed than patients with cataracts. There was no significant difference in anxiety between the two groups but glaucoma patients had a four times higher risk of being depressed as compared to cataract patients. There is a need to address these psychological issues at the community level in order to improve the quality of life of these patients. It is also important to identify those at risk in order to curb this growing trend/concern.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
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
Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid adv...Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.展开更多
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was c...AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery.Preoperative ultrasound biomicroscopy(UBM)images were collected and analyzed.Initially,patients were stratified into two age groups:<60y and≥60y,with no significant intergroup differences in sex or eye laterality.For further analysis,participants were subdivided into three age strata:<60y,60-75y,and>75y.The ILA was measured in four quadrants(superior,inferior,nasal,and temporal).Intergroup differences in ILA were compared,and correlations between age and ILA parameters were analyzed using statistical methods.RESULTS:The sample data were categorized into three groups according to age,<60y(113 patients;55.8%female),60–75y(245 patients;61.0%female),and>75y(70 patients;50.2%female).The superior quadrant ILA increased progressively with age stratification(P=0.02),and the maximum ILA difference(ΔILA)was significantly higher in patients over 75y(P<0.01).Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior(Y=7.487+0.096X,R=0.191,P<0.001)and temporal(Y=10.254+0.052X,R=0.104,P=0.032)quadrants.Additionally,the mean ILA across all quadrants(ILAmean)andΔILA were positively correlated with age(ILAmean:Y=9.721+0.055X,R=0.138,P=0.004;ΔILA:Y=3.267+0.044X,R=0.006,P<0.05).CONCLUSION:In patients with age-related cortical cataracts,ILA increases with age,particularly in the superior and temporal quadrants,suggesting that advanced age is associated with greater lens deviation and decreased lens stability.UBM imaging can effectively evaluate the status of the zonule and lens stability,providing crucial evidence for personalized surgical planning based on patients’age.展开更多
AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabe...AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.展开更多
Clinical investigations have suggested a potential link between cataracts and Alzheimer’s disease(AD).However,whether cataract has an impact on the progression of AD remains unclear.The objective of this research was...Clinical investigations have suggested a potential link between cataracts and Alzheimer’s disease(AD).However,whether cataract has an impact on the progression of AD remains unclear.The objective of this research was to determine the relationship between cataracts and AD.A cataract model was established in APP/PS1[mutant amyloid precursor protein(APP)and a mutant presenilin-1(PS1)gene]mice via lens puncture.Behavioural assays were used to evaluate cognitive function.Immunohistochemistry,immunofuorescence,and enzyme-linked immunosorbent assays(ELISA)were applied to detect AD-related pathology.Visual signals were markedly obstructed following surgery to induce cataracts,and these mice presented an increased cerebral amyloid-beta(Aβ)load,while no signifcant alterations in the levels of enzymes associated with Aβmetabolism were detected.In addition,compared with control mice,cataract model mice presented increased astrogliosis and microgliosis,along with elevated levels of proinfammatory factors.Moreover,cataract model mice presented more pronounced cognitive impairments than did control mice.Our study ofers experimental confrmation that cataract considerably contributes to the pathogenesis of AD,thereby emphasizing the importance of visual signals in maintaining cognitive well-being.展开更多
AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing techn...AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.展开更多
Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without...Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without cataract as controls,three monkeys with naturally occurring cortical cataract,and three monkeys with nuclear cataract as intervention groups.Nanoparticulated thermogel with lanosterol and fluorescein was administered by subconjunctival injection in the monkeys with cataract.Fluorescence changes of injected thermogel and cataract progression were observed.Lanosterol concentration in aqueous humor,solubility changes in lens proteins,and oxidative stress levels were analyzed in the lenses of the control and intervention groups.Results:Injected thermogel showed decreased fluorescence during follow up.Lanosterol concentration in aqueous humor increased in the first 2 weeks and then gradually decreased,which was in accordance with the changes in cortical lens clarity.However,lenses with nuclear opacification showed little change.In the cortical region of lenses with cortical cataract,solubility ofα-crystallin was significantly increased after administration of lanosterol,as well as the reduction of oxidative stress.Conclusions:We demonstrated the effect of lanosterol on cataract progression based on in vivo models of primates.Lanosterol showed a short-term and reliable reversal effect on reducing cataract severity in cortical cataract in the early stages,possibly due to the increase in the solubility of lens proteins and changes in the oxidative stress status.Lanosterol administration using subconjunctival drug release system could be a promising nonsurgical approach for future clinical studies of cataract prevention and treatment.展开更多
Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Desc...Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].展开更多
The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presu...The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.展开更多
In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,hig...In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,highlighted a strong link between early diabetes onset and major eye conditions,such as cataracts,glaucoma,agerelated macular degeneration,and vision loss,independent of glycemic control and disease duration.This finding challenges the previous belief that diabetic eye disease primarily correlates with hyperglycemia.As lifestyles evolve and the age of diabetes diagnosis decreases,understanding this relationship may reveal the complex pathogenesis underlying diabetes-related complications.This editorial summarizes potential mechanisms connecting the age of diabetes onset with four types of ocular diseases,emphasizing the significance of early diagnosis.展开更多
Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and fro...Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and from rigid intraocular lens to foldable intraocular lenses.Manual small incision cataract surgery(MSICS)remains a valuable technique,particularly in rural and underserved areas,due to its cost-effectiveness and simplicity.Its low logistics and favorable outcomes are particularly useful for managing the cataract backlog in developing countries.This review highlights the history and evolution of MSICS,and the reasons for the advent and popularity of this technique,especially in developing countries.It reviews the various recent modifications of the technique,for example,from a superior incision approach to temporal incision to customized MSICS,2 mm MSICS,and astigmatism-correcting MSICS.It provides an overview of its applicability in complicated scenarios(viz.,small pupil,compromised cornea,pseudoexfoliation,subluxated cataract,etc.).It briefly reviews the clinical trials on MSICS and its comparison with phacoemulsification.Finally,the review emphasizes why every ophthalmic surgeon must know MSICS,its relevance in postgraduate teaching,and the role of MSICS simulators for the same.Overall,the review presents a comprehensive picture of the present status of this technique in the surgical armamentarium of ophthalmology.展开更多
Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a...Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.展开更多
As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL pow...As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.展开更多
BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devas...BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.展开更多
文摘Cataracts are the leading cause of blindness worldwide. Current methods for discriminating cataractous lenses from healthy lenses of Sprague-Dawley rats during preclinical studies are based on either histopathological or clinical assessments which are weakened by subjectivity. In this work, both cataractous and healthy lens tissues of Sprague-Dawley rats were studied using multispectral imaging technique in combination with multivariate analysis. Multispectral images were captured in transmission, reflection and scattering modes. In all, five spectral bands were found to be markers for discriminating cataractous lenses from healthy lenses;470 nm and 625 nm discriminated in reflection mode whereas 435 nm, 590 nm and 700 nm discriminated in transmission mode. With Fisher’s Linear discriminant analysis, the midpoints for classifying cataractous from healthy lenses were found to be 14.718 × 10−14 and 3.2374 × 10−14 for the two spectra bands in the reflection mode and the three spectral bands in the transmission mode respectively. Images in scattering mode did not show significant discrimination. These spectral bands in reflection and transmission modes may offer potential diagnostic markers for discriminating cataractous lenses from healthy lenses thereby promising multispectral imaging applications for characterizing cataractous and healthy lenses.
文摘AIM： To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population.METHODS： Human cataractous lenses were collected from the patients who underwent extracapsular cataract extraction surgery; clear lenses were collected from the freshly donated eye bank eyes. Antioxidant molecules such as glutathione and thioltransferase enzyme activity were measured; simultaneously in these lenses a blue fluorophore argpyrimidine, an advanced glycation end（AGE） product level was assessed using high performance liquid chromatography（HPLC）.RESULTS： The protein concentration was found to be present at higher levels in the control lenses compared to cataract lenses. A significant decrease in the glutathione level was observed in the nuclear cataractous lenses compared to cortical cataractous（P=0.004） and clear lenses（P≤0.005）, but no significant change in the level of antioxidant enzyme thioltransferase was observed. Further, argpyrimidine a blue fluorophore（AGE） was found to be significantly higher in the nuclear cataract（P=0.013） compared to cortical cataract lenses.CONCLUSION： Antioxidants such as glutathione significantly decrease in age-related nuclear and cortical cataract and an AGE, argpyrimidine are present at significantly higher levels in nuclear cataract.
文摘Cataracts were observed in the eye lenses of a group of Wistar rats that had been injected with Na2SeO3. The trace elemental analysis of their lenses was carried out by PIXE. The results showed that the variations of elemental contents were different between the injected rats and the controls. The elemental concentrations, which exhibited a certain regularity in their variations,could be related to the time of formation of cataract and to its state.
文摘<strong>Background:</strong> Glaucoma is the leading cause of irreversible blindness worldwide. An appreciable proportion of glaucoma patients have been found to have hidden psychiatric disorders that often go undetected. Anxiety and depression have been found to be major contributors to these psychological issues. This present study aims to compare the prevalence of anxiety and depression amongst glaucoma and cataract patients and to identify risk factors for anxiety and depression amongst these patients. <strong>Materials and Methods:</strong> A comparative crossectional study was carried out among 197 Primary Open Angle Glaucoma (POAG) patients and 197 controls (non-POAG patients that have no ocular disorder other than cataract) attending Deseret Community Vision Institute, Ijebu Imushin, Ogun state from 1st of April to 31st May 2014. POAG was defined as patients with open anterior chamber angles based on gonioscopy, pale and cupped discs (Cup: Disc ratio ≥ 0.4), and corresponding visual field defects with or without an elevated intraocular pressure. Cataract was defined as patients with opacification of the crystalline lens in either or both eyes. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among the participants. Data were analyzed using SPSS Version 20 using Chi-square, Independent student T-test and Logistic regression. <strong>Results:</strong> The mean age of glaucoma subjects was 62.24 years and the cataract subjects was 64.2 years. There was a male preponderance with a male: female ratio of 1.5:1. Anxiety as defined by the HADS was seen in 35.5% of glaucoma patients and 21.8% of the cataract patients but there was no statistically significant difference after controlling for sociodermographic and clinical characteristics on logistic regression. The risk factors for anxiety among the glaucoma participants were those younger than 60 (OR 2.9, 95% CI: 1.3 - 6.5 p = 0.009) and those with severe glaucoma (OR 9.5, 95% CI: 1.7 - 54.4 p = 0.011). The risk factors for anxiety among cataract patients were sociodermographic factors. Those employed (OR 6.4. 95% CI: 2.1 - 20.0 p = 0.001) and those separated and divorced (OR 10.3, 95% CI: 1.4 - 78.4 p = 0.002). Visual status was not a risk factor amongst the cataract participants. Depression as defined by HADS was seen in 24.4% of glaucoma participants and 3.6% of cataract participants. Glaucoma participants were four times more likely to be depressed than the cataract participants after controlling for clinical and sociodermographic variables (OR 4.0, 95% CI: 1.5 - 10.8 p = 0.007). The risk factors for depression among the glaucoma participants were those younger than 60 (OR 4.7, 95% CI: 1.7 - 13.5 p = 0.004), those with primary (OR 6.6, 95% CI: 1.5 - 28.4) p = 0.010) and secondary education (OR 8.0, 95% CI: 2.1 - 29.9 p = 0.002) as compared to those with tertiary education, those unemployed (OR 2.0, 95% CI: 1.0 - 7.2 p = 0.042) as compared to those employed. Those blind (OR 10.8. 95% CI: 2.8 - 42.4 p = 0.001) as compared to those without visual impairment and those that had had surgery (OR 3.7, 95% CI: 1.4 - 10.0 p = 0.011). <strong>Conclusion:</strong> Anxiety and Depression were found in 35.5% and 24.4% of glaucoma patients as compared to 21.8% and 3.6% of cataract patients respectively. Glaucoma patients were 4 times more likely to be depressed than patients with cataracts. There was no significant difference in anxiety between the two groups but glaucoma patients had a four times higher risk of being depressed as compared to cataract patients. There is a need to address these psychological issues at the community level in order to improve the quality of life of these patients. It is also important to identify those at risk in order to curb this growing trend/concern.
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.
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 Key Special Project of“Cutting-Edge Biotechnology”in the National Key Research and Development Program of China(No.2024YFC3406200)Sanming Project of Medicine in Shenzhen(No.SZSM202411007)Shenzhen Science and Technology Program(No.JCYJ20240813152704006).
文摘Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
文摘AIM:To investigate age-related differences in the irislens angle(ILA)among patients with age-related cortical cataracts and elucidate the impact of age on lens stability.METHODS:A prospective observational study was conducted on patients with age-related cortical cataracts scheduled for phacoemulsification surgery.Preoperative ultrasound biomicroscopy(UBM)images were collected and analyzed.Initially,patients were stratified into two age groups:<60y and≥60y,with no significant intergroup differences in sex or eye laterality.For further analysis,participants were subdivided into three age strata:<60y,60-75y,and>75y.The ILA was measured in four quadrants(superior,inferior,nasal,and temporal).Intergroup differences in ILA were compared,and correlations between age and ILA parameters were analyzed using statistical methods.RESULTS:The sample data were categorized into three groups according to age,<60y(113 patients;55.8%female),60–75y(245 patients;61.0%female),and>75y(70 patients;50.2%female).The superior quadrant ILA increased progressively with age stratification(P=0.02),and the maximum ILA difference(ΔILA)was significantly higher in patients over 75y(P<0.01).Simple linear regression analysis demonstrated a positive correlation between age and ILA in the superior(Y=7.487+0.096X,R=0.191,P<0.001)and temporal(Y=10.254+0.052X,R=0.104,P=0.032)quadrants.Additionally,the mean ILA across all quadrants(ILAmean)andΔILA were positively correlated with age(ILAmean:Y=9.721+0.055X,R=0.138,P=0.004;ΔILA:Y=3.267+0.044X,R=0.006,P<0.05).CONCLUSION:In patients with age-related cortical cataracts,ILA increases with age,particularly in the superior and temporal quadrants,suggesting that advanced age is associated with greater lens deviation and decreased lens stability.UBM imaging can effectively evaluate the status of the zonule and lens stability,providing crucial evidence for personalized surgical planning based on patients’age.
文摘AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.
基金upported by the National Key Research and Development Program(2023YFC3605400)the Health Commission of Chongqing Municipality(2024GGXM003)the Natural Science Foundation of Chongqing(cstc2021jcyj-msxmX0335).
文摘Clinical investigations have suggested a potential link between cataracts and Alzheimer’s disease(AD).However,whether cataract has an impact on the progression of AD remains unclear.The objective of this research was to determine the relationship between cataracts and AD.A cataract model was established in APP/PS1[mutant amyloid precursor protein(APP)and a mutant presenilin-1(PS1)gene]mice via lens puncture.Behavioural assays were used to evaluate cognitive function.Immunohistochemistry,immunofuorescence,and enzyme-linked immunosorbent assays(ELISA)were applied to detect AD-related pathology.Visual signals were markedly obstructed following surgery to induce cataracts,and these mice presented an increased cerebral amyloid-beta(Aβ)load,while no signifcant alterations in the levels of enzymes associated with Aβmetabolism were detected.In addition,compared with control mice,cataract model mice presented increased astrogliosis and microgliosis,along with elevated levels of proinfammatory factors.Moreover,cataract model mice presented more pronounced cognitive impairments than did control mice.Our study ofers experimental confrmation that cataract considerably contributes to the pathogenesis of AD,thereby emphasizing the importance of visual signals in maintaining cognitive well-being.
文摘AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.
基金funded by research grants from the National Natural Science Foundation of China(Grants No.82122017,81870642,81970780,81670835,and 81700819)Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(Grants No.19441900700 and 21S31904900)Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital Development Center(Grants No.SHDC12019X08 and SHDC2020CR4078)。
文摘Background:To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.Methods:Nine elder cynomolgus monkeys were used,consisting of three monkeys without cataract as controls,three monkeys with naturally occurring cortical cataract,and three monkeys with nuclear cataract as intervention groups.Nanoparticulated thermogel with lanosterol and fluorescein was administered by subconjunctival injection in the monkeys with cataract.Fluorescence changes of injected thermogel and cataract progression were observed.Lanosterol concentration in aqueous humor,solubility changes in lens proteins,and oxidative stress levels were analyzed in the lenses of the control and intervention groups.Results:Injected thermogel showed decreased fluorescence during follow up.Lanosterol concentration in aqueous humor increased in the first 2 weeks and then gradually decreased,which was in accordance with the changes in cortical lens clarity.However,lenses with nuclear opacification showed little change.In the cortical region of lenses with cortical cataract,solubility ofα-crystallin was significantly increased after administration of lanosterol,as well as the reduction of oxidative stress.Conclusions:We demonstrated the effect of lanosterol on cataract progression based on in vivo models of primates.Lanosterol showed a short-term and reliable reversal effect on reducing cataract severity in cortical cataract in the early stages,possibly due to the increase in the solubility of lens proteins and changes in the oxidative stress status.Lanosterol administration using subconjunctival drug release system could be a promising nonsurgical approach for future clinical studies of cataract prevention and treatment.
基金Supported by the Natural Science Foundation of Fujian Province(No.2024J011318No.2024J011321)Fuzhou Science and Technology Program(No.2023-S-005).
文摘Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].
基金Supported by the National Natural Science Foundation of China(No.82271063No.82471054)Central Guidance for Local Scientific and Technological Development Funding Projects(No.2024ZY01057).
文摘The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.
文摘In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,highlighted a strong link between early diabetes onset and major eye conditions,such as cataracts,glaucoma,agerelated macular degeneration,and vision loss,independent of glycemic control and disease duration.This finding challenges the previous belief that diabetic eye disease primarily correlates with hyperglycemia.As lifestyles evolve and the age of diabetes diagnosis decreases,understanding this relationship may reveal the complex pathogenesis underlying diabetes-related complications.This editorial summarizes potential mechanisms connecting the age of diabetes onset with four types of ocular diseases,emphasizing the significance of early diagnosis.
文摘Cataract surgery is still the most common surgery performed worldwide.It has evolved tremendously in terms of incision,from 12 mm to 1.8 mm,in terms of capsulotomy from envelope type to automated capsulorhexis,and from rigid intraocular lens to foldable intraocular lenses.Manual small incision cataract surgery(MSICS)remains a valuable technique,particularly in rural and underserved areas,due to its cost-effectiveness and simplicity.Its low logistics and favorable outcomes are particularly useful for managing the cataract backlog in developing countries.This review highlights the history and evolution of MSICS,and the reasons for the advent and popularity of this technique,especially in developing countries.It reviews the various recent modifications of the technique,for example,from a superior incision approach to temporal incision to customized MSICS,2 mm MSICS,and astigmatism-correcting MSICS.It provides an overview of its applicability in complicated scenarios(viz.,small pupil,compromised cornea,pseudoexfoliation,subluxated cataract,etc.).It briefly reviews the clinical trials on MSICS and its comparison with phacoemulsification.Finally,the review emphasizes why every ophthalmic surgeon must know MSICS,its relevance in postgraduate teaching,and the role of MSICS simulators for the same.Overall,the review presents a comprehensive picture of the present status of this technique in the surgical armamentarium of ophthalmology.
基金supported by Science and Technology Planning Project of Guangzhou City(2024A04J4474).
文摘Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.
文摘As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.
文摘BACKGROUND Pediatric cataract is a public health concern,and it causes long-term functional impairment and impacts the quality of life of the child with cataract.Visual impairment in children due to cataract has devastating consequences on their health,social life,and academic performance and places a socio-economic burden on the child’s family and society as a whole.Globally,pediatric cataract is a significant contributor to ocular morbidity and blindness.Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.AIM To evaluate the visual acuity outcomes of children after cataract surgery.METHODS The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital(KATH),Ghana.Patient clinical data including demographics,cataract presentation,pre-operative and post-operative visual acuity,surgical procedure,postoperative complications,interventions and refraction were collected and analyzed using the Statistical Package and Service Solution.Pearson'sχ2 test and regression statistics were used to summarize data at a significance of P<0.05.RESULTS 163 children(257 eyes)underwent cataract surgery at KATH.The overall mean age was 3.81±3.56 years.Congenital cataract was commonly observed(56.4 All children underwent keratometry and phacoemulsification procedures.A few children(9.8%)experienced postoperative complications while 90.8%did not require further intervention after the surgery.After the surgery 27.0%of the children had refraction and the majority were corrected for myopia and near addition(12.9%).An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant(P value<0.05).There was a significant improvement in the visual outcomes following cataract surgery.CONCLUSION Timely pediatric cataract surgery improves postoperative visual outcomes.Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.
