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Sample records for routine cataract extraction

  1. Endophthalmitis following cataract extraction.

    PubMed

    McClellan, K; Coster, D J; Badenoch, P R; Sanders, R; Chandraratnam, E; Kupa, A

    1987-02-01

    We describe a case of bacterial endophthalmitis complicating routine cataract extraction and intraocular lens implantation in a 91-year-old woman. The ocular and systemic factors that may have predisposed to intraocular infection in this case, and the possibility of predicting these pre-operatively, are discussed.

  2. Liquefaction for cataract extraction

    PubMed Central

    Labiris, Georgios; Toli, Aspasia; Polychroni, Damaskini; Gkika, Maria; Angelonias, Dimitrios; Kozobolis, Vassilios P.

    2016-01-01

    A systematic review of the recent literature regarding the implementation of the liquefaction in cataract surgery and its short-term and long-term outcomes in various parameters that affect the quality of patients' life, including visual rehabilitation and possible complications was performed based on the PubMed, Medline, Nature and the American Academy of Ophthalmology databases in November 2013 and data from 14 comparative studies were included in this narrative review. Liquefaction is an innovative technology for cataract extraction that uses micropulses of balanced salt solution to liquefy the lens nucleus. Most studies reported that liquefaction is a reliable technology for mild to moderate cataracts, while fragmentation difficulties may be encountered with harder nuclei. PMID:26949656

  3. Liquefaction for cataract extraction.

    PubMed

    Labiris, Georgios; Toli, Aspasia; Polychroni, Damaskini; Gkika, Maria; Angelonias, Dimitrios; Kozobolis, Vassilios P

    2016-01-01

    A systematic review of the recent literature regarding the implementation of the liquefaction in cataract surgery and its short-term and long-term outcomes in various parameters that affect the quality of patients' life, including visual rehabilitation and possible complications was performed based on the PubMed, Medline, Nature and the American Academy of Ophthalmology databases in November 2013 and data from 14 comparative studies were included in this narrative review. Liquefaction is an innovative technology for cataract extraction that uses micropulses of balanced salt solution to liquefy the lens nucleus. Most studies reported that liquefaction is a reliable technology for mild to moderate cataracts, while fragmentation difficulties may be encountered with harder nuclei.

  4. Combined cataract extraction and trabeculotomy; further experiences.

    PubMed

    McPherson, S D; Bell, D M

    1981-01-01

    A procedure combining external trabeculotomy with intracapsular cataract extraction was performed in 40 eyes of 28 patients. 77.5% were controlled without medication and there was no final reduction in visual acuity due to complication from the combined operations. The procedure is advocated for patients with glucoma who must undergo cataract extraction.

  5. [Combined laser instrumental extraction of congenital cataracts in children].

    PubMed

    Khvatova, A V; Arestova, N N; Egian, E S

    2005-01-01

    The authors have developed a new method for removal of congenital cataract in children, by taking into account its clinical forms, namely, combined laser instrumental extraction including YAG-laser anterior capsular rhexis, followed by removal of lens debris by the aspiration-irrigation technique. A differential technology of YAG-laser anterior capsular rhexis has been developed, by taking into account of age-specific features of the lens and eyes in children. The optimum energy modes and techniques have been defined for different clinical forms of congenital forms of congenital cataracts. An analysis of the outcomes and complications of extraction of congenital cataracts has indicated that the authors' combined laser instrumental extract procedure (75 operations) assures the better quality of anterior capsular excision, improves optical and functional effects, and reduces the frequency of some complications as compared to the routine instrumental procedure (107 operations) (p < 0.05-0.001). Clinicofunctional and immunological studies have provided evidence for that the YAG-laser technique has no significant effect on the child's eye. Combined laser instrumental extraction is indicated for the treatment of any forms of congenital cataracts in children.

  6. Cataracts

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Cataracts Sections What Are Cataracts? Cataract Symptoms Who Is ... Videos: What Do Cataracts Look Like? What Are Cataracts? Written by: Kierstan Boyd Reviewed by: Elena M ...

  7. Cataract removal

    MedlinePlus

    ... Names Cataract extraction; Cataract surgery Patient Instructions Bathroom safety - adults Cataracts - what to ask your doctor Preventing falls Preventing falls - what to ask your doctor Images Eye Slit-lamp exam Cataract - close-up of the eye Cataract ...

  8. Cataract

    MedlinePlus

    ... version of this page please turn Javascript on. Cataract What Is a Cataract? Click for more information A Clouding of the ... cannot spread from one eye to the other. Cataracts and Aging Most cataracts are related to aging. ...

  9. Early acute aseptic iritis after cataract extraction.

    PubMed

    Allen, H F; Grove, A S

    1976-01-01

    Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.

  10. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    SciTech Connect

    Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. )

    1991-05-01

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

  11. Manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts

    PubMed Central

    Yang, J; Lai, P; Wu, D; Long, Z

    2014-01-01

    Aims: To report the technique and outcomes of sutureless manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts. Materials and Methods: This retrospective study comprised of 112 eyes of 83 patients with mature cataract who all had manual cataract extraction via a subconjunctival limbus oblique incision. A transconjunctival tunnel is fashioned with a 3.0 mm keratome, 0.5 mm behind the limbal vascular arcades. A limbal tunnel, with a transverse extent of 9 mm in the cornea and 7.0 mm in the limbus, is created beneath the conjunctival/Tenon's tissue using an angled bevel-up crescent blade. Outcome measures included visual acuity, intraoperative complications, surgically induced astigmatism, endothelial cell loss rate and surgery time. Results: Self-sealing wound was achieved in 112 eyes (98.2%). The nucleus was delivered in whole in 108 eyes (96.4%). Intraoperative complications included hyphema in 3 eyes (2.7%), iridodialysis in 2 eyes 1.8%), posterior capsular rupture and zonular dialysis in 2 eyes (1.8%). At the 3-month follow-up, 91% patients achieved a best-corrected visual acuity of 20/20 or better, the mean of surgically induced astigmatism was -0.62 ± 0.41 Diopters and endothelial cell loss was 4.2%. Average surgical time was 3.75 min per case. Conclusion: This subconjunctival limbus oblique incision has the potential to serve as safe and effective technique for mature cataracts. PMID:24722270

  12. Erbium:YAG laser for cataract extraction

    NASA Astrophysics Data System (ADS)

    Snyder, Robert W.; Jani, Mahendra G.; Yarborough, Mike; Marcellino, George R.; Noecker, Robert J.; Kramer, Theresa R.; Vidaurri, Jesus

    1998-06-01

    The Erbium:YAG laser may be an effective laser for use in cataract surgery. At 2.94 mm the energy is maximally absorbed by water thereby efficiently disrupting tissue with minimal surrounding thermal damage. The laser may be safer to use in the eye than conventional ultrasonic emulsifiers. Preliminary clinical studies of the safety and efficacy have begun.

  13. Metadata extraction routines for improving infobutton performance.

    PubMed

    Hulse, Nathan C; Haug, Peter J

    2010-11-13

    Infobuttons have been proven as an effective means for providing quick, context-specific links to pertinent information resources at the point of care. Current infobutton manager implementations, however, lack the ability to exchange metadata, are limited to a relatively small set of information providers, and are targeted primarily for a clinician audience. As part of a local effort to implement infobuttons for patient use via a tethered personal health record, we present a series of metadata extraction routines. These routines were constructed to extract key pieces of information from health information providers on the Internet, including content coverage, language availability, and readability scores. The extraction routines were tested using thirty different disease conditions against eight different providers. The routines yielded 183 potential infobutton targets and associated metadata for each. The capabilities of the extraction routines will be expanded to cover new types of metadata in the future.

  14. Development of appropriateness explicit criteria for cataract extraction by phacoemulsification

    PubMed Central

    Ma Quintana, José; Escobar, Antonio; Aróstegui, Inmaculada

    2006-01-01

    Background Consensus development techniques were used in the late 1980s to create explicit criteria for the appropriateness of cataract extraction. We developed a new appropriateness of indications tool for cataract following the RAND method. We tested the validity of our panel results. Methods Criteria were developed using a modified Delphi panel judgment process. A panel of 12 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the influence of all variables on the final panel score using linear and logistic regression models. The explicit criteria developed were summarized by classification and regression tree analysis. Results Of the 765 indications evaluated by the main panel in the second round, 32.9% were found appropriate, 30.1% uncertain, and 37% inappropriate. Agreement was found in 53% of the indications and disagreement in 0.9%. Seven variables were considered to create the indications and divided into three groups: simple cataract, with diabetic retinopathy, or with other ocular pathologies. The preoperative visual acuity in the cataractous eye and visual function were the variables that best explained the panel scoring. The panel results were synthesized and presented in three decision trees. Misclassification error in the decision trees, as compared with the panel original criteria, was 5.3%. Conclusion The parameters tested showed acceptable validity for an evaluation tool. These results support the use of this indication algorithm as a screening tool for assessing the appropriateness of cataract extraction in field studies and for the development of practice guidelines. PMID:16512906

  15. The outcome of the functioning filter after subsequent cataract extraction.

    PubMed

    Halikiopoulos, D; Moster, M R; Azuara-Blanco, A; Wilson, R P; Schmidt, C M; Spaeth, G L; Katz, L J; Augsburger, J J

    2001-01-01

    To evaluate and compare the outcome of functioning filtration surgery followed by cataract surgery with posterior intraocular lens implantation by both phacoemulsification and extracapsular cataract extraction (ECCE) techniques in glaucomatous eyes. We retrospectively evaluated the clinical course of 77 eyes (68 patients) that after successful trabeculectomy, underwent cataract surgery by either phacoemulsification or ECCE techniques. We determined the frequency of partial and absolute failure following cataract surgery by either phacoemulsification or ECCE in eyes with functioning trabeculectomies. Partial failure of intraocular pressure (IOP), control after cataract extraction was defined as the need for an increased number of antiglaucoma medications or argon laser trabeculoplasty to maintain IOP < or =21mm Hg. Complete failure of IOP control after cataract surgery was defined as an IOP >21 mm Hg on at least two consecutive measurements one or more weeks apart or the performance of additional filtration surgery. Failure rates were calculated using the Kaplan-Meier actuarial method. Failure rates between phacoemulsification and ECCE subgroups were compared using the log rank test. The probability of partial failure by the third postoperative year after cataract surgery was 39.5% in the phacoemulsification subgroup and 37.3% in the ECCE subgroup. This small difference is not statistically significant (P = 0.48). The probability of complete failure by the fourth postoperative year after cataract surgery was 12.0% in the phacoemulsification subgroup and 12.5% in the ECCE subgroup. This difference is also not statistically significant (P = 0.77). At the 6-month follow-up visit, visual acuity of both groups improved one or more lines in 87.0% of patients, and worsened one or more lines in 3.9% of patients. Sixty-one percent achieved visual acuity of 20/40 or better. The most frequent complication was posterior capsular opacification requiring laser capsulotomy that

  16. Mooren''s ulcer following extracapsular cataract extraction.

    PubMed

    Acharya, N R; Srinivasan, M; Kundu, A; Lietman, T M; Whitcher, J P; Cunningham, E T

    2008-01-01

    Prior cataract surgery is a recognized risk factor for the development of Mooren''s ulcer, but the demographic and clinical features of a large cohort of such patients have not been described. The authors performed a retrospective review of demographic and clinical data from 14 eyes in 13 patients who developed Mooren's ulcer following extracapsular cataract extraction at Aravind Eye Hospital in Madurai, South India. Eight (62%) of the 13 patients were men and 5 (39%) were women. The median age in our population was 65 years, with a range of 45 to 85 years. The median number of months from surgery to the onset of Mooren's ulcer was 19, with a range of 4 to 156 months. Of the 14 eyes with prior cataract surgery, the location of the ulcer was at or contiguous with the wound in 10 eyes (71%), which was 2.5 times more likely than other circumlimbal locations, and only one patient (8%) had bilateral disease. Mooren''s ulcer may occur following extracapsular cataract extraction and when it does it is most likely to be unilateral and contiguous with the wound. These findings support the notion that exposure of normally concealed corneal antigens may contribute to the pathogenesis of Mooren''s ulcer in some patients.

  17. Phacoemulsification with indocyanine green versus manual expression extracapsular cataract extraction for advanced cataract.

    PubMed

    Yi, David H; Sullivan, Brian R

    2002-12-01

    To compare the outcomes of indocyanine green dye (ICG)-assisted phacoemulsification with manual expression extracapsular cataract extraction (ECCE) in eyes with advanced cataract. Parkland Memorial Hospital and Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. In this retrospective study, 72 consecutive cases of advanced or mature cataract extractions performed in a 1-year period were reviewed. Fifty-nine eyes met the inclusion and exclusion criteria; 33 had ICG-assisted phacoemulsification and 26, manual expression ECCE. Preoperative and intraoperative findings and the postoperative outcomes up to 6 months were analyzed. Intraoperative complications included posterior capsule tear with vitreous prolapse in 2 eyes (6.6%) and conversion to manual expression ECCE in 1 eye (3.3%) in the ICG phacoemulsification group. There was no intraoperative complication in the manual expression ECCE group. There were significantly more patients with a best corrected visual acuity of 20/30 or better in the ICG phacoemulsification group than in the manual expression ECCE group at all postoperative periods. The mean logMAR visual acuities were significantly better in the ICG phacoemulsification group at all postoperative intervals. The ICG phacoemulsification group had significantly less postoperative astigmatism. There was no significant difference between the groups in the early postoperative intraocular pressure. Phacoemulsification with ICG led to better postoperative visual acuity and less postoperative astigmatism than manual expression ECCE. Phacoemulsification with ICG was associated with more intraoperative complications than manual expression ECCE; however, the complication rate is comparable to a previously published rate for phacoemulsification performed in a university training program. Phacoemulsification with ICG appears to be a reasonable alternative to manual expression ECCE for advanced cataract.

  18. Cataract

    MedlinePlus

    ... Colors that seem faded Glare - headlights, lamps or sunlight may seem too bright. You may also see ... a hat with a brim to block ultraviolet sunlight may help to delay cataracts. NIH: National Eye ...

  19. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty

    PubMed Central

    Zhou, Hong-Wei; Xie, Li-Xin

    2016-01-01

    Background: The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts. Methods: A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density (ECD), and best-corrected visual acuity (BCVA) were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD. Results: Of the 54 eyes included in this study, extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group). There was no significant difference in the median age (P = 0.081) or preoperative ECD (P = 0.585) between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group (P = 0.043). In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P = 0.018), 4 months (P < 0.001), and 6 months (P < 0.001) after cataract surgery. Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.001) and phacoemulsification group (P < 0.001), but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001). There was no significant difference in postoperative BCVA between the two groups (P = 0.065). Conclusion: ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract

  20. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty.

    PubMed

    Zhou, Hong-Wei; Xie, Li-Xin

    2016-09-05

    The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts. A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density (ECD), and best-corrected visual acuity (BCVA) were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD. Of the 54 eyes included in this study, extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group). There was no significant difference in the median age (P = 0.081) or preoperative ECD (P = 0.585) between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group (P = 0.043). In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P = 0.018), 4 months (P < 0.001), and 6 months (P < 0.001) after cataract surgery. Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.001) and phacoemulsification group (P < 0.001), but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001). There was no significant difference in postoperative BCVA between the two groups (P = 0.065). ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

  1. [Evaluation quality of life of patients before and after cataract extraction].

    PubMed

    Płachecka, Elzbieta; Malukiewicz, Grazyna

    2009-01-01

    Our purpose was to identify to what extend cataract influences the quality of life of the affected patients. The examinations were conducted in a sample of patients treated from October 2005 to December 2006. To assess the quality of life the V-14 Questionnaire was used, modified and adapted up to local (Polish) conditions. Cataract and the duration of waiting time for the cataract surgery together impaired psychological state. Cataract significantly decreased individual independence. Cataract extraction significantly improved quality of life, particularly regarding reading, self-care activity, topographical orientation and subjective perception of psychological state.

  2. Anterior vitrectomy for shallow anterior chamber after cataract extraction.

    PubMed

    Dottan, S; Levartovsky, S; Oliver, M

    1982-06-01

    Pars plana anterior vitrectomy was performed in 9 patients with shallow anterior chamber after cataract extraction. Five patients had choroidal and/or ciliary body effusion (CCBE), and 4 had aphakic pupillary block (APB). Vitrectomy was performed only after medical treatment failed to restore a normal anterior chamber depth. In all patients the anterior chamber restored during surgery and remained so thereafter, although in patients with CCBE, the fundal pathology subsided days or even months later. The only surgical complication was a longstanding cystoid macular oedema in one patient. Pars plana vitrectomy would appear to have advantages over other surgical techniques, in similar circumstances.

  3. Toxic endothelial cell destruction of the cornea after routine extracapsular cataract surgery.

    PubMed

    Breebaart, A C; Nuyts, R M; Pels, E; Edelhauser, H F; Verbraak, F D

    1990-08-01

    Eighteen patients developed an acute corneal decompensation following normal intraocular surgery (cataract extraction in 17 patients), characterized by star-shaped endothelial folds, a twofold increase in corneal thickness, and a visual acuity of counting fingers during several postoperative days. In some cases, there was an additional iritis and transient hypotony. There was no effect of topical and/or subconjunctival corticosteroids on the course of the decompensation. Endothelial morphometric analysis showed a mean endothelial cell loss of 72%. Endothelial wound healing, as determined by coefficient of variation and percentage hexagonals, stabilized 6 months postoperatively. We coined the term toxic endothelial cell destruction for this syndrome. Epidemiological evaluation revealed the toxic endothelial cell destruction syndrome to be linked with the 10-fold increase of a detergent solution in the ultrasonic bath for cleaning the surgical instruments.

  4. Corneal endothelial cell loss in post-penetrating keratoplasty patients after cataract surgery: phacoemulsification versus planned extracapsular cataract extraction.

    PubMed

    Acar, Banu Torun; Buttanri, Ibrahim Bulent; Sevim, Mehmet Sahin; Acar, Suphi

    2011-08-01

    To compare the changes in endothelial cell density (ECD) in post-penetrating keratoplasty (PKP) patients after cataract extraction with phacoemulsification or planned extracapsular cataract extraction (ECCE). Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey. Clinical trial. Eyes with hard nuclear cataract that had previous PKP were randomly assigned to have phacoemulsification or ECCE. Noncontact specular microscopy was performed preoperatively and 1, 3, and 6 months postoperatively. Twenty-six eyes of 26 patients were enrolled (14 phacoemulsification; 12 ECCE). Six months postoperatively, the mean corneal ECD was statistically significantly lower in the phacoemulsification group (1869.50 cells/mm(2) ± 158.05 [SD]) than in the ECCE group (1996.00 ± 127.96 cells/mm(2)) (P=.024). The mean percentage of endothelial cell loss at 6 months was 20.3% and 12.7%, respectively (P<.05). In both groups, there was no significant difference in the percentage hexagonality between preoperatively and postoperatively (P>.05). Extracapsular cataract extraction seemed to cause less endothelial cell damage than phacoemulsification in post-PKP patients with hard nuclear cataract. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Evaluation of complications of extracapsular cataract extraction performed by trainees.

    PubMed

    Ezegwui, Ir; Aghaji, Ae; Okpala, Ne; Onwasigwe, En

    2014-01-01

    Cataract extraction is the most common intraocular surgery taught to residents. This study aims to review the complications of trainee-performed extracapsular cataract extraction (ECCE) so as to identify the steps in which the trainee can benefit from closer supervision and practice. This was a descriptive retrospective study of complications in the initial 150 ECCE with intraocular lens implant performed by two Ophthalmologists, from the University of Nigeria Teaching Hospital, Enugu, who visited a high volume training center. Both the intraoperative and early post-operative complications were studied. Data entry and analysis were performed descriptively using the Statiscal Package for the Social Sciences, SPSS version 15.0 (Chicago, IL, USA). The age range of the patients was 40-95 years. The intraoperative complications included capsular flaps 12/161 (7.5%), posterior capsule rent, 10/161 (6.2%) and vitreous loss, 8/161 (5.0%). Corneal complications (striate keratopathy, superior corneal edema, generalized corneal edema and corneal folds) ranked highest in post-operative complications accounting for 34% (56/164). Performance of adequate and proper anterior capsulotomy, minimal handling of the cornea and avoidance of posterior capsular rent are some of the challenges of the trainee in mastering ECCE. Stepwise supervised training can help a trainee master these steps while keeping the complications at acceptably low levels.

  6. Evaluation of Complications of Extracapsular Cataract Extraction Performed by Trainees

    PubMed Central

    Ezegwui, IR; Aghaji, AE; Okpala, NE; Onwasigwe, EN

    2014-01-01

    Background: Cataract extraction is the most common intraocular surgery taught to residents. Aim: This study aims to review the complications of trainee-performed extracapsular cataract extraction (ECCE) so as to identify the steps in which the trainee can benefit from closer supervision and practice. Subjects and Methods: This was a descriptive retrospective study of complications in the initial 150 ECCE with intraocular lens implant performed by two Ophthalmologists, from the University of Nigeria Teaching Hospital, Enugu, who visited a high volume training center. Both the intraoperative and early post-operative complications were studied. Data entry and analysis were performed descriptively using the Statiscal Package for the Social Sciences, SPSS version 15.0 (Chicago, IL, USA). Results: The age range of the patients was 40-95 years. The intraoperative complications included capsular flaps 12/161 (7.5%), posterior capsule rent, 10/161 (6.2%) and vitreous loss, 8/161 (5.0%). Corneal complications (striate keratopathy, superior corneal edema, generalized corneal edema and corneal folds) ranked highest in post-operative complications accounting for 34% (56/164). Conclusions: Performance of adequate and proper anterior capsulotomy, minimal handling of the cornea and avoidance of posterior capsular rent are some of the challenges of the trainee in mastering ECCE. Stepwise supervised training can help a trainee master these steps while keeping the complications at acceptably low levels. PMID:24669342

  7. RISK OF RETINAL DETACHMENT AFTER CATARACT EXTRACTION, 1980–2004: A POPULATION-BASED STUDY

    PubMed Central

    Erie, Jay C.; Raecker, Matthew E.; Baratz, Keith H.; Schleck, Cathy D.; Robertson, Dennis M.

    2006-01-01

    Purpose To estimate the long-term cumulative risk of retinal detachment (RD) after cataract extraction. Methods Using the resources of the Rochester Epidemiology Project, we retrospectively identified all residents of Olmsted County, Minnesota, who had cataract extraction from 1980 through 2004 (10,256 cataract extractions in 7,137 residents) and were diagnosed with RD. The observed probability of RD after cataract extraction was estimated using the Kaplan-Meier method. A cumulative probability ratio of RD after cataract extraction was determined by comparing the observed probability of RD with the expected probability of RD in residents without cataract extraction. Two controls chosen from the primary cataract surgery cohort were matched to each RD case by age, sex, and duration of follow-up. Logistic regression models assessed differences between cases and controls. Results Eighty-two cases of RD after cataract extraction were identified. The cumulative probability of RD after extracapsular cataract extraction (ECCE) and phacoemulsification was 0.27%, 0.71%, 1.23%, 1.58%, and 1.79% at 1, 5, 10, 15, and 20 years after surgery. There was no significant difference in the probability of RD after ECCE when compared to phacoemulsification (P =.13). The cumulative probability ratio of RD at 20 years after ECCE and phacoemulsification was four times (95% CI, 2.6–5.4) higher than would be expected in a similar group of residents not undergoing cataract extraction (P <.001). Males, younger age, myopia, and increased axial length were significantly associated with RD (P <.001). Conclusions The cumulative risk of RD after ECCE and phacoemulsification is increased for up to 20 years after surgery. PMID:17471337

  8. Risk of retinal detachment after cataract extraction, 1980-2004: a population-based study.

    PubMed

    Erie, Jay C; Raecker, Matthew E; Baratz, Keith H; Schleck, Cathy D; Robertson, Dennis M

    2006-01-01

    To estimate the long-term cumulative risk of retinal detachment (RD) after cataract extraction. Using the resources of the Rochester Epidemiology Project, we retrospectively identified all residents of Olmsted County, Minnesota, who had cataract extraction from 1980 through 2004 (10,256 cataract extractions in 7,137 residents) and were diagnosed with RD. The observed probability of RD after cataract extraction was estimated using the Kaplan-Meier method. A cumulative probability ratio of RD after cataract extraction was determined by comparing the observed probability of RD with the expected probability of RD in residents without cataract extraction. Two controls chosen from the primary cataract surgery cohort were matched to each RD case by age, sex, and duration of follow-up. Logistic regression models assessed differences between cases and controls. Eighty-two cases of RD after cataract extraction were identified. The cumulative probability of RD after extracapsular cataract extraction (ECCE) and phacoemulsification was 0.27%, 0.71%, 1.23%, 1.58%, and 1.79% at 1, 5, 10, 15, and 20 years after surgery. There was no significant difference in the probability of RD after ECCE when compared to phacoemulsification (P =.13). The cumulative probability ratio of RD at 20 years after ECCE and phacoemulsification was four times (95% CI, 2.6-5.4) higher than would be expected in a similar group of residents not undergoing cataract extraction (P <.001). Males, younger age, myopia, and increased axial length were significantly associated with RD (P <.001). The cumulative risk of RD after ECCE and phacoemulsification is increased for up to 20 years after surgery.

  9. Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery.

    PubMed

    Gurung, A; Karki, D B; Shrestha, S; Rijal, A P

    2009-01-01

    an effective method for cataract surgery should be identified to combat cataract blindness. to study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. a randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extractionwith posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. in the immediate postoperative period, unaided visual acuity of =or> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI= 1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1l.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =or> 2 at6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI= 1.39-3.73, p=0.0002). both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period.

  10. [Laser magnetotherapy after cataract extraction with implantation of intraocular lens].

    PubMed

    Maksimov, V Iu; Zakharova, N V; Maksimova, I S; Golushkov, G A; Evseev, S Iu

    2002-01-01

    Effects of low-intensive laser and alternating magnetic field on the course of the postoperative period were studied in patients with exudative reaction after extracapsular cataract extraction with implantation of intraocular lens (IOL). The results are analyzed for 148 eyes with early exudative reaction after IOL implantation (136 patients aged 42-75 years). The patients were observed for up to 6 months. The treatment efficiency was evaluated by the clinical picture of inflammatory reaction, visual acuity, and results of biochemical analysis of the lacrimal fluid (the ratio of lipid peroxidation products to antioxidants in cell membrane). The course of the postoperative period was more benign and recovery sooner in patients of the main group in comparison with the control.

  11. The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

    PubMed

    Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

    2016-01-01

    The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

  12. Hospital-based community cataract surgery: comparison of visual outcomes between conventional extra-capsular cataract extraction and small incision cataract surgery.

    PubMed

    Karki, P; Shrestha, K; Shrestha, J B

    2009-01-01

    the small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. to compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. aprospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. the statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of<0.05 was considered significant. of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI= 0.23 -0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 -0.73; p=0.00 12). both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males.

  13. Bacterial flora in relation to cataract extraction. II. Peroperative flora.

    PubMed

    Fahmy, J A; Moller, S; Bentzon, M W

    1975-06-01

    The peroperative flora of 499 patients undergoing cataract extraction was studied with local bacterial cultures taken at the beginning and end of surgery and compared with the preoperative flora examined previously (Fahmy et al. 1975 b) on admission the day prior to surgery. The local application of a single dose of oxytetracycline - polymyxin B, approximately 18 hours before surgery, significantly reduced the incidence of bacteria at the time of surgery. However, 92% of the conjunctivas examined immediately before operation proved to harbour one or more kinds of microorganisms. Futhermore, 61% of the wound sites were found to be contaminated with bacteria at the conclusion of surgery. The reasons are discussed. The origin of Staphylococcus aureus isolated peroperatively from the conjunctiva and wound site was studied. The great majority of strains could be traced to the patient's own conjunctiva preoperatively. In a few cases S. aureus was traced to the patient's own nose, skin of face or to the surgeon's nose. The air of the wards and operating theatre as well as the hands and gloves of surgeons and assistant nurses apparently did not play any role as a source of S. aureus infection.

  14. Structured extracapsular cataract extraction-intraocular lens microsurgical training: report of a trainee's experience.

    PubMed

    Aghaji, A E; Natchiar, G

    2011-01-01

    The aim was to report the experience an ophthalmologist gained in a structured intraocular lens (IOL) microsurgery training program for the information and benefit of colleagues in ophthalmology training institutions. An ophthalmologist was trained in extracapsular cataract extraction (ECCE)-IOL implant in Aravind Eye Hospital (AEH), Madurai, for a period of 8 weeks. Details of patients operated on, procedures observed, and conferences attended were prospectively recorded in a log book. Training was available in conventional ECCE with posterior chamber IOL (ECCE-PCIOL), small incision sutureless cataract surgery, and phacoemulsification. During the period, this trainee observed a total of 1527 cataract extractions, administered 528 retrobulbar and 1047 facial blocks, and also operated on 75 patients. The trainee gained experience and confidence to perform high-quality, low-cost cataract surgery. Hands-on experience and competence in quality ECCE-IOL implant microsurgery can be acquired in a short period of time in a high-volume cataract center. Trainees can also be exposed to other techniques of cataract surgery. Ophthalmology training centers with diminishing surgical training opportunities can also benefit from this structured training in a high-volume cataract center like Aravind Eye Hospital.

  15. Ultrasound diagnosis of bilateral cataracts in a fetus with possible cerebro-ocular congential muscular dystrophy during the routine second trimester anomaly scan.

    PubMed

    Drought, Alexandra; Wimalasundera, Ruwan; Holder, Susan

    2015-08-01

    The finding of bilateral congenital cataracts in the fetus is rare. We report bilateral congenital cataracts detected during the routine second trimester anomaly scan, which subsequently were found to be associated with other congenital anomalies and the parents opted for a termination of pregnancy. At post-mortem, Muscle-Eye Brain disease or Walker-Warburg Syndrome was considered likely, which are autosomal recessive congenital muscular dystrophy disorders associated with cerebral, cerebellar, muscle and eye anomalies. On ultrasound, bilateral cataracts appear as echogenic, solid areas within the fetal orbits. The examination of the fetal face and orbits plays an important role in confirming fetal well-being antenatally. We propose that it should become a routine part of the structural survey of fetal anatomy during the obstetric anomaly scan. This is especially important in pregnancies previously affected by fetal cataracts or pregnancies at risk of rare genetic syndromes.

  16. Outcomes of manual extracapsular versus phacoemulsification cataract extraction by beginner resident surgeons.

    PubMed

    Meeks, Landen A; Blomquist, Preston H; Sullivan, Brian R

    2013-11-01

    To evaluate the safety and efficacy of phacoemulsification cataract extraction and manual extracapsular cataract extraction (ECCE) performed by beginning resident surgeons. Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. Retrospective cohort study. A review was performed of each resident's series of initial cataract surgery procedures as a late first-year or second-year resident. Data were collected for cases performed over almost a 6-year period during which initially the first primary surgeon cases were ECCE and later, the first primary surgeon cases were phacoemulsification. For each case, the following data were gathered: technique of cataract extraction, laterality, resident, vitreous loss or dropped nucleus, placement of posterior chamber intraocular lens (IOL), and need for reoperation within 90 days of surgery. Complications occurred in 6 (2.5%) of 244 cases in which phacoemulsification was performed by a beginner resident primary surgeon and in 7 (4.1%) of 172 cases in which ECCE was used (P=.40). Posterior chamber IOLs were placed in all but 2 phacoemulsification cases and 4 ECCE cases (P=.24). Moreover, 3 cases in the phacoemulsification group and 1 case in the ECCE group required a reoperation within 90 days (P=.65). Phacoemulsification cataract extraction can be taught safely and effectively to residents with no cataract surgery experience as a primary surgeon. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Long-term effect of cataract surgery on intraocular pressure after trabeculectomy: extracapsular extraction versus phacoemulsification.

    PubMed

    Casson, Robert J; Riddell, Claire E; Rahman, Rubina; Byles, Daniel; Salmon, John F

    2002-12-01

    To compare the effect of phacoemulsification with intraocular lens (IOL) implantation on long-term intraocular pressure (IOP) control in glaucoma patients who had previous trabeculectomy with the effect on IOP control in similar patients after extracapsular cataract extraction (ECCE) with IOL implantation. Oxford Eye Hospital, Oxford, England. Twenty-eight consecutive patients who had phacoemulsification with IOL implantation (phaco group) at least 3 months after trabeculectomy were identified from hospital records, and 28 patients who had ECCE with IOL implantation (ECCE group) were matched retrospectively to the phaco group with respect to age, sex, diagnosis, and IOP. In both groups, the IOP before cataract extraction was compared with the IOP at intervals up to 2 years after cataract extraction. A Kaplan-Meier survival analysis was performed. The mean IOP in the phaco group did not differ significantly from the mean IOP before cataract extraction at any interval. Twelve months after cataract extraction, the mean IOP in the ECCE group was significantly higher than preoperatively (P =.01); however, the mean IOP did not differ between groups over time (P =.704). There was significantly better long-term IOP control in the phaco group as determined by Kaplan-Meier survival analysis and the log-rank test (P =.038). After trabeculectomy, phacoemulsification provided better long-term IOP control than ECCE; however, the mean IOP was not significantly lower.

  18. Extracapsular cataract extraction in Nepal. 2-year outcome.

    PubMed

    Ruit, S; Robin, A L; Pokhrel, R P; Sharma, A; DeFaller, J

    1991-12-01

    We evaluated the 2-year outcome of extracapsular cataract surgery with posterior chamber intraocular lens insertion by a single fellowship-trained surgeon in Kathmandu, Nepal. Six hundred ten eyes were followed up for 2 years. Patients underwent manual irrigation and aspiration with the insertion of a modified J loop posterior chamber intraocular lens. Almost half of the patients had uncorrected visual acuities of 20/50 or better after surgery. Sight-threatening complications in seven eyes (1.2%) included retinal detachment, corneal decompensation, and endophthalmitis. Although this rate is comparable to that in developed countries, 21% of patients had posterior capsular opacification at follow-up. Extracapsular cataract surgery with intraocular lens insertion may be an alternative to intracapsular cataract surgery in developing nations, where aphakic spectacles are expensive, not easily obtainable, or difficult to replace.

  19. Visual Routines for Extracting Magnitude Relations

    ERIC Educational Resources Information Center

    Michal, Audrey L.; Uttal, David; Shah, Priti; Franconeri, Steven L.

    2016-01-01

    Linking relations described in text with relations in visualizations is often difficult. We used eye tracking to measure the optimal way to extract such relations in graphs, college students, and young children (6- and 8-year-olds). Participants compared relational statements ("Are there more blueberries than oranges?") with simple…

  20. Visual Routines for Extracting Magnitude Relations

    ERIC Educational Resources Information Center

    Michal, Audrey L.; Uttal, David; Shah, Priti; Franconeri, Steven L.

    2016-01-01

    Linking relations described in text with relations in visualizations is often difficult. We used eye tracking to measure the optimal way to extract such relations in graphs, college students, and young children (6- and 8-year-olds). Participants compared relational statements ("Are there more blueberries than oranges?") with simple…

  1. Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction

    PubMed Central

    Khandelwal, R R; Raje, D; Rathi, A; Agashe, A; Majumdar, M; Khandelwal, R

    2015-01-01

    Purpose To determine the efficacy of safe surgery system trabeculectomy combined with manual small incision cataract surgery/phacoemulsification in primary glaucoma coexistent with cataract. Methods This is a retrospective analysis of 105 cases who underwent single-site combined surgery between January 2008 and December 2009. Safe surgery system trabeculectomy with diffuse and posterior application of mitomycin C was performed in all cases. Cataract extraction was done either by Manual Small Incision Cataract Surgery (MSICS) or phacoemulsification. Main outcome measures were success rate of trabeculectomy, as determined by four different IOP goals and incidence of postoperative complications. Analysis was performed using R-2.15, and the significance was tested at 5% level. Results The minimum follow-up period was 12 months. The overall success rates (with or without medication) when safe surgery system trabeculectomy was combined with MSICS were 91, 70, and 51% for IOP ≤18, ≤15, and ≤12 mm Hg, respectively, and target IOP was achieved in 72% cases. The mean IOP reduction was 43.8% with MSICS and 42.08% with phacoemulsification. The surgical outcome was not significantly different for both techniques. Postoperative complications were infrequent and comparable. Conclusion The Safe Surgery System Trabeculectomy combined with cataract surgery offers excellent IOP control with minimal postoperative complications. It offers an effective and improved solution for primary glaucoma coexistent with cataract found in developing countries. PMID:25502867

  2. Keratometry obtained by corneal mapping versus the IOLMaster in the prediction of postoperative refraction in routine cataract surgery.

    PubMed

    Dulku, Simon; Smith, Henry B; Antcliff, Richard J

    2013-01-01

    To establish whether simulated keratometry values obtained by corneal mapping (videokeratography) would provide a superior refractive outcome to those obtained by Zeiss IOLMaster (partial coherence interferometry) in routine cataract surgery. Prospective, non-randomized, single-surgeon study set at the The Royal United Hospital, Bath, UK, District General Hospital. Thirty-three patients undergoing routine cataract surgery in the absence of significant ocular comorbidity. Conventional biometry was recorded using the Zeiss IOLMaster. Postoperative refraction was calculated using the SRK/T formula and the most appropriate power of lens implanted. Preoperative keratometry values were also obtained using Humphrey Instruments Atlas Version A6 corneal mapping. Achieved refraction was compared with predicted refraction for the two methods of keratometry after the A-constants were optimized to obtain a mean arithmetic error of zero dioptres for each device. The mean absolute prediction error was 0.39 dioptres (standard deviation 0.29) for IOLMaster and 0.48 dioptres (standard deviation 0.31) for corneal mapping (P = 0.0015). Keratometry readings between the devices were highly correlated by Spearman correlation (0.97). The Bland-Altman plot demonstrated close agreement between keratometers, with a bias of 0.0079 dioptres and 95% limits of agreement of -0.48-0.49 dioptres. The IOLMaster was superior to Humphrey Atlas A6 corneal mapping in the prediction of postoperative refraction. This difference could not have been predicted from the keratometry readings alone. When comparing biometry devices, close agreement between readings should not be considered a substitute for actual postoperative refraction data. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  3. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2014-11-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to September 2014), EMBASE (January 1980 to September 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to September 2014), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), (January 1990 to September 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 23 September 2014. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost

  4. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2012-04-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 1), MEDLINE (January 1950 to February 2012), EMBASE (January 1980 to February 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to February 2012), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 14 February 2012. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost-effectiveness. There were not enough data available from the included trials to perform a meta-analysis. Three trials randomly allocating people with age

  5. Comparison of the anti-inflammatory effects of diclofenac and flurbiprofen eye drops after cataract extraction.

    PubMed

    Koçak, I; Yalvaç, I S; Koçak, A; Nurözler, A; Unlü, N; Kasim, R; Duman, S

    1998-06-01

    A clinical double-blind study was performed in patients who had undergone extracapsular cataract extraction and intraocular lens implantation (ECCE+IOL) to compare the anti-inflammatory effects of diclofenac sodium 0.1% and flurbiprofen 0.03% eye drops. The diclofenac group included 21 eyes of 21 patients and the flurbiprofen group included 22 eyes of 22 patients. The parameters compared were pachymetry of the cornea, corneal surface changes, intraocular pressure (IOP) and the degree of inflammation of the anterior chamber at one, three and six weeks after cataract surgery. There was no statistically significant difference between the two treatment groups in corneal pachymetry, corneal surface changes, IOP and the anterior chamber inflammation (p>0.05). Both drugs were well tolerated and may be safely used to reduce inflammation for cataract surgery.

  6. Postoperative inflammation following cataract extraction caused by bacterial contamination of the cleaning bath detergent.

    PubMed

    Kreisler, K R; Martin, S S; Young, C W; Anderson, C W; Mamalis, N

    1992-01-01

    Five of 16 patients who had uncomplicated cataract extraction with intraocular lens (IOL) implantation within a 2.5 day period experienced increased anterior segment inflammation on their first postoperative day. Four of these five patients had phacoemulsification and one a planned extracapsular cataract extraction. All had posterior chamber IOL implantation in the capsular bag. In all patients, this anterior segment inflammation cleared with topical steroids over two to three weeks with no evident residual ocular effects. A careful search for the possible cause of the inflammation showed that the ultrasonic cleaning bath and Weck liquid detergent used to clean the instruments contained Klebsiella pneumoniae bacteria. Further investigation demonstrated the presence of a heat-stable endotoxin produced by the bacteria. We postulate that endotoxin remaining on the instruments after cleaning and sterilization caused this postoperative anterior segment inflammation. To the best of our knowledge, these are the first reported cases caused by contaminated liquid detergent.

  7. Iris-supported lens implantation v. simple cataract extraction. An analysis of data.

    PubMed

    Galin, M A; Obstbaum, S A; Boniuk, V; Galin, A; Silverstone, D

    1977-04-01

    In a study of a selected age (greater than 60) and ocularly matched population requiring cataract extraction, a perfectly executed intracapsular cataract extraction followed by the introduction of a Fyodorov Type II ("Sputnik") lens did not lead to irreversible anterior or posterior segment changes different from those seen in a group followed for from 5 to 9 years. It did lead to an incidence of implant support dislocation and to membrane formation in about 10% of cases, reducible to about 2% with correctly made lenses and the appropriate use of postoperative drugs. The incidence of corneal degeneration (0), retinal detachment (2%), and intraretinal cystic maculopathy (3%) was equal in each group. Visual acuity levels were also equal. In appropriate cases, if the surgery is carried out with sufficient skill, the reward to risk ratio of implantation not only justifies but indicates the use of such lenses.

  8. Safety and Efficacy of the Transition from Extracapsular Cataract Extraction to Manual Small Incision Cataract Surgery in Prevention of Blindness Campaigns

    PubMed Central

    Signes-Soler, Isabel; Javaloy, Jaime; Muñoz, Gonzalo; Moya, Tomas; Montalbán, Raúl; Albarrán, César

    2016-01-01

    Purpose: To compare the safety and the visual outcomes of two experienced cataract surgeons who converted from extracapsular cataract extraction (ECCE) to manual small incision cataract surgery (MSICS) during a campaign for the prevention of blindness. Methods: Two surgeons used the ECCE technique (ECCE group) during a campaign in Burkina Faso on 93 consecutive cataract patients with a corrected distance visual acuity (CDVA) <20/80 in the best eye. Both surgeons used MSICS for the first time on 98 consecutive cases in another campaign in Kenya after theoretical instructional courses. Results: There were no significant differences in CDVA at 3 months postoperatively. There were 69% of eyes with uncorrected distance visual acuity ≥20/60 in the MSICS group and 49% eyes in the ECCE group. Spherical equivalents ranged between −1D and +1D in 55% of the MSICS group versus 43% in the ECCE group. There were significant differences in the changes in the vertical component of astigmatism (J45) but not the horizontal (J0) component. There were no significant differences in the intraoperative complications. The most common postoperative complication was corneal edema on the first day in 40.86% and 19.38% of the ECCE and MSICS groups, respectively. Conclusion: Transitioning from ECCE to MSICS for experienced cataract surgeons in surgical campaigns is safe. The rate of complications is similar for both techniques. Slightly better visual and refractive outcomes can be achieved due to the decreased induction of corneal astigmatism. PMID:27162451

  9. Safety and Efficacy of the Transition from Extracapsular Cataract Extraction to Manual Small Incision Cataract Surgery in Prevention of Blindness Campaigns.

    PubMed

    Signes-Soler, Isabel; Javaloy, Jaime; Muñoz, Gonzalo; Moya, Tomas; Montalbán, Raúl; Albarrán, César

    2016-01-01

    To compare the safety and the visual outcomes of two experienced cataract surgeons who converted from extracapsular cataract extraction (ECCE) to manual small incision cataract surgery (MSICS) during a campaign for the prevention of blindness. Two surgeons used the ECCE technique (ECCE group) during a campaign in Burkina Faso on 93 consecutive cataract patients with a corrected distance visual acuity (CDVA) <20/80 in the best eye. Both surgeons used MSICS for the first time on 98 consecutive cases in another campaign in Kenya after theoretical instructional courses. There were no significant differences in CDVA at 3 months postoperatively. There were 69% of eyes with uncorrected distance visual acuity ≥20/60 in the MSICS group and 49% eyes in the ECCE group. Spherical equivalents ranged between -1D and +1D in 55% of the MSICS group versus 43% in the ECCE group. There were significant differences in the changes in the vertical component of astigmatism (J45) but not the horizontal (J0) component. There were no significant differences in the intraoperative complications. The most common postoperative complication was corneal edema on the first day in 40.86% and 19.38% of the ECCE and MSICS groups, respectively. Transitioning from ECCE to MSICS for experienced cataract surgeons in surgical campaigns is safe. The rate of complications is similar for both techniques. Slightly better visual and refractive outcomes can be achieved due to the decreased induction of corneal astigmatism.

  10. Confocal microscopic evaluation of cornea after AquaLase liquefaction cataract extraction.

    PubMed

    Zhao, Jiang-Yue; Wang, Ming-Wu; Sun, Qi; Zhang, Jin-Song

    2011-01-01

    The most recent and innovative AquaLase liquefaction technology has offered an alternative to lens extraction. Many studies have investigated its functions and advantages. This article focuses on evaluating the in vivo microscopic cornea changes after AquaLase liquefaction by using a laser confocal microscope. In this perspective, randomized case study, 37 eyes of 35 patients submitted to cataract surgery were chosen to undergo AquaLase liquefaction cataract extraction. Each patient was assessed before the operation, on the 1(st), 7(th), and 30(th) postoperative days, and 6 months after the cataract extraction. The morphologies and quantitative comparisons of corneal cells and corneal nerves layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope. ANOVA and Post-Hoc Bonferroni test were carried out to compare the results pre- and post-operation. ANOVA results indicated no post-operation changes for epithelium and anterior stroma cells. Irregular segments of sub-basal nerve fiber were most pronounced seven days post-operation. In the mid and posterior stroma, keratocytes were obvious compared with the preoperative condition. Corneal endothelium cells became obviously swollen in cytoplasm and nucleus. The mid and posterior stroma cell density decreased from the 1(st) to 7(th) postoperative days (P<0.05). The corneal endothelium cell density decreased (P<0.05) and did not revert to the preoperative level after six months (P<0.05). Slight microstructural abnormalities were identified in the corneal recovery process after AquaLase liquefaction. AquaLase liquefaction cataract extraction is safe for cornea.

  11. Confocal microscopic evaluation of cornea after AquaLase liquefaction cataract extraction

    PubMed Central

    Zhao, Jiang-Yue; Wang, Ming-Wu; Sun, Qi; Zhang, Jin-Song

    2011-01-01

    AIM The most recent and innovative AquaLase liquefaction technology has offered an alternative to lens extraction. Many studies have investigated its functions and advantages. This article focuses on evaluating the in vivo microscopic cornea changes after AquaLase liquefaction by using a laser confocal microscope. METHODS In this perspective, randomized case study, 37 eyes of 35 patients submitted to cataract surgery were chosen to undergo AquaLase liquefaction cataract extraction. Each patient was assessed before the operation, on the 1st, 7th, and 30th postoperative days, and 6 months after the cataract extraction. The morphologies and quantitative comparisons of corneal cells and corneal nerves layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope. ANOVA and Post-Hoc Bonferroni test were carried out to compare the results pre- and post-operation. RESULTS ANOVA results indicated no post-operation changes for epithelium and anterior stroma cells. Irregular segments of sub-basal nerve fiber were most pronounced seven days post-operation. In the mid and posterior stroma, keratocytes were obvious compared with the preoperative condition. Corneal endothelium cells became obviously swollen in cytoplasm and nucleus. The mid and posterior stroma cell density decreased from the 1st to 7th postoperative days (P<0.05). The corneal endothelium cell density decreased (P<0.05) and did not revert to the preoperative level after six months (P<0.05). CONCLUSION Slight microstructural abnormalities were identified in the corneal recovery process after AquaLase liquefaction. AquaLase liquefaction cataract extraction is safe for cornea. PMID:22553665

  12. Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial

    PubMed Central

    Minassian, D; Rosen, P; Dart, J; Reidy, A; Desai, P; Sidhu, M

    2001-01-01

    BACKGROUND—Cataract extraction constitutes the largest surgical workload in ophthalmic units throughout the world. Extracapsular cataract extraction (ECCE), through a large incision, with insertion of an intraocular lens has been the most widely used method from 1982 until recently. Technological advances have led to the increasing use of phacoemulsification (Phako) to emulsify and remove the lens The technique requires a smaller incision, but requires substantial capital investment in theatre equipment. In this randomised trial we assessed the clinical outcomes and carried out an economic evaluation of the two procedures.
METHODS—In this two centre randomised trial, 232 patients with age related cataract received ECCE, and 244 received small incision surgery by Phako. The main comparative outcomes were visual acuity, refraction, and complication rates. Resource use was monitored in the two trial centres and in an independent comparator centre. Costs calculated included average cost per procedure, at each stage of follow up.
RESULTS—Phako was found to be clinically superior. Surgical complications and capsule opacity within 1 year after surgery were significantly less frequent, and a higher proportion achieved an unaided visual acuity of 6/9 or better (<0.2 logMAR) in the Phako group. Postoperative astigmatism was more stable in Phako. The average cost of a cataract operation and postoperative care within the trial was similar for the two procedures. With the input of additional spectacles for corrected vision at 6 months after surgery, the average cost per procedure was £359.89 for Phako and £367.57 for ECCE.
CONCLUSION—Phako is clinically superior to ECCE and is cost effective.

 PMID:11423457

  13. Effect of extracapsular cataract extraction and phacoemulsification performed after trabeculectomy on intraocular pressure.

    PubMed

    Manoj, B; Chako, D; Khan, M Y

    2000-01-01

    To determine whether there is a difference in intraocular pressure (IOP) control between extracapsular cataract extraction (ECCE) and phacoemulsification performed after successful trabeculectomy. Eye Unit, St. Woolos Hospital, Newport, United Kingdom. This retrospective study comprised 55 patients with glaucoma who had had trabeculectomy and subsequently had cataract surgery. Extracapsular cataract extraction was performed in 34 eyes and phacoemulsification in 21. The IOP before cataract surgery was used as a baseline for comparison with the IOP at 6 and 12 months and at the last follow-up visit (mean 44.26 months in the ECCE group and 15.09 months in the phacoemulsification group). At the 3 postoperative examinations, the IOP was recorded before and after institution of medical treatment. In the ECCE group, the IOP exceeded the target pressure in 7 eyes and required medical treatment; it remained uncontrolled in 1 eye at the final visit. In the phacoemulsification group, the IOP was less than 18 mm Hg without any medication and within the target pressure in all 21 eyes. The IOP increase after ECCE was statistically significant (mean IOP was 13.61 mm Hg before and 15.53 mm Hg after ECCE; P = .0297). After treatment was instituted, there was no statistically significant difference in the IOP compared with the preoperative value (P = .0796 at 6 months, .677 at 1 year, and .4419 at the final visit in the ECCE group and .0703, .2220, and .1035, respectively, in the phacoemulsification group). The findings indicated that IOP was better controlled by phacoemulsification than by ECCE in patients who had had filtration surgery.

  14. Anti-cataract activity of Pterocarpus marsupium bark and Trigonella foenum-graecum seeds extract in alloxan diabetic rats.

    PubMed

    Vats, V; Yadav, S P; Biswas, N R; Grover, J K

    2004-08-01

    Long-term complications are frequently encountered in diabetes mellitus and are difficult to treat. This study was undertaken to assess the effect of three antidiabetic plants on the development of cataract in rats. An aqueous extract of Pterocarpus marsupium Linn bark (PM, Hindi name: Vijaysar) (1 g kg(-1) day(-1)), Ocimum sanctum Linn leaves (OS, Hindi name, Tulsi) (200 mg kg(-1) day(-1)) and alcoholic extract of Trigonella foenum-graecum Linn seeds (FG, Hindi name, Methi) (2 g kg(-1) day(-1)) were given to alloxan (120 mg kg(-1)) diabetic rats until the development of cataract. Serum glucose and body weight were monitored at regular intervals while cataract was examined through naked eye as well as slit lamp at 75, 100 and 115 days after alloxan administration. Administration of all the three plant extracts exerted a favorable effect on body weight and blood glucose, the effects were best with PM followed by FG and OS. On the course of cataract development, PM followed by FG exerted anti-cataract effect evident from decreased opacity index while OS failed to produce any anti-cataract effect in spite of significant antihyperglycemic activity.

  15. Peroperative microbial contamination of anterior chamber aspirates during extracapsular cataract extraction and phacoemulsification

    PubMed Central

    Beigi, B.; Westlake, W.; Mangelschots, E.; Chang, B.; Rich, W.; Riordan, T.

    1997-01-01

    BACKGROUND—The normal conjunctival flora is one of the main sources of intraocular contamination during cataract surgery. The theory that the positive anterior chamber (AC) pressure during phacoemulsification (phaco), and the smaller wound utilised, might reduce the rate of contamination was studied.
METHODS—The peroperative AC aspirates of 210 consecutive patients undergoing cataract surgery were assessed. In group 1, 100 patients underwent a standard extracapsular cataract extraction (ECCE). In group 2, 110 patients underwent phacoemulsification of the crystalline lens through a scleral tunnel. AC aspirates from the Simcoe irrigation/aspiration cannula (group 1) and phaco probe (group 2) were collected and microbiological studies performed after direct and enrichment cultures.
RESULTS—There were 29 (29%) positives in the ECCE group compared with 22 (20%) positive cultures from AC aspirates in the phaco group. Coagulase negative staphylococcus (CNS) was the commonest contaminant in both groups.
CONCLUSION—Although there was a higher rate of AC contamination during ECCE, the difference was not statistically significant (p> 0.10, χ2=2.31).

 PMID:9505817

  16. Conventional extracapsular cataract extraction and its importance in the present day ophthalmic practice

    PubMed Central

    Mohanty, Preeti; Prasan, Vishnu Vahan; Vivekanand, U.

    2015-01-01

    Purpose: A retrospective study aimed to evaluate high risk cases where conventional Extracapsular cataract extraction (ECCE) was performed, their intra-operative and post-operative outcomes. Setting: Sri Srinivasa Sankara Nethralaya (Tirupati) Tirumala Tirupati Devastanams Central Hospital, Tirupati, India. Subjects and Methods: Retrospective study of 207 patients who underwent ECCE at the hospital between august 2010 to June 2012. Operative data included details like grade of risk, intra and postoperative complications and visual outcome. Results: Out of 207 cases, 188 were in group 3 (moderate risk, 3-5 points) and 19 in group 4 (high risk, 6 points or more). The intra operative complications in group 3 were 8 (0.042%) and none in group 4. Final best corrected visual acuity (BCVA) of 6/12 and more were 184 (88.88%). Final refraction of less than 2.0 astigmatism was seen in 80.19% (n=166). Conclusion: Segregation of cases depending on the risk factors can lead to lower intra operative complications and therefore good postoperative outcome. We believe that phacoemulsification, manual small incision cataract surgery (MSICS) and ECCE each has its own importance and should be used as per the cataract with risk factors. PMID:26903724

  17. Conventional extracapsular cataract extraction and its importance in the present day ophthalmic practice.

    PubMed

    Mohanty, Preeti; Prasan, Vishnu Vahan; Vivekanand, U

    2015-01-01

    A retrospective study aimed to evaluate high risk cases where conventional Extracapsular cataract extraction (ECCE) was performed, their intra-operative and post-operative outcomes. Sri Srinivasa Sankara Nethralaya (Tirupati) Tirumala Tirupati Devastanams Central Hospital, Tirupati, India. Retrospective study of 207 patients who underwent ECCE at the hospital between august 2010 to June 2012. Operative data included details like grade of risk, intra and postoperative complications and visual outcome. Out of 207 cases, 188 were in group 3 (moderate risk, 3-5 points) and 19 in group 4 (high risk, 6 points or more). The intra operative complications in group 3 were 8 (0.042%) and none in group 4. Final best corrected visual acuity (BCVA) of 6/12 and more were 184 (88.88%). Final refraction of less than 2.0 astigmatism was seen in 80.19% (n=166). Segregation of cases depending on the risk factors can lead to lower intra operative complications and therefore good postoperative outcome. We believe that phacoemulsification, manual small incision cataract surgery (MSICS) and ECCE each has its own importance and should be used as per the cataract with risk factors.

  18. Rhizobium (Agrobacterium) radiobacter identified as a cause of chronic endophthalmitis subsequent to cataract extraction.

    PubMed

    Namdari, Hassan; Hamzavi, Sirus; Peairs, Randall R

    2003-08-01

    Herein, we report a case of chronic endophthalmitis caused by a ceftazidime-resistant Rhizobium radiobacter strain in a 62-year-old male. The patient underwent an uneventful cataract extraction of the right eye a week prior to the appearance of symptoms (pain, redness, and blurring vision) which developed following a golf outing. Upon admission the patient received an emergency vitrectomy. The patient remained symptomatic, and R. radiobacter was isolated repeatedly from vitreous fluid cultures over a 5-month period. Ultimately, the infection responded to intravitreal gentamicin, oral ciprofloxacin, and removal of the lens implant.

  19. Effect of methanolic extract of Allium sativum (AS) in delaying cataract in STZ-induced diabetic rats.

    PubMed

    Raju, T Naga; Kanth, V Rajani; Lavanya, K

    2008-03-01

    Glycemic-induced stress is a major culprit contributing to oxidative insult that has far-reaching effects in diabetic cataract worldwide. In an attempt to prevent/delay cataract, many therapeutic agents have been identified, and among these, natural dietary sources have gained pharmacological significance. Hence, we investigated the efficacy of the methanolic garlic extract against diabetic cataract in Wistar rats. Methanolic garlic extract scavenged the transition metal ion-generated H(2)O(2) with an IC(50) of 768.8 +/- 1.76 mug/ml, showing its potential ability as an antioxidant. We have noticed lenticular opacity and oxidative damage in streptozotocin (STZ)-induced hyperglycemic rats. This is evident by the elevation of Ca(2+), Cu(2+), Na(+), Mg(2+), thiobarbituric acid reacting substances (TBARS), and carbonyl content and increased activities of polyol enzymes, glutathione peroxidase (GPx), superoxide dismutase (SOD), and up regulation of iNOS transcript and protein aggregation/cross-linking followed by a decrease in reduced glutathione (GSH), K(+) content, and tryptophan fluorescence in the cataractous lenses of STZ-induced diabetic rats. Garlic administration in a dose-dependent manner attenuated the glycemia-mediated oxidative stress as all the parameters have been found normalized more or less to that of control rats and thus delaying the progression of the lens opacity. We conclude that garlic extract has hypoglycemic and anti oxidant properties that can delay the progression of cataract as revealed in this study.

  20. Cataract Surgery

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Cataracts Sections What Are Cataracts? Cataract Symptoms Who Is ... Pictures and Videos: What Do Cataracts Look Like? Cataract Surgery Written by: Kierstan Boyd Reviewed by: Elena ...

  1. Vitreous loss during conversion from conventional extracapsular cataract extraction to phacoemulsification.

    PubMed

    Ah-Fat, F G; Sharma, M K; Majid, M A; Yang, Y C

    1998-06-01

    To study the outcome of vitreous loss among senior surgeons converting from conventional extracapsular cataract extraction (ECCE) to phacoemulsification. A university teaching hospital in the United Kingdom. A retrospective analysis of 87 planned cataract extractions performed from January 1992 to December 1996 and complicated by vitreous loss was done. Outcome measures included postoperative complication rates and visual acuity. During the study, vitreous loss occurred in 39 patients having ECCE and in 48 having phacoemulsification; the latter group included 8 patients with dropped nucleus. Postoperative complications included cystoid macular edema (18.7% of phaco patients, 30.8% of ECCE patients), retinal detachment (2.1% of phaco patients, 5.1% of ECCE patients), and expulsive hemorrhage (5.1% of ECCE patients). Phaco patients had higher rates of postoperative corneal edema (27.1%) than ECCE patients (12.8%) and transient intraocular pressure elevation (33.3%) versus 20.5%) but were more likely to receive posterior chamber intraocular lenses (70.8% versus 35.9%; P = .0024, chi-square test). After excluding pre-existing diseases, 83.3% of phaco patients and 67.6% of ECCE patients achieved a visual acuity of 6/12 or better. With careful patient selection, experienced extracapsular surgeons converting to phacoemulsification can achieve favorable results even in the presence of complications such as vitreous loss or dropped nucleus.

  2. Effect of Aqueous Extract of Tephrosia purpurea on Cardiovascular Complications and Cataract Associated with Streptozotocin-induced Diabetes in Rats

    PubMed Central

    Bhadada, Shraddha V.; Goyal, R. K.

    2015-01-01

    Tephrosia purpurea has been reported to possess antidiabetic activity, however, its effects on cardiovascular complications and cataract associated with diabetes have not been studied. The objective of the present study was to investigate the effects of aqueous extract of Tephrosia purpurea on cardiovascular complications and cataract associated with streptozotocin-induced diabetes in rats. Sprague Dawley rats of either sex were made diabetic with streptozotocin (45 mg/kg, i.v.). Treatment of aqueous extract of Tephrosia purpurea was given in the dose of 300 and 500 mg/kg/day, p.o for 8 weeks. Various hemodynamic (blood pressure, heart rate, +dp/dt, -dp/dt) and biochemical (serum glucose, cholesterol, triglycerides, creatinine, urea, lactate dehydrogenase and creatinine kinase) parameters were recorded after 8 weeks of the treatment. To evaluate cataract, various biochemical estimations were done in eye lens. Streptozotocin produced hyperglycemia; hypoinsulinemia; hyperlipidemia; increased blood pressure; increased creatinine, cardiac enzymes, reduction in heart rate and cardiac hypertrophy in rats and all these changes were prevented by the treatment with aqueous extract of Tephrosia purpurea in both the doses. Streptozotocin also produced decrease in soluble protein and reduced glutathione in lens of rats that was prevented by aqueous extract of Tephrosia purpurea. Our data suggest that aqueous extract of Tephrosia purpurea prevents not only the streptozotocin-induced metabolic abnormalities but also cardiovascular complications as well as reduce the risk of development of cataract. PMID:26798165

  3. Effect of Aqueous Extract of Tephrosia purpurea on Cardiovascular Complications and Cataract Associated with Streptozotocin-induced Diabetes in Rats.

    PubMed

    Bhadada, Shraddha V; Goyal, R K

    2015-01-01

    Tephrosia purpurea has been reported to possess antidiabetic activity, however, its effects on cardiovascular complications and cataract associated with diabetes have not been studied. The objective of the present study was to investigate the effects of aqueous extract of Tephrosia purpurea on cardiovascular complications and cataract associated with streptozotocin-induced diabetes in rats. Sprague Dawley rats of either sex were made diabetic with streptozotocin (45 mg/kg, i.v.). Treatment of aqueous extract of Tephrosia purpurea was given in the dose of 300 and 500 mg/kg/day, p.o for 8 weeks. Various hemodynamic (blood pressure, heart rate, +dp/dt, -dp/dt) and biochemical (serum glucose, cholesterol, triglycerides, creatinine, urea, lactate dehydrogenase and creatinine kinase) parameters were recorded after 8 weeks of the treatment. To evaluate cataract, various biochemical estimations were done in eye lens. Streptozotocin produced hyperglycemia; hypoinsulinemia; hyperlipidemia; increased blood pressure; increased creatinine, cardiac enzymes, reduction in heart rate and cardiac hypertrophy in rats and all these changes were prevented by the treatment with aqueous extract of Tephrosia purpurea in both the doses. Streptozotocin also produced decrease in soluble protein and reduced glutathione in lens of rats that was prevented by aqueous extract of Tephrosia purpurea. Our data suggest that aqueous extract of Tephrosia purpurea prevents not only the streptozotocin-induced metabolic abnormalities but also cardiovascular complications as well as reduce the risk of development of cataract.

  4. [Trabeculotomy ab interno combined with extracapsular cataract extraction and IOL implantation].

    PubMed

    Alekseev, B N; Ermolaev, A P

    2003-01-01

    We made a total of 96 surgeries of extracapsular cataract extraction and IOL implantation combined with trabeculotomy ab interno during a period of 7 years. Patients with both open-angle and narrow-angle glaucoma of stages I and II and with the intraocular pressure (IOP) below or equal to 23 mm Hg according to Goldman under the conditions of hypotensive medicamental regimen were selected for surgery. After IOL was implanted into the lens bag, trabeculotomy ab interno was implemented as stage 2. A special mirror, introduced through the cataract incision, was used for direct gonioscopic monitoring. The trabecula was incised by the edge of a curved surgical knife under direct visual control. We regarded bleeding from the opened sinus as a favorable sign indicative of that the intrascleral collectors were intact. Only minor hyphemas were registered as postoperative complications; there was not a single case of ciliary-and-choroidal detachment. IOP was compensated for, in 6 months after surgery, in 94% of patients--69.8% of them did not use any hypotensive drops.

  5. Outcome of phacoemulsification and extracapsular cataract extraction: A study in a district hospital in Malaysia.

    PubMed

    Thevi, T; Reddy, S C; Shantakumar, C

    2014-01-01

    The aim of the study was to compare the outcomes of phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE) in a district hospital setting. A retrospective analysis was done from the medical records of the patients who underwent Phaco and ECCE in Temerloh District Hospital, Pahang state between October 2009 and September 2010. The age, gender and ethnicity of the patients, intraoperative and postoperative complications, and the best corrected visual acuity at the last follow-up visit were noted. Statistical analysis was done using Stata Software Version 11.0. The results of the two procedures were compared. Out of the 179 cataract surgeries performed, 146 cases were Phaco and 33 were ECCE. In our study, 82 were men and 97 were women. The age of patients ranged from 39 to 82 years; majority of the patients (71.3%) were more than 60 years of age. There was a significant association between type of surgery and outcome of visual acuity (p = 0.001). There was no significant association between intraoperative complication and type of surgery (p = 0.166). Postoperative complications of the surgeries were not significantly different. Good visual outcome was noted in 80.1% of eyes operated by Phaco compared to 48.5% of eyes operated by ECCE procedure. Since the visual outcome was significantly better in Phaco compared to ECCE procedure (p = 0.001), we recommend that Phaco equipments should be supplied in the district hospitals with adequate facilities for performing intraocular surgery.

  6. Impaired corneal wound healing associated with ketorolac 0.5% after uncomplicated extracapsular cataract extraction.

    PubMed

    Arey, Mark L; Sullivan, Brian R; Reinert, Carol G; McCulley, James P

    2007-12-01

    To describe an apparent association between the use of ketorolac 0.5% (Acular; Allergan) for cystoid macular edema (CME) prophylaxis and impaired corneal wound healing in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation. A retrospective case series reviewing 7 eyes of 7 patients who underwent uncomplicated ECCE with IOL implantation and were treated postoperatively with ketorolac 0.5% 4 times daily as a prophylactic measure against CME. Patients were treated with ketorolac 0.5% 4 times a day for an average of 30 days (range, 20-44 days) after uncomplicated ECCE with IOL implantation. Two eyes developed postoperative endophthalmitis necessitating vitreous tap with intravitreal antibiotic injection; 1 eye went on to require pars plana vitrectomy with corneal wound resuturing. One eye developed corneal wound dehiscence that required wound resuturing in the operating room. One eye developed an inadvertent filtering bleb despite the lack of postoperative suture lysis. Three others were followed up closely postoperatively with slit-lamp evidence of impaired wound healing, manifested by wound avascularity and/or wound gape, and did not require surgical intervention. The use of nonsteroidal anti-inflammatory agents for prophylaxis of CME after cataract surgery is an evolving trend. This retrospective case series showed a possible link between the use of ketorolac 0.5% and impaired corneal wound healing, and caution is urged in the liberal use of this agent postoperatively after ECCE.

  7. A comparison of memory function following local and general anaesthesia for extraction of senile cataract.

    PubMed

    Karhunen, U; Jönn, G

    1982-08-01

    The memory performance of 60 female patients, scheduled for either local or general anaesthesia and extraction of senile cataract, was investigated. Six subtests of the Wechsler Memory Scale and four items of memory tests according to Luria were performed. One week postoperatively there was a diminution in the performance of the Wechsler Memory Scale and Luria tests. Comparison of the pre- and postoperative diminutions between the local and general anaesthesia groups was statistically significant only in the Luria tests. According to this study general anaesthesia does not affect memory function more profoundly than local anaesthesia supplemented with tranquilizing and/or analgesic drugs. In this respect, the advantages of general anesthesia should be utilized, at least in patients without clearcut contraindications.

  8. Sutureless cataract surgery with nucleus extraction: outcome of a prospective study in Nepal

    PubMed Central

    Hennig, A; Kumar, J; Yorston, D; Foster, A

    2003-01-01

    Aim: To report the short and medium term outcome of a prospective series of sutureless manual extracapsular cataract extractions (ECCE) at a high volume surgical centre in Nepal. Methods: Cataract surgery was carried out, on eyes with no co-existing diseases, in 500 consecutive patients who were likely to return for follow up. The technique involved sclerocorneal tunnel, capsulotomy, hydrodissection, nucleus extraction with a bent needle tip hook, and posterior chamber intraocular lens (PC-IOL) implantation according to biometry findings. Surgical complications, visual acuity at discharge, 6 weeks, and 1 year follow up, and surgically induced astigmatism are reported. Results: The uncorrected visual acuity at discharge was 6/18 or better in 76.8% of eyes, and declined to 70.5% at 6 weeks’ follow up, and 64.9% at 1 year. The best corrected visual acuity was 6/18 or better in 96.2% of eyes at 6 weeks and in 95.9% at 1 year. Poor visual outcome (<6/60) occurred in less than 2%. Intraoperative complications included 47 (9.4%) eyes with hyphaema, and one eye (0.2%) with posterior capsule rupture and vitreous in the anterior chamber. Surgery led to an increase in against the rule astigmatism, which was the major cause of uncorrected visual acuity less than 6/18. Six weeks postoperatively, 85.5% of eyes had against the rule astigmatism, with a mean induced cylinder of 1.41 D (SD 0.8). There was a further small increase in against the rule astigmatism of 0.66 D (SD 0.41) between 6 weeks and 1 year. The mean duration of surgery was 4 minutes and the average cost of consumables, including the IOL, was less than $10. Conclusion: Rapid recovery of good vision can be achieved with sutureless manual ECCE at low cost in areas where there is a need for high volume cataract surgery. Further work is required to reduce significant postoperative astigmatism, which was the major cause of uncorrected acuity less than 6/18. PMID:12598434

  9. Ethanol extract of Moringa oliefera prevents in vitro glucose induced cataract on isolated goat eye lens

    PubMed Central

    Kurmi, Raghvendra; Ganeshpurkar, Aditya; Bansal, Divya; Agnihotri, Abhishek; Dubey, Nazneen

    2014-01-01

    Aim of Study: The aim of current work was to evaluate in vitro anticataract potential of Moringa oliefera extract. Materials and Methods: Goat eye lenses were divided into 4 groups; Group served as control, Group II as toxic control, Group III and Group IV were incubated in extract (250 μg/ml and 500 μg/ml of extract of M. oliefera) Group II, III and IV were incubated in 55 mM glucose in artificial aqueous humor to induce lens opacification. Estimation of total, water soluble protein, catalase, glutathione and malondialdehyde along with photographic evaluation of lens was done. Results: Group II (toxic control) lenses showed high amount of MDA (Malondialdehyde), soluble, insoluble protein, decreased catalase and glutathione levels, while lenses treated with Moringa oliefera extract (Group III and Group IV) showed significant (* P < 0.05) reduction in MDA and increased level of catalase, glutathione, total and soluble protein. Conclusion: Results of present findings suggest protective effect of Moringa oliefera in prevention of in vitro glucose induced cataract. PMID:24008789

  10. Ethanol extract of Moringa oliefera prevents in vitro glucose induced cataract on isolated goat eye lens.

    PubMed

    Kurmi, Raghvendra; Ganeshpurkar, Aditya; Bansal, Divya; Agnihotri, Abhishek; Dubey, Nazneen

    2014-02-01

    The aim of current work was to evaluate in vitro anticataract potential of Moringa oliefera extract. Goat eye lenses were divided into 4 groups; Group served as control, Group II as toxic control, Group III and Group IV were incubated in extract (250 μg/ml and 500 μg/ml of extract of M. oliefera) Group II, III and IV were incubated in 55 mM glucose in artificial aqueous humor to induce lens opacification. Estimation of total, water soluble protein, catalase, glutathione and malondialdehyde along with photographic evaluation of lens was done. Group II (toxic control) lenses showed high amount of MDA (Malondialdehyde), soluble, insoluble protein, decreased catalase and glutathione levels, while lenses treated with Moringa oliefera extract (Group III and Group IV) showed significant (FNx01 P < 0.05) reduction in MDA and increased level of catalase, glutathione, total and soluble protein. Results of present findings suggest protective effect of Moringa oliefera in prevention of in vitro glucose induced cataract.

  11. Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery.

    PubMed

    Collier Wakefield, O; Annoh, R; Nanavaty, M A

    2016-04-01

    To assess the relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism correction during cataract surgery. In this cross-sectional study of right eyes of 2247 consecutive patients attending cataract surgery preassessment, data on patient demographics, axial length (AL), anterior chamber depth (ACD), and keratometric astigmatism were collected. Astigmatism was further analyzed as against-the-rule (ATR: steepest meridian 180±30°), with-the-rule (WTR: 90±30°), and oblique (OB: 30-60°or 120-150°). Mean age, AL, and ACD were 72.28±13.84 years, 23.99±1.85 mm and 3.08 ±0.52 mm, respectively. In all, 20.4% eyes had ≤0.50 diopters (D), 55.2% had 0.51-1.50 D, 7.9% had 2.01-3.00 D, and 3.7% eyes had >3.00 D of astigmatism. Overall, 44.2% of eyes had corneal astigmatism >1.00 D. Average astigmatism in age ranges 40-49, 50-59, 60-69, 70-79, 80-89, and 90+ years were 0.82, 1.04, 1.04, 1.02, 1.15 and 2.01 D, respectively. The magnitude of preoperative astigmatism positively correlated with age (P<0.0001), with increasing and decreasing prevalence of ATR and WTR astigmatism, respectively, with advancing age. The magnitude of ATR astigmatism inversely correlates to AL (P<0.0001). ATR astigmatism is more prevalent with increasing magnitude of astigmatism (P<0.0001). A majority of patients for cataract surgery have astigmatism between 0.51 and 1.5 D. ATR astigmatism increases, whereas WTR decreases with age. ATR astigmatism inversely correlates to AL. With increasing age, the magnitude of astigmatism increases and ATR astigmatism becomes increasingly prevalent. The likelihood of a patient requiring astigmatic correction increases with age.

  12. Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery

    PubMed Central

    Collier Wakefield, O; Annoh, R; Nanavaty, M A

    2016-01-01

    Purpose To assess the relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism correction during cataract surgery. Methods In this cross-sectional study of right eyes of 2247 consecutive patients attending cataract surgery preassessment, data on patient demographics, axial length (AL), anterior chamber depth (ACD), and keratometric astigmatism were collected. Astigmatism was further analyzed as against-the-rule (ATR: steepest meridian 180±30°), with-the-rule (WTR: 90±30°), and oblique (OB: 30–60°or 120–150°). Results Mean age, AL, and ACD were 72.28±13.84 years, 23.99±1.85 mm and 3.08 ±0.52 mm, respectively. In all, 20.4% eyes had ≤0.50 diopters (D), 55.2% had 0.51–1.50 D, 7.9% had 2.01–3.00 D, and 3.7% eyes had >3.00 D of astigmatism. Overall, 44.2% of eyes had corneal astigmatism >1.00 D. Average astigmatism in age ranges 40–49, 50–59, 60–69, 70–79, 80–89, and 90+ years were 0.82, 1.04, 1.04, 1.02, 1.15 and 2.01 D, respectively. The magnitude of preoperative astigmatism positively correlated with age (P<0.0001), with increasing and decreasing prevalence of ATR and WTR astigmatism, respectively, with advancing age. The magnitude of ATR astigmatism inversely correlates to AL (P<0.0001). ATR astigmatism is more prevalent with increasing magnitude of astigmatism (P<0.0001). Conclusions A majority of patients for cataract surgery have astigmatism between 0.51 and 1.5 D. ATR astigmatism increases, whereas WTR decreases with age. ATR astigmatism inversely correlates to AL. With increasing age, the magnitude of astigmatism increases and ATR astigmatism becomes increasingly prevalent. The likelihood of a patient requiring astigmatic correction increases with age. PMID:26795412

  13. Cataract (image)

    MedlinePlus

    A cataract is a cloudy or opaque area in the lens of the eye. Cataracts usually develop as a person gets older and ... substances can also accelerate the development of a cataract. Cataracts can cause visual problems such as difficulty ...

  14. Femtosecond laser-assisted keratoplasty combined with cataract extraction in a patient with keratoconus and oculocutaneous albinism

    PubMed Central

    Pásztor, Dorottya; Kolozsvári, Bence Lajos; Losonczy, Gergely; Fodor, Mariann

    2016-01-01

    In this study, we present a case of a 58-year-old male patient with oculocutaneous albinism, keratoconus, total cataract, and glaucoma originating from father-daughter incest. He underwent femtosecond laser-assisted keratoplasty with “open-sky” cataract extraction and posterior chamber intraocular lens implantation. One week after surgery his uncorrected visual acuity improved from hand motion to 20/200. Six months later corneal K values were 49.1 D in the flat and 50.0 D in the steep meridian. The graft had a central corneal thickness of 488 µm and was well fitted. The patient's quality of life improved substantially due to the surgery. To the best of our knowledge, this is the first report on the association of albinism with advanced keratoconus, total cataract, and glaucoma. Moreover, no previous report on femtosecond laser-assisted keratoplasty using VisuMax femtosecond laser system with “open-sky” cataract extraction is available in the literature. The VisuMax femtosecond laser-assisted keratoplasty ensures fast patient rehabilitation in such challenging cases. PMID:27146942

  15. Nystagmus and Related Fixation Instabilities Following Extraction of Unilateral Infantile Cataract in the Infant Aphakia Treatment Study (IATS)

    PubMed Central

    Felius, Joost; Busettini, Claudio; Lynn, Michael J.; Hartmann, E. Eugenie; Lambert, Scott R.

    2014-01-01

    Purpose. To study eye movements in a large group of children after the removal of unilateral infantile cataract, and to compare fixation instabilities between treatment groups with or without IOL implantation. Methods. The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing IOL to contact lens (CL) treatment with a unilateral infantile cataract in participants who underwent cataract surgery at 1 to 6 months of age. At age 4.5 years, eye movements were recorded in 103 participants, using a high-speed video camera while the child performed a fixation task. The recordings were inspected by masked readers for the presence of fixation instabilities (nystagmus and saccadic oscillations). Results. Overall, fixation instabilities were observed in 50 (60%) of 83 children who had evaluable recordings, with no differences between treatment groups (27 [64%] of 42 in the IOL group, 23 [56%] of 41 in the CL group; P = 0.51). Nystagmus was seen in 38% and saccadic oscillations in 31%, with no differences between treatment groups (P > 0.33). Children without a fixation instability had better visual acuity (P = 0.04). Conclusions. Nystagmus and saccadic oscillations are well-known consequences of infantile cataracts, presumably the result of visual deprivation during the critical period of visual development. After early cataract extraction, successful optical correction may reduce further form deprivation and minimize the incidence of these fixation instabilities. In this study, no differences in the presence of fixation instabilities were found between the two treatment strategies (CL or IOL) for optical correction after cataract removal. (ClinicalTrials.gov number, NCT00212134.) PMID:25097243

  16. Risk of retinal detachment after cataract extraction, 1980-2004: a population-based study.

    PubMed

    Erie, Jay C; Raecker, Matthew A; Baratz, Keith H; Schleck, Cathy D; Burke, James P; Robertson, Dennis M

    2006-11-01

    To estimate the long-term cumulative risk of retinal detachment (RD) after cataract extraction (CE). Retrospective cohort study and nested case-control study. All residents of Olmsted County, Minnesota who had CE from 1980 through 2004 (10 256 CEs in 7137 residents) and were diagnosed subsequently with RD in the same period. Two controls chosen from the primary cataract surgery cohort were matched to each RD case by age, gender, and duration of follow-up. Cases were identified through the Rochester Epidemiology Project databases. Records were reviewed to confirm case status and ascertain risk factor information. The observed probability of RD after CE was estimated using the Kaplan-Meier method. A cumulative probability ratio of RD after CE was determined by comparing the observed probability of RD and the expected probability of RD in residents without CE. Logistic regression models assessed differences between cases and controls. Probability of and risk factors associated with RD after CE. Eighty-two cases of RD were identified. The cumulative probability of RD increased in a nearly linear manner over the 25-year study period. At 1, 5, 10, 15, and 20 years after extracapsular CE (ECCE) and phacoemulsification, cumulative probabilities of RD were 0.27%, 0.71%, 1.23%, 1.58%, and 1.79%, respectively. There was no significant difference in the probability of RD after ECCE when compared with phacoemulsification (P = 0.13). The cumulative probability ratio of RD at 20 years after ECCE and phacoemulsification remained 4.0-fold (95% confidence interval, 2.6-5.4) higher than would be expected in a similar group of residents not undergoing CE (P<0.001). Male gender, younger age, myopia, increased axial length, and posterior capsular tear were associated significantly with RD (P<0.01). The cumulative risk of RD after ECCE and phacoemulsification is increased for up to 20 years after surgery.

  17. Syringic Acid Extracted from Herba dendrobii Prevents Diabetic Cataract Pathogenesis by Inhibiting Aldose Reductase Activity

    PubMed Central

    Wei, Xiaoyong; Chen, Dan; Yi, Yanchun; Qi, Hui; Gao, Xinxin; Fang, Hua; Gu, Qiong; Wang, Ling; Gu, Lianquan

    2012-01-01

    Objective. Effects of Syringic acid (SA) extracted from dendrobii on diabetic cataract (DC) pathogenesis were explored. Methods. Both in vitro and in vivo DC lens models were established using D-gal, and proliferation of HLEC exposed to SA was determined by MMT assay. After 60-day treatment with SA, rat lens transparency was observed by anatomical microscopy using a slit lamp. SA protein targets were extracted and isolated using 2-DE and MALDI TOF/TOF. AR gene expression was investigated using qRT-PCR. Interaction sites and binding characteristics were determined by molecule-docking techniques and dynamic models. Results. Targeting AR, SA provided protection from D-gal-induced damage by consistently maintaining lens transparency and delaying lens turbidity development. Inhibition of AR gene expression by SA was confirmed by qRT-PCR. IC50 of SA for inhibition of AR activity was 213.17 μg/mL. AR-SA binding sites were Trp111, His110, Tyr48, Trp20, Trp79, Leu300, and Phe122. The main binding modes involved hydrophobic interactions and hydrogen bonding. The stoichiometric ratio of non-covalent bonding between SA and AR was 1.0 to 13.3. Conclusion. SA acts to prevent DC in rat lenses by inhibiting AR activity and gene expression, which has potential to be developed into a novel drug for therapeutic management of DC. PMID:23365598

  18. Effect of standardized fruit extract of Luffa cylindrica on oxidative stress markers in hydrogen peroxide induced cataract

    PubMed Central

    Dubey, Suchita; Saha, Sudipta; Kaithwas, Gaurav; Saraf, Shubhini A.

    2015-01-01

    Objective: The ability of Luffa cylindrica Roem fruit extract (LCE) to modulate biochemical parameters was investigated by in vitro studies for its role in hydrogen peroxide induced cataract on isolated goat lenses which were incubated for 72 h at 37°C. Materials and Methods: Test groups contained 5, 10, 15, 20, 25, and 30 µg/ml of LCE along with 1 ml of H2O2 (0.5 mM) as cataract inducer. Lenses were examined for morphological variation and transparency periodically during the incubation. Biochemical parameters such as superoxide dismutase (SOD), reduced glutathione (GSH), total protein content (TPC), and malondialdehyde (MDA) were estimated. Results: SOD, GSH, and TPC levels were found to increase proportionally with the concentration of LCE. However, MDA levels were found to be inversely proportional to the concentration of LCE. Opacity was graded as per “lens opacities classification system III.” Morphological examination suggested that LCE (25 µg/ml) maintained a vision for 44 h. No lens in LCE dose groups developed dense nuclear opacity after 24 h as opposed to 80% in negative control. Conclusion: The results suggest that LCE can delay the onset and/or prevent the progression of cataract which can be attributed to the presence of adequate phenolics, flavonoids, and Vitamin A and its high nutritional value. This preliminary study can be further synergized by testing LCE against other in vivo and in vitro models of cataract. PMID:26729957

  19. Effect of standardized fruit extract of Luffa cylindrica on oxidative stress markers in hydrogen peroxide induced cataract.

    PubMed

    Dubey, Suchita; Saha, Sudipta; Kaithwas, Gaurav; Saraf, Shubhini A

    2015-01-01

    The ability of Luffa cylindrica Roem fruit extract (LCE) to modulate biochemical parameters was investigated by in vitro studies for its role in hydrogen peroxide induced cataract on isolated goat lenses which were incubated for 72 h at 37°C. Test groups contained 5, 10, 15, 20, 25, and 30 µg/ml of LCE along with 1 ml of H2O2 (0.5 mM) as cataract inducer. Lenses were examined for morphological variation and transparency periodically during the incubation. Biochemical parameters such as superoxide dismutase (SOD), reduced glutathione (GSH), total protein content (TPC), and malondialdehyde (MDA) were estimated. SOD, GSH, and TPC levels were found to increase proportionally with the concentration of LCE. However, MDA levels were found to be inversely proportional to the concentration of LCE. Opacity was graded as per "lens opacities classification system III." Morphological examination suggested that LCE (25 µg/ml) maintained a vision for 44 h. No lens in LCE dose groups developed dense nuclear opacity after 24 h as opposed to 80% in negative control. The results suggest that LCE can delay the onset and/or prevent the progression of cataract which can be attributed to the presence of adequate phenolics, flavonoids, and Vitamin A and its high nutritional value. This preliminary study can be further synergized by testing LCE against other in vivo and in vitro models of cataract.

  20. Management of plateau iris syndrome with cataract extraction and endoscopic cyclophotocoagulation.

    PubMed

    Hollander, David A; Pennesi, Mark E; Alvarado, Jorge A

    2016-07-28

    Plateau iris configuration describes an anatomic abnormality in which large or anteriorly positioned pars plicata push the iris root forward, thereby narrowing the anterior chamber angle. Plateau iris syndrome (PIS) is diagnosed if the angle remains occludable, either spontaneously or pharmacologically, after iridotomy. PIS has traditionally been treated with chronic pilocarpine or laser peripheral iridoplasty. A series of 9 eyes of 6 patients with PIS, diagnosed by dark room provocative testing and ultrasound biomicroscopy (UBM) following iridotomy, underwent cataract extraction and endoscopic cyclophotocoagulation (ECP). The ciliary body was treated for a median of 180° (range of 120-360°). Post-ECP, the angles in areas treated with ECP were open with corresponding flattened ciliary processes on UBM, while the angles remained occludable in quadrants untreated by ECP despite lens extraction. The mean follow-up time post-ECP was 73.7 ± 34 months (range 11-122 months). The mean IOP was reduced from a baseline of 25.2 ± 10.9 mm Hg on 3.4 ± 1.0 IOP lowering medications to a mean IOP of 17.1 ± 5.3 mm Hg (p < 0.05) on 1.9 ± 1.5, (p < 0.01) medications at last visit. There were no cases of chronic inflammation, eye pain, decreased vision, retinal detachment, or hypotony. Lens extraction and ECP offers an alternative treatment option for patients with PIS, which may directly address the underlying anatomic abnormality leading to angle closure in PIS.

  1. Comparison of phacoemulsification and planned extracapsular cataract extraction in combined pars plana vitrectomy and posterior chamber intraocular lens implantation.

    PubMed

    Hsu, Sheng-Yao; Wu, Wen-Chung

    2005-01-01

    To compare two kinds of cataract removal methods combined with pars plana vitrectomy and posterior chamber intraocular lens (PC-IOL) implantation. Cataract removal was performed by either phacoemulsification or extracapsular cataract extraction (ECCE) and followed by pars plana vitrectomy and PC-IOL implantation. Between May 1996 and June 2001, 31 and 22 patients with cataract and vitreoretinal disease were treated by phacoemulsification and ECCE, respectively, combined with pars plana vitrectomy and PC-IOL implantation. Preoperative demographic data and postoperative vision, astigmatism change, and complications were analyzed. The mean age of patients in the phacoemulsification and ECCE groups was 62.5 and 63.4 years, respectively. Diabetes mellitus was the most common underlying disease resulting in vitreous opacity. Vision improved in 87.1% of the phacoemulsification group and 59.1% of the ECCE group. The change in astigmatism after surgery was 0.92+/-1.08 D (P = .001) in the ECCE group and 0.25+/-0.74 D (P = .087) in the phacoemulsification group. There were fewer postoperative complications, including recurrent vitreous hemorrhage, increased intraocular pressure, and iris changes in the phacoemulsification group than in the ECCE group. Phacoemulsification and ECCE combined with pars plana vitrectomy and PC-IOL implantation are both effective surgical methods to achieve better and more rapid visual rehabilitation for patients with combined cataract and vitreoretinal disease. In this study, phacoemulsification combined with pars plana vitrectomy and PC-IOL implantation resulted in greater improvement in vision, less astigmatism change, and fewer postoperative complications.

  2. Posterior capsule dehiscence during phacoemulsification and manual extracapsular cataract extraction: comparison of outcomes.

    PubMed

    Basti, Surendra; Garg, Prashant; Reddy, Madhukar K

    2003-03-01

    To compare the intraoperative behavior and postoperative outcomes of posterior capsule dehiscence during phacoemulsification and during manual extracapsular cataract extraction (ECCE). L.V. Prasad Eye Institute, Hyderabad, India. This study was a retrospective chart review of consecutive cases of posterior capsule dehiscence over 2 years in patients having phacoemulsification or manual ECCE. A chi-square test was used for statistical comparison of the results in the 2 groups. In the 127 eyes with posterior capsule dehiscence, the incidence of vitreous prolapse was comparable between the 2 groups (phacoemulsification, 61.6%; ECCE, 62.7%). In the phacoemulsification group, vitreous prolapse occurred more frequently if nuclear fragments were present at the time of posterior capsule dehiscence than if they were present during cortex removal (P =.05). Posterior dislocation of nuclear fragments occurred in 4 eyes in the phacoemulsification group. Increased anterior uveitis in the early postoperative period occurred more frequently in the ECCE group (P =.02). The visual outcomes were similar between the 2 groups. Even though differences existed between the intraoperative factors influencing the management of posterior capsule dehiscence during phacoemulsification and ECCE, the final anatomic and visual outcomes were comparable.

  3. Protective effect of the anterior lens capsule during extracapsular cataract extraction. Part I. Experimental animal study.

    PubMed

    Solomon, K D; Gwin, T D; O'Morchoe, D J; Tetz, M R; Hansen, S O; Sugita, A; Imkamp, E M; Apple, D J

    1989-05-01

    In an experimental study using albino Rex rabbits, the intercapsular cataract extraction (ICCE) technique was performed in 20 eyes with a small anterior capsulotomy. A large, can opener capsulotomy was performed in another 20 eyes, and 10 unoperated eyes served as controls. Endothelial cell loss was determined by vital staining with Trypan blue and Alizarin red S stains. Average endothelial cell loss with the ICCE technique was 1.2%; with the can opener technique, the average cell loss was 6.6%. This difference was statistically significant (P less than 0.01). The percentage of endothelial cell loss in the control eyes was 0.5. A positive correlation between endothelial cell loss related to phacoemulsification time and/or the amount of irrigating fluid used existed for the can opener group only (P less than 0.01). These results demonstrate that the presence of an almost intact anterior lens capsule during removal of lens substance is protective to the corneal endothelium.

  4. Posterior lens capsule abscess due to Propionibacterium acnes and Staphylococcus epidermidis following extracapsular cataract extraction.

    PubMed Central

    Manners, R M; Canning, C R

    1991-01-01

    A case of posterior lens capsular abscess occurring many months after an extracapsular cataract extraction is presented. This was caused by a mixed infection involving Propionibacterium acnes and Staphylococcus epidermidis. The significance of Staph epidermidis after such a long postoperative period is uncertain, but the case shows features typical of secondary endophthalmitis due to P acnes, including a long delay in onset and a grumbling course not brought under control by medical treatment. It supports the theory that the nidus of infection is localised in the posterior lens capsule by showing development of a visible capsular abscess with associated vitreous involvement. The subsequent removal of the capsule and vitreous, despite leaving the intraocular lens in place, led to complete resolution of the inflammation. Both organisms have previously been found to be sequestered in the posterior lens capsule by histological and microbiological examination of excised capsular specimens. It is important to consider them as possible causative agents in the formation of a postoperative capsular abscess. Images PMID:1768656

  5. Amblyopia after unilateral infantile cataract extraction after six weeks of age.

    PubMed

    Ejzenbaum, Fábio; Salomão, Solange Rios; Berezovsky, Adriana; Waiswol, Mauro; Tartarella, Márcia Beatriz; Sacai, Paula Yuri; Pereira, Josenilson Martins

    2009-01-01

    To determine interocular grating acuity difference in children treated for unilateral infantile cataract. A group of 27 children previously treated for unilateral infantile cataract, had their monocular visual acuity measured by sweep visual evoked potentials. Interocular grating acuity difference was calculated as the absolute subtraction of monocular acuity scores. Lens status, opacity severity and eye alignment were considered for analysis. Mean interocular grating acuity difference obtained from unilateral cataract patients was 0.58 +/- 0.20 logMAR. This result was significantly larger than 0.10 logMAR used as normative data. Children with severe opacities had a more pronounced amblyopia than the moderate ones. No significant correlation between amblyopia and strabismus or aphakia was found. Interocular acuity difference in this group of unilateral congenital cataract was more pronounced than previous reports, mainly because of delay in diagnosis, surgery and optical correction.

  6. Metabolic syndrome, its components and risk of age-related cataract extraction: a case-control study in Italy.

    PubMed

    Galeone, Carlotta; Petracci, Elisabetta; Pelucchi, Claudio; Zucchetto, Antonella; La Vecchia, Carlo; Tavani, Alessandra

    2010-05-01

    We sought to explore the relationship between age-related cataract extraction and the metabolic syndrome or its various components separately and in various combinations in an Italian case-control study. A total of 761 cases and 1,522 controls in hospital for acute, non-neoplastic, non-ophthalmologic, non-metabolic diseases were interviewed between 1991 and 2003. Odds ratios (ORs), and their 95% confidence intervals (CIs), were computed from multiple logistic regression models, conditioned on sex, age, and study center and adjusted for education and smoking. The ORs were 1.41 for a history of central obesity, 1.42 for hypertension, 1.25 for hyperlipidemia, and 1.16 for diabetes. Patients with the metabolic syndrome (defined as the simultaneous presence of central obesity and at least two other factors among hypertension, hyperlipidemia, diabetes) had an increased risk of cataract, with an OR of 2.01 (95% CI: 1.43-2.83). The ORs were 1.75 for the presence of any of two components and 2.50 for three to four components, with a linear trend in risk. This study indicates that the metabolic syndrome, its components, and their combination are associated with an increased risk of cataract extraction in this Italian population. 2010 Elsevier Inc. All rights reserved.

  7. Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    de Silva, Samantha R; Riaz, Yasmin; Evans, Jennifer R

    2014-01-29

    Age-related cataract is one of the leading causes of blindness worldwide. Therefore, it is important to establish the most effective surgical technique for cataract surgery. The aim of this review is to examine the effects of two types of cataract surgery for age-related cataract: phacoemulsification and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2013), EMBASE (January 1980 to May 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to May 2013), Web of Science Conference Proceedings Citation Index - Science (CPCI-S) (January 1970 to May 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 May 2013. We included randomised controlled trials of phacoemulsification compared to ECCE for age-related cataract. Two authors independently selected and assessed all studies. We defined two primary outcomes: 'good functional vision' (presenting visual acuity of 6/12 or better) and 'poor visual outcome' (best corrected visual acuity of less than 6/60) at three and 12 months after surgery. We also collected data on intra and postoperative complications, and the cost of the procedures. We included 11 trials in this review with a total of 1228 participants, ranging from age 45 to 94. The studies were generally at unclear risk of bias due to poorly reported trial methods. No study reported presenting visual acuity, so we report both uncorrected (UCVA) and best corrected visual acuity (BCVA

  8. Combined cataract and strabismus surgery.

    PubMed

    Gayton, J L; Ledford, J K

    1993-08-01

    A patient with cataracts and congenital exotropia underwent combined cataract and strabismus surgery OU. A lateral rectus recession plus an extracapsular cataract extraction with intraocular lens implantation was done OD first; three months later, this procedure was repeated OS. The patient's postoperative course was benign in both cases, and her strabismus resolved after the second operation. A combined surgical approach to cataracts and strabismus (where only a single muscle is involved) was safe and useful in restoring this patient's vision, binocularity, and appearance.

  9. Vision-specific function and quality of life after cataract extraction in south India.

    PubMed

    Oliver, J E; Thulasiraj, R D; Rahmathullah, R; Baburajan; Katz, J; Tielsch, J M; Schein, O D

    1998-02-01

    To assess visual and overall patient function after intracapsular (ICCE) and extracapsular (ECCE) cataract extraction in rural South India. Aravind Eye Hospital, Tirunelveli, Tamil Nadu, South India, and the Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Baltimore, Maryland, USA. This study evaluated preoperative visual acuity and demographic information and postoperative visual acuity and functional status measures in 71 patients having ECCE with posterior chamber intraocular lens (IOL) placement and 73 patients having ICCE with aphakic spectacle correction at Aravind-Tirunelveli Eye Hospital, Tamil Nadu, India. The principal outcomes assessed were visual acuity; quality-of-life score (possible range 0 to 100%); visual function measurement (possible range 0 to 100%). Patients in the ECCE group scored 10.17 (P = .0001) points higher than those in the ICCE group on the visual function scale after adjustment for differences in age, sex, level of education, marital status, residence, and type of employment. The ECCE group scored 7.69 points higher on visual function when adjusting for the differences in best corrected visual acuity, which was also better in the ECCE group. In the quality-of-life assessment, 77.1% in the ECCE group and 46.6% in the ICCE group scored 90% or better (OR 3.85; P = .006). Patients in rural south India having ECCE with posterior chamber IOL implantation obtained better postoperative visual function, quality of life, and visual acuity than those receiving ICCE with aphakic spectacle correction. These differences, which were not significantly affected by adjustment for age, sex, education, marital status, type of residence, and occupation, indicate that ECCE is clearly superior to ICCE.

  10. Ketorolac-tobramycin combination vs fluorometholone-tobramycin combination in reducing inflammation following phacoemulsification cataract extraction with scleral tunnel incision.

    PubMed

    Guzey, M; Karadede, S; Dogan, Z; Satici, A

    2000-01-01

    The objective of this study was to compare the efficacy of ketorolac-tobramycin combination with fluorometholone-tobramycin combination in the control of ocular inflammation after endocapsular phacoemulsification cataract surgery with scleral tunnel incision. This was a prospective, randomized, investigator masked, 2-week, single-center study. Ocular examinations were carried out preoperatively and postoperatively on days 1 (baseline), 2, 3, 7, and 14. There were 60 patients (30 in each treatment group) undergoing uncomplicated cataract-lens implant surgery enrolled and randomized in the study. The baseline parameters were similar in the two study groups. At each visit comprehensive ocular examinations were performed and a 4-point (0 to 3) grading system was used to record findings of the burning/stinging sensation, blurred vision, ocular discomfort, conjunctival hyperemia, anterior chamber flare, and anterior chamber cells. There was no statistically significant difference between the treatment groups in the findings of the ocular inflammation at any of the postoperative visits. Both treatments were equally well tolerated. This study suggests that ketorolac may be an alternative to some corticosteroids (fluorometholone). It is generally accepted that fluorometholone is not as potent an anti-inflammatory as prednisolone the most commonly used steroid following cataract extraction.

  11. Long-term results of extracapsular cataract extraction and posterior chamber intraocular lens insertion in Nepal.

    PubMed

    Ruit, S; Robin, A L; Pokhrel, R P; Sharma, A; DeFaller, J; Maguire, P T

    1991-01-01

    We performed a prospective study evaluating the 2-year success rate of extracapsular cataract surgery and posterior chamber IOL insertion performed in 610 eyes by an experienced surgeon in the Nepal Eye Hospital, Kathmandu, Nepal. All patients were followed for 2 years. All eyes underwent manual irrigation and aspiration of cortical materials with the insertion of a modified J-loop posterior chamber IOL. Almost one half of eyes had final uncorrected visual acuities of 20/50 or better. Devastating complications, including retinal detachment, corneal decompensation, and endophthalmitis, occurred in 7 (1.2%) eyes. Extracapsular cataract surgery with IOL implantation appears to be a possible alternative in underdeveloped nations where the prevalence of cataract is high and aphakic spectacles are not easily obtained by poor patients and may be lost or broken. The procedure may improve the quality of vision, and therefore the quality of life, in those patients able to obtain pseudophakic vision.

  12. Pupil size after extracapsular cataract extraction and posterior chamber lens implantation: a prospective randomized trial of epinephrine and acetylcholine.

    PubMed

    Elliott, A; Carter, C

    1989-08-01

    The effects of using epinephrine in the irrigating fluid and intracameral acetylcholine were studied by measuring changes in pupil size in the 48 hours following extracapsular cataract extraction and intraocular lens implantation in 39 eyes. Epinephrine reduced peroperative pupil constriction, but its effect was insignificant thereafter. The pupil constriction following acetylcholine was maximal at 2 hours and was still significant at 4 hours, but pupils redilated by 6 hours. Neither drug had any effect after this time. The edge of most lens implants was visible at 6 hours, after which pupils steadily constricted.

  13. A Prospective, Open-label Study to Compare the Efficacy and the Safety of Topical Loteprednol Etabonate and Topical Flurbiprofen Sodium in Patients with Post-Operative Inflammation after Cataract Extraction

    PubMed Central

    Bannale, Sheshidhar G.; Pundarikaksha, H.P.; Sowbhagya, H.N.

    2012-01-01

    Purpose To study the effect of the topical Non-Steroidal Anti Inflammatory Drug (NSAID), Flurbiprofen 0.03%, as an alternative to the topical steroids for the postoperative control of inflammation in cataract surgeries. Methods The effect of the topical NSAID, flurbiprofen sodium 0.03%, was studied and compared with that of the topical steroid – Loteprednol etabonate 0.5% suspension (as eye drops) in a prospective, open labelled study. Both the groups (20 patients each) were similar in the baseline parameters. The postoperative inflammatory response following the standard, small incision, extra capsular cataract extraction was assessed in both the groups for 28 post-operative days. The parameters which were considered for the study were conjunctival hyperaemia, ciliary congestion, corneal oedema, cells in the anterior chamber, aqueous flare and ocular pain. The severity of the postoperative inflammatory responses for both the drugs was graded on the post-operative days 1, 7, 14, 21 and 28 and it was statistically analyzed. Results The 2 groups did not differ statistically in the effect of the treatment for any of the variables, which included aqueous cells, flare, ciliary congestion and conjunctival congestion (p< 0.001). Both the drugs were well tolerated and no severe adverse Drug Reactions (ADRs) were caused by the topical NSAID and the topical steroid. Conclusion The topical NSAID, Flurbiprofen, is as effective as the topical corticosteroid, Loteprednol and it can be used as an alternative in the routine postoperative treatment following uncomplicated cataract surgeries. PMID:23285440

  14. Phacoemulsification versus extracapsular cataract extraction: a comparative study of cell survival and growth on the human capsular bag in vitro

    PubMed Central

    Quinlan, M; Wormstone, I; Duncan, G; Davies, P

    1997-01-01

    AIMS/BACKGROUND—Phacoemulsification is rapidly replacing conventional extracapsular cataract extraction (ECCE) as the method of choice for cataract surgery in the Western world. However, posterior capsule opacification (PCO) still remains the major postoperative complication, affecting 20-50% of patients, and results from persistent cell growth of epithelial cells remaining after surgery. This study aimed to compare cell survival and growth on capsular bags following ECCE and phacoemulsification surgery using an established human capsular bag culture system.
METHODS—Sham ECCE and phacoemulsification cataract operations were performed on pairs of human donor eyes. Capsular bags were dissected free, pinned flat on a petri dish, and incubated with Eagle's minimum essential medium (EMEM) alone or EMEM supplemented with 10% fetal calf serum (FCS). Ongoing observations were made using phase contrast microscopy.
RESULTS—Cell growth was observed across the posterior capsule of all preparations studied. It was found that there was no significant difference in the rate of cell growth on the posterior capsule with the two extraction methods, such that 50% confluency was achieved in 7.0 (SD 1.8) (n=7) days for ECCE and 7.43 (2.1) (n=7) days for phacoemulsification surgery. The physical changes to the capsule as a result of cell growth, such as wrinkling and capsular tensioning, were also seen in both groups.
CONCLUSIONS—Cell survival and growth is dependent on the donor, rather than the surgical technique performed. There is no significant difference between phacoemulsification and ECCE surgery on the rate and nature of cell growth on the posterior capsule in vitro.

 PMID:9486036

  15. Grape seed extract and Zinc containing nutritional food supplement delays onset and progression of Streptozocin-induced diabetic cataract in Wistar rats.

    PubMed

    Satyam, Shakta Mani; Bairy, Laxminaryana Kurady; Pirasanthan, Rajadurai; Vaishnav, Rajdip Lalit

    2015-05-01

    Prevention of hyperglycemia and enhancement of antioxidant defense mechanisms remain major goals in the treatment of diabetic cataract. Earlier, we reported strong anti-hyperglycemic and in vitro antioxidant potential of the combined formulation of grape seed extract and Zincovit tablets. Therefore, the current study was designed to investigate effects of combined formulation of grape seed extract and Zincovit tablets against streptozocin-induced diabetic cataract in Wistar rats. Adult Wistar rats were selected and diabetes was induced by streptozocin (35 mg/kg, i.p) and divided into four groups (group II-V). The normal control (group I) and streptozocin-induced diabetic cataract control rats received only vehicle. Groups III, IV and V animals received orally 40, 80 and 160 mg/kg of combined formulation of Zincovit tablets with grape seed extract respectively for a period of 150 days. The biochemical pathways involved in the pathogenesis of cataract such as oxidative stress, polyol pathway and alterations in adenosine triphosphate, glucose-6-phosphate dehydrogenase and blood glucose were investigated, to understand the possible mechanism of action of combined formulation of grape seed extract and Zincovit tablets. Rats treated with combined formulation of grape seed extract and Zincovit tablets delayed the progression of diabetic cataract as well as it showed significant alterations in oxidative stress markers along with blood glucose, aldose reductase, glucose-6-phosphate dehydrogenase and adenosine triphosphate level in lens. Over all, the results suggest that single combined formulation of grape seed extract and Zincovit tablets may be of great value in delaying diabetic cataract of human subjects as nutritional food supplement.

  16. Effect of oral clonidine on acute intraocular pressure rise after cataract extraction under general anaesthesia.

    PubMed

    Boroojeny, Shahram Borjian; Fard, Maziar Mahjoubi

    2012-12-01

    To evaluate the efficacy of preoperative oral clonidine (5 g/kg) in preventing ocular hypertension in the early period after cataract surgery with posterior chamber intraocular lens implantation under general anaesthesia. This was a randomized double-blind clinical trial comprising of 62 eyes in 62 patients with senile cataract without using any viscoelastics. They were randomly assigned into two groups for preoperative oral clonidine (5 g/kg) and placebo. Intraocular pressure (IOP) was measured 6,12 and 24 hours postoperatively. Mean differences of lOPs at 6 and 12 hours after surgery were significantly lower in clonidine group [+0.41 4.55 (p = 0.612), 0.06 3.62 (p = 0.922)] than placebo group [5.77 4.25 (p = < 0.001), 4.70 3.19p < 0.001)] but was more than preoperative intraocular pressures in both. There was no statistically significant difference between the mean IOP 24hours post operatively in the two groups. But compared to preoperative IOP less increase in mean IOP was seen in clonidine group when compared to placebo group. A single dose of oral clonidine (5 g/kg) preoperatively can produce a significant IOP-lowering effect in early period after cataract surgery, specially in the first 12 hours.

  17. Cataract Vision Simulator

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Cataracts Sections What Are Cataracts? Cataract Symptoms Who Is ... Pictures and Videos: What Do Cataracts Look Like? Cataract Vision Simulator Jun. 11, 2014 How do cataracts ...

  18. Congenital cataract

    MedlinePlus

    ... Congenital and inherited cataracts. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology . 16th ed. Philadelphia, PA: Lippincott ... Cataracts and systemic disease. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology . 16th ed. Philadelphia, PA: Lippincott ...

  19. Predictors of adherence to occlusion therapy three months after cataract extraction in the Infant Aphakia Treatment Study

    PubMed Central

    Drews-Botsch, Carolyn D.; Hartmann, E. Eugenie; Celano, Marianne

    2012-01-01

    Background Little information is available on factors that predict adherence to patching in infants. We evaluated data from the Infant Aphakia Treatment Study (IATS), a randomized clinical trial of treatment for infants with unilateral congenital cataracts, to investigate factors associated with successful adherence to patching protocols. Subjects and Methods In the IATS, patching was prescribed 1 hour daily per month of age until 8 months of age and 50% of waking hours thereafter. A centrally located staff member inquired about adherence to patching in a phone interview with the primary caregiver. Analyses used χ2 tests of independence and logistic regression to identify predictors of reported adherence and of achieving adherence rates of at least 75% (“good”) and 90% (“excellent”). Results A total of 104 caregivers provided data on patching 3 months after surgery, at which time 60% reported patching at least 75% of the prescribed time. Reported adherence was not associated with the type of treatment (P = 0.73) but was better in children with private insurance (P = 0.01) and for children with mothers reporting lower levels of parenting stress (P = 0.03). Conclusions Most caregivers reported being able to adhere to prescribed patching shortly after extraction of a unilateral congenital cataract. The type of correction (IOL vs contact lens) was not associated with the amount of patching achieved, whereas family socioeconomic status and maternal stress appeared to play a role. PMID:22525171

  20. Properties of membranes derived from the total lipids extracted from clear and cataractous lenses of 61–70-year-old human donors

    PubMed Central

    Mainali, Laxman; Raguz, Marija; O'Brien, William J.; Subczynski, Witold K.

    2015-01-01

    Human lens-lipid membranes prepared from the total lipids extracted from clear and cataractous lens cortexes and nuclei of 61–70-year-old donors by use of a rapid solvent-exchange method were investigated. The measured cholesterol-to-phospholipid (Chol/PL) molar ratio in these membranes was 1.8 and 4.4 for cortex and nucleus of clear lenses, respectively, and 1.14 and 1.45 for cataractous lenses. Properties and organization of the lipid bilayer were investigated by use of electron paramagnetic resonance spin-labeling methods. Formation of Chol crystals was confirmed by use of differential scanning calorimetry. Pure cholesterol bilayer domains (CBDs) were formed in all the membranes investigated. It was shown that in clear lens membranes of the nucleus, Chol exists in three different environments: (1) dispersed in phospholipid bilayers (PCDs), (2) in CBDs, and (3) in Chol crystals. In clear lens membranes of the cortex, and in cortical and nuclear cataractous lens membranes, Chol crystals were not detected, because of the lower Chol content. Profiles of membrane properties (alkyl-chain order, fluidity, oxygen transport, and hydrophobicity) across the PCD were very similar for clear and cataractous membranes. Profiles of the oxygen transport parameter across the CBD were, however, different for cortical clear and cataractous membranes—the amount and size of CBDs was less in cataractous membranes. These results suggest that high Chol content, formation of CBDs, and formation of Chol crystals should not be regarded as major predispositions for the development of age-related cataracts. PMID:25502634

  1. Recurrent acute angle-closure attack due to plateau iris syndrome after cataract extraction with or without argon laser peripheral iridoplasty: a case report.

    PubMed

    Choy, Bonnie Nga Kwan; Chan, Jonathan Cheuk Hung; Chien, Carol Pui Yang; Lai, Jimmy Shiu Ming

    2016-05-26

    We describe two cases of recurrent acute angle-closure attack in patients with plateau iris syndrome after cataract extraction. Argon laser peripheral iridoplasty and cataract extraction have been used to reduce the occurrence of acute angle-closure attack in plateau iris syndrome although the risk cannot be completely eliminated. There is no consensus on the long term management of plateau iris syndrome. This is, as far as we know, the first case report of recurrent acute angle-closure attack in plateau iris syndrome after cataract extraction. We report two cases of recurrent acute angle-closure attack in 2 Chinese patients with plateau iris syndrome. The first patient was a 69 year-old woman who received bilateral argon laser peripheral iridoplasty and cataract extraction 2 years prior to the latest acute angle-closure with right eye intraocular pressure 48 mmHg. The attack was aborted medically. Peripheral iridotomy was patent and argon laser peripheral iridoplasty marks were mostly at peripheral 2/3 of the iris. Anterior segment optical coherence tomography confirmed bilateral plateau iris configuration. Use of long term pilocarpine or repeated argon laser peripheral iridoplasty to prevent recurrent angle-closure attack was discussed but she opted for observation. The second patient was a 64 year-old man presented with acute angle-closure after cataract extraction despite placement of laser peripheral iridotomy. Plateau iris syndrome was confirmed by anterior segment optical coherence tomography and he received argon laser peripheral iridoplasty. Acute angle-closure due to plateau iris syndrome can still occur despite previous cataract extraction and argon laser peripheral iridoplasty. These are the first reported cases of recurrent acute angle-closure attack due to plateau iris syndrome following cataract extraction, with or without previous argon laser peripheral iridoplasty. Repeated treatment with argon laser peripheral iridoplasty or pilocarpine could

  2. Risk factors for posterior capsular pearling after uncomplicated extracapsular cataract extraction and plano-convex posterior chamber lens implantation.

    PubMed

    Jamal, S A; Solomon, L D

    1993-05-01

    We retrospectively reviewed 542 consecutive cases of extracapsular cataract extraction with implantation of a plano-convex laser ridge posterior chamber intraocular lens. We were interested in the incidence and probability of the development of postcapsular epithelial pearling that required laser capsulotomy and the risk factors associated with it. After four years of follow-up, 21% of all cases had developed pearling. Over the same period, the probability of pearling, as determined by the Kaplan-Meier curves, was 29% with a 95% confidence interval between 22% and 36%. After one year of follow-up, the probability of pearling was 5%; after two years, 15%; after three years, 24%. Younger age (50 years or less), larger optic, and smaller IOL were identified as significant risk factors when each of these factors was analyzed separately. When all risk factors were studied together, and after applying confounding statistics, only younger age was identified as a significant risk factor (P = .003).

  3. Update on twice-daily bromfenac sodium sesquihydrate to treat postoperative ocular inflammation following cataract extraction

    PubMed Central

    Carreño, Ester; Portero, Alejandro; Galarreta, David J; Herreras, José M

    2012-01-01

    Ophthalmic bromfenac sodium sesquihydrate is a topically applied selective cyclooxygenase (COX)-2 inhibitor. It is similar to amfenac, except for a bromine atom at the C4 of the benzoyl ring position, which markedly affects its in vitro and in vivo potency, extends the duration of anti-inflammatory activity, and enhances its inhibitory effect on COX-2 absorption across the cornea and penetration into ocular tissues. The United States Food and Drug Administration approved bromfenac in 2005 for the treatment of postoperative inflammation and the reduction of ocular pain in patients who have undergone cataract surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs), and among them bromfenac, could be even more effective than steroids at reestablishing the blood–aqueous barrier, as revealed by flare on slit-lamp examination and as quantitatively measured using ocular fluorophotometry. Similar to other NSAIDs, it has a role in inhibiting intraoperative miosis during cataract surgery. However, bromfenac also seems to be useful in other situations, such as refractive surgery, allergic conjunctivitis (not useful in dry eye), choroidal neovascularization, and even ocular oncology. No reports of systemic toxicity have been published and bromfenac has good topical tolerance with a low incidence of adverse effects. PMID:22570544

  4. Fuchs Heterochromic Iridocylitis: Clinical Characteristics and Outcome of Cataract Extraction with Intra Ocular Lens Implantation in a Kashmiri Population- A Hospital Based Study

    PubMed Central

    Lone, Imtiyaz; Mir, Adil Majid; Rashid, Aamir; Latif, Mehreen

    2016-01-01

    Introduction Fuchs Heterochromic Iridocylitis (FHI) is a rare form of uveitis which is frequently complicated by cataract and glaucoma, but it does not show typical features of uveitis like pain, redness and posterior synechia. Aim To study the clinical characteristics and outcome of cataract extraction with Intra Ocular Lens (IOL) implantation in patients with FHI. Materials and Methods The present prospective study was carried out in the Postgraduate Department of Ophthalmology, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Bemina from March 2012 to January 2015. The study included 33 eyes of 32 patients of FHI who underwent thorough clinical examination and cataract surgery with IOL implantation and were evaluated based on their visual outcome and intra and post-operative complications. Post-operative follow-up was done on 1st day, one week, one month, two month, six month and at twelve months. Results Mean age of our study group was 33.9 years (Range 18 to 65 years). No male or female preponderance was seen. There was bilateral involvement of eyes in only one case. Cataract and stellate keratic precipitates were present in all cases whereas, heterochromia was present in only six eyes (18.75%). Best Corrected Visual Acuity (BCVA) showed a significant improvement following cataract surgery (p<0.001). Post-operatively, 26 eyes (78.78%) showed an improvement of four lines or more (BCVA of > 6/12). Most common causes of decreased vision post-operatively were vitreous opacities in nine eyes (27.27%) followed by glaucoma in eight eyes (24.24%) and posterior capsular opacification in six eyes (18.18%). Conclusion Cataract extraction with IOL lens implantation in FHI is a safe procedure associated with good visual prognosis and few complications. However, glaucoma is one of the main concerns and should be closely monitored both pre and post-operatively. PMID:28208900

  5. Simple fixation and storage protocol for preserving the internal structure of intact human donor lenses and extracted human nuclear cataract specimens

    PubMed Central

    Mohamed, Ashik; Gilliland, Kurt O.; Metlapally, Sangeetha; Johnsen, Sönke

    2013-01-01

    Purpose Increased use of phacoemulsification procedures for cataract surgeries has resulted in a dramatic decrease in the availability of cataractous nuclear specimens for basic research into the mechanism of human cataract formation. To overcome such difficulties, a fixation protocol was developed to provide good initial fixation of human donor lenses and extracted nuclei, when available, and is suitable for storing or shipping cataracts to laboratories where structural studies could be completed. Methods Cataractous lens nuclei (n=19, ages 12 to 74 years) were obtained from operating suites after extracapsular extraction. Transparent human donor lenses (n=27, ages 22 to 92 years) were obtained from the Ramayamma International Eye Bank. After the dimensions were measured with a digital caliper, samples were preserved in 10% formalin (neutral buffered) for 24 h and followed by fixation in 4% paraformaldehyde (pH 7.2) for 48 h. Samples were stored cold (4 °C) in buffer until shipped. Samples were photographed and measured before further processing for transmission electron microscopy. Results The dimensions of the samples varied slightly after short fixation followed by 1 to 5 months’ storage before transmission electron microscopy processing. The mean change in the axial thickness of the donor lenses was 0.15±0.21 mm or 3.0±5.4%, while that of the extracted nuclei was 0.05±0.24 mm or 1.8±7.6%. Because the initial concern was whether the nuclear core was preserved, thin sections were examined from the embryonic and fetal nuclear regions. All cellular structures were preserved, including the cytoplasm, complex edge processes, membranes, and junctions. The preservation quality was excellent and nearly equivalent to preservation of fresh lenses even for the lens cortex. Cell damage characteristic of specific nuclear cataract types was easily recognized. Conclusions The novel fixation protocol appears effective in preserving whole donor lenses and cataractous

  6. Microinvasive Glaucoma Stent (MIGS) Surgery With Concomitant Phakoemulsification Cataract Extraction: Outcomes and the Learning Curve.

    PubMed

    Al-Mugheiry, Toby S; Cate, Heidi; Clark, Allan; Broadway, David C

    2017-07-01

    To evaluate learning effects with respect to outcomes of a microinvasive glaucoma stent (MIGS) inserted during cataract surgery in glaucoma patients. Single surgeon, observational cohort study of 25 consecutive Ivantis Hydrus microstent insertions, with a minimum follow-up of 12 months. A learning curve analysis was performed by assessing hypotensive effect, adverse effects, and surgical procedure duration, with respect to consecutive case number. Success was defined with respect to various intraocular pressure (IOP) targets (21, 18, 15 mm Hg) and reduction in required antiglaucoma medications. Complete success was defined as achieving target IOP without antiglaucoma therapy. No clinically significant adverse events or learning effects were identified, although surgical time reduced with consecutive case number. Mean follow-up was 16.8 months. At final follow-up the mean IOP for all eyes was reduced from 18.1 (±3.6) mm Hg [and a simulated untreated value of 25.9 (±5.2) mm Hg] to 15.3 (±2.2) mm Hg (P=0.007; <0.0001) and the mean number of topical antiglaucoma medications was reduced from 1.96 (±0.96) to 0.04 (±0.20) (P<0.0001). Complete success (IOP<21 mm Hg, no medications) was 96% at final follow-up. Complete success (IOP<18 mm Hg, no medications) was 80% at final follow-up, but only 32% with a target IOP of <15 mm Hg (no medications). No significant learning curve effects were observed for a trained surgeon with respect to MIGS microstent insertion performed at the time of cataract surgery. Adjunctive MIGS surgery was successful in lowering IOP to <18 mm Hg and reducing/abolishing the requirement for antiglaucoma medication in eyes with open-angle glaucoma, but less successful at achieving low IOP levels (<15 mm Hg).

  7. Efficacy of combined cataract extraction and endoscopic cyclophotocoagulation for the reduction of intraocular pressure and medication burden

    PubMed Central

    Roberts, Sammie J.; Mulvahill, Matthew; SooHoo, Jeffrey R.; Pantcheva, Mina B.; Kahook, Malik Y.; Seibold, Leonard K.

    2016-01-01

    AIM To report on the efficacy of combined endoscopic cyclophotocoagulation (ECP) and phacoemulsification cataract extraction (PCE) with intraocular lens placement for reduction of intraocular pressure (IOP) and medication burden in glaucoma. METHODS A retrospective case review of 91 eyes (73 patients) with glaucoma and cataract that underwent combined PCE/ECP surgery was performed. Baseline demographic and ocular characteristics were recorded, as well as intraocular pressure, number of glaucoma medications, and visual acuity postoperatively with 12-month follow-up. Treatment failure was defined as less than 20% reduction in IOP from baseline on two consecutive visits (at 1, 3, 6, or 12mo postoperatively), IOP ≥21 mm Hg or ≤5 mm Hg on two consecutive visits, or additional glaucoma surgery performed within 12mo after PCE/ECP. RESULTS Overall, mean medicated IOP was reduced from 16.65 mm Hg at baseline to 13.38 mm Hg at 12mo (P<0.0001). Mean number of glaucoma medications was reduced from 1.88 medications at baseline to 1.48 medications at 12mo (P=0.0003). At 3mo postoperatively, the success rate was 73.6% (95%CI: 63.3, 81.5), 57.1% at 6mo (95% CI: 46.3, 66.6), and 49.7% at 12mo (95%CI: 38.9, 59.6). Patient demographic characteristics were not associated with treatment success. The only ocular characteristic associated with treatment success was a higher baseline IOP. CONCLUSION Combined PCE/ECP surgery is an effective surgical option for the reduction of IOP and medication burden in glaucoma patients. Patients with higher baseline IOP levels are most likely to benefit from this procedure. PMID:27275423

  8. Role of intraocular lens parameters in visual rehabilitation of patients after extracapsular cataract extraction

    NASA Astrophysics Data System (ADS)

    Bakutkin, Valery V.; Galanzha, Vladimir A.

    2001-01-01

    The main method of cataract treatment is micro surgical removing of the opaque lens from the eye with implantation of an intra ocular lens. We performed the comparative study of using various IOL models differing in its materials, index of refraction, spectral properties, configuration, shape, size and other features. Before and after the IOL implantation we performed the following test: visual acuity measuring, refractometry, keratometry, laser interferometric retinometry, color perception assessment, digital photo- and videorecording of the eye with image processing and some others. We found a number of correlations between the IOL properties and some characteristics of the patient's vision. The decentration of the IOL optical part more than 1,5 mm conduced to the non-corneal astigmatism and the prismatic effect. A small diameter of the IOL optical part and high index of refraction promotes to the appearance of the optical aberrations. Leucosapphire IOLs revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. Leucosapphire IOL revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. PMMA IOL revealed the low reflective power and the high adhesive ability. The best color vision was revealed in patients with PMMA IOL with an additional compound absorbing not only UV light but also short-wave blue light.

  9. Stabilisation of refraction following cataract surgery.

    PubMed Central

    Baranyovits, P R

    1988-01-01

    Refraction was performed at frequent, regular intervals for six months following routine intracapsular cataract extraction. Patients were divided into two groups, those whose limbal sections were closed with 8-0 virgin silk or with 9-0 nylon. The stabilisation of refraction was observed, and the most suitable time to prescribe 'first glasses' was estimated retrospectively. In the silk group this was found to be at three months in the nylon group at four months. However, results in the latter were less predictable with greater variation. PMID:3061448

  10. Cataract Surgery in the Glaucoma Patient

    PubMed Central

    Kung, Jennifer S.; Choi, Daniel Y.; Cheema, Anjum S.; Singh, Kuldev

    2015-01-01

    To summarize the role of cataract surgery in the glaucoma patient, in terms of the effect on intraocular pressure (IOP) as well as diagnostic and therapeutic considerations for those with both conditions. Recent evidence suggests that cataract extraction may produce a significant and sustained IOP reduction in individuals with open-angle glaucoma, ocular hypertension, and angle-closure glaucoma. Cataract removal may improve the practitioner's ability to interpret perimetric testing, and re-establishing perimetric and optic nerve imaging baselines is recommended after cataract surgery. The sequence of cataract surgery relative to glaucoma surgery impacts the likelihood of complications and surgical success. There are multiple benefits to perform cataract surgery prior to glaucoma surgery while cataract surgery after trabeculectomy increases the risk of subsequent filtration failure. As “minimally invasive glaucoma surgeries” continue to improve in terms of efficacy, there is an evolving role for combined cataract and glaucoma surgery in patients with early to moderate stages of glaucoma. PMID:25624668

  11. Comparing Laser Peripheral Iridotomy to Cataract Extraction in Narrow Angle Eyes Using Anterior Segment Optical Coherence Tomography

    PubMed Central

    Melese, Ephrem; Peterson, Jeffrey R.; Feldman, Robert M.; Baker, Laura A.; Bell, Nicholas P.; Chuang, Alice Z.

    2016-01-01

    Purpose To evaluate the changes in anterior chamber angle (ACA) parameters in primary angle closure (PAC) spectrum eyes before and after cataract extraction (CE) and compare to the changes after laser peripheral iridotomy (LPI) using anterior segment optical coherence tomography (ASOCT). Methods Twenty-eight PAC spectrum eyes of 18 participants who underwent CE and 34 PAC spectrum eyes of 21 participants who underwent LPI were included. ASOCT images with 3-dimensional mode angle analysis scans were taken with the CASIA SS-1000 (Tomey Corp., Nagoya, Japan) before and after CE or LPI. Mixed-effect model analysis was used to 1) compare best-corrected visual acuity, intraocular pressure, and ACA parameters before and after CE; 2) identify and estimate the effects of potential contributing factors affecting changes in ACA parameters; and 3) compare CE and LPI treatment groups. Results The increase in average angle parameters (TISA750 and TICV750) was significantly greater after CE than LPI. TICV750 increased by 102% (2.114 [±1.203] μL) after LPI and by 174% (4.546 [± 1.582] μL) after CE (P < 0.001). Change of TICV750 in the CE group was significantly affected by age (P = 0.002), race (P = 0.006), and intraocular lens power (P = 0.037). Conclusions CE results in greater anatomic changes in the ACA than LPI in PAC spectrum eyes. ASOCT may be used to follow anatomic changes in the angle after intervention. PMID:27606482

  12. Comparing Laser Peripheral Iridotomy to Cataract Extraction in Narrow Angle Eyes Using Anterior Segment Optical Coherence Tomography.

    PubMed

    Melese, Ephrem; Peterson, Jeffrey R; Feldman, Robert M; Baker, Laura A; Bell, Nicholas P; Chuang, Alice Z; Blieden, Lauren S

    2016-01-01

    To evaluate the changes in anterior chamber angle (ACA) parameters in primary angle closure (PAC) spectrum eyes before and after cataract extraction (CE) and compare to the changes after laser peripheral iridotomy (LPI) using anterior segment optical coherence tomography (ASOCT). Twenty-eight PAC spectrum eyes of 18 participants who underwent CE and 34 PAC spectrum eyes of 21 participants who underwent LPI were included. ASOCT images with 3-dimensional mode angle analysis scans were taken with the CASIA SS-1000 (Tomey Corp., Nagoya, Japan) before and after CE or LPI. Mixed-effect model analysis was used to 1) compare best-corrected visual acuity, intraocular pressure, and ACA parameters before and after CE; 2) identify and estimate the effects of potential contributing factors affecting changes in ACA parameters; and 3) compare CE and LPI treatment groups. The increase in average angle parameters (TISA750 and TICV750) was significantly greater after CE than LPI. TICV750 increased by 102% (2.114 [±1.203] μL) after LPI and by 174% (4.546 [± 1.582] μL) after CE (P < 0.001). Change of TICV750 in the CE group was significantly affected by age (P = 0.002), race (P = 0.006), and intraocular lens power (P = 0.037). CE results in greater anatomic changes in the ACA than LPI in PAC spectrum eyes. ASOCT may be used to follow anatomic changes in the angle after intervention.

  13. Extracapsular cataract extraction training: junior ophthalmology residents' self-reported satisfaction level with their proficiency and initial learning barrier.

    PubMed

    Ting, Daniel Shu Wei; Tan, Sarah; Lee, Shu Yen; Rosman, Mohamad; Aw, Ai Tee; Yeo, Ian Yew San

    2015-07-01

    To investigate residents' self-reported satisfaction level with their proficiency in extracapsular cataract extraction (ECCE) surgery and the initial barriers to learning the procedure. This is a single-centre prospective descriptive case series involving eight first-year ophthalmology residents in Singapore National Eye Center. We recorded the demographics, frequency of review by the residents of their own surgical videos and their satisfaction level with their proficiency at each of the ECCE steps using a 5-point Likert scale. All ECCE surgical videos between October 2013 and May 2014 were collected and analysed for the overall time taken for the surgery and the time taken to perform the individual steps of the procedure. The mean age of the residents was 27.6 ± 1.5 years and 62.5% (5/8) were women. More than half (62.5%, 5/8) reviewed their own surgical videos while 37.5% (3/8) discussed the surgical videos with their peers or supervisors. Of the ECCE steps, the residents were most dissatisfied with their proficiency in performing irrigation and aspiration (87.5%, 7/8), followed by suturing (62.5%, 5/8), intraocular lens insertion (62.5%, 5/8) and tin can capsulotomy (62.5%, 5/8). The average time taken for each ECCE case was 55.0 ± 12.2 min and, of all the steps, most time was spent on suturing (20.5 ± 6.8 min), followed by irrigation and aspiration (5.5 ± 3.6 min) and tin can capsulotomy (3.3 ± 1.8 min). The first-year ophthalmology residents were most dissatisfied with their proficiency in irrigation/aspiration, suturing and tin can capsulotomy. More training needs to be directed to these areas during teaching sessions in the operating room, wet laboratory or cataract simulation training sessions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Senile cataracts and myopia

    SciTech Connect

    Belkin, M.; Jacobs, D.R.; Jackson, S.M.; Zwick, H.

    1982-01-01

    A retrospective survey of 32 persons with myopia and 38 persons with emmetropia who had been operated on at two US Army hospitals on the California coast showed that the persons with myopia who had worn eyeglasses for at least 20 years underwent cataract extraction at a significantly (P less than .00005) older age than the persons with emmetropia (median age at the time of the operation was 70 years, compared with 64 years). These results support the theory that some protection against solar ultraviolet radiation is offered the eyes by eye wear worn continuously and that solar ultraviolet radiation may be a contributing factor in the formation of human senile cataracts.

  15. Treating Cataracts

    MedlinePlus

    ... her experience recently with NIH MedlinePlus magazine. What did you notice about your vision that told you ... how long it would take to recover. Where did you go for information about cataracts and surgery? ...

  16. Cataract: window for systemic disorders.

    PubMed

    Shinohara, Toshimichi; White, Harold; Mulhern, Michael L; Maisel, Harry

    2007-01-01

    Cataract is the leading cause of visual handicap throughout the world, and almost all elderly individuals develop lens opacities. Epidemiological studies have shown that nuclear cataracts in young adults are associated with higher mortality. Many cataractogenic stressors induce endoplasmic reticulum (ER) stress, which in turn induces the unfolded protein response (UPR). The UPR can damage or kill a wide range of cell types and may be involved in many human diseases. We hypothesize that a cataract can be considered a window that can indicate the presence of systemic disorders. This is important because cataract is easily detected during a routine ocular examination. The slightest opacity in any region of the lenses, especially in younger patients, may be a sign of systemic disorders. Earlier detection of systemic disorders can save the lives of patients. If our hypothesis is correct, then elimination of known ER/cataractogenic stressors from individuals with cataracts should be the one of the first steps for treatments of the systemic disorders. We discuss the potential risk factors and beneficial effects of removal of such risk factors in patients with early cataracts. All patients with cataract should be referred for comprehensive medical examination.

  17. Blood-aqueous barrier breakdown after penetrating keratoplasty with simultaneous extracapsular cataract extraction and posterior chamber lens implantation.

    PubMed

    Nguyen, N X; Langenbucher, A; Seitz, B; Graupner, M; Cursiefen, C; Küchle, M; Naumann, G O

    2001-02-01

    The purpose of this study was to quantify breakdown of the blood-aqueous barrier (BAB) following penetrating keratoplasty (PK) with simultaneous extracapsular cataract extraction and posterior chamber lens implantation (triple procedure) and compare it with the alterations following PK only. This study included 72 eyes after triple procedure and 227 eyes after PK only. The diagnosis for PK was Fuchs dystrophy in 39%, keratokonus in 44%, stromal corneal dystrophy in 3% and avascular corneal scars in 6% of cases. The postoperative topical steroid treatment was standardized in both groups. Aqueous flare was quantified using the laser flare-cell meter (FC-1000, Kowa) at defined postoperative intervals (10 days, 6 weeks, then every 3 months until 1 year postoperatively). Patients with conditions associated with impairment of the BAB were excluded from the study. In the early postoperative course, aqueous flare values (photon counts/ms) were significantly higher in patients with triple procedure (21.9 +/- 11.0) than in patients with PK only (9.8 +/- 3.2; P = 0.001). At 6 weeks postoperatively, aqueous flare returned to normal levels in patients after PK only (5.2 +/- 2.3), whereas patients with triple procedure still showed significantly increased flare values (10.8 +/- 5.6; P = 0.01). At 6 months postoperatively, aqueous flare values of patients with triple had returned to normal levels (6.8 +/- 3.8) and did not differ significantly from those after PK only (5.2 +/- 1.9; P = 0.09). Our results indicate that triple procedure causes a more extensive and longer-lasting breakdown of the blood-aqueous barrier than PK only. Quantification of aqueous flare with the laser flare-cell meter is useful in the postoperative follow-up after triple procedure. Further studies are required to investigate the clinical relevance of BAB breakdown on endothelial cell count and the incidence of subsequent immunological graft rejection.

  18. Safety of besifloxacin ophthalmic suspension 0.6% as a prophylactic antibiotic following routine cataract surgery: results of a prospective, parallel-group, investigator-masked study

    PubMed Central

    Malhotra, Ranjan; Gira, Joseph; Berdy, Gregg J; Brusatti, Robert

    2012-01-01

    Background The purpose of this study was to evaluate the safety and tolerability of besifloxacin ophthalmic suspension 0.6% compared with moxifloxacin ophthalmic solution 0.5%, when used for infection prophylaxis following uncomplicated phacoemulsification clear cornea surgery using sutureless corneal incision. Methods This prospective, two-site, parallel-group, investigator-masked clinical study included patients aged ≥18 years scheduled to undergo phacoemulsification with intraocular lens implantation. Patients received one drop of either besifloxacin ophthalmic suspension or moxifloxacin ophthalmic solution four times daily, beginning 3 days prior to surgery, which was continued for 7 days postoperatively. The primary endpoint was the rate of adverse events. Secondary endpoints included endothelial cell count, central corneal thickness, and overall and central corneal staining measured on days 7 (±1 day) and 28 (±2 days) following surgery, and intraocular pressure and best-corrected visual acuity measured on days 1, 7 (±1 day), and 28 (±2 days) following surgery. Results Of the 60 patients enrolled, 58 (29 per treatment group) completed the study. No adverse events were reported in either treatment group. Changes in the central corneal thickness, endothelial cell count, and corneal staining were small and similar between treatments at follow-up visits (P ≥ 0.1549). Intraocular pressure was similar between treatment groups at each visit, as was the distribution of best-corrected visual acuity. The final best-corrected visual acuity was 20/30 or better in 85% of the patients. Conclusion In this study, besifloxacin ophthalmic suspension 0.6% was well tolerated when used prophylactically to prevent postoperative endophthalmitis following sutureless cataract surgery. PMID:22701313

  19. Comparison of prednisolone 1%, rimexolone 1% and ketorolac tromethamine 0.5% after cataract extraction: a prospective, randomized, double-masked study.

    PubMed

    Hirneiss, Christoph; Neubauer, Aljoscha S; Kampik, Anselm; Schönfeld, Carl-Ludwig

    2005-08-01

    To compare the efficacy, safety and patient comfort of two topical steroids (prednisolone 1% and rimexolone 1%) and a topical non-steroidal anti-inflammatory agent (ketorolac tromethamine 0.5%) after extracapsular cataract extraction. Forty-five patients were enrolled in this prospective, randomized, double-blind study. They were assigned to receive topical treatment with either prednisolone, rimexolone or ketorolac tromethamine ophthalmic solution after phacoemulsification for cataract extraction. On postoperative days 1, 3, 5, 14 and 28 best-corrected visual acuity, intraocular pressure (IOP), slit-lamp examination of the anterior segment and report of the patients' comfort were assessed and compared by Friedman rank time analysis. Regarding the primary outcome efficacy of inflammation control the assessment of cells did not differ (p=0.165), while flare in the anterior chamber was lowest (p=0.008) in the non-steroidal anti-inflammatory drug (NSAID) group. Surface inflammation was lowest with prednisolone (p=0.002). Regarding safety, visual acuity did not differ among the groups. In the prednisolone group one patient, however, responded to steroid treatment with elevated IOP and had to be excluded. In the remaining patients IOP was even lower in the two steroidal treatment groups than with ketorolac (p=0.030). One patient receiving ketorolac had to be excluded because a corneal erosion developed. Patient comfort was highest with prednisolone (p=0.041). Ketorolac tromethamine provides good control of intraocular inflammation after cataract extraction without the risk of a steroidal IOP increase, which was also not observed under rimexolone therapy. The best surface inflammation control and patient comfort was observed with prednisolone, which remains a good choice.

  20. [History of cataract operations in Hungary].

    PubMed

    Marsovszky, László

    2013-11-10

    The history of the cataract operations dates back to thousands of years ago. Initially, surgery was carried out using rudimentary operating techniques resulting in the loss of many eyes. Cataract surgery has evolved immersely and now it is a highly refined surgical practice. Evolution of the cataract surgery was closely linked to broadening of anatomical-pathological knowledge and to the development of the instruments applied. Although Daviel performed the first intentional cataract removal in 1747, almost one hundred years passed before the extracapsular cataract extraction method finally replaced the old couching technique. By the middle of the 20th century, with the progression of the operation techniques and instruments, different forms of intracapsular cataract extraction methods became prevalent. Introduction and widespread use of the artificial intraocular lenses from the second half of the 20th century led to the rediscovery and further perfection of the extracapsular cataract extraction technique. Today, phacoemulsification through small incision, along with the foldable intraocular lenses is the gold standard of cataract surgery. The aim of this study is to present the different cataract surgery methods applied throughout the centuries, as well as the difficulties encountered. It discusses pioneering steps of each era, in order to give a closer look at the most frequently performed surgical intervention in ophthalmology.

  1. [Indications for cataract surgery].

    PubMed

    Gloor, B

    1982-09-01

    Progress in surgical methods and advances in the correction of aphakia with contact lenses or intraocular lenses on the one hand, and the greater demands made by patients on the other are the reasons why the cataract surgery is indicated much earlier today than 20 years ago. Occupational considerations and the visual acuity required to keep a driver's licence may be determining factors in the timing of surgery and the choice of one or the other methods o correcting aphakia. To advise the patient correctly, an accurate preoperative assessment of the visual function which can be expected postoperatively has be made. Of the preoperative examinations, results with the test wih the Moiré pattern following Lotmar are mentioned. If the patient's occupation places high demands on visual acuity, as e.g. for bus drivers - 1.0 on the better and 0.8 on the second eye - it seems less risky to go for a contact lens than for an intraocular lens (cystoid macular edema!). Advantages and disadvantages and the special indications and contraindications of correction with cataract glasses, with contact lenses or with different types of intraocular lenses are tabulated. The mathematical conditions which sampling statistics and the success rates of different types of intraocular lenses and surgical procedures have to fulfill, such as extracapsular versus intracapsular cataract extraction, are explained in order to provide a basis of knowledge rather than merely belief. Finally, the indications for different types of surgery in special situations and with different forms of cataract are described, e.g. phakolytic glaucoma, subluxation and luxation of the lens and congenital cataracts.

  2. Long-term change in intraocular pressure after extracapsular cataract extraction with posterior chamber intraocular lens implantation versus phacoemulsification with posterior chamber intraocular lens implantation in Indians.

    PubMed

    Pal, Virendra K; Agrawal, Ajai; Suman, Suwarna; Pratap, V B

    2013-01-01

    The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1(st) month to the 12(th) month. Statistical significance was indicated by P > 0.05. There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P < 0.05, all post-operative visits). After 4(th) monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4(th) month.

  3. Long-Term Change in Intraocular Pressure after Extracapsular Cataract Extraction with Posterior Chamber Intraocular Lens Implantation Versus Phacoemulsification with Posterior Chamber Intraocular Lens Implantation in Indians

    PubMed Central

    Pal, Virendra K; Agrawal, Ajai; Suman, Suwarna; Pratap, V B

    2013-01-01

    Purpose: The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. Materials and Methods: The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1st month to the 12th month. Statistical significance was indicated by P > 0.05. Results: There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P < 0.05, all post-operative visits). After 4th monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. Conclusion: Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4th month. PMID:24339684

  4. The first cataract surgeons in Latin America: 1611–1830

    PubMed Central

    Leffler, Christopher T; Wainsztein, Ricardo D

    2016-01-01

    We strove to identify the earliest cataract surgeons in Latin America. Probably by 1611, the Genovese oculist Francisco Drago was couching cataracts in Mexico City. The surgeon Melchor Vásquez de Valenzuela probably performed cataract couching in Lima by 1697. Juan Peré of France demonstrated cataract couching in Veracruz and Mexico City between 1779 and 1784. Juan Ablanedo of Spain performed couching in Veracruz in 1791. Cataract extraction might have been performed in Havana and Caracas by 1793 and in Mexico by 1797. The earliest contemporaneously documented cataract extractions in Latin America were performed in Guatemala City by Narciso Esparragosa in 1797. In addition to Esparragosa, surgeons born in the New World who established the academic teaching of cataract surgery included José Miguel Muñoz in Mexico and José María Vargas in Caracas. Although cataract surgery came quite early to Latin America, its availability was initially inconsistent and limited. PMID:27143845

  5. Should nylon corneal sutures be routinely removed?

    PubMed Central

    Jackson, H.; Bosanquet, R.

    1991-01-01

    Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery. Images PMID:1751460

  6. [Intraocular hydrodynamics failure as a part of age cataract etiopathogenesis].

    PubMed

    Ignat'ev, S G; Shilkin, G A; Iartseva, N S; Ignat'eva, S G; Al'-Dandan, I Kh

    2011-01-01

    59 (105 eyes) patients with initial, premature and mature cataract are studied. Besides 14 patients (19 eyes) 1-2 years after cataract phacoemulsification with IOL implantation were examined. All patients underwent routine ophthalmological examination and tonography. Average indexes of intraocular hydrodynamics coefficients differed from normal rates: in initial and premature cataract F- coefficient was lower by 34% compared to normal, in mature cataract it was higher by 8,9% than upper limit of normal, in pseudophakia by 86,8% lower. In all groups with cataract patients disbalance of intraocular hydrodynamics was revealed in more than 70% cases, and in pseudophakia group it was found in 100%. Disbalance of intraocular hydrodynamics in cataract confirms hypothesis that intraocular hydrodynamics failure is an important part of cataract etiopathogenesis.

  7. Aging and Health: Cataracts

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Cataracts Basic Facts & Information What are Cataracts? The lens of the eye is a clear ... in the US. The Most Common Types of Cataracts Cataracts are categorized depending on their location. They ...

  8. Pediatric cataract surgery in Nepal.

    PubMed

    Thakur, Jaya; Reddy, Harsha; Wilson, M Edward; Paudyal, Govind; Gurung, Rita; Thapa, Suman; Tabin, Geoffrey; Ruit, Sanduk

    2004-08-01

    To describe the first pediatric cataract surgery case series report from Nepal. Tilganga Eye Center, Kathmandu, Nepal. This study comprised a consecutive series of 112 eyes of 85 children having cataract surgery with intraocular lens (IOL) implantation. General anesthesia of ketamine combined with peribulbar block was used in all patients. Patients' demographics, cataract type and presenting symptoms, surgical intervention, preoperative and postoperative visual acuities, and follow-up clinical examinations were recorded. Seventy-three eyes (65.2%) of 53 patients had extracapsular cataract extraction with posterior capsulotomy, anterior vitrectomy, and posterior chamber IOL implantation (ECCE+PCAP+AV+PCIOL), and 39 eyes (34.8%) of 32 patients had cataract extraction and IOL implantation with an intact posterior capsule (ECCE+PCIOL). Of all patients, the mean age at surgery was 6.2 years +/- 4.3 (SD). The median age in the ECCE+PCAP+AV+PCIOL group was 4.7 years and in the ECCE+PCIOL group, 11.0 years. The mean follow-up was 5.4 +/- 5.3 months. The most common postoperative complication in the ECCE+PCIOL group was visual axis/posterior capsule opacification, which was seen in 18 eyes (46.2%) compared to 4 eyes (5.5%) in the ECCE+PCAP+AV+PCIOL group. Visual acuity improved with surgery in both groups. The leading cause of poor outcomes was deprivation amblyopia. There were no anesthesia-related complications. Implantation of an IOL at the time of cataract extraction under combined systemic ketamine and peribulbar lidocaine anesthesia appeared to be well tolerated and produced significant visual improvement in pediatric patients in Nepal. Primary posterior capsulotomy and AV helped prevent visual axis opacification without a significant increase in complications.

  9. "Ant-egg" cataract revisited.

    PubMed

    Clemmensen, Kåre; Enghild, Jan J; Ivarsen, Anders; Riise, Ruth; Vorum, Henrik; Heegaard, Steffen

    2017-01-01

    Hereditary congenital cataract varies immensely concerning location and form of the lens opacities. A specific and very rare phenotype is called "ant-egg" cataract first described in 1900. "Ant-eggs" have previously been examined using light microscopy, backscattered electron imaging and X-ray scans and electron microscopy. The purpose of this study was to further characterize "ant-egg" cataract using modern technology and display the history of the "ant-eggs" after cataract extraction. "Ant-eggs" were examined using Heidelberg SPECTRALIS Optical Coherence Tomography (OCT)(Heidelberg Engineering, Heidelberg, Germany). Ten "ant-eggs" were extracted; four of these as well as control tissue were analyzed by mass spectrometry (AB Sciex). Proteins were identified and their approximate abundances were determined. Immunohistochemical staining was carried out on the remaining "ant-eggs" for cytokeratin and S100. In anterior OCT-images, the "ant-egg" structures are localized on the iris. Comparative pictures showed that they stayed in the same location for more than 45 years. Mass spectrometry of "ant-eggs" yielded a proteome of 56 different proteins. Eighteen of the 56 "ant-egg" proteins (32 %) were neither present in our controls nor in a known fetal lens proteome. Among these were cytokeratin and Matrix-Gla protein. Immunohistochemical reactions were positive for cytokeratin and S100. This study demonstrates the previously unknown protein composition of the "ant-egg" structures in "ant-egg" cataract. Eighteen of these proteins are not natively found in the human lens. Moreover, "ant-eggs" do not vary over time, after cataract extraction, regarding size and location.

  10. Cataract surgery practices in the United States Veterans Health Administration.

    PubMed

    Havnaer, Annika G; Greenberg, Paul B; Cockerham, Glenn C; Clark, Melissa A; Chomsky, Amy

    2017-04-01

    To describe current cataract surgery practices within the United States Veterans Health Administration (VHA). Veterans Health Administration hospitals in the U.S. Retrospective data analysis. An initial e-mail containing a link to an anonymous 32-question survey of cataract surgery practices was sent to participants in May 2016. Two reminder e-mails were sent to nonresponders 1 week and 2 weeks after the initial survey was sent; the remaining nonresponders were called twice over a 2-week period. The data were analyzed using descriptive statistics. The response rate was 75% (67/89). Cataract surgeons routinely ordered preoperative testing in 29 (45%) of 65 sections and preoperative consultations in 26 (39%) of 66 sections. In 22 (33%) of 66 sections, cataract surgeons administered intracameral antibiotics. In 61 (92%) of 66 sections, cataract surgeons used toric intraocular lenses (IOLs). In 20 (30%) of 66 sections, cataract surgeons used multifocal IOLs. Cataract surgeons in 6 (9%) of 66 sections performed femtosecond laser-assisted cataract surgery. In 6 (9%) of 66 sections, cataract surgeons performed immediate sequential bilateral cataract surgery. Forty-nine (74%) ophthalmology chiefs reported a high level of satisfaction with Veterans Affairs ophthalmology. The survey results indicate that in cataract surgery in the VHA, routine preoperative testing is commonly performed and emerging practices, such as femtosecond laser-assisted cataract surgery and immediate sequential bilateral cataract surgery, have limited roles. The results of this survey could benchmark future trends in U.S. cataract surgery practices, especially in teaching hospital settings. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Daily tonometric curves after cataract surgery

    PubMed Central

    Sacca, S; Marletta, A; Pascotto, A; Barabino, S; Rolando, M; Giannetti, R; Calabria, G

    2001-01-01

    AIM—To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma.
METHODS—108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucleus capture (manual technique with short wound). Intraocular pressure (IOP) was measured by Goldmann tonometry in all patients every 2 hours for 12 hours before the operation and at 1 and 6 months postoperatively.
RESULTS—79 patients completed the 6 month examination. ECCE resulted in greater reductions in IOP than the other procedures (ECCE: 27% and 36% in normal patients and those with POAG, respectively; nucleus capture: 20% and 31%, respectively; phacoemulsification: 19% and 22%, respectively). The fluctuations in IOP before and after surgery were not statistically significant.
CONCLUSION—Cataract surgery in normal patients reduces IOP but does not eliminate fluctuations which are directly proportional to the IOP value and result partly from circadian rhythms. This important finding might influence our approach to treatment of patients with glaucoma.

 PMID:11133707

  12. [Efficacy of topical 0.3% ciprofloxacin application in reducing the conjunctival biota of patients undergoing cataract extraction].

    PubMed

    Carron, A; Samudio, M; Laspina, F; Fariña, N; Sanabria, R R; Cibils, D; Ramirez, L; Carron, J; Mino de Kaspar, H

    2013-09-01

    To determine the efficacy of topical 0.3% ciprofloxacin in reducing conjunctival biota in patients undergoing cataract surgery. Experimental, prospective, randomized, controlled and single-blind study. Forty-six eyes of 46 patients were randomized into 2 groups, the study group (n=23) received topical 0.3% ciprofloxacin one day before surgery for six times, and on the day of the surgery one drop every 15minutes starting one hour before surgery until 3 doses were completed. The control group (n=23) did not receive any antibiotics. For both groups for the surgical field 10% povidone-iodine was applied. Samples from the conjunctiva were taken at four different times and then cultured on solid media (chocolate agar, blood agar) and enrichment broth (thioglycolate). The aqueous humor samples were also cultured in thioglycolate. The presence of bacteria was identified quantitatively and qualitatively, and the frequency of contamination was measured by considering the presence of bacteria in liquid and solid culture media. The number of colony forming units (CFU) was counted in the solid culture medium. Positive cultures were obtained in 82.6% and 78.2% of the patients in the study and control groups, respectively, before the administration of 0.3% ciprofloxacin. The administration of 0.3% ciprofloxacin significantly reduced the CFU compared to the control group (P<.05). Immediately after the use of povidone-iodine, the proportion of patients with a positive culture decreased to 21.7% in the study group, and 8.7% in the control group. At the end of the surgery, this percentage was 26% and 30.4%, respectively. The most common isolated pathogen was negative-coagulase Staphylococcus (66.7%). The administration of 0.3% ciprofloxacin reduces conjunctival bacterial load in the preoperative period. However, it was unable to eradicate the bacteria completely. The administration of povidone-iodine reduced conjunctival biota in 50%-70% of patients undergoing cataract surgery

  13. Prospective evaluation of a new automated nucleic acid extraction system using routine clinical respiratory specimens.

    PubMed

    Mengelle, C; Mansuy, J-M; Sandres-Sauné, K; Barthe, C; Boineau, J; Izopet, J

    2012-06-01

    The aim of the study was to evaluate the MagNA Pure 96™ nucleic acid extraction system using clinical respiratory specimens for identifying viruses by qualitative real-time PCR assays. Three extraction methods were tested, that is, the MagNA Pure LC™, the COBAS Ampliprep™, and the MagNA Pure 96™ with 10-fold dilutions of an influenza A(H1N1)pdm09 sample. Two hundred thirty-nine respiratory specimens, 35 throat swabs, 164 nasopharyngeal specimens, and 40 broncho-alveolar fluids, were extracted with the MagNA Pure 96™ and the COBAS Ampliprep™ instruments. Forty COBAS Ampliprep™ positive samples were also tested. Real-time PCRs were used to identify influenza A and influenza A(H1N1)pdm09, rhinovirus, enterovirus, adenovirus, varicella zoster virus, cytomegalovirus, and herpes simplex virus. Similar results were obtained on RNA extracted from dilutions of influenza A(H1N1)pdm09 with the three systems: the MagNA Pure LC™, the COBAS Ampliprep™, and the MagNA Pure 96™. Data from clinical respiratory specimens extracted with the MagNA Pure 96™ and COBAS Ampliprep™ instruments were in 98.5% in agreement (P < 0.0001) for influenza A and influenza A(H1N1)pdm09. Data for rhinovirus were in 97.3% agreement (P < 0.0001) and in 96.8% agreement for enterovirus. They were in 100% agreement for adenovirus. Data for cytomegalovirus and HSV1-2 were in 95.2% agreement (P < 0.0001). The MagNA Pure 96™ instrument is easy-to-use, reliable, and has a high throughput for extracting total nucleic acid from respiratory specimens. These extracts are suitable for molecular diagnosis with any type of real-time PCR assay.

  14. Cataract and Cognitive Impairment: A Review of the Literature

    PubMed Central

    Jefferis, Joanna M; Mosimann, Urs P; Clarke, Michael P

    2014-01-01

    Acquired cataract and cognitive impairment are both common age related problems, and ophthalmologists are increasingly likely to encounter patients who have both. Dementia types which display early visuo-perceptual impairment may present first to ophthalmology services. When these patients have coexisting cataract it may be difficult to distinguish visual complaints due to cataract from those due to dementia. The interaction between visual impairment due to cataract, and neurodegenerative disorders affecting the central visual pathways, is not fully understood. Visual impairment due to cataract may stress impaired attentional mechanisms, and cataract extraction may improve cognitive performance in some patients with early cognitive impairment; however the benefits of cataract surgery in established dementia are less clear. Here we review the literature on this subject and consider the implications for practice. PMID:20807709

  15. Cataract - Multiple Languages

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Cataract URL of this page: https://medlineplus.gov/languages/cataract.html Other topics A-Z Expand Section ...

  16. Nutritional modulation of cataract

    USDA-ARS?s Scientific Manuscript database

    Cataract, or lens opacification, remains a major cause of blindness worldwide. Cataracts reduce vision in over eighty million people, causing blindness in eighteen million people. The number afflicted by cataract will increase dramatically as the proportion of the elderly global population increase...

  17. Cataracts in Congenital Toxoplasmosis

    PubMed Central

    Arun, Veena; Noble, A. Gwendolyn; Latkany, Paul; Troia, Robert N.; Jalbrzikowski, Jessica; Kasza, Kristen; Karrison, Ted; Cezar, Simone; Sautter, Mari; Greenwald, Mark J.; Mieler, William; Mets, Marilyn B.; Alam, Ambereen; Boyer, Kenneth; Swisher, Charles N.; Roizen, Nancy; Rabiah, Peter; Del Monte, Monte A.; McLeod, Rima

    2008-01-01

    Purpose To determine the incidence and natural history of cataracts in children with congenital toxoplasmosis. Methods Children referred to the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS) between 1981 and 2005 were examined by ophthalmologists at predetermined times according to a specific protocol. The clinical course and treatment of patients who developed cataracts was reviewed. Results In the first year of life, 134 of 173 children examined were treated with pyrimethamine, sulfadiazine, and Leucovorin, while the remaining 39 were not treated. Cataracts occurred in 27 eyes of 20 patients (11.6%, 95% confidence interval [7.2%, 17.3%]). Fourteen cataracts were present at birth, and 13 developed postnatally. Locations of the cataracts included anterior polar (3 eyes), anterior subcapsular (6), nuclear (5), posterior subcapsular (7), and unknown (6). Thirteen cataracts were partial, 9 total, and 5 with unknown complexity. Twelve cataracts remained stable, 12 progressed, and progression was not known for 3. Five of 27 eyes had cataract surgery, with 2 of these developing glaucoma. Sixteen eyes of 11 patients had retinal detachment and cataract. All eyes with cataracts had additional ocular lesions. Conclusions In the NCCCTS cohort, 11.6% of patients were diagnosed with cataracts. There was considerable variability in the presentation, morphology, and progression of the cataracts. Associated intraocular pathology was an important cause of morbidity. PMID:18086432

  18. Gender and use of cataract surgical services in developing countries.

    PubMed Central

    Lewallen, Susan; Courtright, Paul

    2002-01-01

    OBJECTIVE: To determine, from the existing literature, cataract surgical coverage rates by sex and the proportion of cataract blindness that could be eliminated if women and men had equal access to cataract surgical services. METHOD: Methodologically sound population-based cataract surveys from developing countries were identified through a literature search. Cataract surgical coverage rates were extracted from the surveys and rates for women were compared to those for men. Peto odds ratios were calculated for each survey and a meta-analysis of the surveys was performed. FINDINGS: From a literature review and meta-analysis of cataract surveys in developing countries, we found that the cataract surgical coverage rate was 1.2-1.7 times higher for males than for females. For females, the odds ratio of having surgery, compared to males, was 0.67 (95% confidence interval (CI): 0.60- 0.74). Despite their lower coverage rate, females accounted for approximately 63% of all cataract cases in the study populations, and if they received surgery at the same rates as males, the prevalence of cataract blindness would be reduced by a median of 12.5% (range 4-21%). CONCLUSION: Closing the gender gap could thus significantly decrease the prevalence of cataract blindness, and gender-sensitive intervention programmes are needed to improve cataract surgical coverage among females. PMID:12075366

  19. [Comparing patients' quality of life after phacoemulsification with intraocular lens implantation with that after extracapsular cataract extraction with intraocular lens implantation].

    PubMed

    Liu, Jie-wei; Xu, Jing-jing; He, Ming-guang

    2003-02-01

    To Compare the effects of phacoemulsification with intraocular lens implantation (PHACO + IOL) to extracapsular cataract extraction with intraocular lens implantation (ECCE + IOL) on quality of life. The study population consisted of 116 patients receiving PHACO + IOL and 93 patients receiving ECCE + IOL. They were interviewed using the quality of life questionnaire, and the clinical outcomes were obtained before surgery and in 1 week, 1 month, 3 months after surgery respectively. Patients receiving PHACO + IOL reported larger benefit in quality of life and all sub-scales than did those receiving ECCE + IOL in 1 week after surgery. Subjects underwent PHACO + IOL showed better improvement in quality of life and two sub-scales (social and mental) than did those underwent ECCE + IOL in 1 month and 3 months after surgery. However, the improvement in other two sub-scales (self-care and mobility) was similar between two surgical groups in 1 month and 3 months after surgery. The patients receiving PHACO + IOL reported better and more rapid improvement in quality of life within 3 months after surgery. PHACO + IOL and ECCE + IOL have the same effects on improvement in self-care and mobility. So quality of life in patients receiving PHACO + IOL are better than those of ECCE + IOL.

  20. Safety of Besifloxacin Ophthalmic Suspension 0.6% in Cataract and LASIK Surgery Patients

    PubMed Central

    Clinch, Thomas E.

    2014-01-01

    Purpose: The aim of the study was to evaluate the safety of besifloxacin ophthalmic suspension 0.6% as antibacterial prophylaxis in the surgical setting. Methods: Two prospective safety surveillance studies were conducted—one in the cataract surgery setting and the other in the laser-assisted in situ keratomileusis (LASIK) surgery setting. Cases from patients aged 18 years and above were eligible for inclusion. In both surveillance studies, data were collected from consecutive cases of routine primary cataract surgery and LASIK surgery, respectively, in which besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% was used as the topical perioperative prophylactic antibacterial medication as part of the clinician's routine standard of care. The primary safety endpoint was the incidence of treatment-emergent adverse events (TEAEs). Results: The cataract surgery surveillance study included 485 cases/eyes (besifloxacin, n = 333; moxifloxacin, n = 152), whereas the LASIK surveillance study included 456 cases/eyes (besifloxacin, n = 344; moxifloxacin, n = 112). In the cataract study, only 1 TEAE was reported in a besifloxacin case (mild hypersensitivity/allergic reaction considered possibly related to besifloxacin). No TEAEs were reported in the LASIK study. In both studies, surgical outcomes were similar with both treatments. The frequency of preoperative and/or postoperative dosing was generally lower for besifloxacin than that for moxifloxacin. Conclusions: In prospective safety surveillance studies of patients undergoing cataract extraction or LASIK, TEAEs associated with prophylactic use of besifloxacin ophthalmic suspension 0.6% were rare, and surgical outcomes with besifloxacin were similar to those with moxifloxacin ophthalmic solution 0.5%. PMID:24637269

  1. Loss of Thiol Repair Systems in Human Cataractous Lenses

    PubMed Central

    Wei, Min; Xing, Kui-Yi; Fan, Yin-Chuan; Libondi, Teodosio; Lou, Marjorie F.

    2015-01-01

    Purpose. The purpose of this study was to investigate the thiol repair systems of thioltransferase (TTase) and thioredoxin (Trx) and oxidation-damaged proteins in human cataractous lenses. Methods. Cataractous lenses in humans (57–85 years of age) were classified into cortical, nuclear, mixed, mature, and hypermature cataract types by using a lens opacity classification system, and were obtained by extracapsular cataract extraction (ECCE) procedure. Cortical and nuclear cataracts were grouped by decreasing order of visual acuity into optical chart reading (R), counting fingers (CF), hand motion (HM), and light perception (LP). ECCE lens homogenate was analyzed for glutathione (GSH) level and enzyme activities of TTase, glutathione reductase (GR), Trx, and thioredoxin reductase (TR). Cortical and nuclear cataractous lenses (8 of each) with visual acuity better than HM were each dissected into cortical and nuclear portions for measurement of glyceraldehyde 3-phosphate dehydrogenase (G3PD) activity. Clear lenses (in humans 49–71 years of age) were used as control. Results. Compared with control, all cataractous lenses lost more than 80% GSH and 70% GR; TR and Trx activity; and 40% to 70% TTase activity, corroborated with the loss in visual acuity. Among cataracts with R and CF visual acuity, cortical cataract lost more cortical G3PD activity (18% of control) than that of nuclear cataract (50% of control), whereas GSH depletion and TTase inactivation were similar in both cataracts. Conclusions. Thiol repair systems were damaged in all types of cataracts. Cortical and nuclear cataracts showed differential G3PD inactivation in the cortex, implying those 2 type of cataracts might be formed through different mechanisms. PMID:25537203

  2. Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope.

    PubMed Central

    Kirkpatrick, J N; Manivannan, A; Gupta, A K; Hipwell, J; Forrester, J V; Sharp, P F

    1995-01-01

    AIMS--An investigation was carried out to compare the image quality of the ocular fundus obtained clinically, photographically, and with the scanning laser ophthalmoscope (SLO) at visible and infrared wavelengths in patients with significant cataract. METHODS--Nineteen patients admitted for routine cataract extraction were examined clinically by two independent observers to ascertain cataract type and clarity of fundus view with an indirect ophthalmoscope. Fundus photography and both confocal and direct (non-confocal) SLO imaging at 590 nm, 670 nm, and 830 nm were carried out after pupillary dilatation. Images obtained were graded independently using a recognised grading system. RESULTS--Quality of SLO images appeared to be superior to indirect ophthalmoscopy (p < 0.01) and fundus photography (p < 0.001) when graded subjectively. Quantitative analysis of contrast of retinal vessels demonstrated significantly higher contrast for the SLO compared with digitised fundus photographs at all wavelengths tested (p < 0.001), with highest contrast at 590 nm. Use of a confocal aperture significantly improved vessel contrast but may reduce overall image intensity. CONCLUSIONS--Scanning laser ophthalmoscopy may offer a method to observe and record fine fundus detail in patients who have marked cataract. Images PMID:7488576

  3. Health literacy, computer skills and quality of patient-physician communication in Chinese patients with cataract.

    PubMed

    Lin, Xianchai; Wang, Mei; Zuo, Yajing; Li, Mingge; Lin, Xiaofeng; Zhu, Siping; Zheng, Yongxin; Yu, Minbin; Lamoureux, Ecosse L

    2014-01-01

    The aim of the study was to assess levels of health literacy and computer skills in Chinese patients with cataract, and their impact on the doctor-patient relationship. We undertook a cross-sectional study of cataract patients scheduled for cataract extraction procedures in Guangdong Province, China. Generic health literacy was assessed using 3 established screening questions. Adequate computer skills was determined if patients had used a computer and routinely used search engines on the Internet. Socio-demographic measures (e.g., age, sex, education) were obtained from a standardized interview. Participants who indicated that they could not understand what their doctors mean were considered to have had poor patient-physician communications. Of the 211 participants, 92 (43.6%) had inadequate health literacy and 204 (96.7%) inadequate computer skills. In multivariate analysis, females were more likely to have inadequate health literacy (odds ratio = 2.5, 95% confidence intervals [CI]: 1.3 to 4.7). People with inadequately health literacy were more likely to have a poor patient-physician communication (odds ratio = 3.5, 95% CIs: 1.3 to 9.0). Similar associations were found for inadequate computer skills. Chinese elderly patients with cataract have inadequate health literacy and very limited computer skills, which place them at high risk of misunderstanding and mismanaging their ocular conditions. Patient education information other than online materials may improve the eye care and outcomes of these patients.

  4. Establishment of a lens epithelial cell line from a canine mature cataract.

    PubMed

    Kanemaki, Nobuyuki; Saito, Miyoko; Onda, Ken; Maruo, Takuya; Ogihara, Kikumi; Naya, Yuko; Morishita, Taiki; Ochiai, Hideharu

    2012-01-01

    The aim of this study was to establish a lens epithelial cell (LEC) line originated from a cataract of a dog. An anterior capsulorhexis specimen from a dog naturally developing mature cataracts was obtained prior to routine phacoemulsification cataract extraction. The primary lens epithelial cells were transfected with expression plasmid DNA encoding the large T antigen of replication origin-defective simian virus 40 (SV40), and then a colony was cloned using a glass cylinder. The primary cells stopped proliferation in three passages, while the transfected cells remained proliferative. Functional analysis of Na-dependent vitamin C transporter (SVCT) indicated that the Km value toward ascorbic acid (vitamin C) was 19.9 ± 2.8 µM, and RT-PCR analysis showed that SVCT2 was observed in this cell line while SVCT1 was not, which is one of the characteristics of LECs. Western blot analysis and cytoimmunochemistry indicated immortalized cells produced a protein with a molecular mass of 25 kDa, which reacted with an antibody to αB-crystallin within the whole cytosol. The cloned cell line, termed cdLEC, grew well and could be propagated over 250 times by basically splitting at 1:20. These results indicate that cdLEC may also provide a useful in vitro system for the study of the pathophysiology of cataract.

  5. Overview of the current attempts toward the medical treatment of cataract

    SciTech Connect

    Kador, P.F.

    1983-04-01

    A variety of agents are currently available that claim to either prevent, delay, or reverse cataracts associated with aging (senile cataracts), radiation, or diabetes and galactosemia (sugar cataracts). Senile cataract therapy includes formulation containing inorganic salts, nutritional supplements, natural product extracts, sulfhydryl, and sulfonic acid containing compounds and miscellaneous redox and nonsteroidal anti-inflammatory compounds. Agents associated with the treatment of radiation cataracts include antioxidants and free radial scavengers. Aldose reductase inhibitors have been effective in the prevention of sugar cataracts. A summary of these agents and their potential ocular effects are presented.

  6. Measuring aniseikonia using scattering filters to simulate cataract

    NASA Astrophysics Data System (ADS)

    Wilson, Jason

    2011-12-01

    The relationship between anisometropia and aniseikonia (ANK) is not well understood. Ametropic cataract patients provide a unique opportunity to study this relationship after undergoing emmetropizing lens extraction. Because light scatter may affect ANK measurement in cataract patients, its effect should also be evaluated. The Basic Aniseikonia Test (BAT) was evaluated using afocal size lenses to produce specific changes in retinal height. Several light scattering devices were then evaluated to determine which produced effects most similar to cataract. Contrast sensitivity and visual acuity (VA) losses were measured with each device and compared to those reported in cataract. After determining the most appropriate light scattering device, twenty healthy patients with normal visual function were recruited to perform the BAT using the filters to simulate cataract. Cataract patients were recruited from Vision America and the University of Alabama at Birmingham School of Optometry. Patients between 20 and 75 years of age with at least 20/80 VA in each eye, ≥ 2D ametropia, and normal binocular function were recruited. Stereopsis and ANK were tested and each patient completed a symptom questionnaire. ANK measurements using afocal size lenses indicated that the BAT underestimates ANK, although the effect was minimal for vertical targets and darkened surroundings, as previously reported. Based on VA and contrast sensitivity loss, Vistech scattering filters produced changes most similar to cataract. Results of the BAT using Vistech filters demonstrated that a moderate cataract but not a mild cataract may affect the ANK measurement. ANK measurements on cataract patients indicated that those with ≥ 2 D ametropia in each eye may suffer from induced ANK after the first cataract extraction. With upcoming healthcare reform, unilateral cataract extraction may be covered, but not necessarily bilateral, depending on patient VA in each eye. However, a questionnaire about symptoms

  7. Relationships between human cataracts and environmental radiant energy. Cataract formation, light scattering and fluorescence.

    PubMed

    Zigman, S; Sutliff, G; Rounds, M

    1991-01-01

    This preliminary report has two parts. The first is based upon data obtained from a group of cataract patients in southern Florida (USA) with the object of relating the types of cataracts removed to their personal background and their protein biochemistry. Intra-capsular cataract surgery patients at the Venice Eye Clinic (Florida) were interviewed, and their extracted lenses were classified. The parameters were: age, place of residency, occupation, medical and family history and indoor/outdoor activity. Subcapsular cataracts were found mainly in the youngest patients and in those who were in Florida the least. Mixed cataracts predominated in the oldest patients, while non-nuclear cataracts were associated most with outdoor activity. Water-insoluble protein was elevated in nuclei of lenses with nuclear opacities. Soluble proteins in the nuclei of nuclear cataracts had increased levels of voided (heavy) protein, beta-crystallins, and less than 20 Kd peptides. The above changes were enhanced in brunescent cataracts. In lenses with cortical opacities, only increased size heterogeneity in the beta-crystallin region was observed. The second part of this report is based upon direct measurements of the optical properties of freshly extracted intra-capsular cataracts obtained in Rochester, New York (USA). The purpose was to attempt to learn the relative contributions that absorption, scattering, and fluorescence make toward obscuring vision. A general conclusion is that the shorter wavelengths of radiant energy in environmental lighting influence the above-stated optical properties the most, and thus appear to be the major contributors to obscured vision.

  8. [Implantation in severe myopia cataract].

    PubMed

    Metge, P; Ginestet, X; Morin, B; Platon, O

    1989-01-01

    Based upon biometric and statistical analysis of 163 eyes (26 mm or longer), it appears that high myopia cataract occur all the earlier as the eye is long; on average, these were operated on ten years earlier than cataracts in the general population. Extra-capsular extraction and intercapsular implantation were generally used. Pre and post-operative complications are remarkably rare for such abnormal eyes. After a mean period of 22 months, detachment of the retina was observed in 1.84% of patients and secondary capsulotomy performed in 8%. Because they prevent secondary capsular opacification and anterior vitreous propagation, it appears that such barrier-type implants should be systematically placed. Current large-diameter implants allow for vitreoretinal observation. Based upon this patient population, a formula for implant power calculation specific to high myopia has been elaborated. The desired degree of refraction varies with age and patient activity.

  9. The Malaysian Cataract Surgery Registry: Profile of Patients Presenting for Cataract Surgery.

    PubMed

    Salowi, Mohamad Aziz; Goh, Pik-Pin; Lee, Ming-Yueh; Adnan, Tassha Hilda; Ismail, Mariam

    2015-01-01

    To investigate the change in the profile of patients who had cataract surgery at Ministry of Health (MOH) hospitals in Malaysia. Secondary analysis on Malaysian Cataract Surgery Registry data. The Malaysian Cataract Surgery Registry, a MOH-initiated registry, collects data on patients who had cataract surgery at the 36 MOH ophthalmology departments including demography, causes of cataract, systemic and ocular comorbidity, preoperative visual acuity (VA), operative details, and postoperative outcomes. This article reviews data on patient profiles from 2002 to 2004 and 2007 to 2011. The coverage of cataract surgery was 91.5% (171,482/185,388). Mean patient age was 64.5 years, and 51.6% were women. A high proportion of patients had hypertension (48.9%), diabetes mellitus (37.1%), and diabetic retinopathy (10.7%). Most had senile cataract (93.4%) and one third had second eye surgery. Most patients (82.0%) had preoperative unaided VA of worse than 6/12. Eyes presenting with unaided VA of worse than 3/60 decreased from 62.6% in 2002 to 47.7% in 2011, whereas those with 6/18 to 3/60 increased from 35.2% to 48.5% (P < 0.001). Patients who had extracapsular cataract extraction had worse preoperative VA than those who had phacoemulsification (81.3% vs 40% had vision worse than 3/60). The obvious change in patient profiles was the decreasing number of eyes presenting with worse than 3/60 vision. Compared with developed countries, patients who had cataract surgery at MOH hospitals in Malaysia were younger and had higher associations with diabetes mellitus and diabetic retinopathy.

  10. Epidemiology of cataract in India: combating plans and strategies.

    PubMed

    Vajpayee, R B; Joshi, S; Saxena, R; Gupta, S K

    1999-01-01

    Blindness due to cataract presents an enormous problem in India not only in terms of human morbidity but also in terms of economic loss and social burden. The WHO/NPCB (National Programme for Control of Blindness) survey has shown that there is a backlog of over 22 million blind eyes (12 million blind people) in India, and 80.1% of these are blind due to cataract. The annual incidence of cataract blindness is about 3.8 million. The present annual level of performance is in the order of about 1.6-1.9 million cataract operations. To clear the backlog of cataract cases by the year 2000 and to tackle the rising incidence, 5-6 million cataract operations annually will have to be performed as against the present rate of 1. 7 million per year. India is undertaking a new long-term initiative to expand the capability of cataract surgery and service levels with financial assistance from the World Bank. An important feature of this initiative is the attention given to spread the cataract blindness programme in rural and tribal areas. The second feature is the emphasis placed on modern extracapsular cataract extraction with intra-ocular lens implantation as the preferred surgical technique. Another noteworthy feature is developing institutional capacity and appropriate co-ordination mechanisms for collaboration between the non-government organization and the public sector to expand coverage to the most disadvantaged populations. The fourth and the most important strategy is to carry out intensive campaigns at the state and national levels against cataract blindness in order to substantially increase the demand for cataract services. A country like India has more significance for such a plan in view of the fact that various social, economic and environmental factors contribute to cataract blindness in populations at a much younger age.

  11. Nutritional modulation of cataract

    PubMed Central

    Weikel, Karen A; Garber, Caren; Baburins, Alyssa; Taylor, Allen

    2014-01-01

    Lens opacification or cataract reduces vision in over 80 million people worldwide and blinds 18 million. These numbers will increase dramatically as both the size of the elderly demographic and the number of those with carbohydrate metabolism-related problems increase. Preventative measures for cataract are critical because the availability of cataract surgery in much of the world is insuficient. Epidemiologic literature suggests that the risk of cataract can be diminished by diets that are optimized for vitamin C, lutein/zeaxanthin, B vitamins, omega-3 fatty acids, multivitamins, and carbohydrates: recommended levels of micronutrients are salutary. The limited data from intervention trials provide some support for observational studies with regard to nuclear – but not other types of – cataracts. Presented here are the beneficial levels of nutrients in diets or blood and the total number of participants surveyed in epidemiologic studies since a previous review in 2007. PMID:24279748

  12. Multiplex digital colour-coded barcode technology on RNA extracted from routine cytological samples of patients with non-small cell lung cancer: pilot study.

    PubMed

    Sgariglia, Roberta; Pisapia, Pasquale; Nacchio, Mariantonia; De Luca, Caterina; Pepe, Francesco; Russo, Maria; Bellevicine, Claudio; Troncone, Giancarlo; Malapelle, Umberto

    2017-04-06

    In the advanced stages of non-small cell lung cancer (NSCLC), molecular testing is often performed on archival cytological smears. The nCounter system (NanoString Technologies) is a new promising multiplex digital colour-coded barcode technology. However, its feasibility to evaluate the RNA expression of clinical relevant biomarkers on routine cytological smears is still uncertain. To this end, RNA was extracted from 12 NSCLC routine stained cytological smears, and nCounter analysis performed by using a 48-gene panel. Overall, 11/12 (92%) of the smears were adequate for the secondary analysis, fulfilling the quality check parameter analysis of nSolver software. This pilot study shows that RNA nCounter analysis is feasible on routine cytological smears preparing the field for the implementation of this technology in the routine setting.

  13. Outcomes of Cataract Surgery Following Treatment for Retinoblastoma

    PubMed Central

    Kim, Hyeong Min; Lee, Byung Joo; Kim, Jeong Hun

    2017-01-01

    Purpose To evaluate the long-term visual outcomes and complications of cataract surgery in eyes previously treated for retinoblastoma. Methods We reviewed the medical records of patients who underwent cataract extraction and intraocular lens implantation at Seoul National University Children's Hospital for a secondary cataract that developed after retinoblastoma treatment. Results During the period between 1990 and 2014, 208 eyes of 147 patients received eye-salvaging treatment (radiotherapy, chemotherapy, and local therapy) for retinoblastoma at Seoul National University Children's Hospital. Among these eyes, a secondary cataract was detected in 17 eyes of 14 patients, and five eyes of five patients underwent cataract surgery. The median age of cataract formation was 97 months (range, 38 to 153 months). The medial interval between the diagnosis of retinoblastoma and cataract formation was 79 months (range, 29 to 140 months). All patients received posterior chamber intraocular lens insertion after irrigation and aspiration of the lens through a scleral tunnel incision. Anterior vitrectomy and posterior capsulotomy were performed in two eyes and a laser capsulotomy was subsequently performed in one eye. No intraoperative and postoperative complications occurred. The median follow-up after surgery was 36 months (range, 14 to 47 months). The final best corrected visual acuities were improved in all five eyes. No intraocular tumor recurrences or metastases occurred. Conclusions After retinoblastoma regression, cataract extraction in our series was not associated with tumor recurrence or metastasis. Visual improvement was noted in every patient. PMID:28243024

  14. Genetics of Congenital Cataract.

    PubMed

    Pichi, Francesco; Lembo, Andrea; Serafino, Massimiliano; Nucci, Paolo

    2016-01-01

    Congenital cataract is a type of cataract that presents at birth or during early childhood, and it is one of the most easily treatable causes of visual impairment and blindness during infancy, with an estimated prevalence of 1-6 cases per 10,000 live births. Approximately 50% of all congenital cataract cases may have a genetic cause, and such cases are quite heterogeneous. Although congenital nuclear cataract can be caused by multiple factors, genetic mutation remains the most common cause. All three types of Mendelian inheritance have been reported for cataract; however, autosomal dominant transmission seems to be the most frequent. The transparency and high refractive index of the lens are achieved by the precise architecture of fiber cells and homeostasis of the lens proteins in terms of their concentrations, stabilities, and supramolecular organization. Research on hereditary congenital cataract has led to the identification of several classes of candidate genes that encode proteins such crystallins, lens-specific connexins, aquaporin, cytoskeletal structural proteins, and developmental regulators. In this review, we highlight the identified genetic mutations that account for congenital nuclear cataract.

  15. Cataract Surgery in Uveitis

    PubMed Central

    Agrawal, Rupesh; Murthy, Somashiela; Ganesh, Sudha K.; Phaik, Chee Soon; Sangwan, Virender; Biswas, Jyotimai

    2012-01-01

    Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors. PMID:22518338

  16. Evidence-based guidelines for cataract surgery: guidelines based on data in the European Registry of Quality Outcomes for Cataract and Refractive Surgery database.

    PubMed

    Lundström, Mats; Barry, Peter; Henry, Ype; Rosen, Paul; Stenevi, Ulf

    2012-06-01

    In March 2008, the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) commenced. This 3-year project was cofunded by the European Union (EU) and the European Society of Cataract & Refractive Surgeons (ESCRS). The ESCRS became the lead partner in the project with 11 national societies as associated partners. The aims of the project were to improve treatment and standards of care for cataract and refractive surgery and to develop evidence-based guidelines for cataract and refractive surgery across Europe. Surgeons from all participating societies contributed to the database, which contained data on 820,000 cataract surgeries in November 2011. The present guidelines are based on data entered from January 1, 2009, to August 28, 2011 (523,921 cataract extractions). The guidelines include only those steps in the cataract surgery process that can be analyzed by the database. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. [Operation on a congenital cataract in a Siberian Tiger].

    PubMed

    Seitz, R; Weisse, I

    1979-01-01

    A cataract operation in a young Siberian tiger is reported. This 5-month-old tiger, presenting with blindness, showed bilateral residual pupillary membranes and anterior polar cataracts combined with nuclear cataracts. After unilateral intracapsular extraction of the lens, the tiger adapted well to the improvement in sight and behaved almost like an animal with normal vision. The animal died 3 months post-operatively from unknown cause. Histological examination of the aphakic eye showed, at the site of operation on the cornea, an intact epithelium with discrete infiltration of the stroma together with low-grade vascularisation. In the eye not treated operatively, both an anterior polar cataract with adherent pupillary membrane strands and a central cataract were seen. Of particular note, when comparing this large wild cat with the domestic cat, was the marked development of the tapetum lucidum (up to 30 cell layers).

  18. Risk factors for endophthalmitis following cataract surgery-our experience at a tertiary eye care centre in India

    PubMed Central

    Khanna, Rohit C.; Ray, Vanita Pathak; Latha, Madhavi; Cassard, Sandra D; Mathai, Annie; Sekhar, Garudadri C

    2015-01-01

    AIM To determine the risk factors for acute endophthalmitis after cataract extraction in a tertiary care centre in India. METHODS We performed a nested case control study within a retrospective cohort. The surgical records of all patients with clinically diagnosed endophthalmitis within one month after cataract surgery, performed between January 2006 and December 2009, were reviewed. These were compared with randomly selected age and gender-matched controls, from patients having routine cataract surgery within ±1wk of the endophthalmitis case. Univariable and multivariable analysis were performed to identify risk factors for endophthalmitis. RESULTS Of the total 33 856 cataract surgeries performed during this period, there were 57 cases of postoperative acute endophthalmitis that met our study criteria. Thus, the overall incidence of endophthalmitis in our cohort was 1.6 per 1000 cataract extractions performed. Mean age of cases was 55.9y (SD: 10.9y) and for controls was 55.6y (SD: 9.8y). Thirty-five cases (61.4%) and 133 controls (59.6%) were males. Median time of onset of endophthalmitis was 4d (IQR 2-9d; range: 1-30d). Thirty-nine cases (68.4%) presented within 7d and 27 cases (47.4%) were culture positive. Two hundred and twenty-three age and gender matched controls were selected. In multivariate analysis, endophthalmitis was associated with posterior capsular rupture (PCR) during surgery (OR 6.98, 95%CI: 2.22-21.98), phacoemulsification via scleral incision with a foldable intraocular lens (IOL) implantation (OR 3.02, 95%CI: 1.13-8.04) and ocular co-morbidity (OR 2.32, 95%CI: 1.11-4.87). CONCLUSION PCR, presence of ocular co-morbidity, and phacoemulsification via scleral incision with foldable-IOL were found to be independent risk factors for acute endophthalmitis. PMID:26682170

  19. Facts about Cataract

    MedlinePlus

    ... alcohol use). The environment (prolonged exposure to ultraviolet sunlight). What are the symptoms of a cataract? The ... vision. Colors seem faded. Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear ...

  20. Age-related cataract.

    PubMed

    Asbell, Penny A; Dualan, Ivo; Mindel, Joel; Brocks, Dan; Ahmad, Mehdi; Epstein, Seth

    Cataract, opacification of the lens, is one of the commonest causes of loss of useful vision, with an estimated 16 million people worldwide affected. Several risk factors have been identified in addition to increasing age--genetic composition, exposure to ultraviolet light, and diabetes. However, no method to halt the formation of a cataractous lens has been shown to be effective. Nevertheless, advances in surgical removal of cataracts, including small-incision surgery, use of viscoelastics, and the development of intraocular lenses, have made treatment very effective and visual recovery rapid in most cases. Despite these advances, cataract continues to be a leading public-health issue that will grow in importance as the population increases and life expectancy is extended worldwide.

  1. Cataract Surgery Tool

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The NASA-McGannon cataract surgery tool is a tiny cutter-pump which liquefies and pumps the cataract lens material from the eye. Inserted through a small incision in the cornea, the tool can be used on the hardest cataract lens. The cutter is driven by a turbine which operates at about 200,000 revolutions per minute. Incorporated in the mechanism are two passages for saline solutions, one to maintain constant pressure within the eye, the other for removal of the fragmented lens material and fluids. Three years of effort have produced a design, now being clinically evaluated, with excellent potential for improved cataract surgery. The use of this tool is expected to reduce the patient's hospital stay and recovery period significantly.

  2. The Safety and Efficacy of Day Care Cataract Surgery

    PubMed Central

    Cabric, Emir; Zvornicanin, Jasmin; Jusufovic, Vahid

    2014-01-01

    ABSTRACT Purpose: To evaluate safety and efficacy of day care cataract surgery in developing country. Patients and Methods: This prospective study included 200 patients planned for cataract surgery during October and November 2012 divided in to two groups, day care cataract surgery (DCCS) and inpatient cataract surgery (ICS), with same number of male and female patients right and left eyes. All patients had same operative conditions and postoperative follow up. Results: The average age of patients in this study was 68.4 ± 7.47 years. Visual acuity before cataract extraction was 0.1754 where 44.5% of patients had severe visual impairment and another 23% had complicated cataract. Posterior capsule rupture was noted in 4.5% of cases. The main risk factors in both groups were: higher age, female gender, left side, complicated cataract, higher dioptric power of IOL and ECCE. Regular control opthalmologic examinations 30, 90 and 180 days after the cataract extraction did not reveal signs bullous keratopathy, wound dehiscence, cystoid macular edema and endophtalmitis in any of patients. Postoperative visual acuity 180 days after the operation in DCCS was 0.920 ± 0.154 and 0.928 ± 0.144 in ICS. Visual acuity less than 0.5 was noted in 4.5% due to posterior eye segment changes. Patients in DCCS group had 30 control examinations more and 95 days of hospitalization less than ICS with 16.5% cost reduction. Conclusion: The concept of day care cataract surgery is equally safe and more cost effective than inpatient cataract surgery. PMID:24937936

  3. Cataracts - what to ask your doctor

    MedlinePlus

    What to ask your doctor about cataracts; Lens implants - what to ask your doctor ... What is a cataract? How will cataract surgery help my vision? If I have cataracts in both eyes, can I have surgery on ...

  4. Exploiting ensemble learning for automatic cataract detection and grading.

    PubMed

    Yang, Ji-Jiang; Li, Jianqiang; Shen, Ruifang; Zeng, Yang; He, Jian; Bi, Jing; Li, Yong; Zhang, Qinyan; Peng, Lihui; Wang, Qing

    2016-02-01

    Cataract is defined as a lenticular opacity presenting usually with poor visual acuity. It is one of the most common causes of visual impairment worldwide. Early diagnosis demands the expertise of trained healthcare professionals, which may present a barrier to early intervention due to underlying costs. To date, studies reported in the literature utilize a single learning model for retinal image classification in grading cataract severity. We present an ensemble learning based approach as a means to improving diagnostic accuracy. Three independent feature sets, i.e., wavelet-, sketch-, and texture-based features, are extracted from each fundus image. For each feature set, two base learning models, i.e., Support Vector Machine and Back Propagation Neural Network, are built. Then, the ensemble methods, majority voting and stacking, are investigated to combine the multiple base learning models for final fundus image classification. Empirical experiments are conducted for cataract detection (two-class task, i.e., cataract or non-cataractous) and cataract grading (four-class task, i.e., non-cataractous, mild, moderate or severe) tasks. The best performance of the ensemble classifier is 93.2% and 84.5% in terms of the correct classification rates for cataract detection and grading tasks, respectively. The results demonstrate that the ensemble classifier outperforms the single learning model significantly, which also illustrates the effectiveness of the proposed approach.

  5. Mechanisms of senile cataract formation.

    PubMed

    Chylack, L T

    1984-06-01

    Research on the mechanisms of lens opacification during the past 20 years has revealed a number of individual, identifiable cataractogenic stresses in man. They include osmotic cataract formation (diabetic, galactosemic and hypoglycemic cataracts), radiation cataracts (X-irradiation, near U.V. radiation and microwave radiation) and in senile cataract the conversion of soluble low molecular weight cytoplasmic proteins to soluble high molecular weight aggregates, insoluble phases, and insoluble membrane-protein matrices. Oxidative stress has emerged as a common denominator of many changes in senile cataract. As we increase our understanding of these mechanisms, we may be able to intervene therapeutically to delay or prevent human cataract formation in man.

  6. Cataract and Cataract Surgery: Nationwide Prevalence and Clinical Determinants.

    PubMed

    Park, Sang Jun; Lee, Ju Hyun; Kang, Se Woong; Hyon, Joon Young; Park, Kyu Hyung

    2016-06-01

    This study aimed to investigate the prevalence and clinical determinants of cataract and cataract surgery in Korean population. The 2008-2012 Korean National Health and Nutrition Examination Survey was analyzed, which included 20,419 participants aged ≥ 40 years. The survey is a multistage, probability-cluster survey, which can produce nationally representative estimates. Prevalence of cataract and cataract surgery was estimated. Clinical determinants for those were investigated using logistic regression analyses (LRAs). The prevalence of cataract was 42.28% (95% confidence interval [CI], 40.67-43.89); 40.82% (95% CI, 38.97-42.66) for men and 43.62% (95% CI, 41.91-45.33) for women (P = 0.606). The prevalence of cataract surgery was 7.75% (95% CI, 7.30-8.20); 6.38% (95% CI, 5.80-6.96) for men and 9.01% (95% CI, 8.41-9.61) for women (P < 0.001). Cataract was associated with older age (P < 0.001), men (P = 0.032), lower household income (P = 0.031), lower education (P < 0.001), hypertension (P < 0.001), and diabetes mellitus (DM) (P < 0.001). Cataract surgery was consistently associated with older age, occupation, DM, asthma, and anemia in two LRAs, which compared participants with cataract surgery to those without cataract surgery and those having a cataract but without any cataract surgery, respectively. Hypertension, arthritis, and dyslipidemia were associated with cataract surgery at least in one of these LRAs. These results suggest that there are 9.4 million individuals with cataract and 1.7 million individuals with cataract surgery in Korea. Further studies are warranted to reveal the causality and its possible mechanism of developing/exacerbating cataract in novel determinants (i.e., anemia, asthma, and arthritic conditions) as well as well-known determinants.

  7. Cataract and Cataract Surgery: Nationwide Prevalence and Clinical Determinants

    PubMed Central

    2016-01-01

    This study aimed to investigate the prevalence and clinical determinants of cataract and cataract surgery in Korean population. The 2008–2012 Korean National Health and Nutrition Examination Survey was analyzed, which included 20,419 participants aged ≥ 40 years. The survey is a multistage, probability-cluster survey, which can produce nationally representative estimates. Prevalence of cataract and cataract surgery was estimated. Clinical determinants for those were investigated using logistic regression analyses (LRAs). The prevalence of cataract was 42.28% (95% confidence interval [CI], 40.67–43.89); 40.82% (95% CI, 38.97–42.66) for men and 43.62% (95% CI, 41.91–45.33) for women (P = 0.606). The prevalence of cataract surgery was 7.75% (95% CI, 7.30–8.20); 6.38% (95% CI, 5.80–6.96) for men and 9.01% (95% CI, 8.41–9.61) for women (P < 0.001). Cataract was associated with older age (P < 0.001), men (P = 0.032), lower household income (P = 0.031), lower education (P < 0.001), hypertension (P < 0.001), and diabetes mellitus (DM) (P < 0.001). Cataract surgery was consistently associated with older age, occupation, DM, asthma, and anemia in two LRAs, which compared participants with cataract surgery to those without cataract surgery and those having a cataract but without any cataract surgery, respectively. Hypertension, arthritis, and dyslipidemia were associated with cataract surgery at least in one of these LRAs. These results suggest that there are 9.4 million individuals with cataract and 1.7 million individuals with cataract surgery in Korea. Further studies are warranted to reveal the causality and its possible mechanism of developing/exacerbating cataract in novel determinants (i.e., anemia, asthma, and arthritic conditions) as well as well-known determinants. PMID:27247507

  8. Simultaneous Penetrating Keratoplasty and Cataract Surgery

    PubMed Central

    Javadi, Mohammad-Ali; Feizi, Sepehr; Moein, Hamid-Reza

    2013-01-01

    Purpose To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK), cataract removal and intraocular lens implantation (triple procedure), and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either open- sky extracapsular cataract extraction (ECCE) or phacoemulsification (PE). In the ECCE group, the posterior chamber intraocular lens (PCIOL) was implanted in the ciliary sulcus, while in the PE group PCIOLs were fixated within the capsular bag. Outcome measures included best spectacle corrected visual acuity (BSCVA), refractive results, graft clarity and complications. Results Seventy-six eyes of 69 consecutive patients with mean age of 61.4±14.2 years were enrolled. Mean follow-up period was 61.4±37.2 months over which mean BSCVA was significantly improved from 1.40±0.68 to 0.44±0.33 LogMAR (P<0.001). Mean postoperative spherical equivalent refractive error was -2.13±3.02 D, which significantly differed from the target refraction (-0.73±0.29 D, P=0.004). At final follow-up, 89.5% of the corneal grafts remained clear. Conclusion The triple procedure is a safe and effective approach to restore vision in patients with coexisting corneal pathologies and cataracts. However, unacceptable postoperative refractive error can be anticipated. PMID:23825711

  9. An ROP screening dilemma: hereditary cataracts developing in a premature infant after birth.

    PubMed

    Marcus, Inna; Salchow, Daniel J; Stoessel, Kathleen M; Levada, Andrew J

    2012-02-14

    A female infant born prematurely at 23 weeks' gestational age developed bilateral hereditary cataracts at post-menstrual age 33 weeks, which precluded retinopathy of prematurity screening. The infant underwent right cataract extraction 1 week later, and retinopathy of prematurity was monitored by examining the right eye. In the seventeenth week of life (post-menstrual age 40 weeks), the cataract was removed from the left eye. Visual outcome at 19 months of age was good in both eyes. Very early cataract extraction may be necessary in premature infants to allow ROP evaluations.

  10. Virtual Mentor Cataract Surgery Trainer

    DTIC Science & Technology

    2009-09-01

    AD_________________ AWARD NUMBER: W81XWH-08-1-0531 TITLE: Virtual Mentor Cataract Surgery Trainer...REPORT TYPE Annual 3. DATES COVERED 20 Aug 2008 – 19 Aug 2009 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Virtual Mentor Cataract Surgery ...Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Virtual Mentor Cataract Surgery Trainer is a computer based, cognitive

  11. The value of serial personal photographs in timing the onset of unilateral cataracts in children.

    PubMed

    Sawhney, Gagan K; Hutchinson, Amy K; Lambert, Scott R

    2009-10-01

    To determine the value of serial personal photographs in timing the onset of unilateral cataracts in children over 6 months of age. Personal photographs from children with unilateral cataracts who underwent cataract extraction and intraocular lens implantation when > or =6 months of age were reviewed. Photographs were evaluated for changes in the red reflex, which might indicate the presence of a cataract. Twelve children underwent cataract surgery at a mean age of 37 months. They were followed for a mean of 32 months. Ten children were diagnosed as having an acquired cataract by photographic review documenting a previously normal red reflex. The visual acuity in the affected eye of 4 of these children improved to > or =20/60. Cataracts were visible on photographs prior to clinical diagnosis in 6 patients, from 0.5 to 22 months prior to clinical diagnosis. Visual outcomes did not relate closely to the photographically documented duration of the cataract prior to treatment. Photographs were not helpful in timing the onset of cataract in 2 children due to the poor quality of the images. Serial personal photographs are sometimes helpful in determining whether cataracts are acquired. However, the usefulness of personal photographs alone in predicting the visual outcome after cataract surgery was limited in this small, retrospective study.

  12. Cataracts in Kasei Valles

    NASA Image and Video Library

    2017-08-07

    Cataracts are large landforms, and this oblique image from NASA's Mars Reconnaissance Orbiter covers only a small area of the innermost channel. The ridged material on the channel floor may be a lava flow that followed this channel after it was initially carved by giant floods of water.Obviously these are not the kind of cataracts that can develop in the lenses of your eyes, but large erosional scallops that form in river channels, like the Niagara Falls draining the Great Lakes of North America. Obviously these are not the kind of cataracts that can develop in the lenses of your eyes, but large erosional scallops that form in river channels, like the Niagara Falls draining the Great Lakes of North America. https://photojournal.jpl.nasa.gov/catalog/PIA21869

  13. Radiation and cataract.

    PubMed

    Rehani, Madan M; Vano, Eliseo; Ciraj-Bjelac, Olivera; Kleiman, Norman J

    2011-09-01

    When this paper was about to go to press, the International Commission on Radiological Protection released a statement recommending a change in the threshold dose for the eye lens and dose limits for eye for occupationally exposed persons. It is clear that the earlier published threshold for radiation cataract is no longer valid. Epidemiological studies among Chernobyl clean-up workers, A bomb survivors, astronauts, residents of contaminated buildings, radiological technicians and recent surveys of staff in interventional rooms indicate that there is an increased incidence of lens opacities at doses below 1 Gy. Nevertheless, eye lens dosimetry is at a primitive stage and needs to be developed further. Despite uncertainties concerning dose threshold and dosimetry, it is possible to significantly reduce the risk of radiation cataract through the use of appropriate eye protection. By increasing awareness among those at risk and better adoption and increased usage of protective measures, radiation cataract can become preventable despite lowering of dose limits.

  14. Evaluation of the degree of turbidity of cataract lens and its correlation with retinal visual acuity

    NASA Astrophysics Data System (ADS)

    Akchurin, Garif G.; Bakutkin, Valery V.; Zimnyakov, Dmitry A.; Radchenko, Elena Y.; Tuchin, Valery V.; Akchurin, Alexander G.

    1999-06-01

    Experimental in vitro studies of speckle-modulated laser field arising after transmission through different type of human cataractous lenses are presented. Computer analysis of digital imaging has allowed to determinate the degree of destruction of spatial coherence scattered laser beam and the angle of resolution of the retina using Retinal Analyzer of Vision (AROL-1) in diagnosis of cataract. Measurement of retinal visual acuity (RVA) in 135 patient with different types of cataract (senile, complicated, posterior capsular) before and after cataract extraction and also in vitro measurement of RVA with extracted cataractal lenses has shown that laser retinometer can be used for evaluating visual acuity within 0.3 - 1, practically for all types of cataracts.

  15. The Cataract National Dataset electronic multi-centre audit of 55,567 operations: variation in posterior capsule rupture rates between surgeons.

    PubMed

    Johnston, R L; Taylor, H; Smith, R; Sparrow, J M

    2010-05-01

    To demonstrate variations in posterior capsule rupture (PCR) rate between surgeons of the same and different grades as a by-product of routine clinical care. NHS departments using electronic medical record (EMR) systems to collect the Cataract National Dataset (CND) were invited to submit data. Data were remotely extracted, anonymised, assessed for conformity and completeness, and analysed for rates of PCR for individual surgeons within each of the three grades. Data were extracted on 55,567 cataract operations performed at 12 NHS trusts by 406 surgeons between November 2001 and July 2006. Data on the grade of 404 of the 406 surgeons who contributed to the study were available for 55,515 cases (99.9%) and were used for this analysis. Variation in PCR rate between surgeons was highest for the most junior grade of surgeon and between those surgeons contributing relatively few cases to the data set. Variation in PCR was lowest among experienced surgeons contributing large numbers of cases to the data set. Considerable variation in PCR rate exists both between and within surgical grades. Routine electronic collection of the CND allows detailed analysis of variations in PCR rates between individual surgeons. To define acceptable limits for this benchmark complication of cataract surgery, further work is needed to adjust surgeons' outcomes for the case mix complexity.

  16. Automatic Cataract Hardness Classification Ex Vivo by Ultrasound Techniques.

    PubMed

    Caixinha, Miguel; Santos, Mário; Santos, Jaime

    2016-04-01

    To demonstrate the feasibility of a new methodology for cataract hardness characterization and automatic classification using ultrasound techniques, different cataract degrees were induced in 210 porcine lenses. A 25-MHz ultrasound transducer was used to obtain acoustical parameters (velocity and attenuation) and backscattering signals. B-Scan and parametric Nakagami images were constructed. Ninety-seven parameters were extracted and subjected to a Principal Component Analysis. Bayes, K-Nearest-Neighbours, Fisher Linear Discriminant and Support Vector Machine (SVM) classifiers were used to automatically classify the different cataract severities. Statistically significant increases with cataract formation were found for velocity, attenuation, mean brightness intensity of the B-Scan images and mean Nakagami m parameter (p < 0.01). The four classifiers showed a good performance for healthy versus cataractous lenses (F-measure ≥ 92.68%), while for initial versus severe cataracts the SVM classifier showed the higher performance (90.62%). The results showed that ultrasound techniques can be used for non-invasive cataract hardness characterization and automatic classification.

  17. Applicability of a System for fully automated nucleic acid extraction from formalin-fixed paraffin-embedded sections for routine KRAS mutation testing.

    PubMed

    Lehmann, Annika; Schewe, Christiane; Hennig, Guido; Denkert, Carsten; Weichert, Wilko; Budczies, Jan; Dietel, Manfred

    2012-06-01

    Due to the approval of various new targeted therapies for the treatment of cancer, molecular pathology laboratories with a diagnostic focus have to meet new challenges: simultaneous handling of a large number of samples, small amounts of input material, and fragmentation of nucleic acids because of formalin fixation. As a consequence, fully automated systems for a fast and standardized extraction of high-quality DNA from formalin-fixed paraffin-embedded (FFPE) tissues are urgently needed. In this study, we tested the performance of a fully automated, high-throughput method for the extraction of nucleic acids from FFPE tissues. We investigated the extraction performance in sections of 5 different tissue types often analyzed in routine pathology laboratories (cervix, colon, liver, lymph node, and lung; n=340). Furthermore, we compared the quality, labor input, and applicability of the method for diagnostic purposes with those of a laboratory-validated manual method in a clinical setting by screening a set of 45 colorectal adenocarcinoma for the KRAS mutation. Automated extraction of both DNA and RNA was successful in 339 of 340 FFPE samples representing 5 different tissue types. In comparison with a conventional manual extraction protocol, the method showed an overall agreement of 97.7% (95% confidence interval, 88.2%-99.9%) for the subsequent mutational analysis of the KRAS gene in colorectal cancer samples. The fully automated system is a promising tool for a simple, robust, and rapid extraction of DNA and RNA from formalin-fixed tissue. It ensures a standardization of sample processing and can be applied to clinical FFPE samples in routine pathology.

  18. Computational approach to radiogenomics of breast cancer: Luminal A and luminal B molecular subtypes are associated with imaging features on routine breast MRI extracted using computer vision algorithms.

    PubMed

    Grimm, Lars J; Zhang, Jing; Mazurowski, Maciej A

    2015-10-01

    To identify associations between semiautomatically extracted MRI features and breast cancer molecular subtypes. We analyzed routine clinical pre-operative breast MRIs from 275 breast cancer patients at a single institution in this retrospective, Institutional Review Board-approved study. Six fellowship-trained breast imagers reviewed the MRIs and annotated the cancers. Computer vision algorithms were then used to extract 56 imaging features from the cancers including morphologic, texture, and dynamic features. Surrogate markers (estrogen receptor [ER], progesterone receptor [PR], human epidermal growth factor receptor-2 [HER2]) were used to categorize tumors by molecular subtype: ER/PR+, HER2- (luminal A); ER/PR+, HER2+ (luminal B); ER/PR-, HER2+ (HER2); ER/PR/HER2- (basal). A multivariate analysis was used to determine associations between the imaging features and molecular subtype. The imaging features were associated with both luminal A (P = 0.0007) and luminal B (P = 0.0063) molecular subtypes. No association was found for either HER2 (P = 0.2465) or basal (P = 0.1014) molecular subtype and the imaging features. A P-value of 0.0125 (0.05/4) was considered significant. Luminal A and luminal B molecular subtype breast cancer are associated with semiautomatically extracted features from routine contrast enhanced breast MRI. © 2015 Wiley Periodicals, Inc.

  19. The cataract situation in Latin America: barriers to cataract surgery.

    PubMed

    Batlle, Juan Francisco; Lansingh, Van Charles; Silva, Juan Carlos; Eckert, Kristen Allison; Resnikoff, Serge

    2014-08-01

    To provide an update of cataract data and barriers to cataract surgery in Latin America. Review and longitudinal study. Cataract surgery rates and other related indicators that have been reported to the VISION 2020 Latin America program since 2005 were reviewed. PubMed was searched for publications concerning regional epidemiologic studies related to cataract, cataract surgery, barriers, outcomes, and cataract prevalence between January 2012 and October 2013 to obtain the most up-to-date data from 19 countries. The weighted mean regional cataract surgery rate has increased by an impressive 70% since 2005, from 1562 to 2672 cataract surgeries per 1 million inhabitants. The weighted mean number of ophthalmologists per 1 million inhabitants in the region is approximately 62. Cataract surgery coverage varies widely in Latin America, from a meager 15% in El Salvador to a more satisfactory 77% in Uruguay. Five recent surveys indicate that lack of awareness of cataract and the surgery treatment option as well as the cost of the surgery are the main barriers to cataract surgery. In spite of the increasing rates of cataract surgery and the more-than-adequate number of ophthalmologists in Latin America, it is not known how many ophthalmologists actually perform surgery. Coverage remains less than satisfactory across the region. Barriers to cataract surgery hinder the efforts of eye care programming. More comprehensive eye care programs and training centers are needed so that they can focus on reaching the underserved and unaware communities, increase surgery output and uptake, and improve outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Cataract surgery in a case of carotid cavernous fistula.

    PubMed

    Nair, Akshay Gopinathan; Praveen, Smita Vittal; Noronha, Veena Olma

    2014-09-01

    A carotid-cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.

  1. Cataract surgery in a case of carotid cavernous fistula

    PubMed Central

    Nair, Akshay Gopinathan; Praveen, Smita Vittal; Noronha, Veena Olma

    2014-01-01

    A carotid-cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF. PMID:25370401

  2. Differential cataract blindness by sex in India: Evidence from two large national surveys.

    PubMed

    Pant, Hira B; Bandyopadhyay, Souvik; John, Neena; Chandran, Anil; Gudlavalleti, Murthy Venkata S

    2017-02-01

    Women suffer disproportionately more from cataract blindness compared to males in low- and middle-income countries. Two large population-based surveys have been undertaken in India at an interval of 7 years and data from these surveys provided an opportunity to assess the trends in gender differentials in cataract blindness. Data were extracted from the surveys to discern sex differences in cataract blindness. Multivariate analysis was performed to adjust for confounders and their impact on gender differences in cataract blindness. Blindness was defined as presenting vision <20/400 in the better eye, and a cataract blind person was defined as a blind person where the principal cause of loss of vision was cataract. Prevalence of cataract blindness was higher in females compared to males in both surveys. The odds of cataract blindness for females did not change over time as observed in the surveys (1999-2001 and 2006-2007). Adjusted odds ratio from logistic regression analysis revealed that females continued to be at a higher risk of cataract blindness. Sex differences continued in India in relation to cataract blindness despite the gains made by the national program.

  3. Explicit criteria for prioritization of cataract surgery

    PubMed Central

    Ma Quintana, José; Escobar, Antonio; Bilbao, Amaia

    2006-01-01

    Background Consensus techniques have been used previously to create explicit criteria to prioritize cataract extraction; however, the appropriateness of the intervention was not included explicitly in previous studies. We developed a prioritization tool for cataract extraction according to the RAND method. Methods Criteria were developed using a modified Delphi panel judgment process. A panel of 11 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the effect of all variables on the final panel score using general linear and logistic regression models. Priority scoring systems were developed by means of optimal scaling and general linear models. The explicit criteria developed were summarized by means of regression tree analysis. Results Eight variables were considered to create the indications. Of the 310 indications that the panel evaluated, 22.6% were considered high priority, 52.3% intermediate priority, and 25.2% low priority. Agreement was reached for 31.9% of the indications and disagreement for 0.3%. Logistic regression and general linear models showed that the preoperative visual acuity of the cataractous eye, visual function, and anticipated visual acuity postoperatively were the most influential variables. Alternative and simple scoring systems were obtained by optimal scaling and general linear models where the previous variables were also the most important. The decision tree also shows the importance of the previous variables and the appropriateness of the intervention. Conclusion Our results showed acceptable validity as an evaluation and management tool for prioritizing cataract extraction. It also provides easy algorithms for use in clinical practice. PMID:16512893

  4. [Comparative study of complications among routine method,high speed turbine handpiece and piezosurgery device after extraction of impacted wisdom teeth].

    PubMed

    Guo, Zhao-zhong; Zhang, Heng; Li, Yan; Li, Xin; Liu, Yin; Wang, Yang; Yuan, Chun-xia; Liu, Xue

    2012-04-01

    To investigate complications in extraction of complicated impacted wisdom teeth whose root apex near to the inferior alveolar nerve(IAN) by using routine method(chisels),high speed turbine handpiece and piezosurgery device respectively. Three hundred qualified patients with impacted wisdom teeth were divided into three groups randomly,one hundred patients in group A were extracted by routine method, one hundred patients in group B were extracted by high speed turbine handpiece, and one hundred patients in group C were extracted by piezosurgery device. The operation time, postoperative pain duration,dry socket and IAN injury were compared between each two groups. All statistical analysis was performed using SPSS 13.0 software package. Differences between groups were compared using a paired t test (quantitative data) or Chi-square test (qualitative data). The operation time in group A was(14.12±0.12)min, (7.22±0.15)min in group B, (25.23±0.32)min in group C; Significant difference was found between group A and group B(P<0.05), group B and group C(P<0.05),group A and group C(P<0.05).Postoperative pain duration was(62.15±1.51)h in group A, (48.23±1.23)h in group B, (14.34±O.80)h in group C; Significant difference was found between group A and group B(P<0.05), group B and group C(P<0.05),group A and group C(P<0.05).9 patients developed dry socket in group A, 2 in group B, and 1 in group C; Significant difference was found between group A and group B(P<0.05), group A and group C(P<0.05). Six patients had IAN injury in group A, 2 in group B, 0 in group C. Significant difference was found between group A and group C. Compared with routine method, high speed turbine is better in extraction of impacted wisdom teeth, which can shorten operation time, lessen postoperative complications. Although there was longer operation time compared with group A and B, piezosurgery device is more effective in reducing postoperative complications.

  5. Cataract surgery and nonsteroidal antiinflammatory drugs

    PubMed Central

    Hoffman, Richard S.; Braga-Mele, Rosa; Donaldson, Kendall; Emerick, Geoffrey; Henderson, Bonnie; Kahook, Malik; Mamalis, Nick; Miller, Kevin M.; Realini, Tony; Shorstein, Neal H.; Stiverson, Richard K.; Wirostko, Barbara

    2017-01-01

    Nonsteroidal antiinflammatory drugs (NSAIDs) have become an important adjunctive tool for surgeons performing routine and complicated cataract surgery. These medications have been found to reduce pain, prevent intraoperative miosis, modulate postoperative inflammation, and reduce the incidence of cystoid macular edema (CME). Whether used alone, synergistically with steroids, or for specific high-risk eyes prone to the development of CME, the effectiveness of these medications is compelling. This review describes the potential preoperative, intraoperative, and postoperative uses of NSAIDs, including the potency, indications and treatment paradigms and adverse effects and contraindications. A thorough understanding of these issues will help surgeons maximize the therapeutic benefits of these agents and improve surgical outcomes. PMID:27697257

  6. Human cataractous lens nucleus implanted in a sheep eye lens as a model for phacoemulsification training.

    PubMed

    Kayikçioğlu, Ozcan; Eğrilmez, Sait; Emre, Sinan; Erakgün, Tansu

    2004-03-01

    We describe a realistic and inexpensive experimental cataract model for phacoemulsification training. After a capsulorhexis is performed, a deep cavity in the lens of an enucleated sheep eye is formed by phacoemulsification through a lateral incision. An undamaged human cataractous lens nucleus obtained by extracapsular cataract extraction is inserted in the preformed cavity, resting in the center of a cortex cushion. Phacoemulsification training is performed through a corneal tunnel incision. The experimental model is prepared with a human cataractous lens nucleus of the preferred hardness, simulating nuclear phacoemulsification in humans.

  7. The Association Between Aqueous Connective Tissue Growth Factor and the Severity of Age-related Cataracts as Graded by the Lens Opacities Classification System III.

    PubMed

    Hwang, Hyung Bin; Yim, Hye Bin; Cho, Yang Kyung; Choi, Jin A

    2016-01-01

    To evaluate the relationship between aqueous humor concentrations of connective tissue growth factor (CTGF) and the severity of age-related cataracts. We conducted a prospective clinical study on 43 eyes of 43 patients with senile cataracts scheduled to undergo routine phacoemulsification surgery. Before surgery, all patients were graded for cataract severity using the Lens Opacities Classification System III in terms of four features: nuclear opalescence (NO), nuclear color (NC), cortical cataracts (C), and posterior sub-capsular cataracts (P). During surgery, aqueous humor samples were obtained from all patients, and sandwich enzyme-linked immunosorbent assays (ELISAs) were used to determine CTGF concentrations. To assess any relationship between cataract severity and CTGF levels of the aqueous humor, various correlation analyses and multiple linear regression were used. We found a positive correlation between the overall cataract grade and aqueous CTGF level (p < 0.05). In addition, four features of the cataract grade (nuclear opalescence, nuclear color, cortical cataract and posterior sub-capsular cataract) were positively correlated with the aqueous CTGF concentration (p < 0.05). The final regression model identified overall cataract grade as an independent predictor of increased CTGF levels in the aqueous humor (p < 0.05). CTGF tends to increase in the aqueous humor as the severity of age-related cataracts increases. Therefore, this cytokine may play an important role in the pathogenesis of age-related cataracts. Additional studies are required for clarification of this finding.

  8. Adherence to European Society for Cataract and Refractive Surgery recommendations among Italian cataract surgeons: a survey.

    PubMed

    Grosso, Andrea; Pertile, Grazia; Marchini, Giorgio; Scarpa, Giuseppe; Ceruti, Piero; Prigione, Guido; Romano, Mario R; Bert, Fabrizio; Gili, Renata; Panico, Claudio; Siliquini, Roberta; Engelbert, Michael

    2016-08-04

    To survey the surgical routines with regards to prophylactic strategies in a sample of Italian hospitals and compare these with European Society for Cataract and Refractive Surgery (ESCRS) guidelines. Six private and 18 public hospitals were included in this clinical-based retrospective study. The overall volume of cataract operations in the 24 centers in 2013 was 43,553. Main outcome measure was incidence of endophthalmitis per 1,000. An incidence of less than 0.13% was considered acceptable. Our study provides the first Italian data on the use of intracameral antibiotics in cataract surgery as recommended by the ESCRS. Thirteen centers (54%) used intracameral cefuroxime at the end of surgery. Of the 13 centers that used cefuroxime, 8 (62%) had an incidence of endophthalmitis less than 0.13%. Of the 7 (29%) centers that did not use intracameral cefuroxime, all had an endophthalmitis rate of greater than 0.13%. This difference was statistically significant (p<0.05). Among the 4 centers not included, 2 used vancomycin in the infusion bottle, 1 a fluoroquinolone, and the last a combination of antibiotics. The majority of surgeons (71%) used preoperative antibiotic eyedrops, but this measure was not shown to be significantly protective. Slightly more than half of the centers surveyed in this study adhered to the recommendations of the ESCRS and routinely employed prophylactic intracameral cefuroxime. An incidence of endophthalmitis greater than 0.13% was encountered significantly more frequently among centers that did not employ intracameral cefuroxime.

  9. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Cataracts Sections What Are Cataracts? Cataract Symptoms Who Is ... Cataracts Look Like? IOL Implants: Lens Replacement and Cataract Surgery Written by: Kierstan Boyd Reviewed by: Elizabeth ...

  10. Virtual Mentor Cataract Surgery Trainer

    DTIC Science & Technology

    2010-09-01

    TITLE: Virtual Mentor Cataract Surgery Trainer PRINCIPAL INVESTIGATOR: Principal Investigator: John I. Loewenstein MD Co-Investigator: Bonnie A...AND SUBTITLE Virtual Mentor Cataract Surgery Trainer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-1-0531 5c. PROGRAM ELEMENT NUMBER...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Virtual Mentor Cataract Surgery

  11. Management of cataracts in infancy and childhood.

    PubMed

    Davies, P D; Tarbuck, D T

    1977-04-01

    In recent years there has been a considerable improvement in our understanding of the mechanism of stimulus deprivation amblyopia and a continuous development of better surgical techniques for the removal of cataracts in very young patients. In spite of these advances and the fact that modern constant wear soft contact lenses are now a reliable proposition, there has not been a parallel improvement in the visual results achieved after cataract extraction and aphakia continues to present considerable problems of management in children. This study analyses over 100 cases treated at Moorfields Eye Hospital in recent years. As a result of our findings a Paediatric Aphakia Service has been established in order to integrate the surgical, contact lens, and orthoptic care of these patients.

  12. Glucose Levels and Hemodynamic Changes in Patients submitted to Routine Dental Extraction under Local Anesthesia with and without Adrenaline.

    PubMed

    Byakodi, Sanjay; Gurjar, Vivek; Soni, Sushant

    2017-01-01

    In maxillofacial surgery, the simplest procedure that we perform is dental extraction. However, this simple procedure is challenged by the patient's poor medical condition. We generally use local anesthesia in combination with adrenaline; however, as we come across patients with diabetes mellitus and cardiovascular diseases who seek dental extraction, we need to be doubly cautious while using adrenaline. In this study, we intend to compare the effects of local anesthesia with adrenaline and local anesthesia without adrenaline on hemodynamic changes (blood pressure and pulse rate) and random blood sugar levels. The comparison is both within the group and between the two groups. Healthy patients between the ages 20 and 60 years were included and randomized into two groups of 50 each. In one group, plain local anesthesia was used, whereas in the other group, local anesthetic solution containing adrenaline was used. Medically compromised patients were excluded from the study. Random blood sugar levels, blood pressures, and pulse rates were recorded in both groups before and 10 minutes after injecting the solutions. The findings were compared. When results are compared within the group, a modest increase in the blood sugar level was noted with the group receiving local anesthetic with adrenaline. However, blood pressure and pulse rate showed no significant difference. Similarly, when between-the-groups comparison was done, not a single variable showed any significant difference. The patients injected with local anesthesia containing adrenaline showed similar results to that observed in the patients injected with local anesthesia without adrenaline. However, there is a statistically significant rise in blood sugar levels when a local anesthetic is injected with adrenaline. Dental extractions in healthy individuals can be safely performed with local anesthetic containing adrenaline. However, in diabetic patients, it should be cautiously used.

  13. Cataract Research Testing

    NASA Image and Video Library

    2016-04-18

    Dr. Rafat Ansari and James King testing their dynamic light scattering clinical device in NASA's Vision Research Laboratory at NASA Glenn. The objective is to diagnose eye diseases non-invasively long before the clinical symptoms appear and help find non-surgical medical treatments. The device shown was recently used in humans by ophthalmologists and scientists for the study of early onset of cataracts.

  14. Cataracts and macular degeneration.

    PubMed

    Shoch, D

    1979-09-01

    The intraocular lens restores general vision and some degree of independence and mobility to patients with dense cataracts and macular degeneration. The patient, however, must be repeatedly warned that fine central vision, particularly reading, will not be possible after the surgery. An aphakic spectacle leaves such patients a narrow band of vision when superimposed over the macular lesion, and contact lenses are too small for the patient to manage insertion without help.

  15. [Congenital cataract: general review].

    PubMed

    Roche, O; Beby, F; Orssaud, C; Dupont Monod, S; Dufier, J L

    2006-04-01

    Cataract is a loss of lens transparency because of a protein alteration. Etiopathogenesis is poorly understood but new mutations of different developmental genes involved are found in 25% of cases. Frequency of onset, particularly when different ocular development anomalies occur, is related to the lens induction phenomena on the eye's anterior segment structure during embryologic development. Genetic transmission is often found on the dominant autosomal mode. Diagnosis is based on a complete and detailed examination of the eye, often with general anaesthesia. This condition predisposes children to later, sometimes serious amblyopia. Different clinical aspects can be observed: from cataract with ocular and/or systemic anomalies to polymalformative syndrome, skeletal, dermatological, neurological, metabolic, and genetic or chromosomal diseases. A general systematic pediatric examination is necessary. Congenital cataract requires first and foremost early diagnosis and a search for all etiologies. Surgical treatment is adapted case by case but it has progressed with the quality of today's intraocular lenses even if systematic implantation continues to be debated. Life-long monitoring is absolutely necessary.

  16. Reducing older driver motor vehicle collisions via earlier cataract surgery.

    PubMed

    Mennemeyer, Stephen T; Owsley, Cynthia; McGwin, Gerald

    2013-12-01

    Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual's complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call "Current Practice" (CP) and "Earlier Surgery" (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost - all MVC costs plus cataract surgery expenditures - is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60-64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Cataract blindness in Turkmenistan: results of a national survey

    PubMed Central

    Amansakhatov, S; Volokhovskaya, Z P; Afanasyeva, A N; Limburg, H

    2002-01-01

    Aim: To present results of a rapid assessment of cataract in Turkmenistan. Methods: 6120 eligible people of 50 years and older were selected by systematic random sampling from the whole of Turkmenistan. A total of 6011 people were examined (coverage 98.2%). Results: Cataract is the major cause of bilateral blindness (54%), followed by glaucoma (25%). The age and sex adjusted prevalence of bilateral cataract blindness (VA <3/60) in people of 50 years and older was 0.6% (95% CI: 0.4 to 0.9), with a cataract surgical coverage of 75% (people). For VA <6/60 the prevalence was 2.6% (95% CI: 2.1 to 3.2) in people aged 50 and above, approximately 0.26% of the total population. In this last group the surgical coverage was 44% (people) and 32% (eyes). Of the patients operated with IOL implantation 8.2% could not see 6/60, 44.8% of those operated without IOL could not see 6/60. The main barrier to cataract surgery was indifference (“old age, no need for surgery”), followed by “waiting for maturity.” Conclusion: To increase the cataract surgical coverage in Turkmenistan the intake criteria should be lowered to VA <6/60 or less. At the same time the visual outcome of surgery can be improved by expanding the number of IOL surgeries and routine monitoring of cataract outcome. Additional investments will be required to provide all eye surgeons with appropriate equipment and skills for IOL surgery. PMID:12386068

  18. Method for routine screening of pesticides and metabolites in meat based baby-food using extraction and gas chromatography-mass spectrometry.

    PubMed

    Przybylski, Cédric; Segard, Christophe

    2009-06-01

    A simple and complete multiresidue method has been developed for the routine determination of 236 pesticides and degradation products, in meat based baby-food. This original approach combines a modified Quick Easy Cheap Effective Rugged and Safe (QuEChERS) sample preparation method using a triple partitioning extraction step with water/ACN/hexane and a system composed of GC with programmable temperature vaporization injector hyphenated to an IT-MS. Detection was performed in full scan mode, with one quantification ion and one identification ion. We firstly report here the hexane addition in the extraction step to eliminate a major part of lipophile co-extracts. Direct consequences were the increasing of method sensitivity and the diminishment of the frequency of maintenance of the analytical instrument. The recovery data were obtained by spiking blank samples at three concentration levels (10, 50 and 200 microg/kg) over five replicates, yielding average recoveries in the range 70-121% with a RSD evaluated between 2-15%. Linearity was fixed in the range of 10-300 microg/kg with determination coefficients (R2) superior or equal to 0.9814 for all target analytes. Best LODs and LOQs were established as 0.03 and 0.1 microg/kg, respectively. Total instrumental analysis of all molecules was carried out in less than 1 h.

  19. A new method for the routine analysis of LAS and PAH in sewage sludge by simultaneous sonication-assisted extraction prior to liquid chromatographic determination.

    PubMed

    Santos, J L; Aparicio, I; Alonso, E

    2007-12-12

    Linear alkylbenzene sulphonates (LAS) and polycyclic aromatics hydrocarbons (PAH) are organic pollutants in sewage sludge which will have to be monitored in the European Union according to the third draft of a future sludge directive. In the present work, an analytical method for the simultaneous extraction of 4 LAS homologues and 16 PAH congeners in sludge from wastewater treatment plants is proposed to improve the routine analysis of these compounds in sludge samples. The method involves sonication assisted extraction, clean-up and preconcentration by solid phase extraction, and determination by high-performance liquid chromatography with ultraviolet diode array (UV-DAD) and fluorescence (FLD) detectors. Average recoveries were 87% for LAS and 76% for PAH, with relative standard deviations below 13%. Limits of quantification of LAS and PAH were in the range from 13 to 56 mg kg(-1) and from 80 to 650 microg kg(-1), respectively, when using UV-DAD. Limits of quantification of LAS and PAH were in the range 5-18 mg kg(-1) and from 1 to 150 microg kg(-1), respectively, when using FLD. The applicability of the proposed method was evaluated by the determination of these compounds in sludge from wastewater treatment plants in Seville (South Spain).

  20. Assisted extraction of the energy level spacings and lever arms in direct current bias measurements of one-dimensional quantum wires, using an image recognition routine

    NASA Astrophysics Data System (ADS)

    Lesage, A. A. J.; Smith, L. W.; Al-Taie, H.; See, P.; Griffiths, J. P.; Farrer, I.; Jones, G. A. C.; Ritchie, D. A.; Kelly, M. J.; Smith, C. G.

    2015-01-01

    A multiplexer technique is used to individually measure an array of 256 split gates on a single GaAs/AlGaAs heterostructure. This results in the generation of large volumes of data, which requires the development of automated data analysis routines. An algorithm is developed to find the spacing between discrete energy levels, which form due to transverse confinement from the split gate. The lever arm, which relates split gate voltage to energy, is also found from the measured data. This reduces the time spent on the analysis. Comparison with estimates obtained visually shows that the algorithm returns reliable results for subband spacing of split gates measured at 1.4 K. The routine is also used to assess direct current bias spectroscopy measurements at lower temperatures (50 mK). This technique is versatile and can be extended to other types of measurements. For example, it is used to extract the magnetic field at which Zeeman-split 1D subbands cross one another.

  1. Assisted extraction of the energy level spacings and lever arms in direct current bias measurements of one-dimensional quantum wires, using an image recognition routine

    SciTech Connect

    Lesage, A. A. J. Smith, L. W. Griffiths, J. P.; Farrer, I.; Jones, G. A. C.; Ritchie, D. A.; Smith, C. G.; Al-Taie, H.; Kelly, M. J.; See, P.

    2015-01-07

    A multiplexer technique is used to individually measure an array of 256 split gates on a single GaAs/AlGaAs heterostructure. This results in the generation of large volumes of data, which requires the development of automated data analysis routines. An algorithm is developed to find the spacing between discrete energy levels, which form due to transverse confinement from the split gate. The lever arm, which relates split gate voltage to energy, is also found from the measured data. This reduces the time spent on the analysis. Comparison with estimates obtained visually shows that the algorithm returns reliable results for subband spacing of split gates measured at 1.4 K. The routine is also used to assess direct current bias spectroscopy measurements at lower temperatures (50 mK). This technique is versatile and can be extended to other types of measurements. For example, it is used to extract the magnetic field at which Zeeman-split 1D subbands cross one another.

  2. Q192R paraoxonase1 polymorphism is a risk factor for cataract in Pakistani population.

    PubMed

    Baig, Amena; Zohaib, Muhammad; Rehman, Ata-ur; Zarina, Shamshad

    2016-05-01

    Cataract, the lens opacity, is among major causes of blindness in Pakistani population. In recent past, oxidative stress is suggested to play crucial role in loss of transparency. Along with other antioxidants, Paraoxonase 1 (PON1) has also shown decreased activity in patients suffering from cataract. The aim of current study was to examine the possible association of PON polymorphism with predisposition of cataract formation in local population. The study was conducted on 51 cataract patients and 50 control subjects considering all ethical issues. DNA was extracted from whole blood and PON1 polymorphism was identified using tetra primer ARMS-PCR method for both positions L55M and Q192R. Tetra primer ARMS-PCR results revealed that association between L55M polymorphism and cataract was insignificant while 192R genotype PON1 frequency was higher among the people suffering from cataract (78.4%) as compared to control subjects (56%), (odds ratio=2.857, confidence interval=1.197-6.820). Hence, R allele is likely to be a risk factor for cataract with allele frequency (82.3%) and (odds ratio=4.552, confidence interval=1.716-12.073, p-value=0.002). PON1 Q192R polymorphism is likely to be a risk factor for cataract development in Pakistani population while PON1 L55M was not found to be associated with cataract.

  3. Enhancement of Pathologist's Routine Practice: Reuse of DNA Extracted from Immunostained Formalin-fixed Paraffin-embedded (FFPE) Slides in Downstream Molecular Analysis of Cancer

    PubMed Central

    AL-ATTAS*, ASMAA; ASSIDI*, MOURAD; AL-MAGHRABI, JAUDAH; DALLOL, ASHRAF; SCHULTEN, HANS-JUERGEN; ABU-ELMAGD, MUHAMMAD; CHAUDHARY, ADEEL; ABUZENADAH, ADEL; BUDOWLE, BRUCE; BUHMEIDA, ABDELBASET; AL-QAHTANI, MOHAMMED

    2016-01-01

    Background/Aim: To date, the conventional formalin-fixed, paraffin-embedded (FFPE) technique is the gold-standard for preserving histomorphology. Once FFPE tissues are stained, slides are routinely archived along with their blocks at biobanks/hospitals. However, the reuse of fixed and stained biospecimens as DNA source is not a common routine practice worldwide and, thus, indicates the need of studies to investigate the feasibility of extracting DNA from already immunohistochemistry (IHC) FFPE-stained slides and its possible reuse in subsequent downstream molecular analyses. Materials and Methods: FFPE IHC slides from colorectal cancer (CRC) patients were prepared and stored in the CEGMR Biobank. The workflow consists of digitalization of IHC stained slide’s image, removing the slide cover-slip, crude dissection and DNA extraction. Following DNA quality assessment, mutation analysis of CTNNB1 and methylation profile of CDH1 were performed. Results: High-quality DNA was obtained allowing 60% concordance between CDH1 methylation and membranous E-cadherin expression pattern. Clean CTNNB1 DNA chromatograms with evenly-spaced peaks were observed. Conclusion: This study is a proof of concept to recycle and reuse DNA from IHC stained slides with suitable concentration and integrity for further downstream molecular applications. These findings will enhance the pathologists’ knowledge, attitudes and practices (KAP) towards the use of these biospecimens and support the implementation of this approach in clinical pathology practice. Therefore, the scientific community will benefit from the largest comprehensive database of human fully annotated FFPE biospecimens already available at their disposal in order to demystify the complexity and the heterogeneity of many challenging diseases and foster the transition towards precision medicine. *These Authors contributed equally to this manuscript. PMID:27566658

  4. Enhancement of Pathologist's Routine Practice: Reuse of DNA Extracted from Immunostained Formalin-fixed Paraffin-embedded (FFPE) Slides in Downstream Molecular Analysis of Cancer.

    PubMed

    Al-Attas, Asmaa; Assidi, Mourad; Al-Maghrabi, Jaudah; Dallol, Ashraf; Schulten, Hans-Juergen; Abu-Elmagd, Muhammad; Chaudhary, Adeel; Abuzenadah, Adel; Budowle, Bruce; Buhmeida, Abdelbaset; Al-Qahtani, Mohammed

    To date, the conventional formalin-fixed, paraffin-embedded (FFPE) technique is the gold-standard for preserving histomorphology. Once FFPE tissues are stained, slides are routinely archived along with their blocks at biobanks/hospitals. However, the reuse of fixed and stained biospecimens as DNA source is not a common routine practice worldwide and, thus, indicates the need of studies to investigate the feasibility of extracting DNA from already immunohistochemistry (IHC) FFPE-stained slides and its possible reuse in subsequent downstream molecular analyses. FFPE IHC slides from colorectal cancer (CRC) patients were prepared and stored in the CEGMR Biobank. The workflow consists of digitalization of IHC stained slide's image, removing the slide cover-slip, crude dissection and DNA extraction. Following DNA quality assessment, mutation analysis of CTNNB1 and methylation profile of CDH1 were performed. High-quality DNA was obtained allowing 60% concordance between CDH1 methylation and membranous E-cadherin expression pattern. Clean CTNNB1 DNA chromatograms with evenly-spaced peaks were observed. This study is a proof of concept to recycle and reuse DNA from IHC stained slides with suitable concentration and integrity for further downstream molecular applications. These findings will enhance the pathologists' knowledge, attitudes and practices (KAP) towards the use of these biospecimens and support the implementation of this approach in clinical pathology practice. Therefore, the scientific community will benefit from the largest comprehensive database of human fully annotated FFPE biospecimens already available at their disposal in order to demystify the complexity and the heterogeneity of many challenging diseases and foster the transition towards precision medicine. Copyright© 2016, International Institute of Anticancer Research (Dr. John G. Delinasios), All rights reserved.

  5. Hollow needle cataract aspiration in antiquity.

    PubMed

    Pérez-Cambrodí, Rafael J; Ascaso, Francisco J; Diab, Fathi; Alzamora-Rodríguez, Antonio; Grzybowski, Andrzej

    2015-12-01

    The dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community.

  6. [Computer-assisted phacoemulsification for hard cataracts].

    PubMed

    Zemba, M; Papadatu, Adriana-Camelia; Sîrbu, Laura-Nicoleta; Avram, Corina

    2012-01-01

    to evaluate the efficiency of new torsional phacoemulsification software (Ozil IP system) in hard nucleus cataract extraction. 45 eyes with hard senile cataract (degree III and IV) underwent phacoemulsification performed by the same surgeon, using the same technique (stop and chop). Infiniti (Alcon) platform was used, with Ozil IP software and Kelman phaco tip miniflared, 45 degrees. The nucleus was split into two and after that the first half was phacoemulsificated with IP-on (group 1) and the second half with IP-off (group 2). For every group we measured: cumulative dissipated energy (CDE), numbers of tip closure that needed manual desobstruction the amount of BSS used. The mean CDE was the same in group 1 and in group 2 (between 6.2 and 14.9). The incidence of occlusion that needed manual desobstruction was lower in group 1 (5 times) than in group 2 (13 times). Group 2 used more BSS compared to group 1. The new torsional software (IP system) significantly decreased occlusion time and balanced salt solution use over standard torsional software, particularly with denser cataracts.

  7. The First Cataract Surgeons in Anglo-America

    PubMed Central

    Leffler, Christopher T.; Schwartz, Stephen G.; Grzybowski, Andrzej; Braich, Puneet S.

    2014-01-01

    We tried to identify the earliest cataract surgeons in the English-speaking areas of America. In 1751, couching was performed on the Caribbean island of Montserrat by John Morphy. William Stork of England, who couched cataracts, practiced in Jamaica in 1760 and then in cities from Annapolis to Boston between 1761 and 1764. Frederick William Jericho of Germany, upon completion of his training at Utrecht, published his 1767 treatise on his preferred surgical technique of extracapsular cataract extraction. Jericho had practiced in the Leeward Islands by 1776 and then in cities from Charleston to Boston between 1783 and 1785. The French surgeon Lewis Leprilete was the first to advertise cataract extraction in the United States in 1782 and probably passed on the skill to his protégé, Nathaniel Miller of Massachusetts. Leprilete was also the first to publicize Benjamin Franklin's invention of bifocals.. These pioneers exposed American doctors and the public to cataract surgery. Shortly after their arrival, evidence emerges of other surgeons performing these procedures in America. PMID:25444521

  8. Diplopia as the Complication of Cataract Surgery

    PubMed Central

    Gawęcki, Maciej; Grzybowski, Andrzej

    2016-01-01

    The authors present systematic review of aetiology and treatment of diplopia related to cataract surgery. The problem is set in the modern perspective of changing cataract surgery. Actual incidence is discussed as well as various modalities of therapeutic options. The authors provide the guidance for the contemporary cataract surgeon, when to expect potential problem in ocular motility after cataract surgery. PMID:26998351

  9. Cataract Section Across Temporary Stainless-Steel Sutures

    PubMed Central

    MacDonald, R. Keith

    1965-01-01

    The purpose of the technique described was to combine the advantages of a cleanedged Graefe-knife incision with those of safety and near-perfect apposition offered by preplaced sutures: a preliminary to cataract extraction. Uncuttable preplaced 2-mm. stainless steel sutures were finally replaced after completion of the incision by attached braided silk for closure purposes. PMID:14291461

  10. A Proposed Minimum Standard Set of Outcome Measures for Cataract Surgery.

    PubMed

    Mahmud, Imran; Kelley, Thomas; Stowell, Caleb; Haripriya, Aravind; Boman, Anders; Kossler, Ingrid; Morlet, Nigel; Pershing, Suzann; Pesudovs, Konrad; Goh, Pik Pin; Sparrow, John M; Lundström, Mats

    2015-11-01

    Aligning outcome measures for cataract surgery, one of the most frequently performed procedures globally, may facilitate international comparisons that can drive improvements in the outcomes most meaningful to patients. To propose a minimum standard set of outcome measures for cataract surgery that enables global comparisons. A working group of international experts in cataract outcomes and registries was convened, along with a patient advocate, to agree on a consensus of outcome measures for cataract surgery. In a modified Delphi process, the group met regularly between November 10, 2012, and November 21, 2013, to discuss which outcomes to include in a standard set. Included factors were based on extant literature, existing registries, and the experience of group members. Similarly, a series of consensus discussions were held to determine a set of risk factors to be gathered for each patient. The final shortlist was compiled into a standard set. Analysis was performed from November 22, 2013, to April 5, 2014. Development of a recommended standard set encompassing preoperative metrics including patient risk factors, intraoperative factors including surgical complications, and postoperative cataract surgery outcomes. The recommended standard set encompasses all patients treated for cataracts by 1 of 4 surgical approaches (phacoemulsification, sutured manual extracapsular cataract extraction, sutureless manual extracapsular cataract extraction, or intracapsular cataract extraction). The recommended metrics to be recorded preoperatively include demographics, ocular history and comorbidities, preoperative visual acuity, and patient-reported visual function. The recommended outcomes were split into intraoperative and postoperative metrics. Intraoperative outcomes include capsule-related problems, dislocation of lens nucleus fragments into the vitreous, and other complications. Postoperative outcomes include visual acuity, refractive error, patient-reported visual

  11. Etiopathogenesis of cataract: An appraisal

    PubMed Central

    Gupta, Varun B; Rajagopala, Manjusha; Ravishankar, Basavaiah

    2014-01-01

    Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc.), traumatic, complicated (inflammatory and degenerative diseases of eye), metabolic (diabetes, galactosemia etc.), toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc.) are implicated as significant risk factors in the development of cataract. PMID:24618482

  12. [Evolution of cataract surgery: smaller incision--less complications].

    PubMed

    Draganić, Vladimir; Vukosavljević, Miroslav; Milivojević, Milorad; Resan, Mirko; Petrović, Nenad

    2012-05-01

    Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/forceps IOL implantation, phacoemulsification/injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Uncorrected visual aquity 30 days postoperatively was > or = 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  13. Cataract surgery and methods of wound closure: a review

    PubMed Central

    Matossian, Cynthia; Makari, Sarah; Potvin, Richard

    2015-01-01

    Clear corneal incisions are routinely used in cataract surgery, but watertight wound closure may not always be achieved, which can increase the risk for anterior chamber fluid egress or ocular surface fluid ingress. A new US Food and Drug Administration-approved ocular sealant appears to have good efficacy in sealing clear corneal incisions; its use may be indicated when wound integrity is in question. PMID:26045656

  14. Femtosecond laser assisted cataract surgery, beginning of a new era in cataract surgery

    PubMed Central

    Ali, Muhammad Hassaan; Javaid, Mamoona; Jamal, Samreen; Butt, Nadeem Hafeez

    2015-01-01

    The purpose of this article is to analyze and understand the mechanism of action, effectiveness, cost and time benefits, advantages and disadvantages of the femtosecond laser (FSL) assisted cataract surgery. A PubMed search was done using the topic and the keywords. Research shows considerable improvements in corneal incisions, anterior capsulotomy, and phacofragmentation using FSL. We will also discuss and compare FSL with conventional cataract extraction techniques in terms of both short-term and long-term advantages and disadvantages. Limitations of the studies reviewed include small sample size and short-term follow-up. The major dilemma is still considered to be its heavy financial feasibility to date. PMID:26903717

  15. Favorable Long-term Prognosis of Cataract Surgery in Herpes Zoster Ophthalmicus

    PubMed Central

    Chaudhary, Kulbhushan Prakash; Mahajan, Deepti; Panwar, Praveen

    2016-01-01

    Purpose: Scleritis is a rare presentation of herpes zoster ophthalmicus, complicated most commonly by iridocyclitis and raised intraocular pressure. These complications can recur in subsequent years, therefore they should be managed well. Case Report: We describe a female patient who developed scleritis, complicated cataract and secondary glaucoma 2 years after being diagnosed by HZO. Secondary glaucoma was managed medically, and the patient underwent extracapsular cataract extraction for the complicated cataract. Final visual acuity was 6/6 and IOP was 22.4 mm Hg. This is a rare report describing favorable long-term (>20 years) prognosis for surgical management of cataract associated with HZO together with scleritis, secondary glaucoma and post-herpetic neuralgia. Conclusion: A favorable outcome may be attained with surgery for complicated cataract associated with HZO if the condition is managed optimally and intraocular inflammation is well controlled. PMID:27413505

  16. [Systane and cataract surgery].

    PubMed

    Stefan, C; Dumitrica, Diana Melinte

    2007-01-01

    To emphasize and measure the effect of post-cataract surgery Systane treatment. Eye Clinic - Central Clinical Hospital - Bucharest, Romania. Six months clinical, observational, prospective, double-masked study on two groups of patients with cataract surgery (phacoemulsification technique) performed by the same surgeon. Group A (19 patients) received topic treatment with Systane and group B (17 patients) topic treatment with purified water (both with the same presentation form), associated with classical postoperatively treatment. Each patient answered a standardized questionnaire about subjective symptoms of ocular discomfort Several clinical tests were performed for both groups: Schirmer 1 test, tear break-up time (TBUT) and fluorescein staining showing epithelial defects. The groups were homogeneous about the age and sex distribution. any ocular or general associated disease. Statistic analyse: t-student test. First examination (after one week treatment) show that 73,68% patients treated with Systane did not have subjective symptoms comparing with 47,05% patients without Systane. Final tests (3 week examination) results for subjective symptoms were improved in both groups: 94,73% group A and 70,58% group B (p<0,001). Abnormal values (under 10 mm) for Schirmer 1 test were found in 17,64% of group B patients comparing with 11,76% patients of group A at the first examination. Final Schirmer 1 test results are statistically better in group A 100%-normal values, comparing with 88,23%-normal values in group B. The stability of tear film (TBUT) is altered in 52,94% of purified water treated patients; only in 21,05% of Systane patients existing this problem at the first examination (p<0,001). After 3 weeks treatment 23,52% group B patients and 5,26% group A patients had TBUT altered. Initially fluorescein staining is present in 4 group B patients and in 1 group A patient, comparing with only 1 group B patient in final tests. Cataract surgery can affect ocular tear film

  17. Combined cataract and glaucoma procedures using temporal cataract surgery.

    PubMed

    Gayton, J L; Van der Karr, M A; Sanders, V

    1996-12-01

    To evaluate whether separating the procedures in a combined procedure by performing a temporal cataract incision and superior trabeculectomy induces the lower astigmatism of a temporal cataract incision without sacrificing intraocular pressure (IOP) control. EyeSight Associates, Warner Robins, Georgia. This study evaluated 50 consecutive eyes receiving a superior cataract incision with a superonasal trabeculectomy and 65 eyes receiving a temporal cataract incision with a superonasal trabeculectomy. After 3 months, a substantially greater proportion of temporal incision cases had controlled IOP without medication. A substantially higher proportion in the superior incision group had uncontrolled IOP at each time period. Mean surgically induced cylinder was higher in the superior incision group at every time period. The superior group had early with-the-rule mean induced cylinder that decayed to against-the-rule, with a mean induced cylinder with keratometry at the final available visit (more than 3 months) of -1.01 diopter (D). The temporal group started with a negligible induced cylinder (-0.13 D) that drifted slightly with the rule to a final mean induced cylinder of +0.49 D. At the last visit, 31% in the superior incision group and 57% in the temporal incision group had an uncorrected visual acuity of 20/40 or better, and 72% and 94%, respectively, had a best corrected acuity of 20/40 or better. Separating the cataract and glaucoma procedures frees the surgeon to use newer astigmatically neutral techniques for the cataract incision.

  18. [Cataract operation following goniotrepanation].

    PubMed

    Polychronakos, D; Deligiannidis, P; Polychronakos, A

    1984-03-01

    Cataract surgery after goniotrepanation has been performed on 75 eyes at the St. Demetrius Hospital Eye Clinic in Thessaloniki , Greece, in recent years. The patients' ages ranged from 46 to 84 years. Intraocular pressure was between 8 and 19 mm Hg in all but 4 eyes which had IOPs of between 22 and 30 mm Hg. In order to leave the fistula untouched, the incision with the Graefe knife was made in the area of the cornea close to the limbus; it was closed with 7 sutures (7-0 silk). Prolapse of the vitreous occurred in 7 cases. It was possible to follow up 52 of the eyes: IOP remained regulated postoperatively with one exception (26 mm Hg); the upper pressure limit was 18 mm Hg.

  19. Long-term results of bilateral congenital cataract treated with early cataract surgery, aphakic glasses and secondary IOL implantation.

    PubMed

    Kim, Dong-Hyun; Kim, Jeong Hun; Kim, Seong-Joon; Yu, Young Suk

    2012-05-01

    To evaluate the long-term visual outcome after early surgery of bilateral dense congenital cataracts, aphakic correction with glasses and secondary intraocular lens (IOL) implantation around 2 years of age. The medical records of paediatric patients who underwent cataract extraction, aphakic correction and secondary IOL implantation from 1993 to 2004 at Seoul National University Children's Hospital were reviewed retrospectively. Age at secondary IOL implantation, axial length (AL), best corrected visual acuity (BCVA), refractive error, ocular alignment, stereopsis, and postoperative ocular complications were recorded. Thirty-seven paediatric bilateral pseudophakic patients were identified with a mean follow-up period of 81.4 months. Best corrected visual acuity of 20/40 or better were attained in 44.0% of eyes, and the median BCVA was 20/50. Preoperative factors associated with poor visual prognosis included cataract surgery after 8 weeks of age, interocular AL difference of 0.5 mm or more, and glaucoma. Amblyopic eyes showed more myopic change compared to fellow eyes. Good or moderate binocular function was achieved in 18.9% of all patients. Incidences of strabismus, glaucoma, posterior capsular opacity formation were 46.0%, 32.4% and 4.0%, respectively. Good postoperative BCVA and binocular function were achieved in most healthy children with bilateral dense congenital cataract and no posterior segment pathology. Early cataract surgery, aphakic correction with glasses and secondary IOL implantation around 2 years of age appears to be appropriate methods. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

  20. The potential preventive effects of vitamins for cataract and age-related macular degeneration.

    PubMed

    Jacques, P F

    1999-05-01

    Age-related cataract and age-related macular degeneration (AMD) are important public health problems. Approximately 50% of the 30 to 50 million cases of blindness worldwide result from unoperated cataract. In the US and other developed countries AMD is the leading cause of blindness, but age-related cataract remains the leading cause of visual disability. Age-related cataract and AMD represent an enormous economic burden. In the United States more than 1.3 million cataract extractions are performed annually at a cost of approximately $3.5 billion. Much of the experimental research on the etiology of cataract and AMD has focused on the role of nutritional antioxidants (vitamin C, vitamin E, and carotenoids). Evidence from epidemiologic studies support a role for nutritional antioxidants in delaying the onset of these age-related vision disorders. Although it is not yet possible to conclude that antioxidant nutrients have a role in prevention of cataract or AMD, a summary of the epidemiologic evidence suggests that it is prudent to consume diets high in vitamins C and E and carotenoids, particularly the xanthophylls, as insurance against the development of cataract and AMD.

  1. Genetic appraisal of congenital cataract.

    PubMed

    Angra, S K; Rao, P; Panda, A; Grewal, M S

    1987-01-01

    A total of 45 congenital cataract cases were studied for chromosomal aberrations and dermatoglyphic patterns. Whereas parents showed no marked differences, patients showed marked differences in different dermatoglyphic traits as compared to age-sex matched controls. Out of all the patients Rubella, hereditary and undetected actiology groups showed variations differently, SCE were seen in all cataracts irrespective of their aetiology as compared to controls.

  2. Diet, vegetarianism, and cataract risk.

    PubMed

    Appleby, Paul N; Allen, Naomi E; Key, Timothy J

    2011-05-01

    Age-related cataract is a major cause of morbidity. Previous studies of diet and cataract risk have focused on specific nutrients or healthy eating indexes but not on identifiable dietary groups such as vegetarians. We investigated the association between diet and cataract risk in a population that has a wide range of diets and includes a high proportion of vegetarians. We used Cox proportional hazards regression to study cataract risk in relation to baseline dietary and lifestyle characteristics of 27,670 self-reported nondiabetic participants aged ≥40 y at recruitment in the Oxford (United Kingdom) arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) by using data from the Hospital Episode Statistics in England and Scottish Morbidity Records. There was a strong relation between cataract risk and diet group, with a progressive decrease in risk of cataract in high meat eaters to low meat eaters, fish eaters (participants who ate fish but not meat), vegetarians, and vegans. After multivariable adjustment, incidence rate ratios (95% CIs) for moderate meat eaters (50-99 g meat/d), low meat eaters (<50 g meat/d), fish eaters, vegetarians, and vegans compared with high-meat eaters (≥100 g meat/d) were 0.96 (0.84, 1.11), 0.85 (0.72, 0.99), 0.79 (0.65, 0.97), 0.70 (0.58, 0.84), and 0.60 (0.38, 0.96), respectively (P < 0.001 for heterogeneity). Associations between cataract risk and intakes of selected nutrients and foods generally reflected the strong association with diet group. Vegetarians were at lower risk of cataract than were meat eaters in this cohort of health-conscious British residents.

  3. Cataract surgery in ancient Egypt.

    PubMed

    Blomstedt, Patric

    2014-03-01

    Ophthalmology was one of the most important specialties in Egyptian medicine, and more specialists are known in this field than in any other. This specialization seems, however, to have been of a purely noninvasive nature. Even though it has been claimed that cataract surgery was performed in pharaonic Egypt, careful analysis of the sources does not support the claim. No example of cataract surgery or of any other invasive ophthalmologic procedure can be found in the original sources.

  4. The global burden of cataract.

    PubMed

    Rao, Gullapalli N; Khanna, Rohit; Payal, Abhishek

    2011-01-01

    To review the previous year's literature related to prevalence of blindness in general, blindness due to cataract, cataract surgical coverage (CSC) and cataract surgical rates (CSRs). Cataracts are the major cause of blindness and visual impairment in developing countries and contributes to more than 90% of the total disability adjusted life years. This review shows that coverage continues to be a problem in many countries, especially for the female population, those residing in rural areas and those who are illiterate. Although CSR is an indicator of the availability and acceptability of services, for measuring the impact of the program, we should look at combining CSR with CSC. This strategy would also enable us achieve our goal of eliminating avoidable blindness due to cataracts by the year 2020. Cataracts still continue- to be a major cause of blindness globally and with the rapidly aging population, it is a challenge to tackle. We need to plan a comprehensive strategy addressing issues related to availability, affordability, accessibility and acceptability of eye-care services.

  5. Cataract surgery in pseudoexfoliation syndrome.

    PubMed

    Sangal, Neha; Chen, Teresa C

    2014-01-01

    Pseudoexfoliation (PXF) syndrome is characterized by the deposition of distinctive fibrillar material in the anterior segment of the eye. It is an age-related process that is associated with open and narrow angle glaucomas and the formation of cataracts. Not only is PXF associated with the formation of dense nuclear cataracts, it is also well known that those presenting with PXF are at a higher risk of developing complications during, and even after, cataract surgery. Complications associated with cataract surgery in PXF can occur from poor pupillary dilation, zonular weakness leading to intraoperative or postoperative lens dislocation and vitreous loss, postoperative intraocular pressure (IOP) spikes potentiating glaucomatous damage, capsular phimosis, prolonged inflammation, and postoperative corneal decompensation. The surgeon should be prepared to encounter the various potential intraoperative and postoperative complications in eyes with pseudoexfoliation syndrome during cataract surgery. In this way, the surgeon can plan his/her surgical technique to help avoid surprises during cataract surgery and be prepared to manage the potential postoperative complications that can occur in pseudoexfoliation eyes.

  6. Visual outcome of cataract surgery; study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery.

    PubMed

    Lundström, Mats; Barry, Peter; Henry, Ype; Rosen, Paul; Stenevi, Ulf

    2013-05-01

    To analyze the visual outcome after cataract surgery. Cataract surgery clinics in 15 European countries. Database study. Data were drawn from case series of cataract extractions reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. These data were entered into the database via the Web by surgeons or by transfer from existing national registries or electronic medical record systems. The database contains individual anonymous data on preoperative, intraoperative, and postoperative measurements. Data on 368,256 cataract extractions were available for analysis. The best visual outcome was achieved in age groups 40 to 74 years, and men showed a higher percentage of excellent vision (1.0 [20/20] or better) than women. A corrected distance visual acuity (CDVA) of 0.5 (20/40) or better and of 1.0 (20/20) or better was achieved in 94.3% and 61.3% of cases, respectively. Ocular comorbidity and postoperative complications were the strongest influences on the visual outcome; however, surgical complications and ocular changes requiring complex surgery also had a negative influence. Deterioration of visual acuity after the surgery (n= 6112 [1.7% of all cases]) was most common in patients with a good preoperative visual acuity. The visual outcomes of cataract surgery were excellent, with 61.3% of patients achieving a corrected distance visual acuity of 1.0 (20/20) or better. Age and sex influenced the visual outcomes, but the greatest influences were short-term postoperative complications, ocular comorbidity, surgical complications, and complex surgery. A weakness of the study could be that some of the data is self-reported to the registry. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Simultaneous extraction and determination of monoamine neurotransmitters in human urine for clinical routine testing based on a dual functional solid phase extraction assisted by phenylboronic acid coupled with liquid chromatography-tandem mass spectrometry.

    PubMed

    Li, Xiaoguang Sunny; Li, Shu; Kellermann, Gottfried

    2017-04-01

    The major monoamine neurotransmitters, serotonin (5-HT) and catecholamines (i.e., norepinephrine (NE), epinephrine (E), and dopamine (DA)), are critical to the nervous system function, and imbalances of the neurotransmitters have been connected to a variety of diseases, making their measurement useful in a clinical setting. A simple, rapid, robust, sensitive, and specific LC-MS/MS method has been developed and validated for the simultaneous quantitation of urinary serotonin and catecholamines with low cost, which is ideal for routine clinical applications. A simple extraction from complex urine was accomplished using tailored solid phase extraction incorporating phenylboronic acid complexation on a 96-well HLB microplate for the sample extraction and resulted in significantly improved throughput, selectivity, and extraction recovery. Compared to 1-10 mL of urine typically used, this method required only 10 μL. A rapid chromatographic elution with a total cycle time of 6 min per sample compared to reported run times of 19-75 min was achieved on a PFP column. The sensitivity of l and 2 ng mL(-1) for the detection of low abundant E and NE combined with the high coverage of 1024 ng mL(-1) for DA enabled the multi-analyte detection of these biogenic amines in a single run. Good linearity (2.0-512, 1.0-512, 4.0-1024, and 4.0-1024 ng mL(-1) for NE, E, DA, and 5-HT, respectively), accuracy (87.6-104.0%), precision (≤8.0%), extraction recovery (69.6-103.7%), and matrix effect (87.1-113.1% for catecholamines and 63.6-71.4% for 5-HT) were obtained. No autosampler carryover was observed. The analytes were stable for 5 days at 20 °C, 14 days at 4 °C, and 30 days at -20 °C and five freeze-thaw cycles. The easy sample preparation, rapid LC, and multi-analyte MS detection allow two 96-well plates of samples to be extracted within 2 h and analyzed on an LC-MS/MS system within 24 h. The applicability and reliability of the assay were demonstrated by

  8. A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients.

    PubMed

    Schein, Oliver D; Pronovost, Peter J

    2017-03-20

    Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.

  9. 1004 cases of traumatic cataract surgery with implantation of an intraocular lens.

    PubMed

    Fyodorov, S N; Egorova, E V; Zubareva, L N

    1981-04-01

    Traumatic cataracts occurring after ocular trauma were removed by phacoemulsification, cryoextraction or extracapsular cataract extraction, depending on the degree of lens absorption. All eyes received sputnik-style iridocapsular lenses. Most cases were complicated by the presence of synechiae and/or the need for iridoplasty. The surgical technique varied with the specific nature of the ocular pathology. Eyes with penetrating injuries has a higher complication rate. Anterior chamber shallowing or collapse was the most frequent intraoperative complication, and was directly related to the incidence of postoperative complications. Most postoperative complications were typical of those associated with cataract surgery in complicated situations.

  10. [The effect of crystalline lens extraction on intraocular pressure in patients with primary open-angle glaucoma].

    PubMed

    Macarie, S; Macarie, Daniela

    2013-01-01

    This issue presents the results of a study on patients with cataract and primary open angle glaucoma who suffered lens extraction for cataract. We analise the effects of the lens extraction on the level of intraocular pressure at this patients.

  11. Low-Dose Radiation Cataract and Genetic Determinants of Radiosensitivity

    SciTech Connect

    Kleiman, Norman Jay

    2013-11-30

    The lens of the eye is one of the most radiosensitive tissues in the body. Ocular ionizing radiation exposure results in characteristic, dose related, progressive lens changes leading to cataract formation. While initial, early stages of lens opacification may not cause visual disability, the severity of such changes progressively increases with dose until vision is impaired and cataract extraction surgery may be required. Because of the transparency of the eye, radiation induced lens changes can easily be followed non-invasively over time. Thus, the lens provides a unique model system in which to study the effects of low dose ionizing radiation exposure in a complex, highly organized tissue. Despite this observation, considerable uncertainties remain surrounding the relationship between dose and risk of developing radiation cataract. For example, a growing number of human epidemiological findings suggest significant risk among various groups of occupationally and accidentally exposed individuals and confidence intervals that include zero dose. Nevertheless, questions remain concerning the relationship between lens opacities, visual disability, clinical cataract, threshold dose and/or the role of genetics in determining radiosensitivity. Experimentally, the response of the rodent eye to radiation is quite similar to that in humans and thus animal studies are well suited to examine the relationship between radiation exposure, genetic determinants of radiosensitivity and cataractogenesis. The current work has expanded our knowledge of the low-dose effects of X-irradiation or high-LET heavy ion exposure on timing and progression of radiation cataract and has provided new information on the genetic, molecular, biochemical and cell biological features which contribute to this pathology. Furthermore, findings have indicated that single and/or multiple haploinsufficiency for various genes involved in DNA repair and cell cycle checkpoint control, such as Atm, Brca1 or Rad9

  12. Gender and cataract--the role of estrogen.

    PubMed

    Zetterberg, Madeleine; Celojevic, Dragana

    2015-02-01

    There is evidence from epidemiologic data that cataract is more common in women than men. This is not solely due to a higher rate of cataract extraction in women, as is the case in the western world, but several population-based studies show that females have a higher prevalence of lens opacities, especially cortical. There is no firm evidence that lifestyle-related factors are the cause of this gender discrepancy. Focus has therefore been directed towards the role of estrogen in cataract formation. Although data on endogenous and exogenous estrogen involvement in cataractogenesis are conflicting, some studies have indicated that hormone therapy may decrease the risk of cataract and thus be protective. It has been hypothesized that the decrease in estrogen at menopause cause increased risk of cataract in women, i.e. not strictly the concentration of estrogen, but more the withdrawal effect. Estrogens are known to exert several anti-aging effects that may explain the longer lifespan in women, including metabolically beneficial effects, neuroprotection, preservation of telomeres and anti-oxidative properties. Since oxidative stress is considered important in cataractogenesis, studies have investigated the effects of estrogens on lens epithelial cells in culture or in animal models. Several investigators have found protection by physiological concentrations of 17β-estradiol against oxidative stress induced by H2O2 in cultured lens epithelial cells. Although both main types of estrogen receptors, ERα and ERβ, have been demonstrated in lens epithelium, most studies so far indicate that the estrogen-mediated protection in the lens is exerted through non-genomic, i.e. receptor-independent mechanisms, possibly through phosphorylation of extracellular signal-regulated kinase (ERK1/ERK2), a member of the mitogen-activated protein kinase (MAPK)-signaling pathway. Further studies are needed, both epidemiologic as to the role of hormone therapies, and laboratory studies

  13. Results of congenital cataract surgery with and without intraocular lens implantation in infants and children.

    PubMed

    Borisovsky, Gilad; Silberberg, Gilad; Wygnanski-Jaffe, Tamara; Spierer, Abraham

    2013-09-01

    Operations for congenital cataract in children in the past had resulted in aphakia. Improvement in surgical tools and techniques as well as in intraocular lens (IOL) implantation has led to correction of the aphakia by IOL implantation. We report the outcome of cataract surgery with and without IOL on these children in our institution between 1991-2008. In this retrospective cohort study, the medical records of all children who underwent surgery for congenital cataract were reviewed. The final study group included 144 children (218 eyes). Postoperative visual acuity (VA) was tested either by Teller Acuity Cards (in preverbal children) or by the Snellen chart. Data on VA status and postoperative complications were retrieved. Patients with bilateral cataract had better postoperative VA than patients with unilateral cataract (logMAR 0.559 ± 0.455 vs. 0.919 ± 0.685, respectively, P < 0.001). Children who underwent IOL implantation had better postoperative VA than those who did not, but the type of surgery had no significant effect after correction for the child's age at surgery (P = 0.346). Secondary cataract occurred more frequently in the extra-capsular cataract extraction (ECCE) + IOL implantation group than in the ECCE only group (20.6 % vs. 8.3 %, respectively, P = 0.018). Patients with bilateral cataract had better postoperative VA compared with those with unilateral cataract. The type of surgery had no effect on final VA, but there was a higher rate of secondary cataract in the ECCE + IOL patients compared to the ECCE only patients.

  14. In-Vivo Automatic Nuclear Cataract Detection and Classification in an Animal Model by Ultrasounds.

    PubMed

    Caixinha, Miguel; Amaro, Joao; Santos, Mario; Perdigao, Fernando; Gomes, Marco; Santos, Jaime

    2016-11-01

    To early detect nuclear cataract in vivo and automatically classify its severity degree, based on the ultrasound technique, using machine learning. A 20-MHz ophthalmic ultrasound probe with a focal length of 8.9 mm and an active diameter of 3 mm was used. Twenty-seven features in time and frequency domain were extracted for cataract detection and classification with support vector machine (SVM), Bayes, multilayer perceptron, and random forest classifiers. Fifty rats were used: 14 as control and 36 as study group. An animal model for nuclear cataract was developed. Twelve rats with incipient, 13 with moderate, and 11 with severe cataract were obtained. The hardness of the nucleus and the cortex regions was objectively measured in 12 rats using the NanoTest. Velocity, attenuation, and frequency downshift significantly increased with cataract formation ( ). The SVM classifier showed the higher performance for the automatic classification of cataract severity, with a precision, sensitivity, and specificity of 99.7% (relative absolute error of 0.4%). A statistically significant difference was found for the hardness of the different cataract degrees ( P = 0.016). The nucleus showed a higher hardness increase with cataract formation ( P = 0.049 ). A moderate-to-good correlation between the features and the nucleus hardness was found in 23 out of the 27 features. The developed methodology made possible detecting the nuclear cataract in-vivo in early stages, classifying automatically its severity degree and estimating its hardness. Based on this work, a medical prototype will be developed for early cataract detection, classification, and hardness estimation.

  15. [The denominations cataract and glaucoma].

    PubMed

    Tornquist, R

    1997-01-01

    Since ancient times a grey or white pupil in an nearly blind eye was thought to be caused by a mucous substance in front of the lens. It was called "hypochysis" or "hypochyma" in Greece and "suffusio" in Rome. Later the term "cataract" (=waterfall) was the most popular denomination. A surgical method was tried very early with usually good effect, when with a thin needle, introduced into the eye, the opaque material was removed from the pupillary area. In the middle of the 17th century more careful investigations showed that there was no membrane in front of the lens, but the lens itself was opaque. The final proof was delivered when an extraction of the lens was performed with good effect. In ancient times incurable blindness, which was called glaucoma, was thought to be located to the lens, which probably had a very important role in the seeing process. The name (of Greek orgin) is translated "green" or "blue-green", which was sometimes notified to be the color of the lens, seen through the pupil, in these cases. A period of great confusion followed when the removal of this very important part of the eye did not lead to blindness but rather an improved vision. As there were significant difficulties in identifying the specific color of the pupil the name glaucoma seemed to be very inadequate. In the beginning of the 19th century a disease entity (which is to-day called acute closed-angle glaucoma) seemed to eventually fullfill the demand of a greenlooking pupil. The most characteristic symptoms are pain and a high intraocular pressure causing a corneal edema and a change of the blackness of the pupil to hazy grey (and maybe a little green?).

  16. Emerging Technology in Refractive Cataract Surgery

    PubMed Central

    Saraiva, João; Neatrour, Kristin; Waring IV, George O.

    2016-01-01

    Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients. Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs). This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner. PMID:27433353

  17. Blindness, cataract surgery and mortality in Ethiopia.

    PubMed

    Thomas, Benjamin J; Sanders, David S; Oliva, Matthew S; Orrs, Mark S; Glick, Peter; Ruit, Sanduk; Chen, Wei; Luoto, Jill; Tasfaw, Alemu Kerie; Tabin, Geoffrey C

    2016-09-01

    To examine the relationships between blindness, the intervention of cataract surgery and all-cause mortality in a rural Ethiopian population. Population-based, interventional prospective study. Community-based detection methods identified blind Ethiopian persons from two selected kebeles in Amhara region, Ethiopia. Data from 1201 blind patients were collected-628 cataract-blind and 573 blind from other conditions. Free cataract surgery was provided for consenting, cataract-blind patients. Follow-up surveys were conducted after 12 months (±1 month)-the main outcome measure for this report is all-cause mortality at 1 year. During the follow-up period, 110 persons died from the selected population (mortality 9.2%), which consisted of those cataract-blind patients who received cataract surgery (N=461), cataract-blind patients who did not receive surgery (N=167) and all non-cataract-blind patients (N=573). Of the 461 patients who received cataract surgery, 44 patients died (9.5%). Of the 740 patients who did not receive surgery, 66 died (8.9%)-28 patients from the cohort of cataract-blind patients who did not receive surgery (16.8%) and 38 patients from the cohort of non-cataract blind (6.6%). Subgroup analysis revealed significantly increased odds of mortality for cataract-blind patients over 75 years of age who did not receive surgery and for unmarried patients of all age groups. In this population, mortality risk was significantly elevated for older cataract-blind patients when compared with non-cataract-blind patients-an elevation of risk that was not noted in an age-matched cohort of cataract-blind patients who underwent cataract surgery as early as 1-year follow-up. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Emerging Technology in Refractive Cataract Surgery.

    PubMed

    Saraiva, João; Neatrour, Kristin; Waring Iv, George O

    2016-01-01

    Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients. Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs). This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

  19. Cataract surgery with femtosecond lasers.

    PubMed

    Alió, Jorge L

    2011-07-01

    Cataract surgery with femtosecond lasers is approaching its practical application in ophthalmology. These lasers, working in the near infrared wavelength (1030 nm) can penetrate the transparent and even opaque tissues of the anterior segment of the eye, with limitations related to vessels and mineral opacities. Femtosecond lasers, guided by image systems can precisely outline the anatomy of the anterior segment of the eye, acting in a very precise way, performing corneal incisions, capsulorhexis, softening and breaking of the nucleus, which are essential steps in cataract surgery. In this article we summarize the four technologies available and approaching commercial application in the coming future. The main differences between the systems are based on the diagnostic imaging techniques, which might either be based on optical coherence tomography or the Scheimpflug principles. One model (the Technolas Femtec 520 F custom lens, 20/10 Perfect Vision), offers the possibility of combined use in corneal and intraocular surgery. While clinical studies are being performed with all of them, and most probably becoming available on the market during 2011 and 2012, the main problem of this emerging technology is its practical application as the increase in costs will affect their availability in the market of cataract surgery. Research is needed to confirm the practicality and the advantages of femtosecond laser cataract surgery over conventional surgery. Meanwhile, a new path for the future of cataract surgery is opening.

  20. Pain perception in sequential cataract surgery: comparison of first and second procedures.

    PubMed

    Ursea, Roxana; Feng, Matthew T; Zhou, Michael; Lien, Vivian; Loeb, Robert

    2011-06-01

    To compare pain and anxiety between first and second cataract extractions under topical anesthesia with monitored anesthesia care. University ophthalmology clinic. Cohort study. Consecutive adults having bilateral sequential clear corneal cataract extraction using phacoemulsification under topical anesthesia with monitored anesthesia care were recruited. Exclusion criteria included baseline eye pain, poor comprehension, and complicated cataract extraction. Patients completed 4 short perioperative surveys with each cataract extraction as follows: the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Scale (STAI) preoperatively and a 0-to-10 visual analog scale pain survey twice after surgery. Pain and difference in pain were the primary outcomes. Of the 65 patients who completed the study, 26 (40%) reported higher visual analog scale pain scores for the second cataract extraction. Overall, the median pain score was 0 (range 0 to 6) for the first cataract extraction and 1 (range 0 to 9) for the second (P = .004). By 1 day postoperatively, the pain scores were similar (median 0; range 0 to 9; P = .58). Both APAIS and STAI anxiety scores decreased between surgeries (P = .003 and P < .001, respectively). Although cataract extraction remained relatively painless under topical anesthesia with monitored anesthesia care, there was a subtle increase in pain in the second surgery relative to the first. This appears to be associated with decreased preoperative anxiety and may be related to the amnestic effects of intravenous sedation. These data may explain a common operative observation. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Cataract surgery in a patient with severe chronic iritis and corneal endothelial damage.

    PubMed

    Yasukawa, T; Suga, K; Yokoo, N; Asada, S

    1998-07-01

    We report a patient with broad anterior synechias and corneal endothelial damage. The patient had chronic iritis and cataracts secondary to chronic iritis in both eyes. Because the right eye had broad anterior synechias and severe corneal endothelial damage, extracapsular cataract extraction and intraocular lens implantation were performed through the basal iris. Good postoperative visual acuity was obtained. The cornea showed little trauma from the surgery and remained clear 36 months postoperatively.

  2. Surgical strategies for coexisting glaucoma and cataract: an evidence-based update.

    PubMed

    Friedman, David S; Jampel, Henry D; Lubomski, Lisa H; Kempen, John H; Quigley, Harry; Congdon, Nathan; Levkovitch-Verbin, Hani; Robinson, Karen A; Bass, Eric B

    2002-10-01

    To assess short- and long-term control of intraocular pressure (IOP) with different surgical treatment strategies for coexisting cataract and glaucoma. Systematic literature review and analysis. We performed a search of the published literature to identify all eligible articles pertaining to the surgical management of coexisting cataract and glaucoma in adults. One investigator abstracted the content of each article onto a custom-designed form. A second investigator corroborated the findings. The evidence supporting different approaches was graded by consensus as good, fair, weak, or insufficient. Short-term (24 hours or fewer) and long-term (more than 24 hours) IOP control. The evidence was good that long-term IOP is lowered more by combined glaucoma and cataract operations than by cataract operations alone. On average, the IOP was 3 to 4 mmHg lower in the combined groups with fewer medications required. The evidence was weak that extracapsular cataract extraction (ECCE) alone results in short-term increase in IOP and was insufficient to determine the short-term impact of phacoemulsification cataract extraction (PECE) on IOP in glaucoma patients. The evidence was weak that short-term IOP control was better with ECCE or PECE combined with an incisional glaucoma procedure compared with ECCE or PECE alone. The evidence was also weak (but consistent) that long-term IOP is lowered by 2 to 4 mmHg after ECCE or PECE. Finally, there was weak evidence that combined PECE and trabeculectomy produces slightly worse long-term IOP control than trabeculectomy alone, and there was fair evidence that the same is true for ECCE combined with trabeculectomy. There is strong evidence for better long-term control of IOP with combined glaucoma and cataract operations compared with cataract surgery alone. For other issues regarding surgical treatment strategies for cataract and glaucoma, the available evidence is limited or conflicting.

  3. Surgical interventions for age-related cataract.

    PubMed

    Riaz, Y; Mehta, J S; Wormald, R; Evans, J R; Foster, A; Ravilla, T; Snellingen, T

    2006-10-18

    Cataract accounts for 50% of blindness globally and remains the leading cause of visual impairment in all regions of the world, despite improvements in surgical outcomes (WHO 2005). This number is expected to rise due to an aging population and increase in life expectancy. Although cataracts are not preventable, their surgical treatment is one of the most cost-effective interventions in healthcare. To compare the effects of different surgical interventions for age-related cataract. We searched CENTRAL, MEDLINE, EMBASE up to July 2006, NRR Issue 3 2005, the reference lists of identified trials and we contacted investigators and experts in the field for details of published and unpublished trials. We included randomised controlled trials (RCTS). Two review authors independently extracted data and discrepancies were resolved by discussion. Where appropriate, risk ratios, odds ratios and weighted mean differences were summarised after assessing heterogeneity between the studies. We identified 17 trials that randomised a total of 9627 people. Phacoemulsification gave a better visual outcome than extracapsular surgery but similar average cost per procedure in Europe but not in poorer countries. Extracapsular surgery with posterior chamber lens implant and ICCE with or without an anterior chamber intraocular lens (IOL) implant gave acceptable visual outcomes but extracapsular surgery had less complications. Manual small incision surgery provides better visual outcome than ECCE but slightly inferior unaided visual acuity compared to phacoemulsification. This review provides evidence from seven RCTs that phacoemulsification gives a better outcome than ECCE with sutures. We also found evidence that ECCE with a posterior chamber lens implant provides better visual outcome than ICCE with aphakic glasses. The long term effect of posterior capsular opacification (PCO) needs to be assessed in larger populations. The data also suggests that ICCE with an anterior chamber lens

  4. Persistent vertical diplopia after cataract surgery: a case report.

    PubMed

    Migliorini, R; Fratipietro, M; Segnalini, A; Arrico, L

    2013-01-01

    Diplopia is an event that can occur following cataract surgery, although its rate of occurrence is limited and ranges from 0.67% to 0.85%. The authors present a case of vertical diplopia arising after peribulbar anaesthesia for cataract surgery in a 78-year-old woman. Diplopia appeared at distance in primary position, while at near there was binocular single vision. Stereopsis was present at the Lang I - II Test, but the Wirth Test was incomplete. Although in the literature the frequency of these "accidents" is very limited, we think it is relevant to emphasize the need to perform pre-operative routine using a careful orthoptic examination along with a thorough medical, especially strabological, history.

  5. [Cataract phacoemulsification after vitreoretinal surgery].

    PubMed

    Zhou, Qing-hua; Li, Yun

    2008-11-01

    To evaluate the characteristics, safety and therapeutic effect of cataract phacoemulsification after vitreoretinal surgery. We retrospectively reviewed 132 patients (132 eyes) which had phacoemulsification after vitreoretinal surgery between July 2001 and December 2004 in our hospital, among which 67 patients (50.75%) combined with silicon oil removal.We also analyzed the difficulties and complications of the surgery. Patients were followed up for 7-14 months.Three eyes with broken suspensory ligaments were implanted with one point transcleral fixed intraocular lens(iol).Corrected visual acuity improved in 123 patients (93.18%), no change in 6 patients (4.54%), and visual acuity loss in 3 patients (2.27%). Cataract surgery is high difficult after the vitreoretinal surgery. Phacoemulsification can easily adjust and control intraocular pressure, simplify the operation,and reduce complications during and after the surgery. Silicon oil removal combined with cataract phacoemulsification is safe and economic.

  6. Thermal cataract formation in rabbits

    SciTech Connect

    Kramar, P.; Harris, C.; Guy, A.W.

    1987-01-01

    Intraocularly circulating hot water was used to produce cataracts in nine eyes of seven rabbits by maintaining their retrolental temperatures between 43 degrees C and 45 degrees C. A rapid rate of heating (1.3 degrees C/min) plus a sharp temperature gradient across the eye may have been contributing factors in the consistent production of cataracts at these temperatures. Biomicroscopy and light microscopy showed lens changes similar to those associated with acute exposure to microwave radiation. These findings support the assumption that microwave cataractogenesis is due to the local production of elevated temperatures.

  7. Routine Responses to Disruption of Routines

    ERIC Educational Resources Information Center

    Guha, Mahua

    2015-01-01

    "Organisational routines" is a widely studied research area. However, there is a dearth of research on disruption of routines. The few studies on disruption of routines discussed problem-solving activities that are carried out in response to disruption. In contrast, this study develops a theory of "solution routines" that are a…

  8. Cysteamine prevents the development of lens opacity in a rat model of selenite-induced cataract.

    PubMed

    Lee, Sang-Mok; Jeong, Eui Man; Jeong, Jinho; Shin, Dong-Myung; Lee, Hyun-Ju; Kim, Hyo-Jun; Lim, Jisun; Lee, Jin-Haeng; Cho, Sung-Yup; Kim, Mee-Kum; Wee, Won-Ryang; Lee, Jin-Hak; Kim, In-Gyu

    2012-03-15

    The activation of transglutaminase 2 (TG2) by oxidative stress through TGFβ has been reported to play a crucial role in cataract formation. The authors investigated whether TG2 is involved in selenite-induced cataract formation in rats and whether cysteamine, a chemical inhibitor of TG2, can prevent cataract formation in this model. Intracellular TG2 activity was monitored in a human lens epithelial cell (HLE-B3) line and cultured rat lenses after treatment with selenite. Rat pups (13 days old) were injected subcutaneously with sodium selenite (Na(2)SeO(3); 20 μmol/kg) and intraperitoneally with cysteamine (30, 40, and 60 mg/kg) for 14 days. Lenses were evaluated photographically at days 7 and 14. The concentrations of malondialdehyde and glutathione in the lenses were determined. In HLE-B3 cells or rat lenses, selenite induced intracellular TG activity, which was inhibited by cysteamine. In selenite-treated rats, the rate of cataract formation was significantly reduced by cysteamine (P < 0.001). The mean cataract area in the lenses of cysteamine-treated rats was smaller than that of control rats (P < 0.01). The levels of total and reduced glutathione in the lenses of cysteamine-treated rats extracted at day 14 were higher than those of control rats. Cysteamine suppresses cataract formation induced by selenite in rats, suggesting that cysteamine can be used as a pharmaceutical intervention to prevent or delay cataract formation.

  9. A prospective study on postoperative pain after cataract surgery

    PubMed Central

    Porela-Tiihonen, Susanna; Kaarniranta, Kai; Kokki, Merja; Purhonen, Sinikka; Kokki, Hannu

    2013-01-01

    Purpose To evaluate postoperative pain and early recovery in cataract patients. Patients and methods A total of 201 patients who underwent elective first eye cataract extraction surgery were enrolled, and 196 were included in the final analysis. The study design was a single-center, prospective, follow-up study in a tertiary hospital in eastern Finland. Postoperative pain was evaluated with the Brief Pain Inventory at four time points: at baseline, and at 24 hours, 1 week, and 6 weeks postsurgery. Results Postoperative pain was relatively common during the first hours after surgery, as it was reported by 67 (34%) patients. After hospital discharge, the prevalence decreased; at 24 hours, 1 week, and 6 weeks, 18 (10%), 15 (9%) and 12 (7%) patients reported having ocular pain, respectively. Most patients with eye pain reported significant pain, with a score of ≥4 on a pain scale of 0–10, but few had taken analgesics for eye pain. Those who had used analgesics rated the analgesic efficacy of paracetamol and ibuprofen as good or excellent. Other ocular irritation symptoms were common after surgery; as a new postoperative symptom, foreign-body sensation was reported by 40 patients (22%), light sensitivity by 29 (16%), burning by 15 (8%), and itching by 15 (8%). Conclusion Moderate or severe postoperative pain was relatively common after cataract surgery. Thus, all patients undergoing cataract surgery should be provided appropriate counseling on pain and pain management after surgery. PMID:23885165

  10. Treatment of congenital aniridia associated with subluxated infantile cataract.

    PubMed

    Jusufovic, Vahid; Cabric, Emir; Popovic-Beganovic, Allen; Musanovic, Zlatko; Zvornicanin, Jasmin

    2014-01-01

    A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0.08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109 degrees in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of delta6 degrees, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25 Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

  11. Treatment of congenital aniridia associated with subluxated infantile cataract.

    PubMed

    Jusufovic, Vahid; Cabric, Emir; Popovic-Beganovic, Allen; Musanovic, Zlatko; Zvornicanin, Jasmin

    2014-06-01

    A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0,08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109° in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of Δ6º, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

  12. Strategic issues in preventing cataract blindness in developing countries.

    PubMed Central

    Ellwein, L. B.; Kupfer, C.

    1995-01-01

    Cataract blindness is a public health problem of major proportions in developing countries. Intracapsular cataract extraction with aphakic spectacles has been the standard surgical technique for restoring sight. Because of image magnification in the operated eye, however, the result in unilaterally blind patients is less than satisfactory. Fortunately, with the availability of low-cost intraocular lenses (IOL) and ophthalmologists trained in extracapsular surgery, it is now practical to intervene successfully in the unilateral case. The need for increased attention on the quality of the visual high prevalence of cataract blindness in developing countries and an increasing cataract incidence due to an aging population require substantial increases in surgical volume. The third issue relates to cost. If significant increases in surgical volume and quality of outcomes are to be realized without an increased need for external funding, service delivery must be made more efficient. The expansion of IOL surgery for unilateral blindness is a favourable trend in ensuring financial sustainability of delivery systems; patients can be operated on while still economically productive and able to pay rather than waiting for bilateral blindness and a less favourable economic and social impact. If the quality, volume, and cost issues are to be successfully addressed, operational and structural changes to eye care delivery systems are necessary. These changes can be effected through training, technology introduction, management of facilities, social marketing, organizational partnerships, and evaluation. With improved understanding of the critical factors in successful models their widespread replication will be facilitated. PMID:8846495

  13. [Evaluation of results of combined pars plana vitrectomy and cataract removal].

    PubMed

    Wilczyński, Michał; Pikulski, Zbigniew; Dziegielewski, Krzysztof; Omulecki, Wojciech

    2005-01-01

    Cataract often coexists with pathologies of the vitreous body. Moreover, after several months after vitrectomy, the lens becomes opaque. Lens opacities interfere with appropriate visualisation of the vitreous chamber and the eye fundus, which makes performing vitreoretinal procedures difficult. For this reason, in such patients, a combined procedure of pars plana vitrectomy and cataract extraction can be considered. This is retrospective analysis of the indications and results of combined cataract extraction and pars plana vitrectomy. The data were based on case histories of patients who underwent combined cataract extraction and pars plana vitrectomy in the years 2001 - 2003, in the Department of Ophthalmology, Medical University of Lódź. The evaluated data included: diagnosis, pre- and postoperative best corrected visual acuity, intraocular pressure, pre- and postoperative state of the anterior and posterior segment of the eye and the employed surgical techniques. The examined group consisted of 40 patients (40 eyes), including 20 men and 20 women, at the age from 13 to 76 years old (mean 55.7, SD+/-14.6). The indications to vitrectomy were: vitreous haemorrhage, retinal detachment, vitreoretinal proliferations, intraocular foreign body, persistent hyaloid artery and endophthalmitis. Phacoemulsification was the most often used method of cataract extraction (34 people, 85%). In three patients cataract was removed by classical extracapsular cataract extraction (ECCE), and in further 3 patients bimanual aspiration was used. In terms of anatomical results, therapeutic success was achieved in 35 cases (87,5%). Improvement of visual acuity was observed in 28 people (70%), unchanged visual acuity in 10 people (25%), and a decrease in visual acuity in 2 patients (5%). Improvement of visual acuity at least 2 lines on Snellen's chart was achieved in 20 patients (50%).

  14. Dermatoglyphic profile in congenital cataracts.

    PubMed

    Angra, S K; Rao, N P; Panda, A; Grewal, M S

    1990-01-01

    Forty-five children with congenital cataract cases were studied for patterns and compared with age sex matched controls. The patients showed marked differences in different dermatoglyphic traits. The intra uterine aetiological groups i.e. rubella, hereditary and undetected aetiology, showed variations in mainline terminations. Rubella group showed increased angle atd.

  15. Cataract surgery - series (image)

    MedlinePlus

    ... end of the needle produces sound waves. The sound waves break up the lens, which is then sucked out through the needle. This procedure requires a smaller incision than the manual extraction procedure.

  16. Cataract Surgery in a Patient with Amyotrophic Lateral Sclerosis: A Case Report

    PubMed Central

    Cenk Kohen, Maryo; Beril Kucumen, Raciha

    2011-01-01

    Abstract We report a cataract operation with complications in a patient with amyotrophic lateral sclerosis (ALS). The patient had a grade 4 mature brown cataract. Phacoemulsification with intraocular lens (IOL) implantation was planned; however, due to unexpected complications occurring during surgery, the operating technique was revised to an intracapsular cataract extraction. A very high vitreous pressure was found and therefore scleral fixating IOL was not implanted after anterior vitrectomy because of the possibility of choroidal effusion. The postoperative visual acuity improved sufficiently for the patient to communicate. Visual communication is of vital importance for an ALS patient and his caregivers. Therefore, surgery may be advisable in patients at a terminal stage with an advanced cataract, even if their general health condition may not seem appropriate for such an operation. Nevertheless, the intra- and postoperative course of the surgery may show unexpected complications and the surgeon should be prepared for such conditions. PMID:21886620

  17. (An)aerobic bacteria found in secondary-cataract material. A SEM/TEM study.

    PubMed

    Kalicharan, D; Jongebloed, W L; Los, L I; Worst, J G

    1992-01-01

    Twenty four patients, who had marked reduction of vision due to secondary-cataract developed after an ECCE, were treated by surgical cleaning of the posterior lens capsule. During this procedure globular secondary-cataract material was removed and collected for morphological examination by SEM and TEM. Fragments of various sizes and shapes, including some with a 'golf ball' structure, were seen; these closely resembled particles frequently found in cataractous lenses. In addition, in 18 patients micro-organisms were found: rod-shaped bacteria, cocci, and in 2 cases yeasts. These findings were the more remarkable because these were clinically quiet eyes with no signs of intra-ocular inflammation and cultures have been persistently negative. We imagine that these bacteria must have entered the eye during the cataract extraction and have settled there without causing an infection.

  18. Comparison between Subjective Sensations during First and Second Phacoemulsification Eye Surgeries in Patients with Bilateral Cataract

    PubMed Central

    Yu, Ji-guo; Ye, Ting; Huang, Qing; Feng, Yi-fan; Wang, Jue; Fu, Xun-an; Xiang, Yi

    2016-01-01

    Purpose. To evaluate and compare the subjective sensations reported by patients during first and second cataract extractions. Methods. Consecutive patients undergoing bilateral sequential cataract extraction using phacoemulsification were recruited. Following cataract surgery, patients completed questionnaires designed to evaluate subjective sensations, including anxiety, eye bulges, pain, and light sensitivity. Changes in painful sensations experienced by patients between the two surgeries were also recorded. Comparisons were also performed for each subjective sensation between different age groups (<50, 50–59, 60–69, 70–79, and >79 years). Results. A total of 127 patients were included in the final evaluation. Statistical comparison of the results showed that there were significant differences in perception of anxiety, eye bulges, and pain scores between the first and second cataract surgeries (P < 0.05). However, there was no statistically significant difference for light sensitivity scores between the two surgeries (P = 0.555). The differences in anxiety, perception of eye bulges, pain, and light sensitivity scores between both the surgeries showed no correlation with age (P > 0.05 for all). Conclusions. Our research confirms the common observation that patients with bilateral cataracts often report more ocular discomfort during the second surgery. There are, therefore, additional factors that should be considered upon treating patients with bilateral cataracts, and the provision of preoperative counseling could play an important role in providing adequate patient care. PMID:27239336

  19. Folic Acid, Vitamin B6, and Vitamin B12 in Combination and Age-Related Cataract in a Randomized Trial of Women.

    PubMed

    Christen, William G; Glynn, Robert J; Chew, Emily Y; Albert, Christine M; Manson, JoAnn E

    2016-01-01

    To examine the incidence of cataract and cataract extraction in a trial of folic acid and vitamins B6 and B12. In a randomized, double-masked, placebo-controlled trial, 5442 female health professionals aged 40 years or older with preexisting cardiovascular disease (CVD) or three or more CVD risk factors were randomly assigned to receive a combination of folic acid (2.5 mg/day), vitamin B6 (50 mg/day), and vitamin B12 (1 mg/day), or placebo. A total of 3925 of these women did not have a diagnosis of cataract at baseline and were included in this analysis. The primary endpoint was age-related cataract, defined as an incident age-related lens opacity, responsible for a reduction in best-corrected visual acuity to 20/30 or worse, based on self-report confirmed by medical record review. Extraction of incident age-related cataract was a secondary endpoint of the trial. During an average of 7.3 years of treatment and follow-up, 408 cataracts and 275 cataract extractions were documented. There were 215 cataracts in the combination treatment group and 193 in the placebo group (hazard ratio, HR, 1.10, 95% confidence interval, CI, 0.90-1.33; p = 0.36). For the secondary endpoint of cataract extraction, there were 155 in the combination treatment group and 120 in the placebo group (HR 1.28, 95% CI 1.01-1.63; p = 0.04). In this large-scale randomized trial of women at high risk of CVD, daily supplementation with a combination of folic acid, vitamin B6, and vitamin B12 had no significant effect on cataract, but may have increased the risk of cataract extraction.

  20. Surgical techniques of cataract surgery and subsequent postoperative endophthalmitis.

    PubMed

    Trinavarat, Adisak; Atchaneeyasakul, La-ongsri

    2005-11-01

    To compare the incidence and characteristics of patients with endophthalmitis after extracapsular cataract extraction (ECCE) to those after phacoemulsification Records of patients receiving intravitreal antibiotic injection to treat endophthalmitis after cataract surgery between Jan 2001 and Dec 2004 were reviewed. Demographic data and other characteristics including associated diseases, details of cataract surgical procedure and intraoperative complication, onset of endophthalmitis after cataract surgery, presenting symptoms and signs of endophthalmitis, how endophthalmitis was managed, causative organisms, duration of hospitalization and results of treatment were collected. This information was compared between those of endophthalmitis patients after ECCE and those after phacoemulsification. There were 5 cases who developed endophthalmitis after ECCE and 31 cases after phacoemulsification. The incidence was 0.365% after ECCE and 0.279% after phacoemulsification (p = 0.589). Visual acuity (VA) before cataract surgery in ECCE group was worse than the phacoemulsification group (median VA: counting fingers vs 6/36, p = 0.001). Median onset of endophthalmitis was 8 days after ECCE and 6 days after phacoemulsification. Presenting symptoms and signs were similar. Causative agents were identified in 4 (80%) and 14 (45%) cases in the ECCE and phacoemulsification groups respectively. Gram-positive bacteria were the major cause of infection in both groups. Endophthalmitis caused by citrobacter sp. in ECCE group and enterococcus or streptococcus sps. the phacoemulsification in the group ended up with enucleation or no light perception. The present study has not demonstrated an apparent difference between endophthalmitis after ECCE and those after phacoemulsification. Endophthalmitis after either procedure can be managed as the same condition.

  1. Results of cataract surgery in the very elderly population

    PubMed Central

    Michalska-Małecka, Katarzyna; Nowak, Mariusz; Gościniewicz, Piotr; Karpe, Jacek; Słowińska-Łożyńska, Ludmiła; Łypaczewska, Agnieszka; Romaniuk, Dorota

    2013-01-01

    Aim The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older, whom we define as “very elderly.” Methods The study involved a total number of 122 patients (122 eyes) with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old). Phacoemulsification (phaco) was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery. Results Best corrected visual acuity (BCVA) improved in 100 of 122 eyes (82.0%). BCVA remained the same in 20 of 122 eyes (16.4%) and decreased in 2 of 122 eyes (1.6%), mainly because of coexisting age-related macular degeneration (AMD). The BCVA 3 months after surgery was ≥0.8 in 23 of 122 eyes (18.9%), between 0.5 and 0.7 in 28 of 122 eyes (22.3%), and between 0.2 and 0.4 in 33 of 122 eyes (27.1%). We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma. Conclusion Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe. PMID:23966774

  2. Predictive Modeling of Risk Factors and Complications of Cataract Surgery

    PubMed Central

    Gaskin, Gregory L; Pershing, Suzann; Cole, Tyler S; Shah, Nigam H

    2016-01-01

    Purpose To quantify the relationship between aggregated preoperative risk factors and cataract surgery complications, as well as to build a model predicting outcomes on an individual-level—given a constellation of demographic, baseline, preoperative, and intraoperative patient characteristics. Setting Stanford Hospital and Clinics between 1994 and 2013. Design Retrospective cohort study Methods Patients age 40 or older who received cataract surgery between 1994 and 2013. Risk factors, complications, and demographic information were extracted from the Electronic Health Record (EHR), based on International Classification of Diseases, 9th edition (ICD-9) codes, Current Procedural Terminology (CPT) codes, drug prescription information, and text data mining using natural language processing. We used a bootstrapped least absolute shrinkage and selection operator (LASSO) model to identify highly-predictive variables. We built random forest classifiers for each complication to create predictive models. Results Our data corroborated existing literature on postoperative complications—including the association of intraoperative complications, complex cataract surgery, black race, and/or prior eye surgery with an increased risk of any postoperative complications. We also found a number of other, less well-described risk factors, including systemic diabetes mellitus, young age (<60 years old), and hyperopia as risk factors for complex cataract surgery and intra- and post-operative complications. Our predictive models based on aggregated outperformed existing published models. Conclusions The constellations of risk factors and complications described here can guide new avenues of research and provide specific, personalized risk assessment for a patient considering cataract surgery. The predictive capacity of our models can enable risk stratification of patients, which has utility as a teaching tool as well as informing quality/value-based reimbursements. PMID:26692059

  3. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract.

    PubMed

    Mathew, Milan C; Ervin, Ann-Margret; Tao, Jeremiah; Davis, Richard M

    2012-06-13

    Age-related cataract is a major cause of visual impairment in the elderly. Oxidative stress has been implicated in its formation and progression. Antioxidant vitamin supplementation has been investigated in this context. To assess the effectiveness of antioxidant vitamin supplementation in preventing and slowing the progression of age-related cataract. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1950 to March 2012), EMBASE (January 1980 to March 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to March 2012), Open Grey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 2 March 2012. We also checked the reference lists of included studies and ongoing trials and contacted investigators to identify eligible randomized trials. We included only randomized controlled trials in which supplementation with one or more antioxidant vitamins (beta-carotene, vitamin C and vitamin E) in any form, dosage or combination for at least one year was compared to another antioxidant vitamin or to placebo. Two authors extracted data and assessed trial quality independently. We pooled results for the primary outcomes, i.e., incidence of cataract and incidence of cataract extraction. We did not pool results of the secondary outcomes - progression of cataract and loss of visual acuity, because of differences in definitions of outcomes and data presentation. We pooled results by type of cataract when data were available. We did not perform a sensitivity analysis. Nine trials involving 117

  4. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract

    PubMed Central

    Mathew, Milan C; Ervin, Ann-Margret; Tao, Jeremiah; Davis, Richard M

    2013-01-01

    Background Age-related cataract is a major cause of visual impairment in the elderly. Oxidative stress has been implicated in its formation and progression. Antioxidant vitamin supplementation has been investigated in this context. Objectives To assess the effectiveness of antioxidant vitamin supplementation in preventing and slowing the progression of age-related cataract. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1950 to March 2012), EMBASE (January 1980 to March 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to March 2012), Open Grey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 2 March 2012. We also checked the reference lists of included studies and ongoing trials and contacted investigators to identify eligible randomized trials. Selection criteria We included only randomized controlled trials in which supplementation with one or more antioxidant vitamins (beta-carotene, vitamin C and vitamin E) in any form, dosage or combination for at least one year was compared to another antioxidant vitamin or to placebo. Data collection and analysis Two authors extracted data and assessed trial quality independently. We pooled results for the primary outcomes, i.e., incidence of cataract and incidence of cataract extraction. We did not pool results of the secondary outcomes - progression of cataract and loss of visual acuity, because of differences in definitions of outcomes and data presentation. We pooled results by type of cataract when data

  5. Crystal cataracts: Human genetic cataract caused by protein crystallization

    NASA Astrophysics Data System (ADS)

    Pande, Ajay; Pande, Jayanti; Asherie, Neer; Lomakin, Aleksey; Ogun, Olutayo; King, Jonathan; Benedek, George B.

    2001-05-01

    Several human genetic cataracts have been linked recently to point mutations in the D crystallin gene. Here we provide a molecular basis for lens opacity in two genetic cataracts and suggest that the opacity occurs because of the spontaneous crystallization of the mutant proteins. Such crystallization of endogenous proteins leading to pathology is an unusual event. Measurements of the solubility curves of crystals of the Arg-58 to His and Arg-36 to Ser mutants of D crystallin show that the mutations dramatically lower the solubility of the protein. Furthermore, the crystal nucleation rate of the mutants is enhanced considerably relative to that of the wild-type protein. It should be noted that, although there is a marked difference in phase behavior, there is no significant difference in protein conformation among the three proteins.

  6. DETAIL OF NORTHEAST CUT STONE ABUTMENT FROM SOUTHWEST. Cataract ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL OF NORTHEAST CUT STONE ABUTMENT FROM SOUTHWEST. - Cataract Falls Bridge, Spanning Mill Creek, bypassed section of CR 279 (Cataract Falls Unit of Leiber State Recreation Area), Cataract, Owen County, IN

  7. Pre-cataract surgery test using speckle pattern

    NASA Astrophysics Data System (ADS)

    Jutamulia, Suganda; Wihardjo, Erning; Widjaja, Joewono

    2016-11-01

    A laser diode device for pre cataract surgery test is proposed. The operation is based on the speckle generated on the retina by the cataract lens, when the cataract lens is illuminated with a coherent laser light.

  8. Vitrectomy as a Risk Factor for Complicated Cataract Surgery.

    PubMed

    Fenberg, Moss J; Hainsworth, Kenneth J; Rieger, Frank G; Hainsworth, Dean P

    2016-01-01

    A retrospective review of 98 cases of complicated cataract surgery and/or delayed intraocular lens (IOL) dislocation examined the relationship between vitrectomy and cataract surgery complications. Nine (9.2%) of the 98 patients had a history of vitrectomy, before or after cataract surgery, and each had complicated cataract surgery. Six patients who underwent vitrectomy before cataract surgery experienced intraoperative complications. Three patients in whom vitrectomy was performed after uneventful cataract surgery subsequently had delayed IOL dislocation.

  9. Corneal astigmatism after cataract surgery.

    PubMed

    Dekkers, N W; Buijs, J

    1989-08-01

    206 Consecutive cataract patients were at random divided into three groups according to the way the cataract incision was closed: virgin silk 8-0, interrupted nylon 9-0, and double running nylon 9-0. The nylon, whether interrupted or continuous, yielded in the majority of cases a postoperative astigmatism with the rule, whereas virgin silk caused in nearly all patients a postoperative astigmatism against the rule and therefore behaved like an absorbable suture. Silk is chemically non-absorbable, but in virgin silk a natural worm-produced polymer is still present, which provokes a tissue reaction. Softening of tissue diminishes the tensile strength of the suture. With respect to the postoperative astigmatism, the suture material (nylon or virgin silk) seems a more important factor than the way in which it is used (interrupted or continuous).

  10. Long-Term Visual Outcomes of Secondary Intraocular Lens Implantation in Children with Congenital Cataracts

    PubMed Central

    Jiang, Yongxiang; Lu, Yi

    2015-01-01

    Aim The aim of this study was to evaluate the long-term visual outcomes and factors affecting visual results in children undergoing secondary intraocular lens (IOL) implantation following primary congenital cataract extraction. Methods Children with congenital cataracts who underwent secondary IOL implantation for aphakia at the Eye and ENT Hospital of Fudan University between January 1, 2001, and December 31, 2007, were retrospectively reviewed. One eye was randomly selected in children with bilateral cataracts. Laterality, type of cataract (total or partial opacity), sex, age at primary and secondary surgeries, visual axis opacity (VAO), compliance with amblyopia therapy, postoperative ocular complications, refractive error, ocular alignment, and best corrected visual acuity (BCVA) at last follow-up were recorded; potential factors that might have affected the visual results were evaluated. Results Seventy-six bilateral and 34 unilateral congenital cataract cases were analyzed; the mean ages of the children were 12.70±5.06 and 12.50±2.71 years at final follow-up, the mean follow-up periods from IOL implantation were 94.93±24.22 and 109.09±18.89 months, and the mean BCVA (Log MAR) values were 0.51±0.37 and 1.05±0.46, respectively. Final BCVA after secondary IOL implantation was significantly associated with laterality, type of cataract, age at primary cataract extraction, compliance with amblyopia therapy, and refractive correction after surgery. No significant associations were found between BCVA and sex, age at secondary IOL implantation, VAO, or other ocular complications. The most common ocular complications were VAO and elevated intraocular pressure after surgery. There were no other complications, with the exception of one eye with IOL dislocation. Conclusions The results indicate that the important determinants of long-term visual outcomes in children with congenital cataracts undergoing secondary IOL implantation are laterality, cataract type, age at

  11. The global state of cataract blindness.

    PubMed

    Lee, Cameron M; Afshari, Natalie A

    2017-01-01

    Cataracts are a significant cause of blindness and visual impairment worldwide. The present article reviews the literature and describes the current extent of cataracts globally, barriers to treatment, and recommendations for improving the treatment of cataracts. Prevalence and absolute number of blind because of cataracts remain high, although rates are declining in many areas globally. The age-standardized prevalence of blindness in adults older than 50 remains highest in western sub-Saharan Africa, with a rate of 6.0%. The greatest declines in age-standardized blindness because of cataracts in adults older than 50 between 1990 and 2010 were in East Asia, tropical Latin America, and western Europe. Recent studies have largely found higher rates of cataracts in women than in men. A new simulator for training ophthalmologists in manual small-incision cataract surgery holds promise for the future. The rates of cataract surgery are increasing and postoperative outcomes are improving worldwide, yet challenges to reducing the cataract burden further remain. Cost, an insufficient number of ophthalmologists, and low government funding remain significant barriers but investment in further eye care infrastructure and training of additional ophthalmologists would improve the current situation.

  12. MRSA and cataract surgery - reflections for practice.

    PubMed

    Porter, L F; Khan, R U; Hannan, A; Kelly, S P

    2010-10-21

    Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National Health Service (NHS) hospital services has implications for cataract patients and ophthalmology services. To discuss issues for clinical practice as based on reflective experience at a UK district general NHS hospital in relation to care of MRSA-positive cataract patients. Retrospective case series and reflective practice. Three cases presented highlight practice points around cataract patients colonized with MRSA. Known or determined MRSA-colonized patients should be treated with anti-microbial agents at time of cataract surgery known to be active against MRSA. Preventative treatment with intracameral vancomycin or intravenous teicoplanin alongside appropriate topical treatments may be of merit. Importantly fluoroquinolones, often prescribed by cataract surgeons, may have a selective effect favoring the proliferation of MRSA. MRSA screening may cause unnecessary delays in cataract care and may represent a patient safety concern in its own right. Patients colonized with MRSA may safely undergo cataract surgery provided there is no evidence of periorbital infection and provided appropriate infection control and antibiotic prophylaxis measures are used. The well-prepared cataract surgeon needs to be aware of developments in infection control and should liaise with local clinical microbiology colleagues in relation to bacterial resistance to antibiotics.

  13. Anterior chamber bacterial contamination in cataract surgery

    PubMed Central

    2014-01-01

    Background The incidence of postoperative endophthalmitis has reduced during last several years to <0.01%; however, its associated complications continue to be devastating. Several sources of infection, including contamination by air, solutions, surgical instruments, intraocular lens, and wound leakage have been identified. The objective of this study was to evaluate the surgical technique, antibiotics, and asepsis that are used to reduce the risk of infection during cataract surgery. Methods This was a transversal prospective study, in which 64 cataract surgeries were evaluated from 32 patients, with 1 month recovery time; and cultures from preoperative and postoperative aspirates were analyzed. Two groups were established based on whether preoperative antibiotics were given or not. The analysis employed descriptive statistics. Results Of the 32 patients whose aspirates were obtained, three (9.37%) and 10 (31.25%) yielded positive cultures preoperative and postoperatively respectively. Staphylococcus species was the most common contaminating bacteria. The isolation of Staphylococcus species may indicate its potential as exogenous contaminant at time of wound closure. The cultures obtained from patients using preoperative antibiotics were positive for S. aureus in 10% (n = 2) of cases, and positive in 8.33% (n = 1) of cases not using antibiotics. The mean transoperative time with positive growth was 67 ± 17.8 minutes, and with negative growth was 76.3 ± 25.2 minutes. Two surgical techniques were evaluated: phacoemulsification and extracapsular extraction. The extracapsular technique showed a contamination rate of 33.33% (n = 8) compared to phacoemulsification with a rate of 25% (n = 2) (RR = 1.33). Conclusions Common contaminating microorganisms included the Staphylococcus species, which was isolated from the eyelids and ocular annexes at the time of wound closure. The isolation of microorganisms postoperatively could have been

  14. Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

    PubMed Central

    Giles, Kagmeni; Domngang, Christelle; Nguefack-Tsague, Georges; Come, Ebana Mvogo; Wiedemann, Peter

    2015-01-01

    AIM To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. METHODS We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student’s paired t-test was carried out to compare continuous variables, and P-values <0.05 were considered statistically significant. RESULTS Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS (P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well (P < 0.001). CONCLUSION Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time. PMID:26604848

  15. Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project.

    PubMed

    Turalba, Angela; Payal, Abhishek R; Gonzalez-Gonzalez, Luis A; Cakiner-Egilmez, Tulay; Chomsky, Amy S; Vollman, David E; Baze, Elizabeth F; Lawrence, Mary; Daly, Mary K

    2015-10-01

    To compare visual acuity outcomes, vision-related quality of life, and complications related to cataract surgery in eyes with and without glaucoma. Retrospective cohort study. Cataract surgery outcomes in cases with and without glaucoma from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project were compared. We identified 608 glaucoma cases and 4306 controls undergoing planned cataract surgery alone. After adjusting for age, pseudoexfoliation, small pupil, prior ocular surgery, and anterior chamber depth, we found that glaucoma cases were more likely to have posterior capsular tear with vitrectomy (odds ratio [OR] 1.8, P = .03) and sulcus intraocular lens placement (OR 1.65, P = .03) during cataract surgery. Glaucoma cases were more likely to have postoperative inflammation (OR 1.73, P < .0001), prolonged elevated intraocular pressure (OR 2.96, P = .0003), and additional surgery within 30 days (OR 1.92, P = .03). Mean best-corrected visual acuity (BCVA) and Visual Function Questionnaire (VFQ) scores significantly improved after cataract surgery in both groups (P < .0001), but there were larger improvements in BCVA (P = .01) and VFQ composite scores (P < .0001) in the nonglaucoma vs the glaucoma group. A total of 3621 nonglaucoma cases (94.1%) had postoperative BCVA 20/40 or better, compared to 466 glaucoma cases (89.6%) (P = .0003). Eyes with glaucoma are at increased risk for complications and have more modest visual outcomes after cataract surgery compared to eyes without glaucoma. Despite this, glaucoma patients still experience significant improvement in vision-related outcomes after cataract extraction. Further study is needed to explore potential factors that influence cataract surgery outcomes in glaucomatous eyes. Published by Elsevier Inc.

  16. Cataract surgery in one eye or both. A billion dollar per year issue.

    PubMed

    Javitt, J C; Steinberg, E P; Sharkey, P; Schein, O D; Tielsch, J M; Diener, M; Legro, M; Sommer, A

    1995-11-01

    To measure the relative effect of cataract surgery in the second eye compared with the first eye on functional impairment, satisfaction, and vision problems. Seventy-five randomly selected ophthalmologists in three cities in the United States were enrolled in a National Study of Cataract Outcomes. They, in turn, referred eligible, sequential patients scheduled for first-eye cataract surgery. Interviews were conducted at enrollment, 4 months after first-eye surgery, and 12 months after first-eye surgery. An attempt was made to conduct a special, preoperative interview of those patients scheduled to undergo second-eye surgery before the 4-month interview. Each interview included administration of the VF-14 (a 14-item questionnaire that assessed visual function), as well as questions about symptoms possibly related to cataract, "trouble with vision," and satisfaction with vision. Seven hundred seventy-two patients were enrolled in the study, and interview data to 12 months were obtained from 669 (86%) patients. Of these patients, 243 (36%) underwent cataract extraction in the second eye during the 12-month period of observation. Overall, subjects who underwent cataract surgery in both eyes during the 12-month period had 61% greater improvement in VF-14 score (P < 0.001), 27% more decline in trouble with vision (P < 0.001), and 24% greater improvement in satisfaction with vision (P < 0.001) compared with those who underwent surgery in only one eye. Cataract surgery in the second eye of patients with bilateral cataract is associated with clinical and statistically significant improvement in functional impairment, trouble with vision, and satisfaction with vision.

  17. Combining primary and piggyback intraocular lenses to treat extreme myopic astigmatism in stable keratoconus following cataract surgery.

    PubMed

    Goh, Yi Wei; Misra, Stuti; Patel, Dipika V; McGhee, Charles N J

    2013-03-01

    The majority of those with keratoconus can maximise visual acuity with spectacle or contact lens correction as they age; however, as subjects enter their sixties, cataracts may supervene and contact lens tolerance diminishes with consequent reduction in visual acuity. Following cataract extraction, the complex refractive error associated with keratoconus may not be readily corrected by an intraocular lens alone. This report highlights the planned implantation of a primary posterior chamber toric intraocular lens with a secondary piggyback, sulcus-based, intraocular lens in advanced but stable keratoconus with extreme myopic astigmatism and cataract. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  18. Fruit and vegetable intake and vitamins C and E are associated with a reduced prevalence of cataract in a Spanish Mediterranean population

    PubMed Central

    2013-01-01

    Background Cataract is among the major causes of vision impairment and blindness worldwide. Epidemiological studies support the role of antioxidants in the etiology of cataract, but the evidence for one specific antioxidant over another is inconsistent. Few studies have examined the association of cataract with fruit and vegetable intake with inconclusive results. In the present study, the relationship between cataract and fruit and vegetable intake and dietary and blood levels of carotenoids, vitamins C and E were examined in a Spanish Mediterranean population. Methods The present work is an analysis of data from 599 elderly ( ≥ 65 years) participants from the Spanish segment of the EUREYE study. This is a European multi-center cross-sectional population-based study. Cataract was diagnosed using a slit-lamp examination and defined as any lens opacity in either eye or evidence of its removal (cataract extraction). Energy-adjusted intake of fruit and vegetables and antioxidant vitamins was estimated using a semi-quantitative food frequency questionnaire. Plasma concentrations of vitamin C were analyzed by a colorimetric method and carotenoids and α-tocopherol by a HPLC method. The associations between cataract and quartiles of fruit and vegetable intake and plasma antioxidants were investigated using logistic regression models. Results Of the 599 elderly recruited, 433 (73%) had cataract or cataract extraction, 54% were women and 46% were men. After adjustments, increasing quartiles of combined fruit and vegetable intake were associated with decreasing reduction of odds of cataract or cataract extraction, (P for trend = 0.008). Increasing quartiles of dietary intakes from 107 mg/d of vitamin C showed a significant decreasing association with prevalence of cataract or cataract extraction (P for trend = 0.047). For vitamin E, a protective association was found from intakes from 8 mg/d, but no linear trend was observed across quartiles of intake (P for trend = 0

  19. Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia.

    PubMed

    Randall, Deborah A; Reinten, Tracie; Maher, Louise; Lujic, Sanja; Stewart, Jessica; Keay, Lisa; Leyland, Alastair H; Jorm, Louisa R

    2014-01-01

    To investigate variation in rates of cataract surgery in New South Wales, Australia by area of residence for Aboriginal and non-Aboriginal adults. Observational data linkage study of hospital admissions. Two hundred eighty-nine thousand six hundred forty-six New South Wales residents aged 30 years and over admitted to New South Wales hospitals for 444,551 cataract surgery procedures between 2001 and 2008. Analysis of linked routinely collected hospital data using direct standardization and multilevel negative binomial regression models accounting for clustering of individuals within Statistical Local Areas. Age-standardized cataract surgery rates and adjusted rate ratios. Aboriginal people had lower rates of cataract procedures than non-Aboriginal people of the same age and sex, living in the same Statistical Local Area (adjusted rate ratio 0.71, 95% confidence interval 0.68-0.75). There was significant variation in cataract surgery rates across Statistical Local Areas for both Aboriginal and non-Aboriginal people, with the disparity greater in major cities and less disadvantaged areas. Rates of surgery were lower for Aboriginal than non-Aboriginal people in most Statistical Local Areas, but in a few, the rates were similar or higher for Aboriginal people. Aboriginal people in New South Wales received less cataract surgery than non-Aboriginal people, despite evidence of higher cataract rates. This disparity was greatest in urban and wealthier areas. Higher rates of surgery for Aboriginal people observed in some specific locations are likely to reflect the availability of public ophthalmology services, targeted services for Aboriginal people and higher demand for surgery in these populations. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  20. Tea and Risk of Age-Related Cataracts: A Cross-Sectional Study in Zhejiang Province, China

    PubMed Central

    Sheng, Yan; He, Fan; Lin, Jun-Fen; Shen, Wei; Qiu, Yin-Wei

    2016-01-01

    Background The antioxidant properties of tea extracts are considered to be effective in protecting against cataracts. However, there is still insufficient epidemiological knowledge about the protective effects of different types of tea on age-related cataracts. Methods The data was derived from the Zhejiang Major Public Health Surveillance (ZJMPHS) Program on health and related factors in the elderly. The relationships between consumption of different types of tea and risk of age-related cataracts were assessed after adjusting for related covariates. Results The prevalence of age-related cataracts in this study population was 4.4% (409/9343). After adjustment for potential confounders, tea drinking was associated with reduced risk of age-related cataracts (adjusted odds ratio [OR] 0.65; 95% confidence interval [CI], 0.47–0.91). Compared to nondrinkers, green tea drinkers had a significantly reduced risk of cataracts (adjusted OR 0.58; 95% CI, 0.40–0.85). Average tea consumption of 14–27 cups (adjusted OR 0.55; 95% CI, 0.33–0.93) and over 28 cups (adjusted OR 0.58; 95% CI, 0.34–0.99) per week had a protective effect against cataracts in comparison to no consumption. In addition, ingesting a moderate concentration of tea significantly decreased the risk of cataract compared to no consumption (adjusted OR 0.43; 95% CI, 0.27–0.71). Conclusions Tea ingestion was associated with reduced risk of age-related cataracts. In light of these findings, we suggest that reasonable tea consumption (ie, favoring green tea and consuming an average of over 500 mL per day at moderate concentration) should offer protection against age-related cataracts. PMID:27180932

  1. RETROSPECTIVE INVESTIGATION OF CATARACT MANAGEMENT IN AVIAN SPECIES IN A ZOOLOGIC COLLECTION.

    PubMed

    Rainwater, Kimberly L; Sykes, John M; Sapienza, John S

    2015-12-01

    A review of avian cataracts at the Wildlife Conservation Society's Bronx Zoo between 1992 and 2011 was conducted. Ninety cataracts in 54 birds from 42 species were identified. Cataracts were found primarily during examination for ocular abnormalities (29/54, 53.7%) or opportunistically (13/54, 24.1%) and were most commonly diagnosed as mature (22/90, 24.4%). Systemic medical conditions diagnosed in these birds included West Nile virus (4/54, 7.4%), head trauma (3/54, 5.6%), plumbism and Salmonella Pullorum (1/54, 1.9%), Marek's disease (1/54, 1.9%), leukocytosis (1/54, 1.9%), and hyperglycemia (1/54, 1.9%). Cataracts were progressive in seven birds of four species. Unilateral enucleation was performed in 2/54 (3.7%) birds, and 12/54 (22.2%) underwent cataract removal (phacoemulsification in 16 eyes and standard extracapsular cataract extraction in 2 eyes). Concurrent ocular abnormalities, such as corneal scarring and lens-induced uveitis, were seen in 2/18 (11.1%) eyes preoperatively in the group undergoing cataract removal, 2/2 (100%) eyes preoperatively in the group undergoing enucleation, and 33/70 (47.1%) of eyes that did not undergo surgery. For birds undergoing cataract removal, complications included successfully treated cardiorespiratory arrest intraoperatively (1/12, 8.3%) as well as postanesthetic complications of acute respiratory distress and tracheal stricture (2/12, 16.7%). The most common postoperative ocular abnormalities included posterior capsular opacity (4/18 eyes, 22.2%) and corneal scarring (2/18 eyes, 11.1%). Lens cortical regrowth and marked posterior lens capsular opacity occurred in one eye of one bird after phacoemulsification, necessitating a second ocular surgery. A successful outcome, as determined by improved postoperative visual acuity, was seen in 10/12 (83.3%) birds undergoing cataract removal, and 5/12 (41.7%) of these birds were alive >3 yr after surgery. The results of this review will aid clinicians in identifying common stages

  2. [Difficulties in access to treatment for patients undergoing cataract surgery in public and private health systems].

    PubMed

    Kara-Júnior, Newton; Dellapi Jr, Roberto; Espíndola, Rodrigo França de

    2011-01-01

    To identify the difficulties in access to diagnosis and treatment of cataract in patients attended during a cataract campaign. A questionnaire was administered to patients selected for cataract surgery. We evaluated, among others, the following variables: prior access to ophthalmologists (public or private), reason(s) for not having surgery early in the initial service, the average cost charged by cataract surgery and intraocular lens (IOL) (private services and agreements). A total of 627 patients was evaluated. Most of them - 595 (95%) had previously attended an ophthalmologist, and in 63% of cases (375 patients) the consultation had been held for less than a year. The last evaluation was performed by the Brazilian Public Health System (SUS) in 52% of the cases (307 patients). Regarding the reason for not having surgery in the initial service, the high cost of the surgery (R$ 2.000 - R$ 4.000) and the cost of IOLs (R$ 1.000 - R$ 1.500) was the main obstacle for most attended services and private covenants. The results of this study suggest that the routine of ophthalmologic care in SUS at São Paulo is not prepared to answer the demand for cataract surgeries and private healthcare system still excludes a portion of the population. It is important to continue the implementation of community campaigns to serve the population that would be unable to access the surgery through conventional ways.

  3. Cataract and barriers to cataract surgery in a US Hispanic population: Proyecto VER.

    PubMed

    Broman, Aimee Teo; Hafiz, Gulnar; Muñoz, Beatriz; Rodriguez, Jorge; Snyder, Robert; Klein, Ronald; West, Sheila K

    2005-09-01

    To report the prevalence of visually significant cataract and cataract surgery and to determine demographic and socioeconomic factors that influence use of cataract surgery in a US Hispanic population. Proyecto VER is a population-based study of Hispanic individuals, 40 years or older, living in southern Arizona. Visual acuity was measured monocularly, and a dilated ophthalmic examination was performed to determine lens opacities. Visually significant cataract was defined as severe levels of opacity and acuity worse than 20/40. Risk factors were compared between those who obtained cataract surgery in the past and those having visually significant cataract. A majority of the 4774 participants in this study were of Mexican descent; 2.8% had visually significant cataract and 5.1% had undergone bilateral cataract surgery. Among those currently or previously needing surgery, having medical insurance (odds ratio, 2.88; P<.001) and speaking English (odds ratio, 1.80; P = .04) were significantly associated with having obtained surgery in the past. Visually significant cataract appears to be high among US Hispanic individuals of Mexican descent, as evidenced by rates of cataract and cataract surgery. Language and financial barriers in this population impede access to surgery. Further work to remove these barriers and provide sight restoration is warranted among Hispanic individuals of Mexican descent living in the United States.

  4. Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery.

    PubMed

    Guay, Joanne; Sales, Karl

    2015-08-27

    Local anaesthesia for cataract surgery can be provided by sub-Tenon's or topical anaesthesia. Both techniques offer possible advantages. This review, which originally was published in 2007 and was updated in 2014, was undertaken to compare these two anaesthetic techniques. Our objectives were to compare the effectiveness of topical anaesthesia (with or without intracameral local anaesthetic) versus sub-Tenon's anaesthesia in providing pain relief during cataract surgery. We reviewed pain during administration of anaesthesia, postoperative pain, surgical satisfaction with operating conditions and patient satisfaction with pain relief provided, and we looked at associated complications. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE (last search in November 2014) and the reference lists of published articles. We looked for conferences abstracts and trials in progress and placed no constraints on language or publication status. We included all randomized studies that compared sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery. We assessed trial quality and extracted data in the format allowing maximal data inclusion. We included eight studies in this updated review but could retain in the analysis only seven studies on 742 operated eyes of 617 participants. Two cross-over trials included 125 participants, and five parallel trials included 492 participants. These studies were published between 1997 and 2005. The mean age of participants varied from 71.5 years to 83.5 years. The female proportion of participants varied from 54% to 76%. Compared with sub-Tenon's anaesthesia, topical anaesthesia (with or without intracameral injection) for cataract surgery increases intraoperative pain but decreases postoperative pain at 24 hours. The amplitude of the effect (equivalent to 1.1 on a score from 0 to 10 for intraoperative pain, and to 0.2 on the same scale for postoperative pain at 24 hours), although statistically

  5. Effect of cataract surgery on retinal nerve fiber layer thickness parameters using scanning laser polarimetry (GDxVCC).

    PubMed

    Dada, Tanuj; Behera, Geeta; Agarwal, Anand; Kumar, Sanjeev; Sihota, Ramanjit; Panda, Anita

    2010-01-01

    To study the effect of cataract extraction on the retinal nerve fiber layer (RNFL) thickness, and assessment by scanning laser polarimetry (SLP), with variable corneal compensation (GDx VCC), at the glaucoma service of a tertiary care center in North India. Thirty-two eyes of 32 subjects were enrolled in the study. The subjects underwent RNFL analysis by SLP (GDx VCC) before undergoing phacoemulsification cataract extraction with intraocular lens (IOL) implantation (Acrysof SA 60 AT) four weeks following cataract surgery. The RNFL thickness parameters evaluated both before and after surgery included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average, inferior average, and nerve fiber index (NFI). The mean age of subjects was 57.6 +/- 11.7 years (18 males, 14 females). Mean TSNIT average thickness (microm) pre- and post-cataract surgery was 49.2 +/- 14.1 and 56.5 +/- 7.6 ( P = 0.001). There was a statistically significant increase in RNFL thickness parameters (TSNIT average, superior average, and inferior average) and decrease in NFI post-cataract surgery as compared to the baseline values. Mean NFI pre- and post-cataract surgery was 41.3 +/- 15.3 and 21.6 +/- 11.8 ( P = 0.001). Measurement of RNFL thickness parameters by scanning laser polarimetry is significantly altered following cataract surgery. Post the cataract surgery, a new baseline needs to be established for assessing the longitudinal follow-up of a glaucoma patient. The presence of cataract may lead to an underestimation of the RNFL thickness, and this should be taken into account when analyzing progression in a glaucoma patient.

  6. Effect of cataract surgery on retinal nerve fiber layer thickness parameters using scanning laser polarimetry (GDxVCC)

    PubMed Central

    Dada, Tanuj; Behera, Geeta; Agarwal, Anand; Kumar, Sanjeev; Sihota, Ramanjit; Panda, Anita

    2010-01-01

    Purpose: To study the effect of cataract extraction on the retinal nerve fiber layer (RNFL) thickness, and assessment by scanning laser polarimetry (SLP), with variable corneal compensation (GDx VCC), at the glaucoma service of a tertiary care center in North India. Materials and Methods: Thirty-two eyes of 32 subjects were enrolled in the study. The subjects underwent RNFL analysis by SLP (GDx VCC) before undergoing phacoemulsification cataract extraction with intraocular lens (IOL) implantation (Acrysof SA 60 AT) four weeks following cataract surgery. The RNFL thickness parameters evaluated both before and after surgery included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average, inferior average, and nerve fiber index (NFI). Results: The mean age of subjects was 57.6 ± 11.7 years (18 males, 14 females). Mean TSNIT average thickness (μm) pre- and post-cataract surgery was 49.2 ± 14.1 and 56.5 ± 7.6 (P = 0.001). There was a statistically significant increase in RNFL thickness parameters (TSNIT average, superior average, and inferior average) and decrease in NFI post-cataract surgery as compared to the baseline values. Mean NFI pre- and post-cataract surgery was 41.3 ± 15.3 and 21.6 ± 11.8 (P = 0.001). Conclusions: Measurement of RNFL thickness parameters by scanning laser polarimetry is significantly altered following cataract surgery. Post the cataract surgery, a new baseline needs to be established for assessing the longitudinal follow-up of a glaucoma patient. The presence of cataract may lead to an underestimation of the RNFL thickness, and this should be taken into account when analyzing progression in a glaucoma patient. PMID:20689193

  7. Stability control of valerian ground material and extracts: a new HPLC-method for the routine quantification of valerenic acids and lignans.

    PubMed

    Goppel, M; Franz, G

    2004-06-01

    A new HPLC-method for the separation of medium polar and nonpolar compounds in preparations of Valeriana officinalis was established for stability control. Powdered valerian root and a commercial ethanolic valerian extract were investigated for apparent differences in stability behaviour. Storage conditions were chosen according to the ICH-guidelines. Changes in composition of valerenic acids and lignans were observed depending on storage conditions and packaging materials. Hydroxyvalerenic acid, pinoresinol and hydroxypinoresinol were identified as degradation products in Valerian root, especially during accelerated testing. Ethanolic extracts appeared not to be as sensitive for chemical degradation under climatic influences compared to the crude plant material, and showed no increase in the amounts of lignan-aglyka. In comparison, extracts showed high sensitivity on changes of physical properties like loss on drying and viscosity.

  8. Lutein and cataract: from bench to bedside.

    PubMed

    Manayi, Azadeh; Abdollahi, Mohammad; Raman, Thiagarajan; Nabavi, Seyed Fazel; Habtemariam, Solomon; Daglia, Maria; Nabavi, Seyed Mohammad

    2016-10-01

    Cataract is one of the most important leading causes of blindness in the world. Extensive research showed that oxidative stress may play an important role in the initiation and progression of a cataract and other age-related eye diseases. Extra-generation of reactive oxygen and nitrogen species in the eye tissue has been shown as one of the most important risk factors for cataracts and other age-related eye diseases. With respect to this, it can be hypothesized that dietary antioxidants may be useful in the prevention and/or mitigation of cataract. Lutein is an important xanthophyll which is widely found in different vegetables such as spinach, kale and carrots as well as some other foods such as eggs. Lutein is concentrated in the macula and suppresses the oxidative stress in the eye tissues. A plethora of literature has shown that increased lutein consumption has a close correlation with reduction in the incidence of cataract. Despite this general information, there is a negligible number of review articles considering the beneficial effects of lutein on cataracts and age-related eye diseases. The present review is aimed at discussing the role of oxidative stress in the initiation and progression of a cataract and the possible beneficial effects of lutein in maintaining retinal health and fighting cataract. We also provide a perspective on the chemistry, sources, bioavailability and safety of lutein.

  9. Pediatric cataract: challenges and future directions

    PubMed Central

    Medsinge, Anagha; Nischal, Ken K

    2015-01-01

    Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. PMID:25609909

  10. Prevalence of Corneal Astigmatism in an NHS Cataract Surgery Practice in Northern Ireland

    PubMed Central

    Hassett, Patrick

    2017-01-01

    PURPOSE Post-operative corneal astigmatism following cataract surgery can leave the patient with visual impairment. Correcting it at the time of surgery with a toric intraocular lens (TIOL) can give patients a better final visual outcome. The purpose was to determine the prevalence of corneal astigmatism in a cataract population and assess the demand for TIOL. METHODS Keratometric data was collected and analyzed for all patients who attended for routine cataract surgery under the care of a single surgeon based in Altnagelvin Area Hospital, Northern Ireland (NI). All patients were included between January 2008 and December 2014. Data was collected retrospectively for this observational study. RESULTS There were 2080 consecutive eyes of 1788 patients. The mean corneal astigmatism was 1.09 ± 0.83. Corneal astigmatism was 1.50D or less in 1621 eyes (78%). It was more than 2.00 D in 242 eyes (11.6%), more than 2.50 D in 127 eyes (6.1%), more than 3.00D in 68 eyes (3.27%) and more than 3.50 D in 45 eyes (2.16%). CONCLUSION For routine cataract surgery, 41.3% of eyes had more than 1.00 D of corneal astigmatism and 11.6% had more and 2.00D. Females had more astigmatism than males. This shows the potential demand for the TIOL in this population.

  11. Cataract surgery and quality of life implications

    PubMed Central

    Morris, Daniel; Fraser, Scott G; Gray, Christopher

    2007-01-01

    Cataract surgery in the developed world has undergone a revolution over the last 20 years. An operation which used to require a stay in hospital and long visual rehabilitation is now a quick day-case procedure with immediate benefits. As with any surgery there is an associated morbidity, but there is now the potential to provide cataract surgery at an earlier stage of cataract maturation and save patients from a period of severe visual impairment. This article reviews the new techniques available to measure the impact that cataracts have not only on a patient’s visual acuity but also their general physical health, function, cognition, and emotional well-being. New research is described that takes into account these more holistic tests and how they can be used to judge the best time to refer and operate on a patient with cataracts. PMID:18044082

  12. Dosimetry for a study of low-dose radiation cataracts among Chernobyl clean-up workers.

    PubMed

    Chumak, V V; Worgul, B V; Kundiyev, Y I; Sergiyenko, N M; Vitte, P M; Medvedovsky, C; Bakhanova, E V; Junk, A K; Kyrychenko, O Y; Musijachenko, N V; Sholom, S V; Shylo, S A; Vitte, O P; Xu, S; Xue, X; Shore, R E

    2007-05-01

    A cohort of 8,607 Ukrainian Chernobyl clean-up workers during 1986-1987 was formed to study cataract formation after ionizing radiation exposure. Study eligibility required the availability of sufficient exposure information to permit the reconstruction of doses to the lens of the eye. Eligible groups included civilian workers, such as those who built the "sarcophagus" over the reactor, Chernobyl Nuclear Power Plant Workers, and military reservists who were conscripted for clean-up work. Many of the official doses for workers were estimates, because only a minority wore radiation badges. For 106 military workers, electron paramagnetic resonance (EPR) measurements of extracted teeth were compared with the recorded doses as the basis to adjust the recorded gamma-ray doses and provide estimates of uncertainties. Beta-particle doses to the lens were estimated with an algorithm devised to take into account the nature and location of Chernobyl work, time since the accident, and protective measures taken. A Monte Carlo routine generated 500 random estimates for each individual from the uncertainty distributions of the gamma-ray dose and of the ratio of beta-particle to gamma-ray doses. The geometric mean of the 500 combined beta-particle and gamma-ray dose estimates for each individual was used in the data analyses. The median estimated lens dose for the cohort was 123 mGy, while 4.4% received >500 mGy.

  13. Usefulness of surgical complexity classification index in cataract surgery process.

    PubMed

    Salazar Méndez, R; Cuesta García, M; Llaneza Velasco, M E; Rodríguez Villa, S; Cubillas Martín, M; Alonso Álvarez, C M

    2016-06-01

    To evaluate the usefulness of surgical complexity classification index (SCCI) to predict the degree of surgical difficulty in cataract surgery. This retrospective study includes data collected between January 2013 and December 2014 from patients who underwent cataract extraction by phacoemulsification at our hospital. A sample size of 159 patients was obtained by simple random sampling (P=.5, 10% accuracy, 95% confidence). The main variables were: recording and value of SCCI in electronic medical record (EMR), presence of exfoliation syndrome (XFS), criteria for inclusion in surgical waiting list (SWL), and functional results. SCCI was classified into 7 categories (range: 1-4) according to predictors of technical difficulty, which was indirectly estimated in terms of surgical time (ST). All statistical analyses were performed using SPSS v15.0 statistical software. Prevalence of XFS was 18.2% (95%CI: 11.9-24.5). In terms of quality indicators in the cataract surgery process, 96.8% of patients met at least one of the criteria to be included in SWL, and 98.1% gained ≥2 Snellen lines. The SCCI was recorded in EMR of 98.1% patients, and it was grouped for study into 2 categories: High and low surgical complexity. Statistically significant differences in the distribution of ST were found depending on the assigned SCCI (P<.005) and the presence of XFS (P<.005). The SCCI enables to estimate the degree of surgical complexity in terms of ST in cataract surgery, which is especially useful in those areas with high prevalence of XFS, because of the higher theoretical risk of surgical complications. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  14. Missense Mutations in CRYAB Are Liable for Recessive Congenital Cataracts

    PubMed Central

    Irum, Bushra; Khan, Arif O.; Wang, Qiwei; Kabir, Firoz; Khan, Asma A.; Husnain, Tayyab; Akram, Javed; Riazuddin, Sheikh

    2015-01-01

    Purpose This study was initiated to identify causal mutations responsible for autosomal recessive congenital cataracts in consanguineous familial cases. Methods Affected individuals underwent a detailed ophthalmological and clinical examination, and slit-lamp photographs were ascertained for affected individuals who have not yet been operated for the removal of the cataractous lens. Blood samples were obtained, and genomic DNA was extracted from white blood cells. A genome-wide scan was completed with short tandem repeat (STR) markers, and the logarithm of odds (LOD) scores were calculated. Protein coding exons of CRYAB were sequenced, bi-directionally. Evolutionary conservation was investigated by aligning CRYAB orthologues, and the expression of Cryab in embryonic and postnatal mice lens was investigated with TaqMan probe. Results The clinical and ophthalmological examinations suggested that all affected individuals had nuclear cataracts. Genome-wide linkage analysis suggested a potential region on chromosome 11q23 harboring CRYAB. DNA sequencing identified a missense variation: c.34C>T (p.R12C) in CRYAB that segregated with the disease phenotype in the family. Subsequent interrogation of our entire cohort of familial cases identified a second familial case localized to chromosome 11q23 harboring a c.31C>T (p.R11C) mutation. In silico analyses suggested that the mutations identified in familial cases, p.R11C and p.R12C will not be tolerated by the three-dimensional structure of CRYAB. Real-time PCR analysis identified the expression of Cryab in mouse lens as early as embryonic day 15 (E15) that increased significantly until postnatal day 6 (P6) with steady level of expression thereafter. Conclusion Here, we report two novel missense mutations, p.R11C and p.R12C, in CRYAB associated with autosomal recessive congenital nuclear cataracts. PMID:26402864

  15. Innovations in pediatric cataract surgery

    PubMed Central

    Khokhar, Sudarshan Kumar; Pillay, Ganesh; Agarwal, Esha; Mahabir, Manish

    2017-01-01

    Advances in technology have made surgery in children safer and faster. The management of pediatric cataract has made rapid progress in the past decade with the availability of safer anesthesia, newer technique's, more predictable intraocular lens (IOL) power calculation, a better understanding of neurobiology, genetics, amblyopia management, improved IOL designs for preventing visual axis opacification, and adjuvant postoperative care. Modern vitrectomy machines with minimally invasive instruments, radiofrequency, diathermy, and plasma blades help immensely in complicated cases. Preoperative evaluation with ultrasound biomicroscopy and optical coherence tomography (OCT) allows better planning of surgical procedure. The future holds good for stem cell research, customized OCT, and Zepto (precision pulse capsulotomy). PMID:28440249

  16. Innovations in pediatric cataract surgery.

    PubMed

    Khokhar, Sudarshan Kumar; Pillay, Ganesh; Agarwal, Esha; Mahabir, Manish

    2017-03-01

    Advances in technology have made surgery in children safer and faster. The management of pediatric cataract has made rapid progress in the past decade with the availability of safer anesthesia, newer technique's, more predictable intraocular lens (IOL) power calculation, a better understanding of neurobiology, genetics, amblyopia management, improved IOL designs for preventing visual axis opacification, and adjuvant postoperative care. Modern vitrectomy machines with minimally invasive instruments, radiofrequency, diathermy, and plasma blades help immensely in complicated cases. Preoperative evaluation with ultrasound biomicroscopy and optical coherence tomography (OCT) allows better planning of surgical procedure. The future holds good for stem cell research, customized OCT, and Zepto (precision pulse capsulotomy).

  17. Comparison of topically applied flurbiprofen or bromfenac ophthalmic solution on post-operative ocular hypertension in canine patients following cataract surgery.

    PubMed

    Lu, Jennifer; English, Robert; Nadelstein, Brad; Weigt, Anne; Berdoulay, Andrew; Binder, Dan; Ngan, Esther

    2017-03-01

    To compare the prevalence and kinetics of ocular hypertension after routine cataract extraction when using a predominately COX-2 inhibitor (bromfenac) versus a predominately COX-1 inhibitor (flurbiprofen) in combination with a topical corticosteroid. Patients undergoing unilateral or bilateral cataract surgery were randomly assigned to receive flurbiprofen or bromfenac at the day of surgery and continued for 6 weeks postoperatively, along with topical neo poly dexamethasone. No systemic nonsteroidal anti-inflammatory medications were administered before or after surgery. Intraocular pressure was monitored pre and postoperatively. When an IOP of >25 mmHg was detected, therapeutic intervention was performed. Eyes in both treatment groups showed a similar IOP profile with the highest mean IOP occurring two hours postsurgery and slowly declining during the next 6 weeks. However, eyes receiving bromfenac had a higher mean IOP at 2 h post-op (22.1 mmHg) than eyes receiving flurbiprofen (18.8 mmHg) and a slower decrease in IOP in the weeks after surgery. Over the course of the study, a higher percentage of eyes receiving bromfenac had therapy discontinued over concerns of elevated IOP compared to eyes receiving flurbiprofen (bromfenac 23.1% and flurbiprofen 9.8%). On average, the risk of having elevated intraocular pressure with bromfenac is 1.04 times higher than with flurbiprofen. Elevated postoperative IOP was observed in both treatment groups; however, bromfenac-treated eyes were more likely to require intervention for elevated IOP. © 2016 American College of Veterinary Ophthalmologists.

  18. Couching for Cataracts in China

    PubMed Central

    Chan, Chi-Chao

    2010-01-01

    Couching for cataract is one of the most ancient surgical procedures. Maharshi Sushruta, an ancient Indian surgeon, first described the procedure around 600 BC in Sushruta Samhita. The procedure, also known as jin pi shu in Mandarin, was introduced to China via the Silk Road during the late West Han Dynasty (206 BC - 9 AD), and it spread throughout China during the Tang Dynasty (618 – 907 AD). As the procedure was combined with the Chinese concept of acupuncture, jin pi shu was integrated into Chinese medical practice until the founding of the Republic of China in 1911. The government of the Republic of China considered jin pi shu to be unscientific. In 1949, the Communists established the People’s Republic of China. Jin pi shu was revitalized by Chairman Mao (1893-1976), who thought that traditional Chinese medicine, including jin pi shu, was a great treasure. After his death and the opening of China to the external world, many Chinese ophthalmologists pointed out that jin pi shu has relatively high complications and a low success rate, compared to various modern techniques for cataract surgery. This procedure is gradually fading away in China. The use of jin pi shu reflects the history, culture, and political transformation of China. PMID:20451942

  19. Couching for cataract in China.

    PubMed

    Chan, Chi-Chao

    2010-01-01

    Couching for cataract is one of the most ancient surgical procedures. Maharshi Sushruta, an ancient Indian surgeon, first described the procedure around 600 BCE in Sushruta Samhita. The procedure, also known as jin pi shu in Mandarin, was introduced to China via the Silk Road during the late West Han Dynasty (206 BCE-9 CE), and it spread throughout China during the Tang Dynasty (618-907 CE). As the procedure was combined with the Chinese concept of acupuncture, jin pi shu was integrated into Chinese medical practice until the founding of the Republic of China in 1911. The government of the Republic of China considered jin pi shu to be unscientific. In 1949, the Communists established the People's Republic of China. Jin pi shu was revitalized by Chairman Mao Zedong (1893-1976), who thought that traditional Chinese medicine, including jin pi shu, was a great treasure. After his death and the opening of China to the external world, many Chinese ophthalmologists pointed out that jin pi shu had relatively high complications and a low success rate, compared to various modern techniques for cataract surgery. This procedure is gradually fading away in China. The use of jin pi shu reflects the history, culture, and political transformation of China.

  20. Serious Adverse Events After Cataract Surgery

    PubMed Central

    Stein, Joshua D.

    2013-01-01

    Purpose Over the past several decades there have been many advances in the equipment, instrumentation and techniques of performing cataract surgery. This review will address the impact of these advances on the safety profile of cataract surgery. Recent Findings Recent studies have demonstrated a decline in the risk of serious postoperative adverse events (endophthalmitis, suprachoroidal hemorrhage, retinal detachment) following cataract surgery. Factors that increase the risk of serious complications from cataract surgery include patient-related factors (male sex, concomitant diabetic retinopathy, same day cataract surgery combined with another intraocular surgery, tamsulosin use) and surgeon-related factors (low surgical volume, limited experience, operating on patients who are most prone to adverse events). Summary Cataract surgery continues to be a very safe surgical procedure with few patients experiencing serious sight-threatening adverse events. Studies in the literature have helped surgeons identify patients who are at high risk for surgical complications and to develop strategies to limit surgical complications when operating on these patients. As multifocal intraocular lenses, femtosecond laser technology, and other surgical innovations continue to gain popularity, it will be interesting in the coming years to determine whether there will be a continued reduction in complications of cataract surgery. PMID:22450221

  1. Connexin mediated cataract prevention in mice.

    PubMed

    Li, Lin; Cheng, Catherine; Xia, Chun-hong; White, Thomas W; Fletcher, Daniel A; Gong, Xiaohua

    2010-09-09

    Cataracts, named for any opacity in the ocular lens, remain the leading cause of vision loss in the world. Non-surgical methods for cataract prevention are still elusive. We have genetically tested whether enhanced lens gap junction communication, provided by increased α3 connexin (Cx46) proteins expressed from α8(Kiα3) knock-in alleles in Gja8tm1(Gja3)Tww mice, could prevent nuclear cataracts caused by the γB-crystallin S11R mutation in CrygbS11R/S11R mice. Remarkably, homozygous knock-in α8(Kiα3/Kiα3) mice fully prevented nuclear cataracts, while single knock-in α8(Kiα3/-) allele mice showed variable suppression of nuclear opacities in CrygbS11R/S11R mutant mice. Cataract prevention was correlated with the suppression of many pathological processes, including crystallin degradation and fiber cell degeneration, as well as preservation of normal calcium levels and stable actin filaments in the lens. This work demonstrates that enhanced intercellular gap junction communication can effectively prevent or delay nuclear cataract formation and suggests that small metabolites transported through gap junction channels protect the stability of crystallin proteins and the cytoskeletal structures in the lens core. Thus, the use of an array of small molecules to promote lens homeostasis may become a feasible non-surgical approach for nuclear cataract prevention in the future.

  2. Validation of Najjar-Awwad cataract surgery risk score for resident phacoemulsification surgery.

    PubMed

    Blomquist, Preston H; Sargent, James W; Winslow, Heather H

    2010-10-01

    To validate the Najjar-Awwad cataract surgery risk score for residents, which has been proposed to predict surgical complexity and risk. Two urban public county hospitals. Case series. Phacoemulsification cataract surgeries performed by residents between January 2005 and April 2008 were retrospectively reviewed. The cataract risk score was calculated retrospectively. Intraoperative complications included posterior and anterior capsular tears, vitreous prolapse, dropped nucleus, and conversion to manual extracapsular cataract extraction. Of the cases performed by 33 residents, 1833 met the inclusion criteria. There were 120 complications (6.5%); the rate of complications involving vitreous prolapse or loss (including dropped nucleus) was 3.2%. Significant risk factors in the risk score associated with intraoperative complications were dense nuclear sclerosis (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.32-3.26; P = .004) and poor red reflex (OR, 2.10; 95% CI, 1.45-3.06; P = .00007). Cataract risk scores ranged from 3 to 16. The score was less than 5 in 85 cases (4.6%) and less than 7 in 885 cases (48.3%). The OR for complications increased significantly when the risk score was higher than 6 (OR, 2.11; 95% CI, 1.42-3.14; P = .0002). Although the Najjar-Awwad cataract surgery risk score can be used to predict intraoperative complications at the time of cataract surgery, the complication rate did not significantly increase until the score reached 7. There were few cases with scores lower than 5 in these county hospital populations. Beginning surgeons should be given cases with a risk score of less than 7. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. [Rehabilitation methods for children with complicated cataract].

    PubMed

    Ivanov, G; Cuşnir, V; Septichina, Natalia; Cuşnir, Vitalie

    2010-01-01

    The work deals with the results of surgical treatment of 155 patients, who had uveal cataract, by method of facoemulsification with artificial crystalline lens transplanting. The age of the sick varied from 3 to 15 as a result of a complex treatment, involving determination of ethnic factor in the development of uveal cataract, before- and after-operation conservative medical treatment, surgical treatment of abscuration ambliopia 78.1% children and the keenness of sight 0.4 and 68.7% got binocularious sight. The study lot of posttraumatic cataract affected children included 189 patients, from them 68 with stationary cataract, 87 with intumescent cataract and 34 with postoperatorial aphakia. Age from 2 to 15 years. 76.3% cases of evolution without postoperatorial complications, in 13.7% intraoperatorial were observed different complications. The work presents the results of surgical treatment 196 of children, who had innate cataract, by the method of facoasoriation with soft intra-eyepiece lens transplanting from 133 patients who had two-sided cataract, 63 had monolateral cataract. All children underwent laser simulation and videocomputer auto-training in post-operation period. As a result of the treatment, 66.8% patients got the amelioration of sight with 0.4, and 58% got binocular sight. The children's age varied between 6 months and 15 years. This article presents a review of the treatment results of 213 children with posttraumatic, congenital and complicated cataracts. The rehabilitation of the patients with the lens pathology includes a complex of measures of early diagnosis, surgery, optimal correction, medical treatment before and after surgery, the prophilaxis and treatment of complications. This approach permits to increase the visual acuity in 83.8% and to restore the binocular vision in 71.4% patients.

  4. Unfolded protein response activation in cataracts.

    PubMed

    Torres-Bernal, Beatriz E; Torres-Bernal, Luis Fernando; Gutiérrez-Campos, Rafael R; Kershenobich Stalnikowitz, David D; Barba-Gallardo, Luis Fernando; Chayet, Arturo A; Ventura-Juárez, Javier

    2014-10-01

    To analyze the expression of 78 kDa glucose-regulated protein (GRP78) and activating transcription factor 6 (ATF6), 2 factors in the unfolded protein response (UPR), in age-related and diabetes-associated cataract. Universidad Autónoma de Aguascalientes, Aguascalientes, México. Experimental study. The qualitative and quantitative expression of GRP78 and ATF6 were measured in surgical samples from 11 senile cataracts, 9 diabetic-associated cataracts, and 3 normal lenses. Both proteins were detected by immunofluorescence and immunogold-conjugated antibodies. Quantitative morphometry was used to analyze the differences in GRP78 and ATF6 between samples. The Mann-Whitney test was used for statistical analysis. Scanning electron microscopy showed the characteristic organization of fibers in normal lenses with regular alignment and interdigitation between them. On the other hand, lenses from eyes with senile or diabetic cataract showed the same pattern of misalignment and disorganization of the fibers. Both proteins were detected through immunofluorescence in senile and diabetic cataracts, but not in normal lenses. Immunogold-conjugated antibodies and transmission electron microscopy showed that GRP78 and ATF6 grains were 30% higher and 35% higher, respectively, in diabetic cataracts than in senile cataracts (P<.05). These data show for the first time in humans that GRP78 and ATF6 are present in lens fibers of senile cataracts and diabetic cataracts, establishing that the UPR may be important in the process of cataractogenesis. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Revisiting Routine Questions

    ERIC Educational Resources Information Center

    Hughes, Rebecca; Monaghan, John; Shingadia, Eisha; Vaughan, Stephen

    2006-01-01

    What is a routine question? The focus of this paper is routine questions and time (in years) since a hitherto routine question was last attempted by the solver. The data comes from undergraduate students' work on solving two calculus questions. The data was selected for reporting purposes because it is well documented and because it threw up…

  6. Predicting the success of cataract surgery.

    PubMed

    Murphy, S B; Donderi, D C

    1980-03-01

    Fifty-four elderly patients with cataracts were tested with a questionnaire and a series of visual-motor learning and performance tasks immediately before, 7 weeks after, and 16 weeks after cataract surgery. The goal was to learn whether postoperative performance and questionnaire responses could be predicted from the preoperative tasks. Twenty-two elderly people without diagnosed cataracts did the same tasks at comparable intervals to establish normal performance levels and reliabilities. The amount of activity before surgery (walking, shopping, gardening, sewing, etc.) and the ability to learn a new visual-motor coordination were positively correlated with successful recovery as assessed by several measures including spontaneously expressed satisfaction.

  7. Cataracts in Diabetic Patients: A Review Article

    PubMed Central

    Javadi, Mohammad-Ali; Zarei-Ghanavati, Siamak

    2008-01-01

    The number of people with diabetes mellitus is increasing and cataracts are one of the most common causes of visual impairment in these subjects. Advances in cataract surgical techniques and instrumentation have generally improved the outcomes; however,surgery may not be safe and effective in certain individuals with pre-existing retinal pathology or limited visual potential. This review article aims to address different aspects surrounding cataracts in diabetic patients. In a computerized MEDLINE search,relevant studies were selected by two authors using the keywords “diabetes mellitus”, “cataract”, “diabetic retinopathy” and “diabetic maculopathy”. PMID:23479523

  8. Retinal detachment following cataract surgery with capsulorhexis.

    PubMed Central

    Kelley, J S; Doxanas, M T

    1995-01-01

    PURPOSE: To estimate the incidence of retinal detachment after cataract surgery with capsulorhexis. METHODS: A consecutive series of 2,150 cataract operations were followed for incidence of retinal detachment. A series of 1,000 patients from this group were analyzed for high risk factors: myopia, age, sex, operative complications and capsulotomy. RESULTS: With minimum one year follow up in 90% of patients the incidence of retinal detachment was 0.25% (5 cases). CONCLUSION: The true incidence of retinal detachment after cataract surgery remains elusive. There is probably a trend toward lower incidence compared to previous reports. PMID:8719688

  9. Sir Harold Ridley: innovator of cataract surgery.

    PubMed

    Sarwar, H; Modi, N

    2014-09-01

    Cataract surgery has evolved greatly over the years, from the ancient practice of 'couching' where the lens is dislodged, to the modern surgical techniques of today. Sir Harold Ridley's invention of the intraocular lens (IOL) has altered the approach towards cataract surgery, benefitting individuals worldwide. This has been his most notable contribution, it is therefore interesting to explore the build up to this event and gain an understanding of the issues faced by Sir Ridley. This paper explores the significant events and key developments that influenced one of the most valuable innovations in the context of cataract surgery--the intraocular lens.

  10. Cataract surgery in previously vitrectomized eyes.

    PubMed

    Akinci, A; Batman, C; Zilelioglu, O

    2008-05-01

    To evaluate the results of extracapsular cataract extraction (ECCE) and phacoemulsification (PHACO) performed in previously vitrectomized eyes. In this retrospective study, 56 vitrectomized eyes that had ECCE and 60 vitrectomized eyes that had PHACO were included in the study group while 65 eyes that had PHACO in the control group. The evaluated parameters were the incidence of intra-operative and postoperative complications (IPC) and visual outcomes. Chi-squared, independent samples and paired samples tests were used for comparing the results. Deep anterior chamber (AC) was significantly more common in the PHACO group of vitrectomized eyes (PGVE) and observed in eyes that had undergone extensive vitreous removal (p < 0.05). Except for this there were no significant differences in the rate of IPC between the ECCE group and the PGVE (p > 0.05). Some of the intra-operative conditions such as posterior synechiae, primary posterior capsular opacification (PCO) and postoperative complications such as retinal detachment (RD), PCO were significantly more common in vitrectomized eyes than the controls (p < 0.05). There was no significant difference in the visual acuity gain between the ECCE group and the PGVE (p > 0.05). Deep AC is more common in eyes with extensive vitreous removal during PHACO than ECCE. Decreasing the bottle height is advised in this case. Except for this, the results of ECCE and PHACO are similar in previously vitrectomized eyes. Posterior synechiaes, primary and postoperative PCO and RD are more common in vitrectomized eyes than the controls.

  11. Preoperative Medical Testing in Medicare Patients Undergoing Cataract Surgery

    PubMed Central

    Chen, Catherine L.; Lin, Grace A.; Bardach, Naomi S.; Clay, Theodore H.; Boscardin, W. John; Gelb, Adrian W.; Maze, Mervyn; Gropper, Michael A.; Dudley, R. Adams

    2017-01-01

    BACKGROUND Routine preoperative testing is not recommended for patients undergoing cataract surgery, because testing neither decreases adverse events nor improves outcomes. We sought to assess adherence to this guideline, estimate expenditures from potentially unnecessary testing, and identify patient and health care system characteristics associated with potentially unnecessary testing. METHODS Using an observational cohort of Medicare beneficiaries undergoing cataract surgery in 2011, we determined the prevalence and cost of preoperative testing in the month before surgery. We compared the prevalence of preoperative testing and office visits with the mean percentage of beneficiaries who underwent tests and had office visits during the preceding 11 months. Using multivariate hierarchical analyses, we examined the relationship between preoperative testing and characteristics of patients, health system characteristics, surgical setting, care team, and occurrence of a preoperative office visit. RESULTS Of 440,857 patients, 53% had at least one preoperative test in the month before surgery. Expenditures on testing during that month were $4.8 million higher and expenditures on office visits $12.4 million higher (42% and 78% higher, respectively) than the mean monthly expenditures during the preceding 11 months. Testing varied widely among ophthalmologists; 36% of ophthalmologists ordered preoperative tests for more than 75% of their patients. A patient’s probability of undergoing testing was associated mainly with the ophthalmologist who managed the preoperative evaluation. CONCLUSIONS Preoperative testing before cataract surgery occurred frequently and was more strongly associated with provider practice patterns than with patient characteristics. (Funded by the Foundation for Anesthesia Education and Research and the Grove Foundation.) PMID:25875258

  12. Lanosterol synthase mutations cause cholesterol deficiency–associated cataracts in the Shumiya cataract rat

    PubMed Central

    Mori, Masayuki; Li, Guixin; Abe, Ikuro; Nakayama, Jun; Guo, Zhanjun; Sawashita, Jinko; Ugawa, Tohru; Nishizono, Shoko; Serikawa, Tadao; Higuchi, Keiichi; Shumiya, Seigo

    2006-01-01

    The Shumiya cataract rat (SCR) is a hereditary cataractous strain. It is thought that the continuous occurrence of poorly differentiated epithelial cells at the bow area of the lens forms the pathophysiological basis for cataract formation in SCRs. In this study, we attempted to identify the genes associated with cataract formation in SCRs by positional cloning. Genetic linkage analysis revealed the presence of a major cataract locus on chromosome 20 as well as a locus on chromosome 15 that partially suppressed cataract onset. Hypomorphic mutations were identified in genes for lanosterol synthase (Lss) on chromosome 20 and farnesyl diphosphate farnesyl transferase 1 (Fdft1) on chromosome 15, both of which function in the cholesterol biosynthesis pathway. A null mutation for Lss was also identified. Cataract onset was associated with the specific combination of Lss and Fdft1 mutant alleles that decreased cholesterol levels in cataractous lenses to about 57% of normal. Thus, cholesterol insufficiency may underlie the deficient proliferation of lens epithelial cells in SCRs, which results in the loss of homeostatic epithelial cell control of the underlying fiber cells and eventually leads to cataractogenesis. These findings may have some relevance to other types of cataracts, inborn defects of cholesterol synthesis, and the effects of cholesterol-lowering medication. PMID:16440058

  13. Understanding Cataract Risk in Aerospace Flight Crew And Review of Mechanisms of Cataract Formation

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; McCarten, M.; Manuel, K.; Djojonegoro, B.; Murray, J.; Cucinotta, F.; Feiversen, A.; Wear, M.

    2006-01-01

    Induction of cataracts by occupational exposure in flight crew has been an important topic of interest in aerospace medicine in the past five years, in association with numerous reports of flight-associated disease incidences. Due to numerous confounding variables, it has been difficult to determine if there is increased cataract risk directly caused by interaction with the flight environment, specifically associated with added radiation exposure during flight. Military aviator records from the United States Air Force (USAF) and Navy (USN) and US astronauts at the National Aeronautics and Space Administration (NASA)/Lyndon B. Johnson Space Center (JSC) were evaluated for the presence, location and age of diagnosis of cataracts. Military aviators were found to have a statistically significant younger average age of onset of their cataracts compared with astronauts, however the incidence density of cataracts was found to be statistically higher in astronauts than in military aviators. USAF and USN aviator s cataracts were most commonly located in the posterior subcapsular region of the lens while astronauts cataracts were most likely to originate generally in the cortical zone. A prospective clinical trial which controls for confounding variables in examination technique, cataract classification, diet, exposure, and pharmacological intervention is needed to determine what percentage of the risk for cataracts are due to radiation, and how to best develop countermeasures to protect flight crews from radiation bioeffects in the future.

  14. RESULTS OF ROUTINE STRIP EFFLUENT HOLD TANK AND DECONTAMINATED SALT SOLUTION HOLD TANK SAMPLES FROM MODULAR CAUSTIC-SIDE SOLVENT EXTRACTION UNIT DURING MACROBATCH 3 OPERATIONS

    SciTech Connect

    Peters, T.; Fink, S.

    2011-06-10

    Strip Effluent Hold Tank (SEHT) and Decontaminated Salt Solution Hold Tank (DSSHT) samples from several of the 'microbatches' of Integrated Salt Disposition Project (ISDP) Salt Batch ('Macrobatch') 3 have been analyzed for {sup 238}Pu, {sup 90}Sr, {sup 137}Cs, and by Inductively Coupled Plasma Emission Spectroscopy (ICPES). The results indicate good decontamination performance within process design expectations. While the data set is sparse, the results of this set and the previous set of results for Macrobatch 3 samples indicate consistent operations. However, the Decontamination Factors for plutonium and strontium removal have declined in Macrobatch 3, compared to Macrobatch 2. This may be due to the differences in the Pu concentration or the bulk chemical concentrations in the feed material. SRNL is considering the possible reasons for this decline. The DSSHT samples show continued presence of titanium, likely from leaching of the monosodium titanate in ARP. During operation of the ISDP, quantities of salt waste are processed through the Actinide Removal Process (ARP) and MCU in batches of {approx}3800 gallons. Monosodium titanate (MST) is used in ARP to adsorb actinides and strontium from the salt waste and the waste slurry is then filtered prior to sending the clarified salt solution to MCU. The MCU uses solvent extraction technology to extract cesium from salt waste and concentrate cesium in an acidic aqueous stream (Strip Effluent - SE), leaving a decontaminated caustic salt aqueous stream (Decontaminated Salt Solution - DSS). Sampling occurs in the Decontaminated Salt Solution Hold Tank (DSSHT) and Strip Effluent Hold Tank (SEHT) in the MCU process. The MCU sample plan requires that batches be sampled and analyzed for plutonium and strontium content by Savannah River National Lab (SRNL) to determine MST effectiveness. The cesium measurement is used to monitor cesium removal effectiveness and the inductively coupled plasma emission spectroscopy (ICPES) is

  15. Automatic Cataract Classification based on Ultrasound Technique Using Machine Learning: A comparative Study

    NASA Astrophysics Data System (ADS)

    Caxinha, Miguel; Velte, Elena; Santos, Mário; Perdigão, Fernando; Amaro, João; Gomes, Marco; Santos, Jaime

    This paper addresses the use of computer-aided diagnosis (CAD) system for the cataract classification based on ultrasound technique. Ultrasound A-scan signals were acquired in 220 porcine lenses. B-mode and Nakagami images were constructed. Ninety-seven parameters were extracted from acoustical, spectral and image textural analyses and were subjected to feature selection by Principal Component Analysis (PCA). Bayes, K Nearest-Neighbors (KNN), Fisher Linear Discriminant (FLD) and Support Vector Machine (SVM) classifiers were tested. The classification of healthy and cataractous lenses shows a good performance for the four classifiers (F-measure ≥92.68%) with SVM showing the highest performance (90.62%) for initial versus severe cataract classification.

  16. Use of intraocular lenses in children with traumatic cataract in south India

    PubMed Central

    Eckstein, M.; Vijayalakshmi, P; Killedar, M.; Gilbert, C.; Foster, A.

    1998-01-01

    AIMS—To assess the long term results of intraocular lens (IOL) implantation for traumatic cataract in young children in a developing country.
METHODS—Prospective hospital based study of 52 children (age 2-10 years) undergoing unilateral cataract extraction and IOL insertion for traumatic cataract performed by a single surgeon in south India. Children were reviewed regularly and followed up initially for 3 years.
RESULTS—There were no serious operative complications. Clinically significant posterior capsule opacification was almost universal (92%) and YAG capsulotomy or membranectomy was performed on 48 eyes. Some degree of pupil capture affected 35% of eyes and was complete in 6%. Visual acuity was 6/12 or better in 67% of eyes at the last follow up examination.
CONCLUSION—The visual acuity results 3 years after implantation of posterior chamber IOLs in older children with traumatic cataracts in south India were encouraging. In developing countries where follow up is unreliable it is essential to plan to clear the axial part of the posterior capsule either at the time of surgery or soon afterwards.

 Keywords: intraocular lens; children; cataract; India PMID:9828776

  17. Surgery for cataracts in people with age-related macular degeneration

    PubMed Central

    Casparis, Heather; Lindsley, Kristina; Kuo, Irene C; Sikder, Shameema; Bressler, Neil M

    2012-01-01

    Background Cataract and age-related macular degeneration (AMD) are common causes of decreased vision that often occur simultaneously in people over age 50. Although cataract surgery is an effective treatment for cataract-induced visual loss, some clinicians suspect that such an intervention may increase the risk of worsening of underlying AMD and thus have deleterious effects on vision. Objectives The objective of this review was to evaluate the effectiveness and safety of cataract surgery in eyes with AMD., Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 4), MEDLINE (January 1950 to April 2012), EMBASE (January 1980 to April 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to April 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 16 April 2012. Selection criteria We included randomized controlled trials (RCTs) and quasi-randomized trials of eyes affected by both cataract and AMD in which cataract surgery would be compared to no surgery. Data collection and analysis Two authors independently evaluated the search results against the inclusion and exclusion criteria. Two authors independently extracted data and assessed risk of bias for included studies. We resolved discrepancies by discussion. Main results One RCT with 60 participants with visually significant cataract and AMD was included in this review. Participants were randomized to immediate cataract surgery (within two weeks of enrollment) (n = 29) or delayed cataract surgery (six months after enrollment) (n = 31). At six months, four participants were lost to follow-up; two

  18. [Clinical results of tinted aspheric multifocal toric intraocular lens (SND1T3, SND1T4, SND1T5, SND1T6) for eyes following cataract extraction].

    PubMed

    Nakamura, Kunihiko; Bissen-Miyajima, Hiroko; Hayashi, Ken; Yoshino, Mami; Hirasawa, Manabu; Masumoto, Miki; Takimoto, Minehiro; Horikawa, Kumi; Maeda, Naoyuki

    2015-01-01

    The efficacy and safety of tinted aspheric multifocal toric intraocular lens (IOL) (SND1T3, SND1T4, SND1T5, SND1T6 : Alcon) were evaluated in 130 eyes of 65 patients following cataract removal. Visual acuities (VAs) at distance, near (40 cm) and intermediate (50 cm, 1 m), IOL rotation, contrast sensitivity, spectacle usage and glare/halo were examined up to 1 year postoperatively. The mean bilateral uncorrected distance VA was -0.04 ± 0.10 logMAR, near VA was 0.00 ± 0.11 logMAR, intermediate VA at 50 cm was -0.00 ± 0.11 logMAR, intermediate VA at 1 m was 0.11 ± 0.15 logMAR. IOL rotation was 5.73 ± 4.36 degrees, photopic contrast sensitivities were within normal range, and 76.9% of the patients did not require any spectacles. None of the patients complained of either serious glare or halo. The multifocal toric IOL provides better VA from distance to near at 40 cm.

  19. Cataract

    MedlinePlus

    ... activities such as driving, reading, or looking at computer or video screens, even with glasses. Some people ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  20. Cataracts

    MedlinePlus

    ... visual function, preservation of sight, and the special health problems and requirements of the blind.” News & Events Events Calendar NEI Press Releases News from NEI Grantees Spokesperson bios Statistics and ... Frequently asked questions Clinical Studies Publications Catalog ...

  1. Outcomes of cataract surgery in urban southern China: the Liwan Eye Study.

    PubMed

    Huang, Wenyong; Huang, Guofu; Wang, Dandan; Yin, Qiuxia; Foster, Paul J; He, Mingguang

    2011-01-01

    The outcomes of cataract surgery have been well reported in rural China; however, the situation in the urban population remains unclear. This study assessed the outcomes of cataract surgery in urban southern China. Data were gathered from the Liwan Eye Study, a population-based, cross-sectional study conducted in people aged 50 years or more in the Liwan District of Guangzhou. Presenting and best corrected visual acuity and a detailed eye examination were performed. For all aphakic and pseudophakic participants identified, information on the date, setting, type, and complications of cataract surgery were recorded. Of the 1405 participants, 62 people (90 eyes) had undergone cataract surgery. Of those, 54.4% underwent the phacoemulsification (Phaco) technique, 33.3% extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, and 11.1% ECCE without IOL; 1 patient had intracapsular cataract extraction (ICCE). Presenting visual acuity (PVA) was >6/18 in 56 (62.2%) eyes, <6/18 to >6/60 in 20 (22.2%) eyes, <6/60 to >3/60 in 3 (3.3%) eyes, and <3/60 in 11(12.3%) eyes. Of the 34 eyes with PVA less than 6/18, the principal causes were 26.5% retinal abnormalities, 20.6% glaucoma, 35.3% uncorrected aphakia or refractive error, and 14.5% posterior capsule opacification (PCO). ECCE or Phaco with IOL are the major surgical techniques used in urban southern China. More than half of the eyes with poor outcomes due to uncorrected aphakia, refractive error, or PCO are potentially treatable. This result suggests a pressing need for improved surgical training and postoperative care.

  2. Space radiation and cataracts in astronauts.

    PubMed

    Cucinotta, F A; Manuel, F K; Jones, J; Iszard, G; Murrey, J; Djojonegro, B; Wear, M

    2001-11-01

    For over 30 years, astronauts in Earth orbit or on missions to the moon have been exposed to space radiation comprised of high-energy protons and heavy ions and secondary particles produced in collisions with spacecraft and tissue. Large uncertainties exist in the projection of risks of late effects from space radiation such as cancer and cataracts due to the paucity [corrected] of epidemiological data. Here we present epidemiological [corrected] data linking an increased risk of cataracts for astronauts with higher lens doses (>8 mSv) of space radiation relative to other astronauts with lower lens doses (<8 mSv). Our study uses historical data for cataract incidence in the 295 astronauts participating in NASA's Longitudinal Study of Astronaut Health (LSAH) and individual occupational radiation exposure data. These results, while preliminary because of the use of subjective scoring methods, suggest that relatively low doses of space radiation may predispose crew to [corrected] an increased incidence and early appearance of cataracts.

  3. Intraocular lens employed for cataract surgery

    NASA Astrophysics Data System (ADS)

    Roszkowska, A. M.; Torrisi, L.

    2014-04-01

    The aim of this paper is to illustrate the techniques of cataract surgery with implantation of intraocular lenses and some physical properties of the used materials. The new technology, coupled with extensive experience and the studied cases, permits to increase the standardization and accuracy of the engravings, by reducing the use and handling of surgical instruments inside the eye. At present it is possible to replace the cataract with crystalline lenses based on biopolymers such as PMMA, silicone, acrylic hydrophilic and hydrophobic acrylic. These materials are increasingly able to replace the natural lens and to ensure the fully functional of the eye. The role of femtosecond lasers in cataract surgery, to assist or replace several aspects of the manual cataract surgery, are discussed.

  4. Space radiation and cataracts in astronauts

    NASA Technical Reports Server (NTRS)

    Cucinotta, F. A.; Manuel, F. K.; Jones, J.; Iszard, G.; Murrey, J.; Djojonegro, B.; Wear, M.

    2001-01-01

    For over 30 years, astronauts in Earth orbit or on missions to the moon have been exposed to space radiation comprised of high-energy protons and heavy ions and secondary particles produced in collisions with spacecraft and tissue. Large uncertainties exist in the projection of risks of late effects from space radiation such as cancer and cataracts due to the paucity [corrected] of epidemiological data. Here we present epidemiological [corrected] data linking an increased risk of cataracts for astronauts with higher lens doses (>8 mSv) of space radiation relative to other astronauts with lower lens doses (<8 mSv). Our study uses historical data for cataract incidence in the 295 astronauts participating in NASA's Longitudinal Study of Astronaut Health (LSAH) and individual occupational radiation exposure data. These results, while preliminary because of the use of subjective scoring methods, suggest that relatively low doses of space radiation may predispose crew to [corrected] an increased incidence and early appearance of cataracts.

  5. Cataract Surgery in Anterior Megalophthalmos: A Review

    PubMed Central

    GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos

    2015-01-01

    Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950

  6. Cataract surgery at district hospital level.

    PubMed

    van der Windt, C; Chana, H S

    1993-10-01

    Cataract remains the leading cause of blindness worldwide, curable though, by a simple procedure. The backlog of cataract patients in developing countries is mounting despite sustainable and downright efforts by health ministries, international voluntary and non-governmental organisations [1]. The current situation has put many developing countries in a difficult dilemma. The authors present a review of a pilot-project in decentralised eye-care in Mutasa District, Zimbabwe. Cataract surgery is performed by a district general doctor as an alternative to clearing the cataract back-log in developing countries, as suggested in several studies [2-5]. It is important to persuade the health ministries to adopt this simple and cheap policy [6,7].

  7. Space radiation and cataracts in astronauts

    NASA Technical Reports Server (NTRS)

    Cucinotta, F. A.; Manuel, F. K.; Jones, J.; Iszard, G.; Murrey, J.; Djojonegro, B.; Wear, M.

    2001-01-01

    For over 30 years, astronauts in Earth orbit or on missions to the moon have been exposed to space radiation comprised of high-energy protons and heavy ions and secondary particles produced in collisions with spacecraft and tissue. Large uncertainties exist in the projection of risks of late effects from space radiation such as cancer and cataracts due to the paucity [corrected] of epidemiological data. Here we present epidemiological [corrected] data linking an increased risk of cataracts for astronauts with higher lens doses (>8 mSv) of space radiation relative to other astronauts with lower lens doses (<8 mSv). Our study uses historical data for cataract incidence in the 295 astronauts participating in NASA's Longitudinal Study of Astronaut Health (LSAH) and individual occupational radiation exposure data. These results, while preliminary because of the use of subjective scoring methods, suggest that relatively low doses of space radiation may predispose crew to [corrected] an increased incidence and early appearance of cataracts.

  8. Bilateral persistent pupillary membranes associated with cataract

    PubMed Central

    Ahmad, Syed Shoeb; Binson, Caroline; Lung, Chong Ka; Ghani, Shuaibah Abdul

    2011-01-01

    Summary Exuberant persistent pupillary membranes (PPM) are rare in adult eyes. We report the case of a 53-year-old man diagnosed with bilateral, profuse, persistent pupillary membranes and unilateral cataract. PMID:23362401

  9. Cataracts and Other Common Eye Diseases | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Treating Cataracts Cataracts and Other Common Eye Diseases Past Issues / Summer ... eye), and injections of drugs into the eye. Cataracts Cataract: A scene as it might be viewed ...

  10. Fluorometholone-induced cataract after photorefractive keratectomy.

    PubMed

    Bilgihan, K; Gürelik, G; Akata, F; Hasanreisoglu, B

    1997-01-01

    The use of topical corticosteroids following photorefractive keratectomy (PRK) is widespread. The major complications of potent corticosteroids are glaucoma and cataract formation; in order to decrease these complications, 0.1% fluorometholone administration is usually preferred after PRK. We report here a case of lens opacification which was induced by 0.1% fluorometholone administration after PRK in a period of 4 months. To our knowledge, this is the first reported case of 0.1% fluorometholone-induced cataract after PRK.

  11. Serum antioxidant vitamins and risk of cataract.

    PubMed Central

    Knekt, P.; Heliövaara, M.; Rissanen, A.; Aromaa, A.; Aaran, R. K.

    1992-01-01

    OBJECTIVE--To investigate serum concentrations of alpha tocopherol, beta carotene, retinol, and selenium for their prediction of end stage cataract. DESIGN--A case-control study, nested within a cohort study, based on the linkage of records of subjects aged 40-83 from a health survey with those from the national Finnish hospital discharge register. SUBJECTS--47 patients admitted to ophthalmological wards for senile cataract over 15 years and two controls per patient individually matched for sex, age, and municipality. MAIN OUTCOME MEASURE--Concentration of serum micronutrients, development of cataract according to whether operation was performed. RESULTS--Low serum concentrations of antioxidant vitamins predicted the development of senile cataract, the odds ratio between the lowest third and the two higher thirds of the distribution of serum concentrations of alpha tocopherol and beta carotene being 1.9 (95% confidence interval 0.9 to 4.1) and 1.7 (0.8 to 3.8), respectively. Patients with both alpha tocopherol and beta carotene concentrations in the lowest third had an odds ratio of 2.6 (1.0 to 6.8) of cataract compared with subjects in the top two thirds. The associations were strengthened by adjustment for potential confounding factors such as occupation, smoking, blood pressure, serum cholesterol concentration, body mass index, and diabetes. No association was found between the serum concentrations of selenium, retinol, and retinol binding protein and the risk of cataract. CONCLUSIONS--Low serum concentrations of the antioxidant vitamins alpha tocopherol and beta carotene are risk factors for end stage senile cataract. Controlled trials of the role of antioxidant vitamins in cataract prevention are therefore warranted. PMID:1486302

  12. Cosmic Radiation and Cataracts in Airline Pilots

    NASA Astrophysics Data System (ADS)

    Rafnsson, V.; Olafsdottir, E.; Hrafnkelsson, J.; de Angelis, G.; Sasaki, H.; Arnarson, A.; Jonasson, F.

    Nuclear cataracts have been associated with ionising radiation exposure in previous studies. A population based case-control study on airline pilots has been performed to investigate whether employment as a commercial pilot and consequent exposure to cosmic radiation were associated to lens opacification, when adjusted for known risk factors for cataracts. Cases of opacification of the ocular lens were found in surveys among pilots and a random sample of the Icelandic population. Altogether 445 male subjects underwent a detailed eye examination and answered a questionnaire. Information from the airline company on the 79 pilots employment time, annual hours flown per aircraft type, the timetables and the flight profiles made calculation of individual cumulated radiation dose (mSv) possible. Lens opacification were classified and graded according to WHO simplified cataracts grading system using slit lamp. The odds ratio from logistic regression of nuclear cataracts risk among cases and controls was 3.02 (95% CI 1.44 to 6.35) for pilots compared with non-pilots, adjusted for age, smoking and sunbathing habits, whereas that of cortical cataracts risk among cases and controls was lower than unity (non significant) for pilots compared with non-pilots in a logistic regression analysis adjusted for same factors. Length of employment as a pilot and cumulated radiation dose (mSv) were significantly related to the risk of nuclear cataracts. So the association between radiation exposure of pilots and the risk of nuclear cataracts, adjusted for age, smoking and sunbathing habits, indicates that cosmic radiation may be cause of nuclear cataract among commercial pilots.

  13. A survey of preoperative blood tests in primary open-angle glaucoma patients versus cataract surgery patients

    PubMed Central

    Cohen, Laura P.; Wong, Jessica; Jiwani, Aliya Z.; Greenstein, Scott H.; Brauner, Stacey C.; Chen, Sherleen C.; Turalba, Angela V.; Chen, Teresa C.; Shen, Lucy; Rhee, Douglas J.; Wiggs, Janey L.; Kang, Jae Hee; Loomis, Stephanie; Pasquale, Louis R.

    2014-01-01

    Purpose To investigate biomarker differences in routine preoperative blood tests performed on primary open-angle glaucoma (POAG) case and control patients presenting for anterior segment eye surgery. Methods POAG cases and age-related cataract surgery patients (controls) who underwent anterior segment surgery at Massachusetts Eye and Ear from January 2009 through March 2012 were identified by retrospective record review. Patients with diabetes mellitus, secondary glaucoma, and cataract due to trauma or steroid exposure were excluded. Data on demographic features, preoperative ophthalmological and medical diagnosis, blood pressure, anthropometric measures, basic metabolic panel, and complete blood count were extracted from the medical records. Univariate differences in lab values between POAG cases and controls were assessed using unpaired t tests. Multivariate logistic regression analysis was completed to determine the independent associations of biomarkers with POAG. Results A total of 150 cases and 150 age-related controls were included. In multivariate analysis, higher AG was inversely associated with POAG (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.80–1.00), and higher Cl− level was positively associated with POAG (OR = 1.15; 95% CI, 1.02–1.29). The lower AG in POAG patients could be explained by higher IgG levels as the available data in post hoc analysis showed a nonsignificant trend toward higher IgG in cases compared to controls (17 vs 23; 1142 ± 284 mg/dl vs 1028 ± 291 mg/dl; P = 0.22). Furthermore, in multivariable analysis, a higher red blood cell count was also associated with POAG (OR = 1.91; 95% CI, 1.11–3.28). Conclusions Patients with POAG presenting for anterior segment surgery had a lower AG compared to age-related cataract surgery patients. The etiology of this reduced gap is unclear but the possible contribution of IgG warrants further exploration. The etiology of higher red blood cell counts in POAG cases is unknown and

  14. Cataract surgery: interim results and complications of a randomised controlled trial. Oxford Cataract Treatment and Evaluation Team (OCTET).

    PubMed Central

    1986-01-01

    A randomised controlled trial in progress for more than five years, with no loss to follow-up (except death), assessed 333 eyes treated by three methods of cataract surgery. They were (A) intracapsular extraction and contact lens usage, (B) intracapsular extraction and implantation of an iris supported lens (Federov I), and (C) extracapsular extraction and implantation of an iridocapsular lens (Binkhorst 2-loop). The purpose of the paper is to report interim visual results, complications, and corneal endothelial cell loss. More eyes in groups A (contact lens) and C (extracapsular + implant) achieved better visual acuity than in group B (intracapsular + Federov lens), which also had more postoperative complications. Both implant groups lost more endothelial cells than the non-implant group, which did not differ significantly from group B before one year. PMID:2872913

  15. Highly sensitive routine method for urinary 3-hydroxybenzo[a]pyrene quantitation using liquid chromatography-fluorescence detection and automated off-line solid phase extraction.

    PubMed

    Barbeau, Damien; Maître, Anne; Marques, Marie

    2011-03-21

    Many workers and also the general population are exposed to polycyclic aromatic hydrocarbons (PAHs), and benzo[a]pyrene (BaP) was recently classified as carcinogenic for humans (group 1) by the International Agency for Research on Cancer. Biomonitoring of PAHs exposure is usually performed by urinary 1-hydroxypyrene (1-OHP) analysis. 1-OHP is a metabolite of pyrene, a non-carcinogenic PAH. In this work, we developed a very simple but highly sensitive analytical method of quantifying one urinary metabolite of BaP, 3-hydroxybenzo[a]pyrene (3-OHBaP), to evaluate carcinogenic PAHs exposure. After hydrolysis of 10 mL urine for two hours and concentration by automated off-line solid phase extraction, the sample was injected in a column-switching high-performance liquid chromatography fluorescence detection system. The limit of quantification was 0.2 pmol L(-1) (0.05 ng L(-1)) and the limit of detection was estimated at 0.07 pmol L(-1) (0.02 ng L(-1)). Linearity was established for 3-OHBaP concentrations ranging from 0.4 to 74.5 pmol L(-1) (0.1 to 20 ng L(-1)). Relative within-day standard deviation was less than 3% and relative between-day standard deviation was less than 4%. In non-occupationally exposed subjects, median concentrations for smokers compared with non-smokers were 3.5 times higher for 1-OHP (p<0.001) and 2 times higher for 3-OHBaP (p<0.05). The two urinary biomarkers were correlated in smokers (ρ=0.636; p<0.05; n=10) but not in non-smokers (ρ=0.09; p>0.05; n=21).

  16. Evaluation of alternate outreach models for cataract services in rural Nepal

    PubMed Central

    2010-01-01

    Background Bharatpur Eye Hospital in Chitwan District, a primarily agrarian setting in south-central Nepal, reduced the number of diagnostic screening and treatment (DST) camps by one half (151 to 75) in an attempt to increase both the efficiency of its outreach program and the number of people that go directly to the hospital for service. The Hospital evaluated the two program models in terms of program costs, cataract surgical utilization, hospital direct payment and patient equity. Methods The study is a prospective, before and after, study of the impact of an alternate outreach model on cataract service utilization patterns and cost per outreach camp and cost per cataract surgery at Bharatpur Eye Hospital, comparing the service years July 2006 to June 2007, with July 2007 to June 2008. Study findings were based on routinely gathered hospital and outreach administrative data. Results The total cost of the DST camps decreased by approximately US$2000. The cost per camp increased from US$52 to $78 and the cost per cataract surgery decreased from US$ 3.80 to $3.20. The number of patients who went directly to the hospital, and paid for cataract surgery, increased from 432 (17%) to 623 (25%). The total number of cataract surgical procedures at Bharatpur Eye Hospital remained very similar between the two service years (2501 and 2449, respectively). The presenting visual acuity and sex of the two cataract surgical populations were very similar (favouring women, 53 and 55% in the two years, respectively). A shift toward younger men and women occurred with a 245 (64%) increase in people age 50-59 years, and shift away from people age 70 years and older with a 236 (22%) reduction. The age and sex distribution of the direct paying patients were very similar in the two years. Conclusion The new, more concentrated, more rural DST model of service delivery reduced overall outreach program costs, cost per cataract surgery transported, while increasing direct payments to the

  17. Evaluation of alternate outreach models for cataract services in rural Nepal.

    PubMed

    Kandel, Ram P; Rajashekaran, Sowmya R; Gautam, Maria; Bassett, Ken L

    2010-03-25

    Bharatpur Eye Hospital in Chitwan District, a primarily agrarian setting in south-central Nepal, reduced the number of diagnostic screening and treatment (DST) camps by one half (151 to 75) in an attempt to increase both the efficiency of its outreach program and the number of people that go directly to the hospital for service. The Hospital evaluated the two program models in terms of program costs, cataract surgical utilization, hospital direct payment and patient equity. The study is a prospective, before and after, study of the impact of an alternate outreach model on cataract service utilization patterns and cost per outreach camp and cost per cataract surgery at Bharatpur Eye Hospital, comparing the service years July 2006 to June 2007, with July 2007 to June 2008. Study findings were based on routinely gathered hospital and outreach administrative data. The total cost of the DST camps decreased by approximately US$2000. The cost per camp increased from US$52 to $78 and the cost per cataract surgery decreased from US$ 3.80 to $3.20. The number of patients who went directly to the hospital, and paid for cataract surgery, increased from 432 (17%) to 623 (25%). The total number of cataract surgical procedures at Bharatpur Eye Hospital remained very similar between the two service years (2501 and 2449, respectively). The presenting visual acuity and sex of the two cataract surgical populations were very similar (favouring women, 53 and 55% in the two years, respectively). A shift toward younger men and women occurred with a 245 (64%) increase in people age 50-59 years, and shift away from people age 70 years and older with a 236 (22%) reduction. The age and sex distribution of the direct paying patients were very similar in the two years. The new, more concentrated, more rural DST model of service delivery reduced overall outreach program costs, cost per cataract surgery transported, while increasing direct payments to the hospital, with a significant decrease in

  18. Routine determination of sulfonylurea, imidazolinone, and sulfonamide herbicides at nanogram-per-liter concentrations by solid-phase extraction and liquid chromatography/mass spectrometry

    USGS Publications Warehouse

    Furlong, E.T.; Burkhardt, M.R.; Gates, Paul M.; Werner, S.L.; Battaglin, W.A.

    2000-01-01

    Sulfonylurea (SU), imidazolinone (IMI), and sulfonamide (SA) herbicides are new classes of low-application-rate herbicides increasingly used by farmers. Some of these herbicides affect both weed and crop species at low dosages and must be carefully used. Less is known about the effect of these compounds on non-crop plant species, but a concentration of 100 ng/l in water has been proposed as the threshold for possible plant toxicity for most of these herbicides. Hence, analytical methods must be capable of detecting SUs, IMIs, and SAs at concentrations less than 100 ng/l in ambient water samples. The authors developed a two-cartridge, solid-phase extraction method for isolating 12 SU, 3 IMI, and 1 SA herbicides by using high-performance liquid chromatography/electrospray ionization-mass spectrometry (HPLC/ESI-MS) to identify and quantify these herbicides to 10 ng/l. This method was used to analyze 196 surface- and ground-water samples collected from May to August 1998 throughout the Midwestern United States, and more than 100 quality-assurance and quality-control samples. During the 16 weeks of the study, the HPLC/ESI-MS maintained excellent calibration linearity across the calibration range from 5 to 500 ng/l, with correlation coefficients of 0.9975 or greater. Continuing calibration verification standards at 100-ng/l concentration were analyzed throughout the study, and the average measured concentrations for individual herbicides ranged from 93 to 100 ng/l. Recovery of herbicides from 27 reagent-water samples spiked at 50 and 100 ng/l ranged from 39 to 92%, and averaged 73%. The standard deviation of recoveries ranged from 14 to 26%, and averaged 20%. This variability reflects multiple instruments, operators, and the use of automated and manual sample preparation. Spiked environmental water samples had similar recoveries, although for some herbicides, the sample matrix enhanced recoveries by as much as 200% greater than the spiked concentration. This matrix

  19. Lens: Management of Cataract Surgery, Cataract Prevention, and Floppy Iris Syndrome.

    PubMed

    Crispim, Joao; Chamon, Wallace

    2017-01-01

    According to the World Health Organization, cataract is the major cause of reversible visual impairment in the world. It is present as the cause of decreased visual acuity in 33% of the visual impaired citizens. With the increase of life expectancy in the last decades, the number of patients with cataract is expected to grow for the next 20 years. Nowadays, the only effective treatment for cataracts is surgery and its surgical outcomes have been increasingly satisfactory with the technological advancement.Pharmaceutical development has been also responsible for surgical outcomes enhancement. This includes the development of new ophthalmic viscoelastic devices (OVDs), intraocular dyes, mydriatics, miotics, anesthetics, irrigating solutions, and antibiotics. However, the increased costs and demand for cataract surgery may be hard to meet in the future unless clinical preventive and curative options are evaluated.In this chapter, we review the studies that addressed pharmacological applications in cataract.

  20. Proficiency of eye drop instillation in postoperative cataract patients in Ghana.

    PubMed

    Liu, Yang; Murdoch, Amanda; Bassett, Ken; Dharamsi, Shafik

    2013-01-01

    The purpose of the study was to evaluate the efficacy of postoperative instruction on proficiency of eye drop instillation following cataract surgery, and to determine whether such proficiency correlates with the prevalence and/or duration of irritation and pain experienced in operated eyes. This was a prospective, nonrandomized control trial with an educational intervention conducted via a single eye clinic in Accra, Ghana. The 218 subjects who completed the study were postoperative cataract surgery patients whose surgery had been funded by the nongovernmental organization Unite for Sight. Patients were evaluated on their ability to administer eye drops correctly on their first attempt on postoperative day one. If unsuccessful, patients were given an educational session that consisted of verbal instructions and an educational video. Both groups (successful and unsuccessful) on the first postoperative day were tested again for proficiency on postoperative day 30. The baseline group was evaluated only on postoperative day 30 and consisted of 36 patients. Of the 133 patients who received the educational session on eye drop instillation, 112 (84%) exhibited proficiency on postoperative day 30 as compared with 29 of 49 patients (59%) who did not receive the intervention. Additionally, there were fewer reports of pain and irritation following cataract extraction in the patients who received the educational session. This study supports the efficacy of patient education in improving proficiency in eye drop instillation and in reducing pain and irritation following cataract extraction surgeries.

  1. Complications in resident‐performed phacoemulsification cataract surgery at New Jersey Medical School

    PubMed Central

    Bhagat, Neelakshi; Nissirios, Nicholas; Potdevin, Lindsay; Chung, Jacob; Lama, Paul; Zarbin, Marco A; Fechtner, Robert; Guo, Suquin; Chu, David; Langer, Paul

    2007-01-01

    Aim To describe the complications related to cataract surgery performed by phacoemulsification technique by third‐year ophthalmology residents at New Jersey Medical School, who are trained to perform phacoemulsification without any prior experience with extracapsular extraction. Design Retrospective, observational case series. Methods A retrospective chart review of 755 patients who underwent cataract surgery by third‐year residents between July 2000 and June 2005 at the Institute of Ophthalmology and Visual Science was performed. Details of intraoperative complications (posterior capsular rupture, vitreous loss, subluxation of lens fragments into the vitreous, extracapsular cases converted to phacoemulsification, retinal detachment, vitreous haemorrhage and haemorrhagic choroidals) of the cases done by phacoemulsification technique were recorded. Results were analysed and compared with complication rates reported from other residency programmes and from experienced ophthalmologists. Results Of 755 cataract surgeries, 719 were performed using phacoemulsification technique. Posterior capsule disruption occurred in 48 (6.7%), vitreous loss in 39 (5.4%) and dislocated lenticular fragments in 7 (1.0%) of 719 cases that underwent phacoemulsification technique. Subsequent pars plana lensectomy was required in 5 (0.7%) cases; 1 case (0.1%) experienced retinal detachment and haemorrhagic choroidal detachment. Conclusion The residents can perform phacoemulsification well with a very low complication rate, without prior training with extracapsular cataract extraction technique. PMID:17431020

  2. The carbon footprint of cataract surgery

    PubMed Central

    Morris, D S; Wright, T; Somner, J E A; Connor, A

    2013-01-01

    Background Climate change is predicted to be one of the largest global health threats of the 21st century. Health care itself is a large contributor to carbon emissions. Determining the carbon footprint of specific health care activities such as cataract surgery allows the assessment of associated emissions and identifies opportunities for reduction. Aim To assess the carbon footprint of a cataract pathway in a British teaching hospital. Methods This was a component analysis study for one patient having first eye cataract surgery in the University Hospital of Wales, Cardiff. Activity data was collected from three sectors, building and energy use, travel and procurement. Published emissions factors were applied to this data to provide figures in carbon dioxide equivalents (CO2eq). Results The carbon footprint for one cataract operation was 181.8 kg CO2eq. On the basis that 2230 patients were treated for cataracts during 2011 in Cardiff, this has an associated carbon footprint of 405.4 tonnes CO2eq. Building and energy use was estimated to account for 36.1% of overall emissions, travel 10.1% and procurement 53.8%, with medical equipment accounting for the most emissions at 32.6%. Conclusions This is the first published carbon footprint of cataract surgery and acts as a benchmark for other studies as well as identifying areas for emissions reduction. Within the procurement sector, dialogue with industry is important to reduce the overall carbon footprint. Sustainability should be considered when cataract pathways are designed as there is potential for reduction in all sectors with the possible side effects of saving costs and improving patient care. PMID:23429413

  3. The carbon footprint of cataract surgery.

    PubMed

    Morris, D S; Wright, T; Somner, J E A; Connor, A

    2013-04-01

    Climate change is predicted to be one of the largest global health threats of the 21st century. Health care itself is a large contributor to carbon emissions. Determining the carbon footprint of specific health care activities such as cataract surgery allows the assessment of associated emissions and identifies opportunities for reduction. To assess the carbon footprint of a cataract pathway in a British teaching hospital. This was a component analysis study for one patient having first eye cataract surgery in the University Hospital of Wales, Cardiff. Activity data was collected from three sectors, building and energy use, travel and procurement. Published emissions factors were applied to this data to provide figures in carbon dioxide equivalents (CO2eq). The carbon footprint for one cataract operation was 181.8 kg CO2eq. On the basis that 2230 patients were treated for cataracts during 2011 in Cardiff, this has an associated carbon footprint of 405.4 tonnes CO2eq. Building and energy use was estimated to account for 36.1% of overall emissions, travel 10.1% and procurement 53.8%, with medical equipment accounting for the most emissions at 32.6%. This is the first published carbon footprint of cataract surgery and acts as a benchmark for other studies as well as identifying areas for emissions reduction. Within the procurement sector, dialogue with industry is important to reduce the overall carbon footprint. Sustainability should be considered when cataract pathways are designed as there is potential for reduction in all sectors with the possible side effects of saving costs and improving patient care.

  4. RISK OF LATE INTRAOCULAR LENS DISLOCATION AFTER CATARACT SURGERY, 1980–2009: A Population-Based Study

    PubMed Central

    Pueringer, Sam L.; Hodge, David O.; Erie, Jay C.

    2013-01-01

    Purpose To estimate the long-term cumulative risk of late posterior chamber intraocular lens (IOL) dislocation after cataract extraction in a population-based cohort. Design Retrospective cohort study and nested case-control study Methods The records of all residents of Olmsted County, Minnesota who had cataract extraction from January 1, 1980 through May 31, 2009 (14,471 cases in 9,577 residents) and were diagnosed with late posterior chamber IOL dislocation in the same period were reviewed. Cases were identified through the Rochester Epidemiology Project. Three controls chosen from the cataract surgery cohort were matched to each IOL dislocation case by age, gender, and duration of follow-up. Records were reviewed to confirm case status and ascertain risk factor information. The cumulative risk of IOL dislocation was estimated by using the Kaplan-Meier method. Logistic regression models assessed differences between cases and controls. Results We identified 16 cases of late posterior chamber IOL dislocation, 9 with in-the-bag dislocations and 7 with out-of-the bag dislocations. At 5, 10, 15, 20, and 25 years after cataract extraction, the cumulative risk of IOL dislocation was 0.1%, 0.1%. 0.2%, 0.7%, and 1.7%, respectively. There was no significant difference in the risk of late IOL dislocation after extracapsular cataract extraction when compared to phacoemulsification (P=0.21), or between different decades of surgery (P=0.92). Pseudoexfoliation and zonular laxity at surgery were associated significantly with late IOL dislocation (P=0.01). Conclusions The long-term cumulative risk of late IOL dislocation after cataract extraction was low and did not significantly change over our nearly 30-year study period. PMID:21683329

  5. Outcomes of Cataract Surgery at a Referral Center

    PubMed Central

    Mohammadi, Seyed-Farzad; Hashemi, Hassan; Mazouri, Arash; Rahman-A, Nazanin; Ashrafi, Elham; Mehrjardi, Hadi Z.; Roohipour, Ramak; Fotouhi, Akbar

    2015-01-01

    Purpose: To report the outcomes of cataract surgery at a large referral eye hospital and to identify factors associated with less than excellent visual outcomes. Methods: Hospital records of patients, who had undergone age-related cataract extraction (1,285 procedures) within a two-year period were sampled randomly for 353 patients (405 eyes) and baseline characteristics were recorded. Up to three causes of visual loss (contributory reasons) were considered and the principal cause of “less than excellent outcome,” i.e., best spectacle corrected visual acuity (BSCVA) <20/25 was defined as the primary reason. Results: Mean age of the participants was 68.6 years, and 50.7% of enrolled subjects were female. Phacoemulsification had been performed in 92.1% of cases. Out of 405 eyes, 54%, 78%, and 97% achieved BSCVA of ≥20/25, ≥20/40, and ≥20/200, respectively. Poor visual outcomes were significantly associated with older age (OR: 4.55 for age >70 years), female gender (OR: 4.64), ocular comorbidities (OR: 7.68), surgically challenging eyes (OR: 7.33), long and short eyes (versus eyes with normal axial length, OR: 3.24), and being operated on by a novice surgeon (OR: 2.41). The leading contributory reasons for unfavorable outcome, in descending order were maculopathy (17%), posterior capsule opacification (PCO, 11.8%), corneal opacity (5.7%), and degenerative myopia (5.4%). Conclusion: Maculopathy, PCO, corneal opacity, degenerative myopia and ARMD may contribute to unfavorable outcomes in cataract surgery. PMID:26730309

  6. A comprehensive review of Cataract (Kaphaja Linganasha) and its Surgical Treatment in Ayurvedic Literature

    PubMed Central

    Dhiman, K. S.; Dhiman, Kamini; Puri, Samita; Ahuja, Deepak

    2010-01-01

    Ayurveda the science of life, since its origin is serving the mankind throughout in health & disease state of life. Shalakyatantra, one of its specialized branch deals with the science of Ophthalmology, Otorhinolaryngology, Orodental surgery & Head; was contributed and developed by Rajrishi Nimi, the King of Videha, who was a colleague of Atreya, Punarvasu, Dhanwantri, Bharadwaja, Kashyapa etc. The available literature related to this speciality is reproduced from original text of Nimitantra in Uttartantra of Sushruta samhita. So Rajrishi Nimi deserves all the credit and regards for Shalakyatantra and for being the first eye surgeon on this earth. The fact regarding the technique of cataract surgery adopted by ancient surgeons is still a matter of debate. Most of the medical fraternity accepts cataract surgery of ancient surgeons as couching procedure but after going through forth coming pages, the prevailing concept will prove to be a myth. It started with extra capsular extraction through small incision during the period of Sushruta Samhita but later shifted to couching like technique by Acharya Vagbhatta. Secondly, the objective of this literary research paper is to find proper co-relation of the disease cataract to those mentioned in Ancient Ayurvedic classic. Linganasha has been inadvertently taken as cataract but this is neither logical nor in accordance with classics. We find detailed description of cataract's differential diagnosis, indications, contra- indications, pre/intra/post operative procedures and complication in ancient texts of Ayurveda. Not only this, vivid description of treatment of various complications of cataract surgery are also given. Needless to say, no other surgically treatable diseases & its complications except Kaphaja Linganasha are given this much attention. PMID:22131692

  7. Tools to fight the cataract epidemic: A review of experimental animal models that mimic age related nuclear cataract.

    PubMed

    Lim, Julie C; Umapathy, Ankita; Donaldson, Paul J

    2016-04-01

    Cataract is the leading cause of blindness worldwide and accounts for approximately half of all forms of vision loss. Currently, the only way to treat cataracts is by surgery. However, with an ageing population, the demand for surgery and the need for cost effective alternative solutions grows exponentially. To reduce the need for cataract surgery, alternative medical therapies to delay cataracts are urgently required. However, given the difficulty in accessing human cataract lenses, investigating the process of cataract formation and testing the efficacy of potential therapies in humans is problematic. Therefore, researchers have looked to create suitable animal models of cataractogenesis to identify therapeutic options. This review will provide an overview of the cataract specific changes previously reported in human cataract lenses, before focussing on the specific changes that occur in age related nuclear (ARN) cataract, the most common form of cataract in humans. This will be followed by a discussion of a range of existing animal cataract models and their respective suitability for mimicking the processes associated with the development of ARN cataract, and therefore their utility as models to test anti-cataract therapies for future use in humans. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Current concepts in the management of canine cataract: a survey of techniques used by surgeons in Britain, Europe and the USA and a review of recent literature.

    PubMed

    Williams, D L; Boydell, I P; Long, R D

    1996-04-13

    One of the authors (D. L. W.) visited ophthalmologists in Great Britain, Europe and the USA to assess current practice in the surgery of cataracts in dogs. This paper describes the results of these visits and provides a survey of the literature. The success rates in canine cataract surgery have increased markedly in the last 10 years, particularly as a result of the introduction of phacoemulsification techniques and the reduction in the use of extracapsular cataract extraction; these new techniques and the problems they seek to overcome are discussed. The paper also considers the developing field of intraocular lens implantation, the rationale behind such developments and the benefits and potential problems which may occur after the extraction of a cataract and the implantation of a lens.

  9. Genetics Home Reference: congenital cataracts, facial dysmorphism, and neuropathy

    MedlinePlus

    ... Health Conditions CCFDN congenital cataracts, facial dysmorphism, and neuropathy Printable PDF Open All Close All Enable Javascript ... collapse boxes. Description Congenital cataracts, facial dysmorphism, and neuropathy ( CCFDN ) is a rare disorder that affects several ...

  10. Combined cataract and glaucoma surgery: trabeculectomy versus endoscopic laser cycloablation.

    PubMed

    Gayton, J L; Van Der Karr, M; Sanders, V

    1999-09-01

    To determine whether combined cataract surgery with endoscopic laser cycloablation produces less inflammation than cataract surgery combined with a filtering procedure. Taylor Regional Hospital (surgeries) and EyeSight Associates (examinations), Warner Robins, Georgia, USA. A randomized prospective study was conducted of 58 eyes of 58 patients comparing endoscopic laser cycloablation performed through a cataract incision at the time of cataract surgery with combined trabeculectomy and cataract surgery. Mean follow-up was 2 years. At the final available visit, 30% of endoscopic laser patients achieved intraocular pressure control (below 19 mm Hg) without medication and 65% with medication. Forty percent of trabeculectomy patients achieved control without medication and 52% with medication. Four endoscopic laser patients (14%) and 3 trabeculectomy patients (10%) were considered treatment failures (required additional surgical intervention). Endoscopic laser cycloablation performed through a cataract incision was a reasonably safe and effective alternative to combined cataract and trabeculectomy surgery, providing an option for cataract patients who have glaucoma requiring surgical intervention.

  11. Achieving target refraction after cataract surgery.

    PubMed

    Simon, Shira S; Chee, Yewlin E; Haddadin, Ramez I; Veldman, Peter B; Borboli-Gerogiannis, Sheila; Brauner, Stacey C; Chang, Kenneth K; Chen, Sherleen H; Gardiner, Matthew F; Greenstein, Scott H; Kloek, Carolyn E; Chen, Teresa C

    2014-02-01

    To evaluate the difference between target and actual refraction after phacoemulsification and intraocular lens implantation at an academic teaching institution's Comprehensive Ophthalmology Service. Retrospective study. We examined 1275 eye surgeries for this study. All consecutive cataract surgeries were included if they were performed by an attending or resident surgeon from January through December 2010. Postoperative refractions were compared with preoperative target refractions. Patients were excluded if they did not have a preoperative target refraction documented or if they did not have a recorded postoperative manifest refraction within 90 days. The main outcome measure was percentage of cases achieving a postoperative spherical equivalent ± 1.0 diopter (D) of target spherical equivalent. We performed 1368 cataract surgeries from January through December of 2010. Of these, 1275 (93%) had sufficient information for analysis. Of the included cases, 94% (1196 of 1275) achieved ± 1.0 D of target refraction by 90 days after cataract surgery. This paper establishes a new benchmark for a teaching hospital, where 94% of patients achieved within 1.0 D of target refraction after cataract surgery. The refractive outcomes after cataract surgery at this academic teaching institution were higher than average international benchmarks. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. Antioxidant vitamins, minerals and cataract: current opinion.

    PubMed

    Ugboaja, Onyinye C; Bielory, Leonard; Bielory, Brett P; Ehiorobo, Egbe S

    2012-10-01

    The purpose of this review is to assess the most recent findings and literature on the effect of minerals and antioxidant vitamins in the prevention of development and progression of cataract. To retrieve most recent and relevant articles for this review, an intense and thorough search was conducted in databases and journal articles. Experts in the field of study were also contacted to know what the current opinions were in their practice. The data retrieved were qualitatively analysed and synthesized in order to arrive with the most objective conclusions. The result on the use of single antioxidant supplement did not show any significant effect on the cataract. A combination of antioxidant vitamins such as vitamins C and E may have a synergistic effect on cataract prevention; however, more studies need to be conducted to prove this. There are still inconsistent results on the exact antioxidant and the required amount needed to prevent cataract. On the basis of the insufficient and inconsistent results of recent trials reviewed it is not clear that antioxidant vitamins and minerals nor that healthy diets prevent the development and progression of cataract.

  13. Acid phosphatase and lipid peroxidation in human cataractous lens epithelium.

    PubMed

    Vasavada, A R; Thampi, P; Yadav, S; Rawal, U M

    1993-12-01

    The anterior lens epithelial cells undergo a variety of degenerative and proliferative changes during cataract formation. Acid phosphatase is primarily responsible for tissue regeneration and tissue repair. The lipid hydroperoxides that are obtained by lipid peroxidation of polysaturated or unsaturated fatty acids bring about deterioration of biological membranes at cellular and tissue levels. Acid phosphatase and lipid peroxidation activities were studied on the lens epithelial cells of nuclear cataract, posterior subcapsular cataract, mature cataract, and mixed cataract. Of these, mature cataractous lens epithelium showed maximum activity for acid phosphatase (516.83 moles of p-nitrophenol released/g lens epithelium) and maximum levels of lipid peroxidation (86.29 O.D./min/g lens epithelium). In contrast, mixed cataractous lens epithelium showed minimum activity of acid phosphatase (222.61 moles of p-nitrophenol released/g lens epithelium) and minimum levels of lipid peroxidation (54.23 O.D./min/g lens epithelium). From our study, we correlated the maximum activity of acid phosphatase in mature cataractous lens epithelium with the increased areas of superimposed cells associated with the formation of mature cataract. Likewise, the maximum levels of lipid peroxidation in mature cataractous lens epithelium was correlated with increased permeability of the plasma membrane. Conversely, the minimum levels of lipid peroxidation in mixed cataractous lens epithelium makes us presume that factors other than lipid peroxidation may also account for the formation of mixed type of cataract.

  14. The gene of an early onset progressive cataract (cerulean cataract) maps to 17q24

    SciTech Connect

    Armitage, M.M.; Ferrell, R.E.; Kivlin, J.D.

    1994-09-01

    Cerulean cataract is an autosomal dominant, fully penetrant, early onset, progressive cataract characterized by blue or white opacifications in the nucleus and cortex of the lens. A five generation family with 44 available affected members in three generations allowed exclusion of linkage of the cerulean cataract phenotype to lens structural protein genes and to all of the chromosomal regions to which autosomal dominant cataract phenotypes have previously been mapped. Exclusion of the plausible candidate instigated a genome-wide search utilizing short tandem repeat polymorphims. The genome search localized the cerulean cataract disease gene to chromosomal region 17q24. The three markers closest to the disease gene are D17S802 [Z({theta})=9.20 at ({theta})=0.086], D17S836 [Z({theta})=4.22 at ({theta})=0.061], and AFMa238yb5 [Z({theta})=7.11 at ({theta})=0.032]. Multipoint analysis yielded a maximum lod score of Z({theta})=11.4 between D17S802 and D17S836 at recombination rates of 0.048 and 0.013 respectively. Three genes that map near the 17q24 chromosomal region and are known to contain highly polymorphic microsatellites were tested for linkage. The genes, DHP-sensitive calcium channel gamma subunit (CACNLG), human somatastatin receptor (SSTR2), and the skeletal muscle sodium channel alpha subunit (SCN4A), were all excluded [Z({theta})=-{infinity} at ({theta})=0] as the gene causing cerulean cataract. The galactokinase (GK1) gene has not been cloned, but its map location is 17q23-q25. Galactokinase deficiency is characterized by a recessive, progressive, early onset cataract. Because of the map location of galactokinase, the age-at-onset, and progressive nature of cataracts associated with galactokinase deficiency, galactokinase is being investigated as a candidate gene for the cerulean cataract phenotype.

  15. Aqueous humor ferritin in hereditary hyperferritinemia cataract syndrome.

    PubMed

    Lenzhofer, Markus; Schroedl, Falk; Trost, Andrea; Kaser-Eichberger, Alexandra; Wiedemann, Helmut; Strohmaier, Clemens; Hohensinn, Melchior; Strasser, Michael; Muckenthaler, Martina U; Grabner, Guenther; Aigner, Elmar; Reitsamer, Herbert A

    2015-04-01

    Hereditary hyperferritinemia cataract syndrome (HHCS) is a rare autosomal dominant hereditary disease, characterized by hyperferritinemia but with absence of body iron excess and early onset of bilateral cataracts. Although 5- to 20-fold increased serum ferritin concentrations have been reported in HHCS patients, data of ferritin levels in aqueous humor have not been obtained. We therefore aimed to investigate the ferritin levels in aqueous humor and serum and further present histological and ultrastructural data of the lens. During cataract extraction and intraocular lens implantation, aqueous humor and lens aspirate of a 37-year-old HHCS patient were obtained from both eyes. Ferritin levels in serum and aqueous humor were quantitatively analyzed via immunoassays in the HHCS patient and healthy control subjects (n = 6). Lens aspirate in HHCS was analyzed histologically and at the ultrastructural level. Further, genetic mutation screening by polymerase chain reaction and DNA sequencing in blood was performed. Serum ferritin levels in the control group were 142.2 ± 38.7 μg/L, whereas in the HHCS patient, this parameter was excessively increased (1086 μg/L). Analysis of ferritin in aqueous humor revealed 6.4 ± 3.8 μg/L in normal control subjects and 146.3 μg/L (OD) and 160.4 μg/L (OS) in the HHCS patient. DNA analysis detected a C>A mutation on position +18, a T>G mutation on position +22, a T>C mutation on position +24, and a T>G polymorphism on position +26 in the iron-responsive element of the light-chain ferritin (L-ferritin) gene. In the HHCS patient, a 23-fold (OD) to 25-fold (OS) increased aqueous humor ferritin level was detected. Therefore, the formation of bilateral cataract in HHCS is most likely a result of elevated aqueous humor ferritin. In addition, a novel mutation in this rare disease in the iron-responsive element of L-ferritin gene is reported.

  16. Lack of association of the WRN C1367T polymorphism with senile cataract in the Israeli population

    PubMed Central

    Ehrenberg, M.; Dratviman-Storobinsky, O.; Avraham-Lubin, B.R.

    2010-01-01

    Purpose Werner syndrome is an autosomal recessive disease of premature aging caused by a polymorphic C1367T mutation in the Werner (WRN) gene. Although there are differences between the pathobiology of normal aging and the phenotype of Werner syndrome, the clinical age-related changes are similar. The aim of the study was to investigate the incidence of the C1367T (rs1346044) polymorphism in patients with age-related cataract. Methods The study group consisted of 81 patients with senile cataract undergoing cataract extraction surgery. Data on age, sex, and medical history of microvascular disease and cancer were obtained from the medical files. Anterior lens capsule material was collected during surgery. DNA was extracted, amplified by polymerase chain reaction, and screened for the C1367T polymorphism in WRN using restriction enzymes followed by sequencing. Results There were 33 male and 48 female patients of mean age 74.3±9 years. Genotypic frequencies were 67% for TT and 33% for TC. None of the patients had the CC genotype. Ten patients had a history of myocardial infarct, 8 cerebrovascular accident, and 8 various tumors. The distribution of these morbidities was similar in the two genotype groups. Conclusions The distribution of the C1367T WRN polymorphism in patients with senile cataract is similar to that in the normal population. Cataract formation in the elderly is not linked to a WRN mutation. PMID:20808731

  17. Deprivation amblyopia and congenital hereditary cataract.

    PubMed

    Mansouri, Behzad; Stacy, Rebecca C; Kruger, Joshua; Cestari, Dean M

    2013-01-01

    Amblyopia is a neurodevelopmental disorder of vision associated with decreased visual acuity, poor or absent stereopsis, and suppression of information from one eye.(1,2) Amblyopia may be caused by strabismus (strabismic amblyopia), refractive error (anisometropic amblyopia), or deprivation from obstructed vision (deprivation amblyopia). 1 In the developed world, amblyopia is the most common cause of childhood visual impairment, 3 which reduces quality of life 4 and also almost doubles the lifetime risk of legal blindness.(5, 6) Successful treatment of amblyopia greatly depends on early detection and treatment of predisposing disorders such as congenital cataract, which is the most common cause of deprivational amblyopia. Understanding the genetic causes of congenital cataract leads to more effective screening tests, early detection and treatment of infants and children who are at high risk for hereditary congenital cataract.

  18. Methylphenidate (Ritalin)-associated cataract and glaucoma.

    PubMed

    Lu, Chao-Kung; Kuang, Tung-Mei; Chou, Joe Ching-Kuang

    2006-12-01

    Methylphenidate hydrochloride (Ritalin) is the drug of choice for attention deficit hyperactivity disorder (ADHD). However, an association of Ritalin with glaucoma has been reported. We report a case of Ritalin-associated cataract and glaucoma. A 10-year-old boy was diagnosed with ADHD and had received methylphenidate hydrochloride, 60 mg/day for 2 years. He presented with blurred vision. Best-corrected visual acuity was 6/60 in both eyes. Ocular examinations revealed intraocular pressure (IOP) of 30 mmHg under medication, dense posterior subcapsular opacity of lens, pale disc with advanced cupping, and marked constriction of visual field. Despite maximal anti-glaucomatous medication, IOP still could not be controlled. The patient then received combined cataract and glaucoma surgery. Visual acuity improved and IOP was within normal limits in both eyes postoperatively. Large dose of methylphenidate may cause cataract and glaucoma. The mechanism remains unclear. Doctors should be aware of the possible ocular side effects of methylphenidate.

  19. Thermal cataract, from furnaces to lasers.

    PubMed

    Vos, Johannes J; van Norren, Dirk

    2004-11-01

    Thermal cataract has long been known as an occupational disease in furnace workers. This affliction has virtually disappeared in western countries due to improved working conditions. However, new light sources have appeared on the scene, in particular lasers, which might also be capable of producing thermal cataract. The aim of this survey is to review the history and describe the present state of knowledge. Experimental work, mainly on rabbits, was reviewed and complemented with the results of calculations on the thermal changes in the ocular media. Safe exposure limits were derived over the optical spectrum from the near ultraviolet to the far infrared. Lasers may be a cause of thermal cataract only in the near ultraviolet. Moreover, in this field of research too, it is concluded that science may be regarded as the present state of misunderstanding.

  20. Clear Corneal Incision in Cataract Surgery

    PubMed Central

    Al Mahmood, Ammar M.; Al-Swailem, Samar A.; Behrens, Ashley

    2014-01-01

    Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature. PMID:24669142

  1. [Cataract surgery - essentials for the general practitioner].

    PubMed

    Amstutz, Ch; Thiel, M A; Kaufmann, Claude

    2010-08-11

    Age-related cataracts are mainly caused by life-long accumulation of oxidative stress on the lens fibres. Symptoms include reduced visual acuity, requiring more light for reading, and glare. The only treatment that provides a cure for cataracts is surgery. Phacoemulsification represents the preferred method of lens removal. It involves fragmentation of the lens using ultrasound and insertion of an artificial intraocular lens. The preoperative assessment the general practitioner provides to surgeon and anesthesia team has an important share in the low complication rate of the procedure in the event of co-existing systemic disease. Growing patient expectation for spectacle independence following cataract surgery is met to some extent using techniques for astigmatism control and presbyo-pia-correcting intraocular lenses.

  2. Indoor fitness routine

    MedlinePlus

    ... health care provider before starting an exercise program . Circuit Training Circuit training is 1 type of routine ... your hips and knees until your thighs are parallel to the floor. Return to starting position. 15 ...

  3. Daily exercise routines

    NASA Technical Reports Server (NTRS)

    Anderson, Patrick L.; Amoroso, Michael T.

    1990-01-01

    Viewgraphs on daily exercise routines are presented. Topics covered include: daily exercise and periodic stress testings; exercise equipment; physiological monitors; exercise protocols; physiological levels; equipment control; control systems; and fuzzy logic control.

  4. Routine sputum culture

    MedlinePlus

    Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, ... . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:409- ...

  5. Cataracts induced by microwave and ionizing radiation

    SciTech Connect

    Lipman, R.M.; Tripathi, B.J.; Tripathi, R.C.

    1988-11-01

    Microwaves most commonly cause anterior and/or posterior subcapsular lenticular opacities in experimental animals and, as shown in epidemiologic studies and case reports, in human subjects. The formation of cataracts seems to be related directly to the power of the microwave and the duration of exposure. The mechanism of cataractogenesis includes deformation of heat-labile enzymes, such as glutathione peroxide, that ordinarily protect lens cell proteins and membrane lipids from oxidative damage. Oxidation of protein sulfhydryl groups and the formation of high-molecular-weight aggregates cause local variations in the orderly structure of the lens cells. An alternative mechanism is thermoelastic expansion through which pressure waves in the aqueous humor cause direct physical damage to the lens cells. Cataracts induced by ionizing radiation (e.g., X-rays and gamma rays) usually are observed in the posterior region of the lens, often in the form of a posterior subcapsular cataract. Increasing the dose of ionizing radiation causes increasing opacification of the lens, which appears after a decreasing latency period. Like cataract formation by microwaves, cataractogenesis induced by ionizing radiation is associated with damage to the lens cell membrane. Another possible mechanism is damage to lens cell DNA, with decreases in the production of protective enzymes and in sulfur-sulfur bond formation, and with altered protein concentrations. Until further definitive conclusions about the mechanisms of microwaves and ionizing radiation induced cataracts are reached, and alternative protective measures are found, one can only recommend mechanical shielding from these radiations to minimize the possibility of development of radiation-induced cataracts. 74 references.

  6. Complication rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital.

    PubMed

    Haripriya, Aravind; Chang, David F; Reena, Mascarenhas; Shekhar, Madhu

    2012-08-01

    To analyze the rate of intraoperative complications, reoperations, and endophthalmitis with phacoemulsification, manual small-incision cataract surgery (SICS), and large-incision extracapsular cataract extraction (ECCE). Aravind Eye Hospital, Madurai, India. Retrospective cohort study. This study comprised consecutive cataract surgeries performed during a 12-month period. All surgical complications and endophthalmitis cases were tabulated and analyzed for each of 4 surgeon groups (staff, fellows, residents, visiting trainees). Within each surgeon group, complication rates with phacoemulsification, manual SICS, and ECCE were compared. The surgical distribution was 20,438 (26%) phacoemulsification, 53,603 (67%) manual SICS, and 5736 (7%) ECCE. The overall intraoperative complication rate was 0.79% for staff, 1.19% for fellows, 2.06% for residents, and 5% for visiting trainees. Extracapsular cataract extraction had the highest overall rate of surgical complications (2.6%). The overall complication rate was 1.01% for manual SICS and 1.11% for phacoemulsification. However, the combined complication rate for trainees was significantly higher with phacoemulsification (4.8%) than with manual SICS (1.46%) (P<.001). The corrected distance visual acuity was better than 6/12 in 96% after phacoemulsification complications and 89% after manual SICS complications (P<.001). There were 27 cases (0.04%) of endophthalmitis but no statistical differences between surgical methods or surgeon groups. For staff surgeons experienced with both phacoemulsification and manual SICS, intraoperative complication rates were comparably low. However, for trainee surgeons, the complication rate was significantly higher with phacoemulsification, suggesting that manual SICS may be a safer initial procedure to learn for inexperienced cataract surgeons in the developing world. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS

  7. Management of coexisting cataract and glaucoma.

    PubMed

    Crichton, Andrew

    2010-03-01

    The optimal management of cataract in the glaucoma patient must be constantly updated as advances in both subspecialties impact the surgical decision. The primary considerations at this time include combining the procedures as opposed to sequential operations and optimizing the effectiveness of the operations while reducing complications. Recent findings would certainly suggest an individualized approach based not only on the glaucoma and cataract condition of the patient but also on the experience of the surgeon with varied techniques. Further time and research are required to determine whether certain approaches or techniques will become more universally adopted. At present, there certainly is support for a variety of approaches.

  8. Uveal melanoma presenting as cataract and staphyloma

    PubMed Central

    Khetan, Vikas; Gupta, Kshanada; Mohan, E. Ravindra; Gopal, Lingam

    2009-01-01

    Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma. The patient underwent extended enucleation and histopathology was consistent with uveal melanoma. PMID:19384018

  9. Uveal melanoma presenting as cataract and staphyloma.

    PubMed

    Khetan, Vikas; Gupta, Kshanada; Mohan, E Ravindra; Gopal, Lingam

    2009-01-01

    Blind eyes can harbor a choroidal melanoma. We report a case of uveal melanoma presenting as staphyloma and complicated cataract in a 45-year-old female. The left eye was blind for six months. She underwent comprehensive ocular examination but fundus examination was precluded due to total cataract. The ultrasound of the eye showed a large mass filling the superior, nasal and inferonasal vitreous cavity with high surface reflectivity and low to moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed the diagnosis of choroidal melanoma. The patient underwent extended enucleation and histopathology was consistent with uveal melanoma.

  10. Partially coherent interferometric biometry in cataract surgery

    NASA Astrophysics Data System (ADS)

    Drexler, Wolfgang; Findl, Oliver; Menapace, Rupert; Hitzenberger, Christoph K.; Fercher, Adolf F.

    1999-02-01

    In an earlier study we showed that precise axial eye length measurement on cataract eyes is possible with the dual beam partial coherence interferometry technique (PCI). A high correlation with the standard ultrasound technique has been obtained. Recently, in a prospective study, partially coherent interferometry and ultrasound biometry were compared in cataract surgery using the SRK II formula based on US applanation biometry. Three months after surgery PCI was repeated and refractive outcome was determined. The use of PCI would have improved refractive outcome by about 30%.

  11. High-fidelity cataract surgery simulation and third world blindness.

    PubMed

    Singh, Ajay; Strauss, Glenn H

    2015-04-01

    The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery.

  12. [Appropriate cataract surgery training can promote work of blindness prevention].

    PubMed

    Zhang, Mingzhi

    2014-03-01

    Cataract is the first blinding eye disease in the world and China. However, due to various reasons, cataract surgery rate (CSR) in China is much lower than in developed countries and even some developing countries. Properly and standardized training of cataract surgery for ophthalmologists from primary hospital and young eye doctors is one of the key point to improve CSR. For above, we had explored actively to establish an appropriate and suitable training model of cataract surgery. Ophthalmologist in primary hospital can provide high quality medical services to cataract patients in accordance with their own conditions after training and promote the sustainable development of blindness prevention work.

  13. [Ten most progression of cataract research in China].

    PubMed

    2015-04-01

    Ten researches that may represent the most advanced cataract related studies in China were reviewed, which were recommended and voted by specialists from Chinese Cataract and Intraocular Lens Society. These researches focused on the following fields: the clinical study of the refractive cataract surgery, the clinical study on the premium intraocular lens, location and function study of the disease-associated genes of congenital cataract, the mechanism and prevention of age-related cataract, the mechanism and prevention of oxidative damage of crystalline lens and so on. These studies represented the level of crystalline lens related disease field in China.

  14. High-Fidelity Cataract Surgery Simulation and Third World Blindness

    PubMed Central

    Singh, Ajay

    2015-01-01

    The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery. PMID:24996918

  15. IOP Elevation After Cataract Surgery: Results for Residents and Senior Staff at Henry Ford Health System.

    PubMed

    Elfersy, Adrian J; Prinzi, Robert A; Peracha, Zuhair H; Kim, Daniel D; Crandall, David A; Darnley-Fisch, Deborah A; Imami, Nauman R

    2016-10-01

    To determine the incidence of intraocular pressure (IOP) elevation on postoperative day 1 (POD1) after cataract surgery performed by resident surgeons compared with attending surgeons and to examine the influence of associated variables on the incidence of postoperative IOP elevation. Retrospective review of 2472 consecutive 2.2 to 2.8 mm temporal clear corneal cataract extractions by phacoemulsification performed by either residents or attending surgeons at Henry Ford Health System. Fellow eyes were excluded, resulting in 1847 eyes. IOP measurements of >40, >30, and >23 mm Hg were noted along with incremental IOP elevations of ≥10 and 20 mm Hg over preoperative/baseline IOP. Associated variables included: age, sex, diabetes mellitus, hypertension, glaucoma, glaucoma suspect, uveitis, prior ocular trauma, and vitreous loss at surgery. Resident-performed cataract surgery was associated with statistically significant higher rates of IOP elevation in all categories and in all clinical situations known to be associated with postoperative IOP spike, that is, vitreous loss at surgery, prior ocular trauma, and preexisting glaucoma. The incidence of postoperative day 1 IOP elevation after phacoemulsification performed by resident surgeons was 2 to 5 times that of experienced cataract surgeons. Variables including vitreous loss at surgery, prior ocular trauma, preexisting glaucoma, glaucoma suspect status, and male sex were significant contributors. Consideration for prophylactic IOP lowering is advised in high-risk patients.

  16. Torsional ultrasound efficiency under different vacuum levels in different degrees of nuclear cataract.

    PubMed

    Wang, Yujuan; Xia, Yuanling; Zeng, Mingbing; Liu, Xialin; Luo, Lixia; Chen, Bing; Liu, Yuhua; Liu, Yizhi

    2009-11-01

    To evaluate the efficiency of torsional ultrasound (US) under different vacuum levels in eyes with cataract with different degrees of nuclear density. Cataract Service, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. In this prospective randomized series, eyes with age-related cataract were divided into 3 groups based on nuclear density. Eyes in each group were randomly assigned to 1 of 3 subgroups and treated with phacoemulsification under vacuum of 250 mm Hg (subgroup 1), 450 mm Hg (subgroup 2), or 600 mm Hg (subgroup 3). Data included preoperative and postoperative corrected distance visual acuity (CDVA), endothelial cell density, and central corneal thickness (CCT) and intraoperative US time and cumulative dissipated energy (CDE). The study evaluated 998 patients (1073 eyes). In each group, there was a statistically significant decrease in US time, CDE, and postoperative endothelial cell loss with increased vacuum (P<.05). At 1 day and 7 days, the CDVA was statistically significantly better in subgroups 2 and 3 (P<.05) and the CCT was thinner when vacuum was higher. There was no statistically significant difference in CDVA and CCT between subgroups 30 days postoperatively (P>.05). Torsional US with a high vacuum level was safe for cataract extraction. With less US energy and endothelial cell loss, torsional US was more efficient than with higher vacuum levels with lower levels.

  17. Cost and reimbursement of cataract surgery in Europe: a cross-country comparison.

    PubMed

    Fattore, Giovanni; Torbica, Aleksandra

    2008-01-01

    The number of cataract extractions has increased substantially over time. At present, cataract surgery is estimated to be the most common single procedure performed in the developed world. The present study compares the costs of a cataract intervention across nine European countries. To enhance comparability, data were collected using a common template based on a case vignette. Adequate data for analysis were collected from 41 providers and were used to evaluate variation across countries and providers. Ordinary least squares and a multilevel model were used to investigate cost variation. Mean total costs per cataract intervention varied considerably from country to country, ranging from 318 euros in Hungary to 1087 euros in Italy. Variations of a similar magnitude were detected for personnel costs and overheads. However, variations in the cost of the lens were more modest. Overall, our results confirm expectations about the causes of cost variations across EU member states, indicating that these variations may be attributable to the quantity of resources used in performing the operation, the price of resources, and the type of setting in which the operation is performed. The study highlights how accounting practices and available cost data differ across Europe. It also shows the feasibility of collecting data on the basis of vignettes using common cost templates. Studies following this approach will gain importance if cross-country comparisons are to be used to promote European benchmarking exercises. Copyright 2008 John Wiley & Sons, Ltd.

  18. Cat-Map: putting cataract on the map

    PubMed Central

    Bennett, Thomas M.; Hejtmancik, J. Fielding

    2010-01-01

    Lens opacities, or cataract(s), may be inherited as a classic Mendelian disorder usually with early-onset or, more commonly, acquired with age as a multi-factorial or complex trait. Many genetic forms of cataract have been described in mice and other animal models. Considerable progress has been made in mapping and identifying the genes and mutations responsible for inherited forms of cataract, and genetic determinants of age-related cataract are beginning to be discovered. To provide a convenient and accurate summary of current information focused on the increasing genetic complexity of Mendelian and age-related cataract we have created an online chromosome map and reference database for cataract in humans and mice (Cat-Map). PMID:21042563

  19. Quality of care from the perspective of the cataract patient. QUOTE cataract questionnaire.

    PubMed

    Nijkamp, Marjan D; Sixma, Herman J; Afman, Hennie; Hiddema, Frans; Koopmans, Steven A; van den Borne, Bart; Hendrikse, Fred; Nuijts, Rudy M M A

    2002-11-01

    To examine the potential of a questionnaire (QUOTE Cataract) to measure quality of care from the perspective of cataract patients in quality-assurance or improvement programs. Department of Ophthalmology, University Hospital Maastricht, Maastricht, University Hospital Groningen, Groningen, and Rotterdam Eye Hospital, Rotterdam, The Netherlands. Cataract patients (N = 540) who had cataract surgery 2 to 8 months previously rated 31 quality-of-care aspects in terms of importance (range 0, not important, to 10, extremely important) and performance (0 = yes, 1 = no). An arithmetic combination of the 2 parameters was used to generate quality-impact factors (Q) (range 0, best quality of care, to 10, this aspect needs improvement according to every respondent). The goal was to identify bottlenecks in the quality of care. Patients scored aspects concerning patient education as the most important quality aspects. The top 3 quality-impact factors were to inform patients what to do in emergency situations (Q = 3.39), inform patients about the risks of treatment (Q = 3.00), and minimize the number of ophthalmologists to 1 per patient (Q = 2.79). The QUOTE Cataract Questionnaire effectively measured quality of care in cataract surgery patients in different hospital settings and provided practical information for quality-assurance programs.

  20. Effect of prior anti-VEGF injections on the risk of retained lens fragments and endophthalmitis post cataract surgery in the elderly

    PubMed Central

    Hahn, Paul; Yashkin, Arseniy P.; Sloan, Frank A.

    2015-01-01

    caution, and postoperative vigilance are recommended in patients with a prior history of intravitreal injections undergoing cataract extraction. PMID:26278863

  1. Sunlight and Cataracts: Are Athletes at Risk?

    ERIC Educational Resources Information Center

    Cinque, Chris

    1989-01-01

    Reports on a recent study of Chesapeake Bay watermen, which indicates a possible association between long-term exposure of the eyes to ultraviolet B rays and risk of cataract development. Authorities recommend protective lenses for outdoor athletes, especially those involved in winter sports. (SM)

  2. Sunlight and Cataracts: Are Athletes at Risk?

    ERIC Educational Resources Information Center

    Cinque, Chris

    1989-01-01

    Reports on a recent study of Chesapeake Bay watermen, which indicates a possible association between long-term exposure of the eyes to ultraviolet B rays and risk of cataract development. Authorities recommend protective lenses for outdoor athletes, especially those involved in winter sports. (SM)

  3. Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops: a systematic review.

    PubMed

    Kessel, Line; Tendal, Britta; Jørgensen, Karsten Juhl; Erngaard, Ditte; Flesner, Per; Andresen, Jens Lundgaard; Hjortdal, Jesper

    2014-10-01

    Favorable outcome after cataract surgery depends on proper control of the inflammatory response induced by cataract surgery. Pseudophakic cystoid macular edema is an important cause of visual decline after uncomplicated cataract surgery. We compared the efficacy of topical steroids with topical nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling inflammation and preventing pseudophakic cystoid macular edema (PCME) after uncomplicated cataract surgery. Patients undergoing uncomplicated surgery for age-related cataract. We performed a systematic literature search in Medline, CINAHL, Cochrane, and EMBASE databases to identify randomized trials published from 1996 onward comparing topical steroids with topical NSAIDs in controlling inflammation and preventing PCME in patients undergoing phacoemulsification with posterior chamber intraocular lens implantation for age-related cataract. Postoperative inflammation and pseudophakic cystoid macular edema. Fifteen randomized trials were identified. Postoperative inflammation was less in patients randomized to NSAIDs. The prevalence of PCME was significantly higher in the steroid group than in the NSAID group: 3.8% versus 25.3% of patients, risk ratio 5.35 (95% confidence interval, 2.94-9.76). There was no statistically significant difference in the number of adverse events in the 2 treatment groups. We found low to moderate quality of evidence that topical NSAIDs are more effective in controlling postoperative inflammation after cataract surgery. We found high-quality evidence that topical NSAIDs are more effective than topical steroids in preventing PCME. The use of topical NSAIDs was not associated with an increased events. We recommend using topical NSAIDs to prevent inflammation and PCME after routine cataract surgery. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  4. Preventive Effect of Zea mays L. (Purple Waxy Corn) on Experimental Diabetic Cataract

    PubMed Central

    Thiraphatthanavong, Paphaphat; Wattanathorn, Jintanaporn; Muchimapura, Supaporn; Thukham-mee, Wipawee; Wannanon, Panakaporn; Tong-un, Terdthai; Suriharn, Bhalang; Lertrat, Kamol

    2014-01-01

    Recently, substances possessing antioxidant can prevent cataractogenesis of diabetic cataract. Therefore, this study was carried out to determine the anticataract effect of Zea mays L. (purple waxy corn), a flavonoids rich plant, in experimental diabetic cataract. Enucleated rat lenses were incubated in artificial aqueous humor containing 55 mM glucose with various concentrations of Zea mays L. (purple waxy corn) ranging between 2, 10, and 50 mg/mL at room temperature for 72 h. At the end of the incubation period, the evaluation of lens opacification, MDA level, and the activities of SOD, CAT, GPx, and AR in lens were performed. The results showed that both medium and high doses of extract decreased lens opacity together with the decreased MDA level. In addition, medium dose of extract increased GPx activity while the high dose decreased AR activity. No other significant changes were observed. The purple waxy corn seeds extract is the potential candidate to protect against diabetic cataract. The mechanism of action may occur via the decreased oxidative stress and the suppression of AR. However, further research in vivo is still essential. PMID:24527449

  5. Preventive effect of Zea mays L. (purple waxy corn) on experimental diabetic cataract.

    PubMed

    Thiraphatthanavong, Paphaphat; Wattanathorn, Jintanaporn; Muchimapura, Supaporn; Wipawee, Thukham-mee; Wannanon, Panakaporn; Terdthai, Tong-un; Suriharn, Bhalang; Lertrat, Kamol

    2014-01-01

    Recently, substances possessing antioxidant can prevent cataractogenesis of diabetic cataract. Therefore, this study was carried out to determine the anticataract effect of Zea mays L. (purple waxy corn), a flavonoids rich plant, in experimental diabetic cataract. Enucleated rat lenses were incubated in artificial aqueous humor containing 55 mM glucose with various concentrations of Zea mays L. (purple waxy corn) ranging between 2, 10, and 50 mg/mL at room temperature for 72 h. At the end of the incubation period, the evaluation of lens opacification, MDA level, and the activities of SOD, CAT, GPx, and AR in lens were performed. The results showed that both medium and high doses of extract decreased lens opacity together with the decreased MDA level. In addition, medium dose of extract increased GPx activity while the high dose decreased AR activity. No other significant changes were observed. The purple waxy corn seeds extract is the potential candidate to protect against diabetic cataract. The mechanism of action may occur via the decreased oxidative stress and the suppression of AR. However, further research in vivo is still essential.

  6. Manual Small Incision Cataract Surgery in Phacomorphic Glaucoma: Surgical Technique and Outcome in North-eastern India.

    PubMed

    Rajkumari, Vidyarani; Singh Kaminibabu, Khongbantabam; Bhabanisana, Rajkumari Devi; Victor, Rajkumar

    2013-01-01

    North-eastern region of India continue to suffer from limited resources, added upon by Mongoloid racial similarity and poor cataract surgery rate has contributed to the increase incidence of advanced cataract like phacomorphic glaucoma. To evaluate the visual prognosis and related complications of phacomorphic glaucoma cases by manual small incision cataract surgeries in North-eastern region of India. This retrospective case series study includes 65 phacomorphic glaucoma cases diagnosed between June 2009 to December 2011 in Jawaharlal Nehru Institute of Medical Sciences, Manipur. Preoperative routine evaluation includes slit-lamp biomicroscopy, measurement of IOP, gonioscopy of fellow eye, axial length measurement, AC depth and lens thickness by A-scan. Manual small incision cataract surgery with intraocular lens implantation was performed in all the 65 eyes. Complete ophthalmic examination was done at each follow-up visit. The mean preoperative IOP was 35.14 (±6.35) mm Hg and IOP at the 3rd month follow-up was 18.65 (±1.3) mm Hg with a statistically significant lowering of IOP (p < 0.0001) at the last follow-up. Intraoperative complications were minimal. Corneal edema, fibrinous exudates in AC was seen in few cases. Postoperative best corrected visual acuity was 6/6-6/12 in 46 eyes, 6/18-6/36 in 12 eyes, 6/60-3/60 in 4 eyes and less than 3/60 in three eyes. Antiglaucoma medication was discontinued immediately after each surgery. Manual small incision cataract surgery being inexpensive play a key role in management of poor outreach program marker like phacomorphic glaucoma in effectively controlling the IOP and achieving good visual acuity with minimal complications. How to cite this article: Rajkumari V, Kaminibabu KS, Bhabanisana RD, Victor R. Manual Small Incision Cataract Surgery in Phacomorphic Glaucoma: Surgical Technique and Outcome in North-eastern India. J Current Glau Prac 2013; 7(2):43-48.

  7. The impact of successful cataract surgery on quality of life, household income and social status in South India.

    PubMed

    Finger, Robert P; Kupitz, David G; Fenwick, Eva; Balasubramaniam, Bharath; Ramani, Ramanathan V; Holz, Frank G; Gilbert, Clare E

    2012-01-01

    To explore the hypothesis that sight restoring cataract surgery provided to impoverished rural communities will improve not only visual acuity and vision-related quality of life (VRQoL) but also poverty and social status. Participants were recruited at outreach camps in Tamil Nadu, South India, and underwent free routine manual small incision cataract surgery (SICS) with intra-ocular lens (IOL) implantation, and were followed up one year later. Poverty was measured as monthly household income, being engaged in income generating activities and number of working household members. Social status was measured as rates of re-marriage amongst widowed participants. VRQoL was measured using the IND-VFQ-33. Associations were explored using logistic regression (SPSS 19). Of the 294 participants, mean age ± standard deviation (SD) 60 ± 8 years, 54% men, only 11% remained vision impaired at follow up (67% at baseline; p<0.001). At one year, more participants were engaged in income generating activities (44.7% to 77.7%; p<0.001) and the proportion of households with a monthly income <1000 Rps. decreased from 50.5% to 20.5% (p<0.05). Overall VRQoL improved (p<0.001). Participants who had successful cataract surgery were less likely to remain in the lower categories of monthly household income (OR 0.05-0.22; p<0.02) and more likely to be engaged in income earning activities one year after surgery (OR 3.28; p = 0.006). Participants widowed at baseline who had successful cataract surgery were less likely to remain widowed at one year (OR 0.02; p = 0.008). These findings indicate the broad positive impact of sight restoring cataract surgery on the recipients' as well as their families' lives. Providing free high quality cataract surgery to marginalized rural communities will not only alleviate avoidable blindness but also - to some extent - poverty in the long run.

  8. Routine DNA testing

    USDA-ARS?s Scientific Manuscript database

    Routine DNA testing. It’s done once you’ve Marker-Assisted Breeding Pipelined promising Qantitative Trait Loci within your own breeding program and thereby established the performance-predictive power of each DNA test for your germplasm under your conditions. By then you are ready to screen your par...

  9. Motivation through Routine Documentation

    ERIC Educational Resources Information Center

    Koth, Laurie J.

    2016-01-01

    This informed commentary article offers a simple, effective classroom management strategy in which the teacher uses routine documentation to motivate students both to perform academically and to behave in a manner consistent with established classroom rules and procedures. The pragmatic strategy is grounded in literature, free to implement,…

  10. Graph-Plotting Routine

    NASA Technical Reports Server (NTRS)

    Kantak, Anil V.

    1987-01-01

    Plotter routine for IBM PC (AKPLOT) designed for engineers and scientists who use graphs as integral parts of their documentation. Allows user to generate graph and edit its appearance on cathode-ray tube. Graph may undergo many interactive alterations before finally dumped from screen to be plotted by printer. Written in BASIC.

  11. Learning from Homeschooling Routines

    ERIC Educational Resources Information Center

    Thomas, Jesse

    2016-01-01

    This study provides a rare opportunity to look inside the homeschool and to observe the routines of homeschooling families from across the United States. With more than 1000 survey participants, and nine parents selected for interviews, the compiled data were analyzed through open coding techniques. Meaningful aspects that arose from the routines…

  12. When Denial Becomes Routine.

    ERIC Educational Resources Information Center

    Kuper, Leo

    1991-01-01

    Claims denial of genocide has become a routine defense as a result of the United Nations definition of international crimes. Describes grounds for denial by various governments and list arguments they have made to justify genocidal policies. Argues some academics assist in the process of denial by using revisionist strategies. (NL)

  13. PROPER: Optical propagation routines

    NASA Astrophysics Data System (ADS)

    Krist, John E.

    2014-05-01

    PROPER simulates the propagation of light through an optical system using Fourier transform algorithms (Fresnel, angular spectrum methods). Distributed as IDL source code, it includes routines to create complex apertures, aberrated wavefronts, and deformable mirrors. It is especially useful for the simulation of high contrast imaging telescopes (extrasolar planet imagers like TPF).

  14. Motivation through Routine Documentation

    ERIC Educational Resources Information Center

    Koth, Laurie J.

    2016-01-01

    This informed commentary article offers a simple, effective classroom management strategy in which the teacher uses routine documentation to motivate students both to perform academically and to behave in a manner consistent with established classroom rules and procedures. The pragmatic strategy is grounded in literature, free to implement,…

  15. Learning from Homeschooling Routines

    ERIC Educational Resources Information Center

    Thomas, Jesse

    2016-01-01

    This study provides a rare opportunity to look inside the homeschool and to observe the routines of homeschooling families from across the United States. With more than 1000 survey participants, and nine parents selected for interviews, the compiled data were analyzed through open coding techniques. Meaningful aspects that arose from the routines…

  16. Effects of phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract

    PubMed Central

    Li, Bo; Wang, Feng-Yun; Lv, Tai-Liang; Zhu, Yu

    2016-01-01

    The aim of the present study was to examine the effects of phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract in the elderly. A total of 68 patients were consecutively selected and divided into the control group with 33 cases (48 eyes) and the observation group with 35 cases (53 eyes). Cataract surgery combined with trabeculectomy was performed on the patients in the control group and phacoemulsification cataract extraction combined with ciliarotomy was performed on the subjects in the observation group, to compare postoperative effects and complications. Following surgery, the visual acuity of patients in the two groups significantly improved, intraocular pressure decreased, and improvement of the observation group was more evident (P<0.05). Following surgery, the depth of central anterior chamber and width of chamber angle of patients in two groups was increased, and improvement of the observation group was significantly more evident (P<0.05). Additionally, the incidence of complications, including corneal swelling, shallow of anterior chamber, fibrinous exudate in iris, and filtering bleb leaking and following cataract removal, of patients in the observation group was significantly reduced compared to the control group (P<0.05). In summary, the results of the present study show that, phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract in the elderly is a safe and effective method and should be applied in the clinic. PMID:27698750

  17. A nonsense mutation of γD-crystallin associated with congenital nuclear and posterior polar cataract in a Chinese family.

    PubMed

    Zhai, Yi; Li, Jinyu; Zhu, Yanan; Xia, Yan; Wang, Wei; Yu, Yinhui; Yao, Ke

    2014-01-01

    The goal of this study was to characterize the disease-causing mutations in a Chinese family with congenital nuclear and posterior polar cataracts. Clinical data of patients in the family were recorded using slit-lamp photography and high definition video. Genomic DNA samples were extracted from the peripheral blood of the pedigree members and 100 healthy controls. Mutation screening was performed in the candidate genes by bi-directional sequencing of the amplified products. The congenital cataract phenotype of the pedigree was identified by slit-lamp examinations and observation during surgery as nuclear and posterior polar cataracts. Through the sequencing of the candidate genes, a heterozygous c. 418C>T change was detected in the coding region of the γD-crystallin gene (CRYGD). As a result of this change, a highly conserved arginine residue was replaced by a stop codon (p. R140X). This change was discovered among all of the affected individuals with cataracts, but not among the unaffected family members or the 100 ethnically matched controls. This study identified a novel congenital nuclear and posterior polar cataract phenotype caused by the recurrent mutation p. R140X in CRYGD.

  18. A Nonsense Mutation of γD-crystallin Associated with Congenital Nuclear and Posterior Polar Cataract in a Chinese Family

    PubMed Central

    Zhai, Yi; Li, Jinyu; Zhu, Yanan; Xia, Yan; Wang, Wei; Yu, Yinhui; Yao, Ke

    2014-01-01

    Objective: The goal of this study was to characterize the disease-causing mutations in a Chinese family with congenital nuclear and posterior polar cataracts. Methods: Clinical data of patients in the family were recorded using slit-lamp photography and high definition video. Genomic DNA samples were extracted from the peripheral blood of the pedigree members and 100 healthy controls. Mutation screening was performed in the candidate genes by bi-directional sequencing of the amplified products. Results: The congenital cataract phenotype of the pedigree was identified by slit-lamp examinations and observation during surgery as nuclear and posterior polar cataracts. Through the sequencing of the candidate genes, a heterozygous c. 418C>T change was detected in the coding region of the γD-crystallin gene (CRYGD). As a result of this change, a highly conserved arginine residue was replaced by a stop codon (p. R140X). This change was discovered among all of the affected individuals with cataracts, but not among the unaffected family members or the 100 ethnically matched controls. Conclusions: This study identified a novel congenital nuclear and posterior polar cataract phenotype caused by the recurrent mutation p. R140X in CRYGD. PMID:24465161

  19. Results and safety profile of trainee cataract surgeons in a community setting in East Africa.

    PubMed

    Mavrakanas, Nikolaos; Dhalla, Kazim A; Jecha, Jerry; Kapesa, Imani; Odouard, Capucine; Murdoch, Ian

    2016-11-01

    To evaluate the results and safety profile of assistant medical officer ophthalmologists (AMO-O) performing cataract surgery in the last stage of their surgical training, before their appointment to local communities. We retrospectively analyzed the records of patients who underwent cataract surgery by AMO-Os at Dar es Salaam, Comprehensive Community Based Rehabilitation for Tanzania Disability Hospital between September 2008 and June 2011. Surgical options were either extracapsular cataract extraction (ECCE) or manual small incision cataract surgery (MSICS), both with polymethylmethacrylate intraocular lens implantation. Four hundred and fourteen patients were included in the study. Two hundred and twenty-five (54%) underwent ECCE and 189 had MSICS. Mean logarithm of the minimum angle of resolution (logMAR) uncorrected visual acuity (UCVA) improved from 2.4 ± 0.6 preoperatively to 1.3 ± 0.8 1 week postoperatively (t-test, P < 0.001) and to 1.1 ± 0.7 3 months postoperatively (t-test, P < 0.001). Mean logMAR best-corrected visual acuity (BCVA) was 0.7 ± 0.5 1 week postoperatively and 0.6 ± 0.5 3 months postoperatively. There was no significant difference in mean logMAR UCVA (P = 0.7) and BCVA (P = 0.7) postoperatively between ECCE and MSICS. 89.5% achieved BCVA better than 6/60 and 57.3% better than 6/18 with a follow-up of 3 months. Posterior capsule rupture and/or vitreous loss occurred in 34/414 patients (8.2%) and was more frequent (P = 0.047) in patients undergoing ECCE (10.2%) compared with MSICS (5.3%). AMO-O cataract surgeons at the end of their training offer significant improvement in the visual acuity of their patients. Continuous monitoring of outcomes will guide further improvements in surgical skills and minimize complications.

  20. Causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir.

    PubMed

    Ahangar, Andleeb; Sufi, Aalia Rasool; Nabi, Mushood; Rather, Muddasar Hassan

    2014-10-01

    Cataract surgery is aimed at restoring sight to near normal vision. This study, conducted at the Department of Ophthalmology, Government Medical College, Srinagar, is an attempt to determine the causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir. One hundred patients who underwent cataract surgery with an unaided visual acuity of <6/9 at 16 weeks postoperatively were included in the study. Postoperative follow-up examinations were conducted until the 16th week. Intraoperative and postoperative complications were recorded to determine the cause of subnormal vision. Of 100 patients, 40 underwent extracapsular cataract extraction (ECCE), 30 underwent small incision cataract surgery (SICS) and 30 underwent phacoemulsification. Seventy-five percent of the patients who underwent ECCE had postoperative astigmatism with a mean astigmatism of 2.2 ± 0.81 diopters at 16 weeks, with the majority having with-the-rule astigmatism. In the SICS group, 17 (56.6 %) patients had a mean postoperative astigmatism of 0.75 ± 0.40 diopters, with the majority (82.3 %) having against-the-rule (ATR) astigmatism. In the phacoemulsification group, 13 (43.3 %) of the patients had a mean postoperative astigmatism of 0.48 ± 0.23 diopters with the majority having ATR astigmatism. Other causes of subnormal vision were pseudophakic ametropia, posterior capsular opacity and intraoperative complications like posterior capsular rent and vitreous loss. Postoperative astigmatism was the major cause of subnormal vision with greater astigmatism seen in the ECCE group. Therefore, procedures like smaller incision sutureless surgery and careful biometry are advocated to improve visual outcome and patient satisfaction.

  1. Preoperative visual acuity among cataract surgery patients and countries’ state of development: a global study

    PubMed Central

    Gilbert, Claire E; Razavi, Hessom; Turner, Elizabeth L; Lindfield, Robert J

    2011-01-01

    Abstract Objective To describe the preoperative surgical case mix among patients undergoing cataract extraction and explore associations between case mix, country level of development (as measured by the Human Development Index, HDI) and cataract surgery rates (CSRs). Methods Ophthalmologists in 50 countries were invited to join the newly-established International Eye Research Network and asked to complete a web-based questionnaire about their eye hospitals. Those who complied received a data collection form for recording demographic and clinical data on 100 consecutive patients about to undergo cataract surgery. Countries were ranked into five HDI categories and multivariable regression was used to explore associations. Findings Ophthalmologists at 112 eye hospitals (54% of them nongovernmental) in 50 countries provided data on 11 048 cataract procedures over 9 months in 2008. Patients whose visual acuity (VA) before surgery was < 6/60 in the better eye comprised 47% of the total case mix in poorly developed countries and 1% in developed countries (P < 0.001). Overall, 72% of the eyes undergoing surgery had a VA < 6/60. Very low VA before cataract surgery was strongly associated with poor development at the country level and inversely associated with national CSR. Conclusion The proportion of patients with very poor preoperative VA is a simple indicator that can be easily measured periodically to monitor progress in ophthalmological services. Additionally, the internet can be an effective tool for developing and supporting an ophthalmological research network capable of providing a global snapshot of service activity, particularly in developing countries. PMID:22084513

  2. A simple and rapid analytical method based on solid-phase extraction and liquid chromatography-tandem mass spectrometry for the simultaneous determination of free catecholamines and metanephrines in urine and its application to routine clinical analysis.

    PubMed

    Woo, Hye In; Yang, Jeong Soo; Oh, Hyeon Ju; Cho, Yoon Young; Kim, Jae Hyeon; Park, Hyung-Doo; Lee, Soo-Youn

    2016-05-01

    Urinary catecholamines and metanephrines are biochemical indicators of pheochromocytoma. We developed and validated a rapid and precise analytical method based on solid-phase extraction (SPE) and liquid chromatography separation coupled to tandem mass spectrometry (LC-MS/MS) for measuring urinary free catecholamines and metanephrines in a clinical setting. Following SPE purification of catecholamines and metanephrines from urine specimens, chromatographic separation and quantitative detection were performed using LC-MS/MS. The developed method for simultaneous measurement of urinary free catecholamines and metanephrines was validated with clinical urine specimens and was compared with other clinical and biochemical results, including urinary total metanephrines, vanillylmandelic acid (VMA), and plasma free metanephrines. The performance of our newly developed method for measuring urinary free epinephrine (EPI), norepinephrine (NE), dopamine (DA), metanephrine (MN), and normetanephrine (NMN), was acceptable. The recoveries and matrix effects of analytes were 61-107% and 84.5-130.7%. The linear ranges of each analyte were 3.8-2163μg/L, 7.4-2,359μg/L, 5.4-2,825μg/L, 3.5-2,466μg/L, and 3.7-2,569μg/L, and the coefficients of variation (CV) were less than 10% with respect to imprecision. Carryover and sample stability were also validated. Validation using clinical urine specimens by comparison with various biochemical results showed that urinary free metanephrines had comparable sensitivity (100%) and superior specificity (97.1%) to urinary total and plasma free metanephrines. The facile and reliable simultaneous measurement method for urinary free catecholamines and metanephrines using LC-MS/MS developed in this study is helpful in obtaining information about multiple metabolites and is applicable to routine clinical settings for the screening of pheochromocytoma. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights

  3. Genetic and Dietary Factors Influencing the Progression of Nuclear Cataract.

    PubMed

    Yonova-Doing, Ekaterina; Forkin, Zoe A; Hysi, Pirro G; Williams, Katie M; Spector, Tim D; Gilbert, Clare E; Hammond, Christopher J

    2016-06-01

    To determine the heritability of nuclear cataract progression and to explore prospectively the effect of dietary micronutrients on the progression of nuclear cataract. Prospective cohort study. Cross-sectional nuclear cataract and dietary measurements were available for 2054 white female twins from the TwinsUK cohort. Follow-up cataract measurements were available for 324 of the twins (151 monozygotic and 173 dizygotic twins). Nuclear cataract was measured using a quantitative measure of nuclear density obtained from digital Scheimpflug images. Dietary data were available from EPIC food frequency questionnaires. Heritability was modeled using maximum likelihood structural equation twin modeling. Association between nuclear cataract change and micronutrients was investigated using linear and multinomial regression analysis. The mean interval between baseline and follow-up examination was 9.4 years. Nuclear cataract progression. The best-fitting model estimated that the heritability of nuclear cataract progression was 35% (95% confidence interval [CI], 13-54), and individual environmental factors explained the remaining 65% (95% CI, 46-87) of variance. Dietary vitamin C was protective against both nuclear cataract at baseline and nuclear cataract progression (β = -0.0002, P = 0.01 and β = -0.001, P = 0.03, respectively), whereas manganese and intake of micronutrient supplements were protective against nuclear cataract at baseline only (β = -0.009, P = 0.03 and β = -0.03, P = 0.01, respectively). Genetic factors explained 35% of the variation in progression of nuclear cataract over a 10-year period. Environmental factors accounted for the remaining variance, and in particular, dietary vitamin C protected against cataract progression assessed approximately 10 years after baseline. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  4. Contribution of the Nurses’ Health Study to the Epidemiology of Cataract, Age-Related Macular Degeneration, and Glaucoma

    PubMed Central

    Wu, Juan; Cho, Eunyoung; Ogata, Soshiro; Jacques, Paul; Taylor, Allen; Chiu, Chung-Jung; Wiggs, Janey L.; Seddon, Johanna M.; Hankinson, Susan E.; Schaumberg, Debra A.; Pasquale, Louis R.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Study (NHS) to understanding the genetic and lifestyle factors that influence the risk of cataract, age-related macular degeneration, and glaucoma. Methods. We performed a narrative review of the publications of the NHS between 1976 and 2016. Results. The NHS has helped to elucidate the roles of genetics, lifestyle factors (e.g., cigarette smoking associated with cataract extraction and age-related macular degeneration), medical conditions (e.g., diabetes associated with cataract extraction and glaucoma), and dietary factors (e.g., greater carotenoid intake and lower glycemic diet associated with lower risk of age-related macular degeneration) in the etiology of degree and progression of lens opacities, cataract extraction, age-related macular degeneration, primary open-angle glaucoma, and exfoliation glaucoma. Conclusions. The findings from the NHS, combined with those of other studies, have provided compelling evidence to support public health recommendations for helping to prevent age-related eye diseases: abstinence from cigarette smoking, maintenance of healthy weight and diabetes prevention, and a healthy diet rich in fruits and vegetables. PMID:27459452

  5. Prevalence of Cataract in an Older Population in India

    PubMed Central

    Vashist, Praveen; Talwar, Badrinath; Gogoi, Madhurjya; Maraini, Giovanni; Camparini, Monica; Ravindran, Ravilla D.; Murthy, Gudlavalleti V.; Fitzpatrick, Kathryn E.; John, Neena; Chakravarthy, Usha; Ravilla, Thulasiraj D.; Fletcher, Astrid E.

    2011-01-01

    Purpose To describe the prevalence of cataract in older people in 2 areas of north and south India. Design Population-based, cross-sectional study. Participants Randomly sampled villages were enumerated to identify people aged ≥60 years. Of 7518 enumerated people, 78% participated in a hospital-based ophthalmic examination. Methods The examination included visual acuity measurement, dilatation, and anterior and posterior segment examination. Digital images of the lens were taken and graded by type and severity of opacity using the Lens Opacity Classification System III (LOCS III). Main Outcome Measures Age- and gender-standardized prevalence of cataract and 95% confidence intervals (CIs). We defined type of cataract based on the LOCS III grade in the worse eye of: ≥4 for nuclear cataract, ≥3 for cortical cataract, and ≥2 for posterior subcapsular cataract (PSC). Any unoperated cataract was based on these criteria or ungradable dense opacities. Any cataract was defined as any unoperated or operated cataract. Results The prevalence of unoperated cataract in people aged ≥60 was 58% in north India (95% CI, 56–60) and 53% (95% CI, 51–55) in south India (P = 0.01). Nuclear cataract was the most common type: 48% (95% CI, 46–50) in north India and 38% (95% CI, 37–40) in south India (P<0.0001); corresponding figures for PSC were 21% (95% CI, 20–23) and 17% (95% CI, 16–19; P = 0.003), respectively, and for cortical cataract 7.6% (95% CI, 7–9) and 10.2% (95% CI, 9–11; P<0.004). Bilateral aphakia/pseudophakia was slightly higher in the south (15.5%) than in the north (13.2%; P<0.03). The prevalence of any cataracts was similar in north (73.8%) and south India (71.8%). The prevalence of unoperated cataract increased with age and was higher in women than men (odds ratio [OR], 1.8). Aphakia/pseudophakia was also more common in women, either unilateral (OR, 1.2; P<0.02) or bilateral (OR, 1.3; P<0.002). Conclusions We found high rates of unoperated

  6. #4: No Routine Interventions

    PubMed Central

    Lothian, Judith; Amis, Debby; Crenshaw, Jeannette; Goer, Henci

    2004-01-01

    In this position paper—one of six care practice papers published by Lamaze International and reprinted here with permission—the benefit of no routine interventions during birth is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. It presents evidence related to restrictions on eating and drinking, use of intravenous fluids, continuous electronic fetal monitoring, artificial rupture of the membranes, augmentation of labor, and epidural analgesia. The accompanying commentary—written by an award-winning medical writer—supports and expands on the benefits of no routine interventions during birth. Lamaze International recommends that laboring women avoid restrictions on eating and drinking. The organization also recommends avoidance of IVs, continuous electronic fetal monitoring, epidurals, and efforts to speed up labor, unless a clear indication for their use is evident. PMID:17273385

  7. An Interactive Plotting Routine

    NASA Technical Reports Server (NTRS)

    Bowdish, D. W.

    1985-01-01

    Routine called CRTRPM meets needs of applications programer to plot data in interactive environment on Tektronix graphics terminal. CRTRPM designed specifically for applications where data is viewed and responded to at terminal. CRTRPM produces from one to four grids on terminal screen at one time, with from one to ten plots of X-Y data on each grid. CRTRPM written in FORTRAN V for interactive execution.

  8. Office-Based Cataract Surgery: Population Health Outcomes Study of More than 21 000 Cases in the United States.

    PubMed

    Ianchulev, Tsontcho; Litoff, David; Ellinger, Donna; Stiverson, Kent; Packer, Mark

    2016-04-01

    To identify safety and effectiveness outcomes of office-based cataract surgery. Each year, approximately 3.7 million cataract surgeries in the United States are performed in Ambulatory Surgery Center (ASC) and Hospital Outpatient Department (HOPD) locations. Medicare in July 2015 published a solicitation for expert opinion on reimbursing office-based cataract surgery. Large-scale, retrospective, consecutive case series of cataract surgeries performed in Minor Procedure Rooms (MPRs) of a large US integrated healthcare center. More than 13 500 patients undergoing elective office-based cataract surgery. Phacoemulsification cataract surgery performed in MPRs of Kaiser Permanente Colorado from 2011 to 2014. Postoperative visual acuity and intraoperative and postoperative adverse events (AEs). Office-based cataract surgery was completed in 21 501 eyes (13 507 patients, age 72.6±9.6 years). Phacoemulsification was performed in 99.9% of cases, and manual extracapsular extraction was performed in 0.1% of cases. Systemic comorbidities included hypertension (53.5%), diabetes (22.3%), and chronic obstructive pulmonary disease (9.4%). Postoperative mean best-corrected visual acuity measured 0.14±0.26 logarithm of the minimum angle of resolution units. Intraoperative ocular AEs included 119 (0.55%) cases of capsular tear and 73 (0.34%) cases of vitreous loss. Postoperative AEs included iritis (n = 330, 1.53%), corneal edema (n = 110, 0.53%), and retinal tear or detachment (n = 30, 0.14%). No endophthalmitis was reported. Second surgeries were performed in 0.70% of treated eyes within 6 months. There were no life- or vision-threatening intraoperative or perioperative AEs. This is the largest US study to investigate the safety and effectiveness of office-based cataract surgery performed in MPRs. Office-based efficacy outcomes were consistently excellent, with a safety profile expected of minimally invasive cataract procedures performed in ASCs and HOPDs. Copyright © 2016

  9. On the significance of the phacoautoantibodies demonstrated in the sera of patients with senile cataract

    PubMed Central

    Vulchanov, V. H.; Nikolov, L. S.; Kehayov, I. R.

    1967-01-01

    Serum was obtained from fifty-one patients before operation for senile cataract. Individual extracts were prepared from the excised lenses and were used as autologous antigens in complement-fixation and precipitin tests upon the patients' sera. The complement-fixation test was positive with forty-three of the fifty-one sera and the precipitin tests with twenty-seven out of forty-five of the sera tested by this method. The incidence of both antibodies was higher in patients with cataract of relatively long duration, but complement-fixing antibody of titre 1:32 or more appears to develop earlier during the course of the disease than positive precipitin tests. The incidence of complement-fixation antibody was also relatively high in patients undergoing operation for a second cataract. No obvious correlation was observed between the two antibodies in individual sera but the most strongly positive precipitin reactions tended to be associated with negative or low titre complement-fixation tests. Serum from forty individuals without eye disease were also tested, using as antigen a pooled extract of many lenses; the results were completely negative. PMID:6020397

  10. Blindness and cataract surgical services in Atsinanana region, Madagascar.

    PubMed

    Randrianaivo, Jean-Baptiste; Anholt, R Michele; Tendrisoa, Diarimirindra Lazaharivony; Margiano, Nestor Jean; Courtright, Paul; Lewallen, Susan

    2014-01-01

    To assess the prevalence and causes of avoidable blindness in Atsinanana Region, Madagascar, with the Rapid Assessment of Avoidable Blindness (RAAB) survey. We analyzed the hospital records to supplement the findings for public health care planning. Only villages within a two-hour walk from a road, about half of the population of Atsinanana was included. Seventy-two villages were selected by population-proportional-to-size sampling. In each village, compact segment sampling was used to select 50 people over age 50 for eye examination using standard RAAB methods. Records at the two hospitals providing cataract surgery in the region were analyzed for information on patients who underwent cataract surgery in 2010. Cataract incidence rate and target cataract surgery rate (CSR) was modeled from age-specific prevalence of cataract. The participation rate was 87% and the sample prevalence of blindness was 1.96%. Cataract was responsible for 64% and 85.7% of blindness and severe visual impairment, respectively. Visual impairment was due to cataract (69.4%) and refractive error (14.1%). There was a strong positive correlation between cataract surgical rate by district and the proportion of people living within 2 hours of a road. There were marked differences in the profiles of the cataract patients at the two facilities. The estimated incidence of cataract at the 6/18 level was 2.4 eyes per 100 people over age 50 per year. Although the survey included only people with reasonable access, the main cause of visual impairment was still cataract. The incidence of cataract is such that it ought to be possible to eliminate it as a cause of visual impairment, but changes in service delivery at hospitals and strategies to improve access will be necessary for this change.

  11. Elevated Frequency of Cataracts in Birds from Chernobyl

    PubMed Central

    Mousseau, Timothy Alexander; Møller, Anders Pape

    2013-01-01

    Background Radiation cataracts develop as a consequence of the effects of ionizing radiation on the development of the lens of the eye with an opaque lens reducing or eliminating the ability to see. Therefore, we would expect cataracts to be associated with reduced fitness in free-living animals. Methodology/Principal Findings We investigated the incidence of lens opacities typical of cataracts in more than 1100 free-living birds in the Chernobyl region in relation to background radiation. The incidence of cataracts increased with level of background radiation both in analyses based on a dichotomous score and in analyses of continuous scores of intensity of cataracts. The odds ratio per unit change in the regressor was 0.722 (95% CI 0.648, 0.804), which was less than odds ratios from investigations of radiation cataracts in humans. The relatively small odds ratio may be due to increased mortality in birds with cataracts. We found a stronger negative relationship between bird abundance and background radiation when the frequency of cataracts was higher, but also a direct effect of radiation on abundance, suggesting that radiation indirectly affects abundance negatively through an increase in the frequency of cataracts in bird populations, but also through direct effects of radiation on other diseases, food abundance and interactions with other species. There was no increase in incidence of cataracts with increasing age, suggesting that yearlings and older individuals were similarly affected as is typical of radiation cataract. Conclusions/Significance These findings suggest that cataracts are an under-estimated cause of morbidity in free-living birds and, by inference, other vertebrates in areas contaminated with radioactive materials. PMID:23935827

  12. ICO-OSCAR for pediatric cataract surgical skill assessment.

    PubMed

    Swaminathan, Meenakshi; Ramasubramanian, Srikanth; Pilling, Rachel; Li, Junhong; Golnik, Karl

    2016-08-01

    Pediatric cataract surgical skill assessment is important to ensure the competency of the trainees, especially pediatric ophthalmology fellows. Using a rubric would ensure objectivity in this process. The ICO-OSCAR pediatric cataract surgery rubric has been developed with global variations in techniques of pediatric cataract surgery in mind. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  13. Serum 25-hydroxyvitamin D and Age-Related Cataract.

    PubMed

    Park, Sangshin; Choi, Nam-Kyong

    2017-10-01

    Cataract and insufficient vitamin D intake are both increasing worldwide concerns, yet little is known about the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and age-related cataract. We performed this study to determine the association between serum 25(OH)D levels and age-related cataract in adults. Study participants comprised 16,086 adults aged 40 years or older who had never been diagnosed with or undergone surgery for cataract using Korean National Health and Nutrition Examination Survey data from 2008 to 2012. Participants were assessed to have cataract when diagnosed with cortical, nuclear, anterior subcapsular, posterior subcapsular, or mixed cataract. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the magnitude and significance of the association between serum 25(OH)D levels and cataract in multivariable logistic regression models. The OR for nuclear cataract with the highest quintile of serum 25(OH)D levels was 0.86 (95% CI 0.75-0.99) compared to the lowest quintile. A linear trend across quintiles was significant. Natural log-transformed serum 25(OH)D levels were also significantly associated with nuclear cataract (OR 0.84, 95% CI 0.75-0.95). The opulation-attributable fraction of nuclear cataract due to serum 25(OH)D insufficiency (<30 ng/mL) was 8.8% (p = 0.048). Serum 25(OH)D levels were inversely associated with the risk of nuclear cataract. Prospective studies investigating the effects of serum 25(OH)D levels on the development of nuclear cataract are needed to confirm our findings.

  14. Elevated frequency of cataracts in birds from chernobyl.

    PubMed

    Mousseau, Timothy Alexander; Møller, Anders Pape

    2013-01-01

    Radiation cataracts develop as a consequence of the effects of ionizing radiation on the development of the lens of the eye with an opaque lens reducing or eliminating the ability to see. Therefore, we would expect cataracts to be associated with reduced fitness in free-living animals. We investigated the incidence of lens opacities typical of cataracts in more than 1100 free-living birds in the Chernobyl region in relation to background radiation. The incidence of cataracts increased with level of background radiation both in analyses based on a dichotomous score and in analyses of continuous scores of intensity of cataracts. The odds ratio per unit change in the regressor was 0.722 (95% CI 0.648, 0.804), which was less than odds ratios from investigations of radiation cataracts in humans. The relatively small odds ratio may be due to increased mortality in birds with cataracts. We found a stronger negative relationship between bird abundance and background radiation when the frequency of cataracts was higher, but also a direct effect of radiation on abundance, suggesting that radiation indirectly affects abundance negatively through an increase in the frequency of cataracts in bird populations, but also through direct effects of radiation on other diseases, food abundance and interactions with other species. There was no increase in incidence of cataracts with increasing age, suggesting that yearlings and older individuals were similarly affected as is typical of radiation cataract. These findings suggest that cataracts are an under-estimated cause of morbidity in free-living birds and, by inference, other vertebrates in areas contaminated with radioactive materials.

  15. Blindness and Cataract Surgical Services in Atsinanana Region, Madagascar

    PubMed Central

    Randrianaivo, Jean-Baptiste; Anholt, R. Michele; Tendrisoa, Diarimirindra Lazaharivony; Margiano, Nestor Jean; Courtright, Paul; Lewallen, Susan

    2014-01-01

    Purpose: To assess the prevalence and causes of avoidable blindness in Atsinanana Region, Madagascar, with the Rapid Assessment of Avoidable Blindness (RAAB) survey. We analyzed the hospital records to supplement the findings for public health care planning. Materials and Methods: Only villages within a two-hour walk from a road, about half of the population of Atsinanana was included. Seventy-two villages were selected by population-proportional-to-size sampling. In each village, compact segment sampling was used to select 50 people over age 50 for eye examination using standard RAAB methods. Records at the two hospitals providing cataract surgery in the region were analyzed for information on patients who underwent cataract surgery in 2010. Cataract incidence rate and target cataract surgery rate (CSR) was modeled from age-specific prevalence of cataract. Results: The participation rate was 87% and the sample prevalence of blindness was 1.96%. Cataract was responsible for 64% and 85.7% of blindness and severe visual impairment, respectively. Visual impairment was due to cataract (69.4%) and refractive error (14.1%). There was a strong positive correlation between cataract surgical rate by district and the proportion of people living within 2 hours of a road. There were marked differences in the profiles of the cataract patients at the two facilities. The estimated incidence of cataract at the 6/18 level was 2.4 eyes per 100 people over age 50 per year. Conclusions: Although the survey included only people with reasonable access, the main cause of visual impairment was still cataract. The incidence of cataract is such that it ought to be possible to eliminate it as a cause of visual impairment, but changes in service delivery at hospitals and strategies to improve access will be necessary for this change. PMID:24791107

  16. Surgical simulators in cataract surgery training.

    PubMed

    Sikder, Shameema; Tuwairqi, Khaled; Al-Kahtani, Eman; Myers, William G; Banerjee, Pat

    2014-02-01

    Virtual simulators have been widely implemented in medical and surgical training, including ophthalmology. The increasing number of published articles in this field mandates a review of the available results to assess current technology and explore future opportunities. A PubMed search was conducted and a total of 10 articles were reviewed. Virtual simulators have shown construct validity in many modules, successfully differentiating user experience levels during simulated phacoemulsification surgery. Simulators have also shown improvements in wet-lab performance. The implementation of simulators in the residency training has been associated with a decrease in cataract surgery complication rates. Virtual reality simulators are an effective tool in measuring performance and differentiating trainee skill level. Additionally, they may be useful in improving surgical skill and patient outcomes in cataract surgery. Future opportunities rely on taking advantage of technical improvements in simulators for education and research.

  17. [Clinical practice variation in cataract surgery].

    PubMed

    García-Martín, M J; Giménez-Gómez, R; García-Catalán, R; Herrador, M A; Gallardo, J M

    2015-05-01

    Cataract surgery rates have dramatically increased in the last two decades. However, clinical practice variation in cataract surgery has not been thoroughly studied. The aim of this review is to analyze clinical practice variation, including the causes and consequences of this phenomenon. Then, its role in health care planning and health care quality is focused, emphasizing the importance of reducing it and providing several practical strategies to accomplish it. The latest researches are presented in this article. They identify the development and implementation of clinical practice guidelines as the best tool to standardize care processes. Managing unwarranted or unwanted variation would improve quality of care and may lead to a significant saving in health care spending. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  18. [Correlation between Alzheimer disease and cataract].

    PubMed

    Liu, S S; Zhu, S Q

    2017-04-11

    Alzheimer disease (AD) is a progressive neurodegenerative disease and is a leading cause of dementia among elders. In the early phase of AD, even if neuropathological changes presented, but little to none clinical symptoms were found. Therefore, it is difficult to diagnose AD in the beginning of the disease. It is vital to find a noninvasive way for both diagnose and prognosis of AD. Studies have found that β-amyloid (Aβ) works as a connection between AD and cataract. This review will discuss AD and its associated markers which may be present in the lens and cataract related AD to provide more basis for early diagnosis of AD. (Chin J Ophthalmol, 2017, 53: 314-316).

  19. Surgical correction of astigmatism during cataract surgery.

    PubMed

    Buckhurst, Phillip J; Wolffsohn, James S; Davies, Leon N; Naroo, Shehzad A

    2010-11-01

    High levels of corneal astigmatism are prevalent in a significant proportion of the population. During cataract surgery pre-existing astigmatism can be corrected using single or paired incisions on the steep axis of the cornea, using relaxing incisions or with the use of a toric intraocular lens. This review provides an overview of the conventional methods of astigmatic correction during cataract surgery and in particular, discusses the various types of toric lenses presently available and the techniques used in determining the correct axis for the placement of such lenses. Furthermore, the potential causes of rotation in toric lenses are identified, along with techniques for assessing and quantifying the amount of rotation and subsequent management options for addressing post-operative rotation.

  20. Corneal melting after cataract surgery in a patient with autoimmune disease.

    PubMed

    García de Oteyza, G; Gómez, A; de la Paz, M

    2017-07-22

    A 78-year-old woman with rheumatoid arthritis and secondary Sjögren's syndrome presented with corneal melting three days after cataract extraction that required penetrating keratoplasty. By the fourth month, a second corneal transplant was needed due to a new descemetocele associated with her systemic disease. The underlying disease, together with the surgical history, was responsible for the complication presented. The correct anamnesis prior to cataract surgery, a refined technique, and a close post-operative follow-up can avoid such a serious complication. Immunomodulatory treatments are essential in this type of patient. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Cataract influence on iris recognition performance

    NASA Astrophysics Data System (ADS)

    Trokielewicz, Mateusz; Czajka, Adam; Maciejewicz, Piotr

    2014-11-01

    This paper presents the experimental study revealing weaker performance of the automatic iris recognition methods for cataract-affected eyes when compared to healthy eyes. There is little research on the topic, mostly incorporating scarce databases that are often deficient in images representing more than one illness. We built our own database, acquiring 1288 eye images of 37 patients of the Medical University of Warsaw. Those images represent several common ocular diseases, such as cataract, along with less ordinary conditions, such as iris pattern alterations derived from illness or eye trauma. Images were captured in near-infrared light (used in biometrics) and for selected cases also in visible light (used in ophthalmological diagnosis). Since cataract is a disorder that is most populated by samples in the database, in this paper we focus solely on this illness. To assess the extent of the performance deterioration we use three iris recognition methodologies (commercial and academic solutions) to calculate genuine match scores for healthy eyes and those influenced by cataract. Results show a significant degradation in iris recognition reliability manifesting by worsening the genuine scores in all three matchers used in this study (12% of genuine score increase for an academic matcher, up to 175% of genuine score increase obtained for an example commercial matcher). This increase in genuine scores affected the final false non-match rate in two matchers. To our best knowledge this is the only study of such kind that employs more than one iris matcher, and analyzes the iris image segmentation as a potential source of decreased reliability

  2. Prevalence of corneal astigmatism before cataract surgery.

    PubMed

    Mohammadi, Mehran; Naderan, Mohammad; Pahlevani, Rozhin; Jahanrad, Ali

    2016-12-01

    The purpose of this study was to describe and analyze the prevalence and pattern of corneal astigmatism in cataract surgery candidates. In a prospective cross-sectional study, preoperative demographics, and keratometric and refractive values of cataract surgery candidates were collected from January 2013 to December 2014. Axial length (AL) and flat and steep keratometry measurements were optically measured by a partial coherence interferometry device (IOLMaster). This study consisted of 2156 eyes of 1317 patients with a mean age of 64.92 ± 11.48 (SD) (30-88 years). The mean of AL was 23.33 ± 1.37 mm, and the mean of corneal astigmatism was 1.12 ± 1.10 diopter (D) (range 0.0-7.00), in all patients. Furthermore, the mean of flat and steep keratometry were 43.70 ± 1.70 and 44.83 ± 1.79 D, respectively. Corneal astigmatism was 1.50 D or less in 1590 eyes (73.7 %), more than 1.50 D in 566 eyes (26.2 %), 3.00 D or more in 161 eyes (7.4 %), WTR in 796 eyes (36.9 %), ATR in 1010 eyes (46.8 %), and oblique in 350 eyes (16.2 %). ATR astigmatism axis significantly increased with the increase in age. Corneal astigmatism of most cataract surgery candidates fell between 0.50 and 1.50 D. The results of our study however is confined to our demographics might provide useful data for cataract patients, surgeons, and intraocular lens manufacturers for different purposes.

  3. Combined surgery versus cataract surgery alone for eyes with cataract and glaucoma

    PubMed Central

    Zhang, Mingjuan Lisa; Hirunyachote, Phenpan; Jampel, Henry

    2016-01-01

    Background Cataract and glaucoma are leading causes of blindness worldwide, and their co-existence is common in elderly people. Glaucoma surgery can accelerate cataract progression, and performing both surgeries may increase the rate of postoperative complications and compromise the success of either surgery. However, cataract surgery may independently lower intraocular pressure (IOP), which may allow for greater IOP control among patients with co-existing cataract and glaucoma. The decision between undergoing combined glaucoma and cataract surgery versus cataract surgery alone is complex. Therefore, it is important to compare the effectiveness of these two interventions to aid clinicians and patients in choosing the better treatment approach. Objectives To assess the relative effectiveness and safety of combined surgery versus cataract surgery (phacoemulsification) alone for co-existing cataract and glaucoma. The secondary objectives include cost analyses for different surgical techniques for co-existing cataract and glaucoma. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2014), EMBASE (January 1980 to October 2014), PubMed (January 1948 to October 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to October 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 3 October 2014. We checked the reference lists of the included trials to identify further relevant trials. We used the Science

  4. Surgical tools recognition and pupil segmentation for cataract surgical process modeling.

    PubMed

    Bouget, David; Lalys, Florent; Jannin, Pierre

    2012-01-01

    In image-guided surgery, a new generation of Computer-Assisted-Surgical (CAS) systems based on information from the Operating Room (OR) has recently been developed to improve situation awareness in the OR. Our main project is to develop an application-dependant framework able to extract high-level tasks (surgical phases) using microscope videos data only. In this paper, we present two methods: one method to segment the pupil and one to extract and recognize surgical tools. We show how both methods improve the accuracy of the framework for analysis of cataract surgery videos, to detect eight surgical phases.

  5. Assessing the elasticity change of cataract lens with OCE

    NASA Astrophysics Data System (ADS)

    Wu, Chen; Liu, Chih-Hao; Raghunathan, Raksha; Singh, Manmohan; Li, Jiasong; Han, Zhaolong; Larin, Kirill V.

    2016-03-01

    Cataract is one of the most common degenerative diseases that causes blindness. Careful quantification of lens biomechanical properties can greatly assist in early detection of the disease as well as personalization of treatment procedures. In this study, we utilize a phase-sensitive optical coherence elastography (OCE) system to assess the effects of the cold cataract on the biomechanical properties of porcine crystalline lens in vitro. Relaxation rates of air puff induced elastic waves were measured on the same crystalline lens with and without cold cataract. Results demonstrate that the relaxation rate and, thus, associated elasticity of the porcine lens, increased due to the presence of cold cataract.

  6. Global Challenges in the Management of Congenital Cataract

    PubMed Central

    Lenhart, Phoebe D.; Courtright, Paul; Wilson, M. Edward; Taylor, David Samuel; Lewallen, Susan; Ventura, Marcelo C.; Bowman, Richard; Woodward, Lee; Ditta, Lauren C.; Kruger, Stacey; Haddad, Danny; El Shakankiri, Nihal; Rai, Salma KC; Bailey, Tehara; Lambert, Scott R.

    2015-01-01

    Summary Childhood cataracts have become a leading cause of preventable childhood blindness in many areas of the world. Here we summarize regional focus group discussions from the 4th Annual International Congenital Cataract Symposium on the current situation, challenges, and recommendations for the management of congenital cataracts in sub-Saharan Africa, the Middle East and North Africa, South Asia, Central America, South America, and developed nations. Strategies for managing congenital cataracts must be adapted and developed according to regional conditions. A basic framework for acceptable outcomes must focus on developing systems to address the critical components of education, access, quality care, and good follow-up. PMID:25892047

  7. Advances in pharmacological strategies for the prevention of cataract development

    PubMed Central

    Gupta, S K; Selvan, V Kalai; Agrawal, S S; Saxena, Rohit

    2009-01-01

    Cataractous-opacification of the lens is one of the leading causes of blindness in India. The situation can be managed by surgical removal of the cataractous lens. Various pharmacological strategies have been proposed for the prevention and treatment of cataract. Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients. This review deals with the various mechanisms, and possible pharmacological interventions for the prevention of cataract. The article also reviews research on potential anticataractous agents, including aldose reductase inhibitors, glutathione boosters, antiglycating agents, vitamins and various drugs from indigenous sources. PMID:19384010

  8. Quality of care from the perspective of the cataract patient: the reliability and validity of the QUOTE-cataract.

    PubMed

    Nijkamp, M D; Sixma, H J M; Afman, H; Hiddema, F; Koopmans, S A; van den Borne, B; Hendrikse, F; Nuijts, R M M A

    2002-08-01

    To assess reliability and validity of the QUOTE-cataract, a questionnaire that measures the quality of care from the perspective of cataract patients. The QUOTE-cataract was tested in a multicentre study among 540 cataract patients in three different hospitals. Reliability was represented by internal consistency (Cronbach's alpha), and repeatability (intraclass correlation coefficient (ICC)). Validity was evaluated qualitatively and by factor analyses. A strong internal consistency coefficient (0.89), and high repeatability (ICC = 0.76) demonstrated good reliability. Content validity was assured by involvement of patients in the development of the questionnaire. Factor analysis confirmed an underlying taxonomy of generic and disease specific items. The QUOTE-cataract has good reliability and provides a valid assessment of quality of care in cataract surgery.

  9. Quality of care from the perspective of the cataract patient: the reliability and validity of the QUOTE-Cataract

    PubMed Central

    Nijkamp, M D; Sixma, H J M; Afman, H; Hiddema, F; Koopmans, S A; van den Borne, B; Hendrikse, F; Nuijts, R M M A

    2002-01-01

    Background/aims: To assess reliability and validity of the QUOTE-cataract, a questionnaire that measures the quality of care from the perspective of cataract patients. Methods: The QUOTE-cataract was tested in a multicentre study among 540 cataract patients in three different hospitals. Reliability was represented by internal consistency (Cronbach’s α), and repeatability (intraclass correlation coefficient (ICC)). Validity was evaluated qualitatively and by factor analyses. Results: A strong internal consistency coefficient (0.89), and high repeatability (ICC = 0.76) demonstrated good reliability. Content validity was assured by involvement of patients in the development of the questionnaire. Factor analysis confirmed an underlying taxonomy of generic and disease specific items. Conclusion: The QUOTE-cataract has good reliability and provides a valid assessment of quality of care in cataract surgery. PMID:12140198

  10. Diclofenac drops to treat inflammation after cataract surgery.

    PubMed

    Herbort, C P; Jauch, A; Othenin-Girard, P; Tritten, J J; Fsadni, M

    2000-08-01

    To compare the anti-inflammatory effect of topical diclofenac sodium 0.1% in a fixed combination with gentamicin 0.3% to the anti-inflammatory effect of dexamethasone phosphate 0.1% in a prospective randomized double-masked double-dummy study in patients undergoing cataract surgery. Trial performed from June 1991 to April 1992 at the Hôpital Jules Gonin, Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland. Inclusion of patients scheduled for extracapsular cataract extraction (ECCE) with implantation of an all PMMA intraocular lens (IOL). Double-masked comparison of post-operative inflammation in two randomized treatment groups: (1) fixed diclofenac sodium 0.1%/gentamicin 0.3% and vehicle drops 4X/day until day 12-14 and diclofenac sodium 0.1% 3X/day until day 28. (2) dexamethasone phosphate 0.1% drops 4X/day until postoperative day 12-14 and 3X/day until day 28 and gentamicin 0.3% drops 4X/day until day 12-14. Anterior chamber flare and cells, measured by laser flare-cell photometry, were analyzed as the primary outcomes. Eighty-seven patients were recruited, 45 being assigned to the diclofenac group and 42 to the dexamethasone control group. Diclofenac was significantly better than dexamethasone at controlling flare at day 3 (p< or =0.01) and day 12-14 (p< or =0.002). Mean anterior chamber cells were also significantly lower at day 12-14 (p< or =0.021) and day 28 (p< or =0.012). The commonest adverse event was transient punctate keratitis, which occurred in 15 diclofenac and 3 dexamethasone patients. While both treatments were effective at controlling post-operative inflammation, the diclofenac-gentamicin combination followed by diclofenac alone was significantly better at suppressing flare and cells but showed a slightly higher incidence of punctate keratitis and eye discomfort.

  11. Relationship of sociodemographic variables with outcomes after cataract surgery.

    PubMed

    Quintana, J M; Garcia, S; Aguirre, U; Gonzalez, N; Arteta, E; Escobar, A; Bare, M; Blasco, J A; Martínez-Tapias, J

    2013-06-01

    The objective of this study is to analyse the relationship between sociodemographic characteristics of patients undergoing cataract extraction and their outcomes. The method comprised a prospective cohort study of patients recruited from 17 hospitals of different areas of Spain. Data gathered before surgery included sociodemographic variables, visual acuity, and visual function (using the Visual Function Index-14). After surgery, we assessed visual acuity and visual function at 6 weeks and at 3 months, respectively. Multivariate multilevel analysis was performed to assess the relationship of sociodemographic variables with changes in visual acuity and function, analysing whether improvements surpassed the minimal clinically important differences (MCIDs). Multivariate analysis showed that for visual acuity, (i) older men had a lower odds ratio (OR) of surpassing the MCID (OR: 65-75 years, 0.64; >75 years, 0.51); (ii) those with primary (1.65) or secondary (1.41) education had higher ORs than those with no formal education; and (iii) those living in a residential home had a lower OR than men living alone (0.36). In women, we found that the higher the educational level, the greater the improvement in visual acuity (primary, 1.41; secondary, 1.76), whereas socially dependent women (0.70) were less likely to exceed the MCID. With regards to predictors related to achievement of an MCID in visual function, only dependency was associated with more improvement in men (OR: 1.39), whereas in women the educational level was the only predictor (primary: 0.72; secondary: 0.61). This study found that patients with certain sociodemographic characteristics were less likely to experience an MCID in visual acuity or visual function after cataract surgery.

  12. Nocardia endophthalmitis after cataract surgery: clinicomicrobiological study.

    PubMed

    Haripriya, Aravind; Lalitha, Prajna; Mathen, Minu; Prajna, Namperumalsamy Venkatesh; Kim, Ramasamy; Shukla, Dhananjay; Natchiar, Govindappa; Srinivasan, Muthiah

    2005-05-01

    To analyze the clinical presentation, microbiological profile, and treatment outcome in cases of nocardial endophthalmitis after cataract surgery. Retrospective, observational case series. setting: Tertiary referral hospital. patients: Retrospective analysis of 24 cases of culture-proven exogenous nocardial endophthalmitis following cataract surgery between January 2000 and December 2003. main outcome measures: Visual acuity and anatomic outcome. Visual outcome was poor in most patients, with 79% (19/24) of patients obtaining a final visual acuity of hand motions or worse and 46% (11/24) of patients with no light perception. Initial presenting visual acuity was strongly associated with final visual outcome (P = .0026). There was a statistically significant trend favoring better visual outcome in patients who presented early after the onset of symptoms (P = .01). The majority of the eyes (23/24) had an early onset with predominantly anterior segment involvement. Wound infection was noted in 46% (11/24) of the patients at presentation. Clinical features included scleral abscess, cotton ball exudates in the anterior chamber, fluffy exudates on the corneal endothelium, nodular exudates on the iris, and hypopyon. Among the specimens cultured, the highest positivity was seen with the anterior chamber aspirate (15/16 = 93.75%), which was significantly higher than the vitreous aspirate cultured (1/22 = 4.54%) (P = .001). Nocardia endophthalmitis after cataract surgery is an aggressive disease with poor visual prognosis. Early diagnosis and treatment with good visual acuity at presentation may be associated with better visual outcome.

  13. United Kingdom National Ophthalmology Database Study of Vitreoretinal Surgery: Report 1; Case mix, complications, and cataract

    PubMed Central

    Jackson, T L; Donachie, P H J; Sparrow, J M; Johnston, R L

    2013-01-01

    Aim To report the vitreoretinal (VR) surgical case mix in the United Kingdom, the intraoperative complication rate of pars plana vitrectomy (PPV), and the incidence of post-vitrectomy cataract extraction. Methods Participating hospitals prospectively collected ophthalmic data using a single electronic medical record system, with automatic extraction of anonymised data to a national database. This study included the subset of 11 618 VR operations undertaken on 9619 eyes, of 8741 patients, over 8 years, from 27 sites. Surgical data included the indication for surgery, all procedure elements, and whether or not an intraoperative complication occurred. Post-vitrectomy cataract data were also analysed. The main outcome measures were a description of the indications for surgery, intraoperative PPV complication rate, and percentage of eyes undergoing post-vitrectomy cataract surgery (PVCS). Results The most common indications for VR intervention were retinal breaks and rhegmatogenous retinal detachment (48.5%), macular hole (9.8%), epiretinal membrane (9.6%), and diabetic eye disease (7.3%). Overall, 7.8% of PPVs had at least one intraoperative complication—the most common were iatrogenic retinal breaks (3.2%), and lens touch (1.2–1.6% of phakic eyes). PVCS occurred in 50.2, 68.7, and 74.0% of eyes at 1, 2, and 3 years, respectively. Conclusion VR surgery is undertaken for a wide range of conditions, but a small number of diagnoses encompass the majority of cases. Intraoperative PPV complications are not uncommon, and post-vitrectomy cataract is to be expected in most phakic eyes. PMID:23449509

  14. Diurnal curve after phacoemulsification in patients with pseudoexfoliation syndrome and cataract.

    PubMed

    Rao, Aparna

    2012-01-01

    To evaluate the effect of phacoemulsification on the diurnal curve in patients with pseudoexfoliation syndrome. 2052 patients aged 40 years and older attending our OPD services were screened, of whom 62 patients with pseudoexfoliation and associated significant cataract were selected for the study. All underwent a detailed examination including slit lamp examination, IOP, gonioscopy, and fundus examination. Diurnal variation of intraocular pressure was done at baseline and two and four weeks after phacoemulsification with IOL implantation. The IOP differences after surgery were compared and analyzed. All 62 patients underwent successful phacoemulsification with IOL implantation. Anterior chamber IOL was implanted in 2 of the 6 cases with vitreous loss. The peak IOP of the diurnal curve reduced from 26 ± 3.2 mmHg pre surgery to 19 ± 1.2 mmHg, p < 0.01, while the mean baseline IOP reduced from 22 ± 5.3 mmHg to 15 ± 2.1 mmHg at 2 months after cataract extraction, p = 0.02. The IOP fluctuations (max-min IOP difference) in the diurnal curve also flattened significantly post-surgery in eyes with both open and occludable angles, p < 0.01, with the maximum difference observed during the later part of the day in both groups. Early cataract extraction with IOL can smooth out intraocular pressure fluctuations in patients with pseudoexfoliation and associated cataract with open or narrow angles.

  15. Evaluation of the Community Cataract Surgical Services of a University Teaching Hospital Using Cataract Surgical Coverage in Nigeria.

    PubMed

    Olokoba, L; Mahmoud, O; Adepoju, F; Olokoba, A; Durowade, K

    2016-03-01

    Cataract is the leading cause of blindness in the world. An efficient and effective cataract surgical service is necessary to reduce the backlog of cataract blindness in the community. This study aims to determine the cataract surgical coverage among individuals aged 50 years and above residing in Esie and Arandun communities. This will serve as a measure of the impact of the cataract intervention programme provided by the University of Ilorin Teaching Hospital, Nigeria. The study was a population-based, cross sectional survey conducted from November to December, 2013. Cataract surgical services are provided by the University of Ilorin Teaching Hospital, Nigeria, at Esie and Arandun communities as out-reach centres. Seven hundred and fifty-five individuals aged 50 years and above residing in these communities had basic ocular examination done. Out of the 765 subjects registered, 755(98.7%) were examined. Out of these, 38.4% were males and 61.6% were females. The prevalence of bilateral cataract blindness was 1.6%. The Cataract Surgical Coverage (eyes) at visual acuity < 3/60 for males and females were 52.3% and 51.2% respectively (X2=19.30, p=0.001), while the Cataract Surgical Coverage (person) at visual acuity less < 3/60 for males and females were 80.6% and 68.4% respectively (X2=2.10, p=0.147). The Cataract Surgical Coverage was high with a correspondingly low prevalence of cataract blindness in these communities. The availability of cataract surgical services via out-reach programmes bridges the gap between eye care-givers and the community.

  16. Risk of Cataract after Exposure to Low Doses of Ionizing Radiation: A 20-Year Prospective Cohort Study among US Radiologic Technologists

    PubMed Central

    Bekiroglu, Nural; Hauptmann, Michael; Alexander, Bruce H.; Freedman, D. Michal; Doody, Michele Morin; Cheung, Li C.; Simon, Steven L.; Weinstock, Robert M.; Bouville, André; Sigurdson, Alice J.

    2008-01-01

    The study aim was to determine the risk of cataract among radiologic technologists with respect to occupational and nonoccupational exposures to ionizing radiation and to personal characteristics. A prospective cohort of 35,705 cataract-free US radiologic technologists aged 24–44 years was followed for nearly 20 years (1983–2004) by using two follow-up questionnaires. During the study period, 2,382 cataracts and 647 cataract extractions were reported. Cigarette smoking for ≥5 pack-years; body mass index of ≥25 kg/m2; and history of diabetes, hypertension, hypercholesterolemia, or arthritis at baseline were significantly (p ≤ 0.05) associated with increased risk of cataract. In multivariate models, self-report of ≥3 x-rays to the face/neck was associated with a hazard ratio of cataract of 1.25 (95% confidence interval: 1.06, 1.47). For workers in the highest category (mean, 60 mGy) versus lowest category (mean, 5 mGy) of occupational dose to the lens of the eye, the adjusted hazard ratio of cataract was 1.18 (95% confidence interval: 0.99, 1.40). Findings challenge the National Council on Radiation Protection and International Commission on Radiological Protection assumptions that the lowest cumulative ionizing radiation dose to the lens of the eye that can produce a progressive cataract is approximately 2 Gy, and they support the hypothesis that the lowest cataractogenic dose in humans is substantially less than previously thought. PMID:18664497

  17. [Direct measurement of nitric oxide levels in aqueous humor with selective iso-NO electrode under physiologic conditions and after extracapsular cataract extraction and artificial lens implantation with PMMA in experiments with rabbits].

    PubMed

    Jurowski, P; Goś, R

    2000-01-01

    To estimate the level of the nitric oxide (NO) within the aqueous humor of the rabbit eye after ECCE and PMMA artificial lens implantation using selective, nitric oxide sensitive electrode Iso-NO. We analysed the NO level during early postoperative period between the 1st and the 5th day. We examined 30 gray rabbits (weighing 3.0-3.5 kg). Just before surgery, samples of aqueous humor were aspirated to control the NO level in physiological condition. Lens was extracted with ECCE (envelope) technique. In 15 eyes PMMA IOL were implanted and 15 eyes were left aphacic. The aqueous samples were also collected 1, 3, 5 days after surgery. Nitric oxide in each sample was estimated directly with selective, nitric oxide sensitive electrode Iso-NO. Changing values of the NO concentration during the examination were expressed using evaluation of field under curve in the absolute values. Such results were compared with control group. During physiological conditions the mean value of the field under curve of the NO concentration was estimated as 4987.29 +/- 895.89. After ECCE with or without PMMA artificial lens implantation the levels of the NO were higher as compared to the control group. After ECCE and PMMA artificial lens implantation the highest level of NO was estimated on the 3rd postoperative day (7978.98 +/- 949.77). During the examinations the fields under curve of NO concentration were estimated as 6626.30 +/- 1176.53 and 6288.19 +/- 604.90 (on the 1st and the 5th days, respectively). On all postoperative days, values of the field under curve of NO were significantly higher as compared to the control group. In contrast, after ECCE without lens implantation the highest value of NO field under curve, was estimated on the 1st postoperative day as 11727.83 +/- 1032.44. During the examinations, the fields under curve of NO concentration were estimated as 9841.52 +/- 698.06 and 5446.96 +/- 568.47 (on the 3rd and the 5th postoperative days, respectively). Moreover, on all days

  18. A novel splice site mutation of CRYBA3/A1 gene associated with congenital cataract in a Chinese family

    PubMed Central

    Wu, Meng-Han; Yu, Yin-Hui; Hao, Qin-Long; Gong, Xiao-Hua; Yao, Ke

    2017-01-01

    AIM To identify the disease-causing mutation responsible for the presence of congenital cataract in a Chinese family. METHODS The study recruited a four-generation Chinese pedigree affected by autosomal dominant congenital cataract (ADCC). Family history and the history of cataract extraction were recorded. Blood samples were collected from individuals for DNA extraction. Direct sequencing of congenital cataract-associated genes was performed. Single-strand conformational polymorphism and bioinformatic analysis were conducted to further study the mutation. RESULTS Direct sequencing revealed a novel splice site mutation of c.30-2 A>G in the CRYBA3/A1 gene. The mutation co-segregated within all affected individuals in the family and was not found in unaffected members or 100 unrelated normal controls. These results were further confirmed by single-strand conformational polymorphism and bioinformatic analysis using the Human Splicing Finder and MaxEnt online software and Annovar computer software. CONCLUSION c.30-2 A>G mutation of CRYBA3/A1 gene is a novel mutation and broadens the genetic spectrum of ADCC. PMID:28149769

  19. Routine vaccination against chickenpox?

    PubMed

    2012-04-01

    Varicella-zoster virus (VZV) causes both varicella and herpes zoster. In 1995 a varicella vaccine was licensed in the USA and was incorporated into the routine vaccination programme for children; a decline of varicella among children and adults, and a reduction in associated hospitalisation, complications and mortality, has resulted. In the UK, a policy of targeted vaccination of at-risk groups has been in place since the vaccine was introduced. Here we review the evidence for the different approaches to VZV vaccination policy.

  20. CHR -- Character Handling Routines

    NASA Astrophysics Data System (ADS)

    Charles, A. C.; Rees, P. C. T.; Chipperfield, A. J.; Jenness, T.

    This document describes the Character Handling Routine library, CHR, and its use. The CHR library augments the limited character handling facilities provided by the Fortran 77 standard. It offers a range of character handling facilities: from formatting Fortran data types into text strings and the reverse, to higher level functions such as wild card matching, string sorting, paragraph reformatting and justification. The library may be used simply for building text strings for interactive applications or as a basis for more complex text processing applications.

  1. A silent mutation in human alpha-A crystallin gene in patients with age-related nuclear or cortical cataract.

    PubMed

    Mynampati, Bharani K; Muthukumarappa, Thungapathra; Ghosh, Sujata; Ram, Jagat

    2017-02-01

    A cataract is a complex multifactorial disease that results from alterations in the cellular architecture, i.e. lens proteins. Genes associated with the development of lens include crystallin genes. Although crystallins are highly conserved proteins among vertebrates, a significant number of polymorphisms exist in human population. In this study, we screened for polymorphisms in crystallin alpha A (CRYAA) and alpha B (CRYAB) genes in 200 patients over 40 years of age, diagnosed with age-related cataract (ARC; nuclear and cortical cataracts). Genomic DNA was extracted from the peripheral blood. The coding regions of the CRYAA and CRYAB gene were amplified using polymerase chain reaction and subjected to restriction digestion. Restriction fragment length polymorphism (RFLP) was performed using known restriction enzymes for CRYAA and CRYAB genes. Denaturing high performance liquid chromatography and direct sequencing were performed to detect sequence variation in CRYAA gene. In silico analysis of secondary CRYAA mRNA structure was performed using CLC RNA Workbench. RFLP analysis did not show any changes in the restriction sites of CRYAA and CRYAB genes. In 6 patients (4 patients with nuclear cataract and 2 with cortical cataract), sequence analysis of the exon 1 in the CRYAA gene showed a silent single nucleotide polymorphism [D2D] (CRYAA: C to T transition). One of the patients with nuclear cataract was homozygous for this allele. The in silico analysis revealed that D2D mutation results in a compact CRYAA mRNA secondary structure, while the wild type CRYAA mRNA has a weak or loose secondary structure. D2D mutation in the CRYAA gene may be an additional risk factor for progression of ARC.

  2. Comparison of the efficacy and safety of femtosecond laser capsulotomy between mature and non-mature cataracts.

    PubMed

    Asena, Bilgehan Sezgin; Kaskaloglu, Mahmut

    2016-08-01

    This study aims to compare the efficacy and safety of femtosecond (FS) laser capsulotomy between mature and non-mature cataracts. Kaskaloglu Eye Hospital, single center study. Prospective, controlled, and masked cross-sectional disease. A total of 133 eyes of 97 patients were included in this study. The Lens Opacities Classification System III grading scale was used in order to classify cataracts into two groups: mature and non-mature. The LenSx laser system (Alcon Labs Inc, Fort Worth, TX) was used. Data were extracted from patient charts, which included cataract grading, capsulotomy problems (tag, incomplete capsulotomy, and anterior capsule tears). The mean age was 69.2 ± 10 years (64 males, 34 females). There were 50 eyes in Group I and 83 eyes in Group II. In 20 out of 133 eyes (15%) capsule tags occurred. Of these 20 eyes, 12 were in Group I, and 8 were in Group II. The number of tag occurrences was statistically higher in Group I when compared to Group II (P = 0.011). Incomplete capsulotomy was significantly higher in Group I when compared to Group II (P < 0.0001). Free capsulotomy was present in 36 out of 50 eyes (72%) in Group I and 75 out of 83 eyes (90%) in Group II (P = 0.03). The grade of cataract significantly increased the number of suboptimal capsulotomy outcomes in FS laser capsulotomy. In mature cataract cases, the surgeon should be aware of limitations of FS laser in order to prevent capsule-related complications. Further studies of the relationship between pulse energy, patient interface design, and capsule burst strength will help elucidate the optimum parameters for laser capsulotomy creation in mature cataracts. Lasers Surg. Med. 48:590-595, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Cataract Blindness in Osun State, Nigeria: Results of a Survey

    PubMed Central

    Kolawole, Olubayo U.; Ashaye, Adeyinka O.; Mahmoud, Abdulraheem O.; Adeoti, Caroline O.

    2012-01-01

    Purpose: To estimate the burden of blindness and visual impairment due to cataract in Egbedore Local Government Area of Osun State, Nigeria. Materials and Methods: Twenty clusters of 60 individuals who were 50 years or older were selected by systematic random sampling from the entire community. A total of 1,183 persons were examined. Results: The age- and sex-adjusted prevalence of bilateral cataract-related blindness (visual acuity (VA) < 3/60) in people of 50 years and older was 2.0% (95% confidence interval (CI): 1.6–2.4%). The Cataract Surgical Coverage (CSC) (persons) was 12.1% and Couching Coverage (persons) was 11.8%. The age- and sex-adjusted prevalence of bilateral operable cataract (VA < 6/60) in people of 50 years and older was 2.7% (95% CI: 2.3–3.1%). In this last group, the cataract intervention (surgery + couching) coverage was 22.2%. The proportion of patients who could not attain 6/60 vision after surgery were 12.5, 87.5, and 92.9%, respectively, for patients who underwent intraocular lens (IOL) implantation, cataract surgery without IOL implantation and those who underwent couching. “Lack of awareness” (30.4%), “no need for surgery” (17.6%), cost (14.6%), fear (10.2%), “waiting for cataract to mature” (8.8%), AND “surgical services not available” (5.8%) were reasons why individuals with operable cataract did not undergo cataract surgery. Conclusions: Over 600 operable cataracts exist in this region of Nigeria. There is an urgent need for an effective, affordable, and accessible cataract outreach program. Sustained efforts have to be made to increase the number of IOL surgeries, by making IOL surgery available locally at an affordable cost, if not completely free. PMID:23248537

  4. Vertical Feature Mask Feature Classification Flag Extraction

    Atmospheric Science Data Center

    2013-03-28

    ... Feature Mask Feature Classification Flag Extraction This routine demonstrates extraction of the feature type information stored in a ... Vertical Feature Mask Feature Classification Flag Extraction routine  (5 KB) Interactive Data Language (IDL) is available from  ...

  5. Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: Study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery.

    PubMed

    Manning, Sonia; Barry, Peter; Henry, Ype; Rosen, Paul; Stenevi, Ulf; Young, David; Lundström, Mats

    2016-12-01

    To compare the visual, refractive, and adverse outcomes of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery. Cataract surgery clinics in 9 European countries and Australia (femtosecond-assisted) and 18 European countries and Australia (conventional). Multicenter case-control study. Eyes having femtosecond laser-assisted cataract surgery were matched to eyes from the European Registry of Quality Outcomes for Cataract and Refractive Surgery phacoemulsification cataract surgery database for preoperative corrected distance visual acuity (CDVA), age, and preoperative risk factors. Intraoperative and postoperative complications, postoperative CDVA, and refractive outcome were compared. The follow-up was 7 to 60 days. The study matched 2814 femtosecond-assisted cases to 4987 conventional phacoemulsification cases. Femtosecond-assisted surgery compared as follows to conventional phacoemulsification: posterior capsule complications, 0.7% versus 0.4%; postoperative logMAR CDVA, 0.05 (6/6(-3)) versus 0.03 (6/6(-2)); worse postoperative CDVA at follow-up (by 5 letters or more), 1.0% versus 0.4%; CDVA 0.3 (6/12) or better, 96.3% versus 97.1%; absolute biometry prediction error, 0.43 diopter (D) versus 0.40 D; within ±0.5 D of target, 72% versus 74.3%; and postoperative complications, 3.4% versus 2.3%. Femtosecond laser-assisted cataract surgery did not yield better visual or refractive outcomes than conventional phacoemulsification cataract surgery. Intraoperative complications were similar and low in both groups. Postoperative complications were lower in conventional phacoemulsification cataract surgery. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Visual Routines Are Associated with Specific Graph Interpretations

    ERIC Educational Resources Information Center

    Michal, Audrey L.; Franconeri, Steven L.

    2017-01-01

    We argue that people compare values in graphs with a "visual routine"--attending to data values in an ordered pattern over time. Do these visual routines exist to manage capacity limitations in how many values can be encoded at once, or do they actually affect the relations that are extracted? We measured eye movements while people…

  7. Age-related Cataract in a Randomized Trial of Selenium and Vitamin E in Men: The SELECT Eye Endpoints (SEE) Study

    PubMed Central

    Christen, William G.; Glynn, Robert J.; Gaziano, J. Michael; Darke, Amy K.; Crowley, John J.; Goodman, Phyllis J.; Lippman, Scott M.; Lad, Thomas E.; Bearden, James D.; Goodman, Gary E.; Minasian, Lori M.; Thompson, Ian M.; Blanke, Charles D.; Klein, Eric A.

    2014-01-01

    Importance Observational studies suggest a role for dietary nutrients such as vitamin E and selenium in cataract prevention. However, the results of randomized trials of vitamin E supplements and cataract have been disappointing, and are not yet available for selenium. Objective To test whether long-term supplementation with selenium and vitamin E affects the incidence of cataract in a large cohort of men. Design, Setting, and Participants The SELECT Eye Endpoints (SEE) study was an ancillary study of the SWOG-coordinated Selenium and Vitamin E Cancer Prevention Trial (SELECT), a randomized, placebo-controlled, four arm trial of selenium and vitamin E conducted among 35,533 men aged 50 years and older for African Americans and 55 and older for all other men, at 427 participating sites in the US, Canada, and Puerto Rico. A total of 11,267 SELECT participants from 128 SELECT sites participated in the SEE ancillary study. Intervention Individual supplements of selenium (200 µg/d from L-selenomethionine) and vitamin E (400 IU/d of all rac-α-tocopheryl acetate). Main Outcome Measures Incident cataract, defined as a lens opacity, age-related in origin, responsible for a reduction in best-corrected visual acuity to 20/30 or worse based on self-report confirmed by medical record review, and cataract extraction, defined as the surgical removal of an incident cataract. Results During a mean (SD) of 5.6 (1.2) years of treatment and follow-up, 389 cases of cataract were documented. There were 185 cataracts in the selenium group and 204 in the no selenium group (hazard ratio [HR], 0.91; 95 percent confidence interval [CI], 0.75 to 1.11; P=.37). For vitamin E, there were 197 cases in the treated group and 192 in the placebo group (HR, 1.02; CI, 0.84 to 1.25; P=.81). Similar results were observed for cataract extraction. Conclusions and Relevance These randomized trial data from a large cohort of apparently healthy men indicate that long-term daily supplementation with selenium

  8. Non-steroidal anti-inflammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery.

    PubMed

    Juthani, Viral V; Clearfield, Elizabeth; Chuck, Roy S

    2017-07-03

    Cataract is a leading cause of blindness worldwide. Cataract surgery is commonly performed but can result in postoperative inflammation of the eye. Inadequately controlled inflammation increases the risk of complications. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are used to prevent and reduce inflammation following cataract surgery, but these two drug classes work by different mechanisms. Corticosteroids are effective, but NSAIDs may provide an additional benefit to reduce inflammation when given in combination with corticosteroids. A comparison of NSAIDs to corticosteroids alone or combination therapy with these two anti-inflammatory agents will help to determine the role of NSAIDs in controlling inflammation after routine cataract surgery. To evaluate the comparative effectiveness of topical NSAIDs (alone or in combination with topical corticosteroids) versus topical corticosteroids alone in controlling intraocular inflammation after uncomplicated phacoemulsification. To assess postoperative best-corrected visual acuity (BCVA), patient-reported discomfort, symptoms, or complications (such as elevation of IOP), and cost-effectiveness with the use of postoperative NSAIDs or corticosteroids. To identify studies relevant to this review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register (2016, Issue 12), MEDLINE Ovid (1946 to December 2016), Embase Ovid (1947 to 16 December 2016), PubMed (1948 to December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 16 December 2016), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com; last searched 17 June 2013), ClinicalTrials.gov (www.clinicaltrials.gov; searched December 2016), and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en; searched December 2016). We included randomized controlled trials (RCTs) in which

  9. CALIPSO User-Provided Routines

    Atmospheric Science Data Center

    2013-04-01

    ... data files. These routines are written in Interactive Data Language (IDL). A README file demonstrating use of the routines is also available. Interactive Data Language (IDL) is available from  Exelis Visual Information Solutions . ...

  10. Pulsed electron avalanche knife: new technology for cataract surgery

    PubMed Central

    Priglinger, Siegfried G; Palanker, Daniel; Alge, Claudia S; Kreutzer, Thomas C; Haritoglou, Christos; Grueterich, Martin; Kampik, Anselm

    2007-01-01

    Background The pulsed electron avalanche knife (PEAK‐fc) is a new pulsed electrosurgical device that allows for precise, “cold” and traction‐free tissue dissection. Aim To evaluate the surgical applicability, safety and potential complications of PEAK‐fc in complicated cataract surgery. Methods The study included five children with congenital cataracts, two patients with advanced senile cataracts, six adults with mature cataracts, three of them with posterior iris synechia, three patients with post‐traumatic cataracts with zonulolysis, one patient with intumescent traumatic cataract and three patients with massive anterior capsule opacification. Anterior and posterior capsulotomies, iris synechiolysis, dissection of anterior capsule opacification and fibrotic scar tissue were performed. PEAK‐fc was set at voltages of 500–700 V, pulse duration of 0.1 m and repetition rate of 40–100 Hz. Results Anterior and posterior capsulotomies were successfully and safely performed in all eyes. The edges of capsulotomies appeared sharp, showing only limited collateral damage. PEAK‐fc worked best by just gently touching the capsule, thereby avoiding tractional forces or pressure on the lens capsule. Posterior iris synechiae could be released and anterior capsule opacification was dissected without complications. Conclusions PEAK‐fc is a very helpful cutting device for complicated cases of cataract surgery, especially for mature and congenital cataracts, traumatic zonulolysis or anterior segment complications after intraocular inflammation. PMID:17229798

  11. Barriers to Cataract Surgery in Africa: A Systematic Review.

    PubMed

    Aboobaker, Shaheer; Courtright, Paul

    2016-01-01

    Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms "barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC), and rapid assessment of avoidable blindness (RAAB)." The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa.

  12. Barriers to Cataract Surgery in Africa: A Systematic Review

    PubMed Central

    Aboobaker, Shaheer; Courtright, Paul

    2016-01-01

    Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms “barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC), and rapid assessment of avoidable blindness (RAAB).” The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa. PMID:26957856

  13. Trainee ophthalmologists' opinions on ways to improve cataract surgical rate.

    PubMed

    Ayanniyi, Abdulkabir Ayansiji; Adepoju, Feyi Grace; Owoeye, Joshua Foluso

    2009-01-01

    To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. Most trainees had a positive view about actions towards raising CSR: Structured ophthalmic training- 25 (92.6%), monthly cataract camps by eye departments in teaching hospitals- 21 (77.8%), rural allowance for ophthalmologists- 26 (96.3%) and welfare package for indigent cataract patients- 21 (77.8%). Other actions included local production of cataract consumables- 22 (81.5%), duty-free importation of ophthalmic materials- 23 (85.2%), employment of ophthalmologists in the services of the state governments- 24 (88.9%) and local governments- 20 (74.1%), effective primary eye care- 25 (92.6%) and marketing of cataract surgical services- 23 (85.2%). However, only 16 (59.3%) trainees wanted first ladies (wives of the president, governors and local government chairmen) to adopt cataract elimination as pet projects, and 24 (88.9%) opposed the introduction of cataract surgeons. Most trainees had positive perceptions about most actions that can raise CSR. However, top-priority actions to improve CSR were attractive rural allowance, structured training, resource availability, cost reduction and marketing of cataract surgical services. Multiple actions might be necessary to raise CSR.

  14. Carbon footprint and cost-effectiveness of cataract surgery.

    PubMed

    Venkatesh, Rengaraj; van Landingham, Suzanne W; Khodifad, Ashish M; Haripriya, Aravind; Thiel, Cassandra L; Ramulu, Pradeep; Robin, Alan L

    2016-01-01

    This article raises awareness about the cost-effectiveness and carbon footprint of various cataract surgery techniques, comparing their relative carbon emissions and expenses: manual small-incision cataract surgery (MSICS), phacoemulsification, and femtosecond laser-assisted cataract surgery. As the most commonly performed surgical procedure worldwide, cataract surgery contributes significantly to global climate change. The carbon footprint of a single phacoemulsification cataract surgery is estimated to be comparable to that of a typical person's life for 1 week. Phacoemulsification has been estimated to be between 1.4 and 4.7 times more expensive than MSICS; however, given the lower degree of postoperative astigmatism and other potential complications, phacoemulsification may still be preferable to MSICS in relatively resource-rich settings requiring high levels of visual function. Limited data are currently available regarding the environmental and financial impact of femtosecond laser-assisted cataract surgery; however, in its current form, it appears to be the least cost-effective option. Cataract surgery has a high value to patients. The relative environmental impact and cost of different types of cataract surgery should be considered as this treatment becomes even more broadly available globally and as new technologies are developed and implemented.

  15. The effect of glasses on visual function following cataract surgery in a cataract camp.

    PubMed

    Maki, J; Kusakul, S; Morley, K; Sanguansak, T; Seddon, J; Hartung, L; Morley, M

    2008-07-01

    To investigate visual and functional impact of glasses following cataract surgery in a high-volume cataract camp as measured by the World Health Organization Prevention of Blindness Visual Function Questionnaire (WHO/PBD-VFQ-20). Subjects were administered the WHO/PBD-VFQ three times: (1) preoperatively; (2) 3 months postoperatively, before glasses; and (3) 6 months postoperatively, after 3 months with glasses. Patients were given prescription glasses or +2.50 readers at the 3-month follow-up. 315 patients enrolled in the study; 113 patients had complete WHO/PBD-VFQ and visual acuity data from all three administrations. The mean preoperative visual acuity in the surgical eye was 20/327. Following cataract surgery but before glasses, visual acuity improved to 20/57. Total WHO/PBD-VFQ and subscale scores improved significantly at the 3-month point. With glasses, visual acuity improved to 20/43. Total WHO/PBD-VFQ scores did not change following glasses, although the overall and near vision subscales did improve significantly. Glasses were worn once per week or less in 56% of patients. Postoperative glasses result in modest improvements in visual acuity. Total WHO/PBD-VFQ scores did not change significantly following glasses, but the overall and near vision subscales did improve. The net beneficial effect of glasses was small relative to cataract surgery itself.

  16. Ocular hypertension after cataract surgery: a comparison of three surgical techniques and two viscoelastics.

    PubMed

    Jürgens, I; Matheu, A; Castilla, M

    1997-01-01

    To evaluate the incidence and course of ocular hypertension after cataract surgery using two different viscoelastics and three different surgical techniques. Thirty-six patients who had undergone extracapsular cataract extraction (ECCE), 22 who had undergone phacoemulsification (PHACO), and 16 who had undergone manual nucleofragmentation (MNF) were randomized to receive either a low-viscosity viscoelastic (LVV) or a high-viscosity viscoelastic (HVV) intraoperatively. Post-operative evaluation included anamnesis, intraocular pressure (IOP) measurement, and slit-lamp examination at 3, 6, 24, and 72 hours and 7 days. The incidence of increased IOP over baseline after cataract surgery was 74.3%. The study of both viscoelastics revealed a trend for higher IOP during the first 24 hours for patients who received HVV (P < .05). Greater differences were observed when comparing surgical techniques. Small-incision techniques showed higher mean postoperative IOPs, and more severe hypertensions (PHACO 5/22 [22.7%] and MNF 2/16 [12.5%] vs ECCE 3/36 [8.3%]) (P < .05). Ocular hypertension is a frequent postoperative complication. It is slightly more common when using HVV. Small-incision techniques show higher mean postoperative IOPs and more severe hypertensions.

  17. A nonsense mutation in CRYGC associated with autosomal dominant congenital nuclear cataract in a Chinese family

    PubMed Central

    Jin, Chongfei; Zhu, Ning; Wang, Wei; Wu, Renyi; Jiang, Jin; Shentu, Xingchao

    2008-01-01

    Purpose To identify the genetic defect associated with autosomal dominant congenital nuclear cataract in a Chinese family. Methods Family history and phenotypic data were recorded, and the phenotypes were documented by slit lamp photography. The genomic DNA was extracted from peripheral blood leukocytes. All the exons and flanking intronic sequences of CRYGC and CRYGD were amplified by polymerase chain reaction (PCR) and screened for mutation by direct DNA sequencing. Structural models of the wild type and mutant γC-crystallin were generated and analyzed by SWISS-MODEL. Results Sequencing of the coding regions of CRYGC and CRYGD showed the presence of a heterozygous C>A transversion at c.327 of the coding sequence in exon 3 of CRYGC (c.327C>A), which results in the substitution of a wild type cysteine to a nonsense codon (C109X). One and a half Greek key motifs at the COOH-terminus were found to be absent in the structural model of the mutant truncated γC-crystallin. Conclusions A novel nonsense mutation in CRYGC was detected in a Chinese family with consistent autosomal dominant congenital nuclear cataract, providing clear evidence of a relationship between the genotype and the corresponding cataract phenotype. PMID:18618005

  18. Environmental-Analysis Routine Library

    NASA Technical Reports Server (NTRS)

    Parker, K.; Torian, J.

    1982-01-01

    Program available from COSMIC contains library of routines that simulate environmental control and life support systems (ECLSS). Through interactive dialogue with program, user selects routines to be assembled into simulation of particular ECLSS under consideration. Program is modular, and allows addition of new routines as they are required.

  19. Surgical options for correction of refractive error following cataract surgery.

    PubMed

    Abdelghany, Ahmed A; Alio, Jorge L

    2014-01-01

    Refractive errors are frequently found following cataract surgery and refractive lens exchange. Accurate biometric analysis, selection and calculation of the adequate intraocular lens (IOL) and modern techniques for cataract surgery all contribute to achieving the goal of cataract surgery as a refractive procedure with no refractive error. However, in spite of all these advances, residual refractive error still occasionally occurs after cataract surgery and laser in situ keratomileusis (LASIK) can be considered the most accurate method for its correction. Lens-based procedures, such as IOL exchange or piggyback lens implantation are also possible alternatives especially in cases with extreme ametropia, corneal abnormalities, or in situations where excimer laser is unavailable. In our review, we have found that piggyback IOL is safer and more accurate than IOL exchange. Our aim is to provide a review of the recent literature regarding target refraction and residual refractive error in cataract surgery.

  20. Cataracts in retired actinide-exposed radiation workers.

    PubMed

    Jacobson, Baruch S

    2005-01-01

    Radiation-induced cataracts are predominantly of the posterior sub-capsular (PSC) type, whereas about 90% of age-related cataracts are of other types. Retired workers, likely to have transuranic body burdens, from three DOE-supported installations were questioned regarding their eye-care history and asked for permission to contact their eye-care providers regarding any cataracts. In 97 cases with lifetime exposure records 20 cases (20.6%) were reported to have PSC cataracts. However, of 24 individuals with recorded lifetime doses of 200-600 mSv, nine (37.5%) had PSC cataracts, compared with 15.1% of 73 cases with doses of less than 200 mSv. This difference is statistically significant at the 5% level.

  1. Screening, genetics, risk factors, and treatment of neonatal cataracts.

    PubMed

    Li, Jinyu; Xia, Chun-Hong; Wang, Eddie; Yao, Ke; Gong, Xiaohua

    2017-06-01

    Neonatal cataracts remain the most common cause of visual loss in children worldwide and have diverse, often unknown, etiologies. This review summarizes current knowledge about the detection, treatment, genetics, risk factors, and molecular mechanisms of congenital cataracts. We emphasize significant progress and topics requiring further study in both clinical cataract therapy and basic lens research. Advances in genetic screening and surgical technologies have improved the diagnosis, management, and visual outcomes of affected children. For example, mutations in lens crystallins and membrane/cytoskeletal components that commonly underlie genetically inherited cataracts are now known. However, many questions still remain regarding the causes, progression, and pathology of neonatal cataracts. Further investigations are also required to improve diagnostic criteria for determining the timing of appropriate interventions, such as the implantation of intraocular lenses and postoperative management strategies, to ensure safety and predictable visual outcomes for children. Birth Defects Research 109:734-743, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  2. Changing trends in barriers to cataract surgery in India.

    PubMed Central

    Vaidyanathan, K.; Limburg, H.; Foster, A.; Pandey, R. M.

    1999-01-01

    Cataract is a major cause of blindness in Asia. Efforts in India to provide cataract surgical services have had limited success in reaching the cataract-blind population. Earlier studies identified the major barriers to cataract surgery as poverty, lack of transportation or felt need, or sex related; and the critical barriers in rural areas as lack of awareness, difficult access, and cost. Compared with these earlier data, the results of the present study in Karnataka State indicate a shift in the character of the barriers. They now appear to be more related to case selection and service provision. These shifts are analysed and alternative strategies to increase the uptake to cataract surgery are recommended. PMID:10083707

  3. Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2.

    PubMed

    Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero

    2011-06-01

    To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Manual Suture Less Small Incision Cataract Surgery in Patients with Uveitic Cataract

    PubMed Central

    Bhargava, Rahul; Kumar, Prachi; Bashir, Hafsa; Sharma, Shiv Kumar; Mishra, Anurag

    2014-01-01

    Purpose: The purpose of this study is to evaluate the outcome of manual small incision cataract surgery (SICS) in eyes with uveitic cataract. Setting: Medical college hospital of the subcontinent. Design: Retrospective case series. Materials and Methods: In this retrospective study, patients who underwent SICS with posterior chamber intraocular lens implantation for uveitic cataract from 2006 to 2009 were evaluated. Patients with less than 3 months follow-up were excluded. Post-operative vision and complications were analyzed. Results: A total of 54 patients completed the study. The mean age was 52.3 ± 9.3 years. The mean follow-up was 11.53 ± 5.05 months. The mean surgical time was (10.2 ± 3.8 min). Etiological diagnosis was possible in 31.41% (17/54) of patients. There was a statistically significant improvement in vision after surgery (P < 0.001). When uveitis was well-controlled, pre-operative corticosteroids did not change post-operative inflammation (P = 0.796). However, pre-operative corticosteroids were statistically significantly associated to final best corrected visual acuity (BCVA) (P = 0.010). Conclusion: SICS with posterior chamber intraocular lens implantation is safe in most cataracts due to uveitis and improves BCVA at 6 months. Inflammation should be well-controlled pre-operatively for at least 3 months. Posterior capsule opacification, macular edema and persistent uveitis were the main factors affecting visual outcome. SICS requires minimal instrumentation, surgical time is short and can also be performed in rural clinics and eye-camps, where phacoemulsification machines are unavailable. SICS may be a more practical and cost-effective technique for uveitic cataract, in such circumstances. PMID:24669151

  5. Internal wave structures in abyssal cataract flows

    NASA Astrophysics Data System (ADS)

    Makarenko, Nikolay; Liapidevskii, Valery; Morozov, Eugene; Tarakanov, Roman

    2014-05-01

    We discuss some theoretical approaches, experimental results and field data concerning wave phenomena in ocean near-bottom stratified flows. Such strong flows of cold water form everywhere in the Atlantic abyssal channels, and these currents play significant role in the global water exchange. Most interesting wave structures arise in a powerful cataract flows near orographic obstacles which disturb gravity currents by forced lee waves, attached hydraulic jumps, mixing layers etc. All these effects were observed by the authors in the Romanche and Chain fracture zones of Atlantic Ocean during recent cruises of the R/V Akademik Ioffe and R/V Akademik Sergei Vavilov (Morozov et al., Dokl. Earth Sci., 2012, 446(2)). In a general way, deep-water cataract flows down the slope are similar to the stratified flows examined in laboratory experiments. Strong mixing in the sill region leads to the splitting of the gravity current into the layers having the fluids with different densities. Another peculiarity is the presence of critical layers in shear flows sustained over the sill. In the case under consideration, this critical level separates the flow of near-bottom cold water from opposite overflow. In accordance with known theoretical models and laboratory measurements, the critical layer can absorb and reflect internal waves generated by the topography, so the upward propagation of these perturbations is blocked from above. High velocity gradients were registered downstream in the vicinity of cataract and it indicates the existence of developed wave structures beyond the sill formed by intense internal waves. This work was supported by RFBR (grants No 12-01-00671-a, 12-08-10001-k and 13-08-10001-k).

  6. Liquefied after cataract and its surgical treatment

    PubMed Central

    Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Bhattacharjee, Pankaj; Das, Dipankar; Gogoi, Krishna; Arati, Diyali

    2014-01-01

    Aims: To describe liquefied after cataract (LAC) and its surgical management following an uneventful phacoemulsification with posterior chamber in-the-bag intraocular lens (IOL) implantation and continuous curvilinear capsulorrhexis (CCC). Design: Interventional case series. Materials and Methods: Eleven patients with LAC, following uneventful phacoemulsification with CCC and in-the-bag IOL implantation were enrolled. After the basic slit lamp examination, each case was investigated with Scheimpflug photography and ultrasound biomicroscopy (UBM). Each case was treated with capsular lavage. Biochemical composition of the milky fluid was evaluated and ring of anterior capsular opacity (ACO) was examined under electron microscope. Results: All 11 cases presented with blurring of vision after 6-8 years of cataract surgery with IOL implantation. All cases had IOL microvacuoles, 360° anterior capsule, and anterior IOL surface touch along with ACO, ring of Soemmering, and posterior capsule distension filled with opalescent milky fluid with whitish floppy or crystalline deposits. Biochemically, the milky fluid contained protein (800 mg/dl), albumin (100 mg/dl), sugar (105 mg/dl), and calcium (0.13%) and was bacteriologically sterile. Histologically, the dissected ACO showed fibrous tissue. All cases were successfully treated with capsular lavage with good visual recovery and with no complication. There was no recurrence of LAC during 2 years postoperative follow-up in any of the cases. Conclusions: LAC is a late complication of standard cataract surgery. It may be a spectrum of capsular bag distension syndrome (CBDS) without shallow anterior chamber and secondary glaucoma. Capsular bag lavage is a simple and effective treatment for LAC and a safe alternative to neodymium-doped yttrium aluminum garnet (Nd-YAG) capsulotomy. PMID:24881605

  7. Are Entry Criteria for Cataract Surgery Justified?

    PubMed Central

    Böhringer, Daniel; Vach, Werner; Hagenlocher, Kai; Eberwein, Philipp; Maier, Philip; Reinhard, Thomas

    2014-01-01

    Purpose The German Ophthalmological Society (GOS) recently proposed surgical entry criteria, i.e. 300 cataract surgeries. We herein correlate the surgical hands-on experience with the risk of posterior capsule ruptures in order to assess whether this number is appropriate. Methods We identified all cataract operations that had been performed at the University Eye Hospital Freiburg since 1995. For each surgeon, we assigned a running number to his/her procedures in the order they had been performed. Thereafter, we excluded all combined procedures and the second eyes. We then selected the 5475 surgical reports between November 2008 and November 2012 for detailed review. We additionally classified each surgery into low- vs. high- à priori risk for posterior capsule ruptures. We fitted a multifactorial logistic regression model to assess the GOS recommendation of 300 surgeries under supervision. In the low-risk group, we additionally visualized the 'typical' learning curve by plotting the posterior capsule ruptures against the respective rank numbers. Results The odds ratio for posterior capsule ruptures of 'learning-mode' (one of the respective surgeon's 300 first procedures) vs. the non-learning-mode was 3.8 (p<0.0001). By contrast, classification into the low-risk group lowered the risk of posterior capsule ruptures three fold (p<0.0001). According to the low-risk plot, the surgeons started with a complication rate of 4% and continuously improved towards 0.5% after 1500 operations. Thereafter, the rate increased again and stabilized around one percent. Conclusion The learning curve with respect to posterior capsule ruptures is surprisingly flat. The GOS entry criterion of 300 cataract procedures is therefore most likely justified. Careful selection of low-risk patients for the training surgeons may help in reducing the rate of posterior capsule ruptures during training. PMID:25401738

  8. Time analysis of corneal endothelial cell density after cataract extraction.

    PubMed

    Galin, M A; Lin, L L; Fetherolf, E; Obstbaum, S A; Sugar, A

    1979-07-01

    Serial endothelial photographs were taken preoperatively and postoperatively in 200 eyes; 111 eyes contained a Rayner iris clip lens, 54 eyes contained a Fyodorov Sputnik lens, and 35 eyes had no lens. Central endothelial cell density was changed in all instances, with counts in implanted eyes declining 25 to 30%, and in nonimplanted eyes 10 to 15%. In both instances, the decline essentially ceased at about three months. The cause of the greater decline in implanted eyes appeared to be mechanical and subsequent cell loss after the 90-day period was virtually equal for the two groups. Methods that may be used to alter the difference in cell density occurring with implantation are best analyzed by using the 90-day period data for comparison.

  9. Impact of cataract surgery in reducing visual impairment: a review.

    PubMed

    Khandekar, Rajiv; Sudhan, Anand; Jain, B K; Deshpande, Madan; Dole, Kuldeep; Shah, Mahul; Shah, Shreya

    2015-01-01

    The aim was to assess the impact of cataract surgeries in reducing visual disabilities and factors influencing it at three institutes of India. A retrospective chart review was performed in 2013. Data of 4 years were collected on gender, age, residence, presenting a vision in each eye, eye that underwent surgery, type of surgery and the amount the patient paid out of pocket for surgery. Visual impairment was categorized as; absolute blindness (no perception of light); blind (<3/60); severe visual impairment (SVI) (<6/60-3/60); moderate visual impairment (6/18-6/60) and; normal vision (≥6/12). Statistically analysis was performed to evaluate the association between visual disabilities and demographics or other possible barriers. The trend of visual impairment over time was also evaluated. We compared the data of 2011 to data available about cataract cases from institutions between 2002 and 2009. There were 108,238 cataract cases (50.6% were female) that underwent cataract surgery at the three institutions. In 2011, 71,615 (66.2%) cases underwent surgery. There were 45,336 (41.9%) with presenting vision < 3/60 and 75,393 (69.7%) had SVI in the fellow eye. Blindness at presentation for cataract surgery was associated to, male patients, Institution 3 (Dristi Netralaya, Dahod) surgeries after 2009, cataract surgeries without Intra ocular lens implant implantation, and patients paying <25 US $ for surgery. Predictors of SVI at time of cataract surgery were, male, Institution 3 (OM), phaco surgeries, those opting to pay 250 US $ for cataract surgeries. Patients with cataract seek eye care in late stages of visual disability. The goal of improving vision related quality of life for cataract patients during the early stages of visual impairment that is common in industrialized countries seems to be non-attainable in the rural India.

  10. Use of intraocular lenses in cataract surgery in developing countries: memorandum from a WHO meeting.

    PubMed Central

    1991-01-01

    Visual loss or disability from cataract represents a massive public health and socioeconomic problem in most developing countries. At present, some 13.5 million cases require treatment and this number will increase, as most countries in the Third World are unable to cope with both the backlog and new cases. Cataract extraction with intraocular lens (IOL) implantation is now the established and preferred method in industrialized countries. The introduction of IOLs in developing countries, however, depends on their having adequately trained manpower and facilities (equipment and supplies, including IOLs) for surgery. This will inevitably increase the cost per operated case which, despite the scarce resources for cataract surgery in many developing countries, may be justified by the improved restoration of the patient's vision. Experience has led to the following generic designs for IOLs: the one-piece or three-piece C-loop polymethylmethacrylate (PMMA) posterior chamber lens, which is the current favourite; and, the flexible or rigid one-piece all-PMMA anterior chamber lens, which is a valid alternative in many situations. Further scientific evaluation of the use of these lenses in a wide variety of settings in developing countries is required. Operations research is also needed in order better to define and standardize the various steps and procedures in the surgical and post-operative management of IOL implantation in Third World settings. Meanwhile, the following should be available to ensure safe and good quality cataract surgery using IOLs in developing countries: properly trained surgeons; the needed facilities and equipment with regular supplies; a good quality lens of appropriate design; and the necessary means for careful follow-up of operated patients. PMID:1786616

  11. [The recovery of binocular vision in the early post-operative stage of senile cataract patient].

    PubMed

    Qin, Xue-jiao; Zhang, Xiao; Li, Jing-hai; Wang, Hong

    2003-05-01

    To study the recovery of binocular vision and the risk factors that affect the recovery in the early post-operative stage of senile cataract patients. Patients undergone extracapsular cataract extraction with intraocular lens implantation (ECCE group) or cataract phacoemulsification with intraocular lens implantation (PHACO group) were examined for their corrected visual acuity, refractive power, simultaneous perception, fusion, near and far-distance stereoacuity. Before operation, the visual acuity was worse in the ECCE group than that in the PHACO group (chi(2) = 9.769, P < 0.05); After operation, the visual acuity between ECCE group and PHACO group was not statistically significant (chi(2) = 0.52 for operated eyes, P > 0.05, chi(2) = 3.52 for non-operated eyes, P > 0.05). The cylinder anisometropia in ECCE group was worse than the PHACO group (chi(2) = 12.496, P < 0.01). All patients obtained simultaneous perception and fusion sense. There was more or less far-distance stereoacuity 83.3% in ECCE group and 94.7% in PHACO group, which was no statistical significant (chi(2) = 1.456, P > 0.05). Foveal near stereoacuity was established in ECCE group (2.8%) and in PHACO group (21.1%), which were statistically significant (chi(2) = 5.029, P < 0.05). There is incomplete recovery of binocular vision in the early post-operative stage of senile cataract patients. The vision depression, especially monocular depression before surgery and the anisometropia after operation may affect the recovery of binocular vision.

  12. Cataracts induced by neodymium-yttrium-aluminium-garnet laser lysis of vitreous floaters.

    PubMed

    Koo, Ellen H; Haddock, Luis J; Bhardwaj, Namita; Fortun, Jorge A

    2017-06-01

    Neodymium-yttrium-aluminium-garnet (Nd:YAG) laser vitreolysis has been proposed as a treatment modality for symptomatic vitreous floaters. The purpose of this paper is to report two cases of cataracts associated with posterior capsular compromise, induced by Nd:YAG laser vitreolysis for symptomatic vitreous floaters. Case series. Two patients who underwent ND:YAG laser vitreolysis for symptomatic floaters, presented with decline in visual acuity in the treated eye after the laser procedure. At the slit-lamp biomicroscope, each patient was found to have a posterior subcapsular cataract in the treated eye, with obvious loss of integrity of the posterior capsule. These two patients underwent cataract extraction by the same surgeon via phacoemulsification. Both eyes were found to have a defect in the posterior capsule intraoperatively. In both cases, a three-piece acrylic intraocular lens implant was placed in the sulcus, achieving optic capture. The best-corrected visual acuity (BCVA) was 20/20 in both patients, at 1 month following the surgery. At 2 months, one patient had a BCVA of 20/15. The second patient maintained a BCVA of 20/20 at 3 months. Secondary cataract formation accompanied by loss of integrity of the posterior capsule is a potential complication of Nd:YAG laser vitreolysis for symptomatic floaters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. [Anterior chamber inflammation following cataract surgery in patients with non-insulin-dependent diabetes mellitus].

    PubMed

    Zarnowski, Tomasz; Machowicz-Matejko, Eulalia; Zagórski, Zbigniew

    2002-01-01

    The aim of the study was to estimate the early breakdown of the blood-aqueous barrier (BAB) following uneventful cataract surgery in patients with non-insulin dependent diabetes mellitus. Aqueous flare was estimated in 54 diabetic eyes before and after cataract surgery. Fifteen eyes underwent uneventful ECCE (extracapsular cataract extraction with "can opener" capsulotomy) and 39 phacoemulsification with continuous curvilinear capsulorhexis. All procedures were performed by experienced surgeons. Fifty six eyes of age-matched healthy patients undergoing uncomplicated cataract surgery served, as control. Anterior chamber flare was quantified preoperatively, 1 and 3 days postoperatively, using laser-flare meter (Kowa FM-500). Laser flare values were expressed in photon counts/millisecond. Mean preoperative anterior chamber flare in diabetes type 2 was as follows: normal fundus--6.7, background retinopathy--8.6 and proliferative retinopathy--14.1 (p < 0.01 vs NF group). Significantly lower anterior chamber flare measurements following phacoemulsification (25.0-1 day, 17.8-3 days post surgery), than after ECCE (63.7 and 45.6, respectively) (p < 0.01) were observed in diabetic eyes. In phaco group, we noted lower flare values in eyes without retinopathy; 25.2-1 day, 14.0-3 days post surgery, than in proliferative retinopathy (31.5 and 28.4, respectively) (p < 0.05 vs no retinopathy group). Phacoemulsification, as a less traumatising technique produces less BAB breakdown and seems to be more suitable than ECCE in diabetic eyes. Following phacoemulsification, eyes with proliferative retinopathy had significantly higher flare values than eyes without retinopathy.

  14. Loteprednol etabonate 0.5% versus prednisolone acetate 1.0% for the treatment of inflammation after cataract surgery.

    PubMed

    Lane, Stephen S; Holland, Edward J

    2013-02-01

    To evaluate the efficacy of loteprednol etabonate 0.5% versus prednisolone acetate 1.0% for the control of postoperative inflammation in patients having routine cataract surgery. Private practice, Stillwater, Minnesota, and Cincinnati Eye Institute, Cincinnati, Ohio, USA. Comparative case series. Patients were at least 18 years of age and scheduled for routine cataract surgery. Patients were excluded from the study if they had preexisting medical conditions (ie, elevated intraocular pressure [IOP], retinopathy, maculopathy, uveitis) or required medications the investigator believed would put the patient at risk or confound the study. Patients were randomized to receive loteprednol etabonate or prednisolone acetate 4 times daily in addition to bromfenac 0.09% and besifloxacin 0.6% after surgery. Visual acuity, IOP, and anterior chamber cell and flare intensity were assessed over 3 weeks after cataract surgery. The primary endpoint was the level of anterior chamber cell and flare intensity in patients treated with loteprednol etabonate or prednisolone acetate. The study enrolled 88 patients (46 loteprednol etabonate, 42 prednisolone acetate). Equivalency was achieved between the 2 treatment groups with no significant differences throughout the 3-week follow-up. There was less fluctuation in IOP assessments in patients treated with loteprednol etabonate than in patients treated with prednisolone acetate, in particular 1 day and 3 days postoperatively. The results indicate that equivalent control of inflammation can be obtained through treatment with loteprednol etabonate or prednisolone acetate after cataract surgery. In addition, treatment with loteprednol etabonate may result in less IOP fluctuation. Dr. Lane is a consultant to Bausch & Lomb, Rochester, New York, Alcon Laboratories, Inc., Fort Worth, Texas, and ISTA Pharmaceuticals, Irvine, California, USA. Dr. Holland is a consultant to Bausch & Lomb, Rochester, New York, and Alcon Laboratories, Inc., Fort Worth

  15. What percentage of patients presenting for routine eye examinations require referral for secondary care? A study of referrals from optometrists to ophthalmologists.

    PubMed

    Dobbelsteyn, David; McKee, Katherine; Bearnes, Reece D; Jayanetti, Sujani N; Persaud, David D; Cruess, Alan F

    2015-05-01

    The aim was to investigate the percentage of asymptomatic patients presenting for routine optometric eye examinations that have pathology or pathology-related risk factors warranting referral for ophthalmological consultation. This was a retrospective, cohort case study and the inclusion criteria for participants included: (i) the patient presented for routine optometric eye care during a specified period of time; (ii) the patient was found to have pathology (or showed enough risk of pathology) resulting in referral to an ophthalmologist; and (iii) a referral report was received from the consulting ophthalmologist stating the diagnosis and the treatment plan. The data set was further reviewed to indicate presenting symptoms and patient age. Adult patients, ages 20 to 64 years, were reviewed separately; this age group is not covered by provincial health services for routine eye care in Nova Scotia. Files were obtained from two clinics through an electronic charting program. A database was created that included date of referral, clinical reasons for the referral, diagnosis and treatment plan. Clinical reasons for referral were extracted from the referral letters and reports and sorted into six disease categories: age-related macular degeneration, cataract, glaucoma, diabetic retinopathy, retinopathy and 'other'. The overall referral rate for the combined data set was nine per cent for all ages; 2.4 per cent of the overall patients were asymptomatic. There was a similar number of asymptomatic patients referred in the adult (20 to 64 years) age group compared to all ages (2.5 per cent). A significant number of patients that present for routine eye examinations without any symptoms indicative of ocular disease are subsequently found to have a degree of pathology or risk thereof requiring referral for ophthalmological consultation. These referrals occur for adults under 64 years as much as for all patients of all ages. © 2015 The Authors. Clinical and Experimental

  16. Long term management of congenital cataracts.

    PubMed Central

    Burns, E C; Jones, R B

    1985-01-01

    Presentation and outcome, particularly in terms of development, nursery, and school placement of 55 children with treated congenital cataracts was studied. Results indicate that although most children have satisfactory vision many of their parents would have welcomed more support at the time of the diagnosis, an opportunity to talk to parents of similarly affected children, and further advice on their child's early development and educational placement. It is suggested that improved communications between clinicians, therapists, and teachers, and parents' support groups would be helpful to these families. PMID:3923944

  17. Day care versus in-patient surgery for age-related cataract.

    PubMed

    Lawrence, David; Fedorowicz, Zbys; van Zuuren, Esther J

    2015-11-02

    Age-related cataract accounts for more than 40% of cases of blindness in the world with the majority of people who are blind from cataract living in lower income countries. With the increased number of people with cataract, it is important to review the evidence on the effectiveness of day care cataract surgery. To provide authoritative, reliable evidence regarding the safety, feasibility, effectiveness and cost-effectiveness of day case cataract extraction by comparing clinical outcomes, cost-effectiveness, patient satisfaction or a combination of these in cataract operations performed in day care versus in-patient units. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2015), EMBASE (January 1980 to August 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to August 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 17 August 2015. We included randomised controlled trials comparing day care and in-patient surgery for age-related cataract. The primary outcome was the achievement of a satisfactory visual acuity six weeks after the operation. Two review authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We collected adverse effects information from the trials. We included two trials. One study was conducted in the USA in 1981 (250 people randomised and completed trial) and one study conducted in Spain in 2001 (1034 randomised, 935 completed trial). Both trials

  18. How to prevent endophthalmitis in cataract surgeries?

    PubMed

    Kelkar, Aditya; Kelkar, Jai; Amuaku, Winfried; Kelkar, Uday; Shaikh, Aarofil

    2008-01-01

    Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to surgery, proper construction of wound, injectable intraocular lenses, use of prophylactic intracameral antibiotics or prophylactic subconjunctival antibiotic injection at the conclusion of cataract surgery, placing a patch after the surgery for at least 4 h and initiating topical antibiotics from the same day of surgery helps to lower the frequency of postoperative endophthalmitis. Intraoperative posterior capsule rupture and anterior vitrectomy are risk factors for acute endophthalmitis, and utmost care to prevent posterior capsular rent should be taken while performing cataract surgery. Also, in case of such complication, these patients should be closely monitored for early signs of endophthalmitis in the postoperative period. In the unfortunate event of endophthalmitis the diagnosis should be prompt and treatment must be initiated as early as possible.

  19. Standard, routine and non-routine processes in health care.

    PubMed

    Lillrank, Paul; Liukko, Matti

    2004-01-01

    Quality management methods have been introduced into health care with variable success. Industrial approaches, such as standardization, are not always applicable professional services, because of fundamental differences in conceptions of aims and the predictability of the results of action. Processes in health care can be classified into standard, routine and non-routine depending on the level of repetition and amount of variation, variety and uncertainty. Quality problems are different in each type: standard processes may produce deviations from targets, routines errors in classification, and non-routines failures in interpretation. Different management approaches for each type are discussed. A metaphor to assist discussion, The Broom, is introduced.

  20. Risk factors associated with incident cataracts and cataract surgery in the Age-related Eye Disease Study (AREDS): AREDS report number 32.

    PubMed

    Chang, Jessica R; Koo, Euna; Agrón, Elvira; Hallak, Joelle; Clemons, Traci; Azar, Dimitri; Sperduto, Robert D; Ferris, Frederick L; Chew, Emily Y

    2011-11-01

    To investigate potential risk factors associated with incident nuclear, cortical, and posterior subcapsular (PSC) cataracts and cataract surgery in participants in the Age-Related Eye Disease Study (AREDS). Clinic-based prospective cohort study. Persons (n = 4425) 55 to 80 years of age enrolled in a controlled clinical trial of antioxidant vitamins and minerals, AREDS, for age-related macular degeneration and cataract. Lens photographs were graded centrally for nuclear, cortical, and PSC opacities using the AREDS system for classifying cataracts. Type-specific incident cataracts were defined as an increase in cataract grade from none or mild at baseline to a grade of moderate at follow-up, also with a grade of at least moderate at the final visit, or cataract surgery. Cox regression analyses were used to assess baseline risk factors associated with type-specific opacities and cataract surgery. Moderate cataract was defined as a grade of 4.0 or more for nuclear opacity, 10% or more involvement within the full visible lens for cortical opacity, and 5% or more involvement of the central 5-mm circle of the lens for PSC opacity. These were graded on baseline and annual lens photographs. A clinic-based cohort of 4425 persons 55 to 80 years of age at baseline was followed up for an average of 9.8±2.4 years. The following associations were found: increasing age with increased risk of all types of cataract and cataract surgery; males with increased risk of PSC and decreased risk of cortical cataracts; nonwhite persons with increased risk of cortical cataract; hyperopia with decreased risk of PSC, nuclear cataract, and cataract surgery; Centrum (Wyeth Consumer Healthcare, Madison, NJ) use with decreased risk of nuclear cataract; diabetes with increased risk of cortical, PSC cataract, and cataract surgery; higher educational level with decreased risk of cortical cataract; and smoking with increased risk of cortical cataract and cataract surgery. Estrogen replacement therapy

  1. [Research progress in relative crystallin genes of congenital cataract].

    PubMed

    Wang, D D; Yang, H J; Yi, J L

    2016-02-01

    Congenital cataract is the common cause of visual disability in children. Nearly one third of congenital cataract cases may have a related genetic mutation. With the development of molecular genetics, especially gentechnik, more and more genes, such as crystallin genes, membrane protein genes, eytoskeletal protein genes and regulatory protein genes have been confirmed to participate in the process of congenital cataract. Furthermore, crystallin genes account for most of these genes and the crystallin has the highest amount of the whole protein in lens.It has been found that nearly one hundred mutations in crystallin genes are associated with the onset of congenital cataract. Researchers are exploring how these mutations further affect the function of cellular biology and eventually lead to cataract. Although more and more research results gradually reveal the pathogenesis of congenital cataract from the level of gene and protein, the specific pathogenesis is still unclear. The recent progression about inherited congenital cataract related with crysallin genes is summarized in this review.

  2. The Association between Systemic Glucocorticoid Use and the Risk of Cataract and Glaucoma in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

    PubMed Central

    Hill, Catherine L.; Lester, Susan; Dixon, William G.

    2016-01-01

    Objective Glucocorticoids (GCs) are often used to treat Rheumatoid Arthritis (RA) despite their many side effects and the availability of other effective therapies. Cataract and glaucoma are known side effects of GCs but the risk of them developing in the setting of GC use for RA is unknown. The aim wa