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
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
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 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
Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underly...Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.展开更多
AIM:To analyze the environmental impact of patient travel for cataract surgery at a German ophthalmology center.METHODS:All cataract surgeries performed between October 23 and October 27,2023,were analyzed,and all pat...AIM:To analyze the environmental impact of patient travel for cataract surgery at a German ophthalmology center.METHODS:All cataract surgeries performed between October 23 and October 27,2023,were analyzed,and all patient records were reviewed for follow-up visits.All travel distances were calculated,and the associated emissions were quantified.Additionally,patients’utilization of geographically closer branch practices for follow-up care was evaluated,along with the corresponding effects on travel-related emissions.RESULTS:A total of 69 patients underwent unilateral cataract surgery.The average one-way travel distance was 40.1 km(24.9 mi;SD=23.6 km).Corresponding emissions were 1284.8 kg of greenhouse gas(GHG),2.477 kg of nitrogen oxides,and 0.101 kg of particulates.All patients attended at least two follow-up visits.Conducting followup visits at branch practices reduced travel distance by 49.1%.The associated GHG emissions from all travel were 1984.3 kg.Emissions from follow-up visits were 54.4%higher than those from the surgery itself.Total GHG emissions amounted to 3269.1 kg,with an average of 47.4 kg of GHG per patient for all travel associated with cataract surgery.CONCLUSION:A dense network of branch practices contributes to reducing the carbon footprint of cataract surgery-related patient travel;however,the development of digital health approaches for follow-up care is necessary to further optimize the environmental sustainability of cataract surgery.展开更多
AIM:To explore the role of a previously-found MYH9 tail domain mutation(p.E1384Q)in the pathogenesis of congenital cataract.METHODS:The cell experiments were conducted in vitro.Wild-type(WT)MYH9 and p.E1384Q mutant fr...AIM:To explore the role of a previously-found MYH9 tail domain mutation(p.E1384Q)in the pathogenesis of congenital cataract.METHODS:The cell experiments were conducted in vitro.Wild-type(WT)MYH9 and p.E1384Q mutant fragments were constructed,which was then transiently transfected into Hek293T cell lines.Western blotting and quantitative real time polymerase chain reaction(qRT-PCR)were used to analyze the protein and mRNA level of non-muscle myosin IIA(NM IIA)and F-actin in transfected cells,and fluorescence microscopy was applied to explore the subcellular localization of NM IIA and F-actin.Cell counting kit-8(CCK8),woundhealing and double staining flow cytometry assays were performed to evaluate the proliferation,migration and apoptosis function of transfected cells,respectively.Transmission electron microscope was conducted to observe the alteration of organelle structure.RESULTS:The transiently-transfected WT and p.E1384Q mutant Hek293T cell lines was constructed.Western blot demonstrated that,comparing with MYH9WT group,the relative protein amount of NM IIA and F-actin significantly decreased in MYH9E1384Q cells(P<0.001).qRT-PCR analysis revealed that the relative mRNA amount of NM IIA and F-actin also significantly reduced in MYH9E1384Q cells when compared with MYH9WT.The immunofluorescence microscopy showed that the fluorescence signal of NM IIA and F-actin significantly decreased in E1384Q cells.The diffuse cytoplasmic distribution of NM IIA in MYH9WT was changed to be clumped distribution,presenting a“speckled”pattern characterized by aggregates of small size in MYH9E1384Q.Functional study revealed that the E1384Q mutation significantly inhibited cell proliferation(P=0.003)and migration(P<0.001),and promoted apoptosis(P<0.001).Electron microscope showed that the mutation remarkably decreased the number of mitochondria(P<0.001)and changed the phenotype of mitochondria.CONCLUSION:The missense gene mutation in MYH9(p.E1384Q)causing congenital cataract results in decreased amount and altered subcellular distribution of NM IIA and F-actin,accompanied by decreased cell proliferation and migration,promotes apoptosis and mitochondrial alteration.展开更多
AIM:To evaluate the efficacy of the Tecnis Symfony ZXR00 lens in achieving optimal visual outcomes for cataract surgery patients with axial length(AL)shorter than 24 mm.METHODS:A total of 21 subjects(37 eyes)were subm...AIM:To evaluate the efficacy of the Tecnis Symfony ZXR00 lens in achieving optimal visual outcomes for cataract surgery patients with axial length(AL)shorter than 24 mm.METHODS:A total of 21 subjects(37 eyes)were submitted to cataract surgery and implantation of Tecnis Symfony ZXR00 lens(Johnson&Johnson Vision)was assessed.Patients were examined at 5 m,80 cm,and 40 cm for uncorrected distance visual acuity(UCDVA)and corrected distance visual acuity(CDVA),uncorrected intermediate(UCIVA),and uncorrected near visual acuity(UCNVA).Further,based on the optimal distance correction,the monocular defocusing curve in the range of+0.5 to-3.5 D was investigated.A simple patient-reported spectacle independence questionnaire(PRSIQ)was used to evaluate subjects’subjective feelings about their dependence on glasses at various distances.Multiple linear regression was employed to examine the association amony intraocular lenses(IOLs)diopter,AL,corneal curvature,anterior chamber depth,mean manifest refractive spherical equivalent,pupil,pupil/scan,target refraction,and near vision(logMAR).RESULTS:The study demonstrated enhanced UCNVA alongside comparable distant vision and UCIVA outcomes in eyes with AL shorter than 24 mm.Mean post-operative UCDVA significantly improved from preoperative levels 0.530±0.406(P=0.000).Notably,83.3%of eyes achieved 0.01 logMAR in UCNVA.Five unilateral cases with blended IOL implantation also showed satisfactory visual acuity and satisfaction.The 90.5%(19/21)achieved spectacle independence.The average score for self-reported spectacle-independence on the PRSIQ was 3.52 with a standard deviation of 0.98.The results of the regression analysis revealed that one predictor,the pupil/scan accounted for 27.6%of the variation in near vision[logMAR;F(1,35)=13.33,P<0.01].CONCLUSION:The results affirm the effectiveness of the Tecnis Symfony ZXR00 lens in enhancing visual outcomes for cataract surgery patients with AL shorter than 24 mm.Additionally,the pupil/scan emerges as a critical factor influencing postoperative near vision.展开更多
This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime,including possible risk factors,clinical manifestations,visual prognosis and treatment.Refereed publications were retriev...This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime,including possible risk factors,clinical manifestations,visual prognosis and treatment.Refereed publications were retrieved from PubMed,the Cochrane Library,and EMBASE databases,using the search terms cefuroxime,retina,macular edema,serous retinal detachment,toxic,cataract surgery.The screening was not limited by publication date,country or study type.We screened out 51 articles out of which 32 met the inclusion criteria for this systematic review.Data regarding sample size calculation reporting and trial characteristics were extracted for each trial.Retinal toxicity can be caused by both high and standard doses of cefuroxime injections in different ethnic groups,with risk factors including overdose,blood-retinal barrier disruption,anterior and posterior chamber connection.The typical clinical manifestations of retinal toxicity are cystoid macular edema and extensive serous retinal detachment,mainly involving the outer nuclear and outer plexiform layers,with a good prognosis for visual acuity in most cases,but in a small number of cases,the prognosis is not satisfactory.In conclusion,though the current use of intracameral injection antibiotics in cataract surgery is gradually increasing,the potential risks should not be ignored.Unexplained poor vision on the first day after cataract surgery can be supplemented with macular optical coherence tomography to rule out cefuroxime-related retinal toxicity.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 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.
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 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.
基金supported by the General Program of Natural Science Foundation of Guangdong Province(2023A1515011102).
文摘Pediatric cataract,a leading cause of blindness in children globally,imposing a significant financial burden on both families and society.The extensive phenotypic heterogeneity of this condition means that the underlying mechanisms remain poorly understood,limiting the development of precise and effective treatments.The advent of omics technologies has provided potent tools for unraveling the pathogenesis of pediatric cataract.By mapping expression profiles across various molecular levels,these omics approaches enhance our understanding of the disease’s etiological mechanisms,aid in the identification of novel biomarkers and key pathways,and offer researchers new insights for the innovative strategies in disease diagnosis and targeted therapies.In this review,we summarize the application of omics approaches in clinical and basic research on pediatric cataract over the past decade,encompassing genomics,transcriptomics,proteomics,and metabolomics.Furthermore,we discuss the current challenges and future prospects of omics analyses in pediatric cataract studies.
文摘AIM:To analyze the environmental impact of patient travel for cataract surgery at a German ophthalmology center.METHODS:All cataract surgeries performed between October 23 and October 27,2023,were analyzed,and all patient records were reviewed for follow-up visits.All travel distances were calculated,and the associated emissions were quantified.Additionally,patients’utilization of geographically closer branch practices for follow-up care was evaluated,along with the corresponding effects on travel-related emissions.RESULTS:A total of 69 patients underwent unilateral cataract surgery.The average one-way travel distance was 40.1 km(24.9 mi;SD=23.6 km).Corresponding emissions were 1284.8 kg of greenhouse gas(GHG),2.477 kg of nitrogen oxides,and 0.101 kg of particulates.All patients attended at least two follow-up visits.Conducting followup visits at branch practices reduced travel distance by 49.1%.The associated GHG emissions from all travel were 1984.3 kg.Emissions from follow-up visits were 54.4%higher than those from the surgery itself.Total GHG emissions amounted to 3269.1 kg,with an average of 47.4 kg of GHG per patient for all travel associated with cataract surgery.CONCLUSION:A dense network of branch practices contributes to reducing the carbon footprint of cataract surgery-related patient travel;however,the development of digital health approaches for follow-up care is necessary to further optimize the environmental sustainability of cataract surgery.
基金Supported by Beijing Municipal Natural Science Foundation(No.7202229No.7242168)China Primary Health Care Foundation(No.MTP2022C025).
文摘AIM:To explore the role of a previously-found MYH9 tail domain mutation(p.E1384Q)in the pathogenesis of congenital cataract.METHODS:The cell experiments were conducted in vitro.Wild-type(WT)MYH9 and p.E1384Q mutant fragments were constructed,which was then transiently transfected into Hek293T cell lines.Western blotting and quantitative real time polymerase chain reaction(qRT-PCR)were used to analyze the protein and mRNA level of non-muscle myosin IIA(NM IIA)and F-actin in transfected cells,and fluorescence microscopy was applied to explore the subcellular localization of NM IIA and F-actin.Cell counting kit-8(CCK8),woundhealing and double staining flow cytometry assays were performed to evaluate the proliferation,migration and apoptosis function of transfected cells,respectively.Transmission electron microscope was conducted to observe the alteration of organelle structure.RESULTS:The transiently-transfected WT and p.E1384Q mutant Hek293T cell lines was constructed.Western blot demonstrated that,comparing with MYH9WT group,the relative protein amount of NM IIA and F-actin significantly decreased in MYH9E1384Q cells(P<0.001).qRT-PCR analysis revealed that the relative mRNA amount of NM IIA and F-actin also significantly reduced in MYH9E1384Q cells when compared with MYH9WT.The immunofluorescence microscopy showed that the fluorescence signal of NM IIA and F-actin significantly decreased in E1384Q cells.The diffuse cytoplasmic distribution of NM IIA in MYH9WT was changed to be clumped distribution,presenting a“speckled”pattern characterized by aggregates of small size in MYH9E1384Q.Functional study revealed that the E1384Q mutation significantly inhibited cell proliferation(P=0.003)and migration(P<0.001),and promoted apoptosis(P<0.001).Electron microscope showed that the mutation remarkably decreased the number of mitochondria(P<0.001)and changed the phenotype of mitochondria.CONCLUSION:The missense gene mutation in MYH9(p.E1384Q)causing congenital cataract results in decreased amount and altered subcellular distribution of NM IIA and F-actin,accompanied by decreased cell proliferation and migration,promotes apoptosis and mitochondrial alteration.
文摘AIM:To evaluate the efficacy of the Tecnis Symfony ZXR00 lens in achieving optimal visual outcomes for cataract surgery patients with axial length(AL)shorter than 24 mm.METHODS:A total of 21 subjects(37 eyes)were submitted to cataract surgery and implantation of Tecnis Symfony ZXR00 lens(Johnson&Johnson Vision)was assessed.Patients were examined at 5 m,80 cm,and 40 cm for uncorrected distance visual acuity(UCDVA)and corrected distance visual acuity(CDVA),uncorrected intermediate(UCIVA),and uncorrected near visual acuity(UCNVA).Further,based on the optimal distance correction,the monocular defocusing curve in the range of+0.5 to-3.5 D was investigated.A simple patient-reported spectacle independence questionnaire(PRSIQ)was used to evaluate subjects’subjective feelings about their dependence on glasses at various distances.Multiple linear regression was employed to examine the association amony intraocular lenses(IOLs)diopter,AL,corneal curvature,anterior chamber depth,mean manifest refractive spherical equivalent,pupil,pupil/scan,target refraction,and near vision(logMAR).RESULTS:The study demonstrated enhanced UCNVA alongside comparable distant vision and UCIVA outcomes in eyes with AL shorter than 24 mm.Mean post-operative UCDVA significantly improved from preoperative levels 0.530±0.406(P=0.000).Notably,83.3%of eyes achieved 0.01 logMAR in UCNVA.Five unilateral cases with blended IOL implantation also showed satisfactory visual acuity and satisfaction.The 90.5%(19/21)achieved spectacle independence.The average score for self-reported spectacle-independence on the PRSIQ was 3.52 with a standard deviation of 0.98.The results of the regression analysis revealed that one predictor,the pupil/scan accounted for 27.6%of the variation in near vision[logMAR;F(1,35)=13.33,P<0.01].CONCLUSION:The results affirm the effectiveness of the Tecnis Symfony ZXR00 lens in enhancing visual outcomes for cataract surgery patients with AL shorter than 24 mm.Additionally,the pupil/scan emerges as a critical factor influencing postoperative near vision.
基金Supported by Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases,Shanghai,China(No.19DZ2250100)Shanghai First People’s Hospital Featured Research Projects(No.CCTR-2022C08).
文摘This review is to elucidate the retinal toxicity following intraocular injections of cefuroxime,including possible risk factors,clinical manifestations,visual prognosis and treatment.Refereed publications were retrieved from PubMed,the Cochrane Library,and EMBASE databases,using the search terms cefuroxime,retina,macular edema,serous retinal detachment,toxic,cataract surgery.The screening was not limited by publication date,country or study type.We screened out 51 articles out of which 32 met the inclusion criteria for this systematic review.Data regarding sample size calculation reporting and trial characteristics were extracted for each trial.Retinal toxicity can be caused by both high and standard doses of cefuroxime injections in different ethnic groups,with risk factors including overdose,blood-retinal barrier disruption,anterior and posterior chamber connection.The typical clinical manifestations of retinal toxicity are cystoid macular edema and extensive serous retinal detachment,mainly involving the outer nuclear and outer plexiform layers,with a good prognosis for visual acuity in most cases,but in a small number of cases,the prognosis is not satisfactory.In conclusion,though the current use of intracameral injection antibiotics in cataract surgery is gradually increasing,the potential risks should not be ignored.Unexplained poor vision on the first day after cataract surgery can be supplemented with macular optical coherence tomography to rule out cefuroxime-related retinal toxicity.
