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PubMed1993

The prevention of cataract caused by oxidative stress in cultured rat lenses. I. H2O2 and photochemically induced cataract.

H2O2 stress is shown to produce cataract in cultured rat lenses. The loss of transparency begins in the equatorial region within 24 hours and the entire superficial cortex is opaque by 96 hours. No involvement of the nuclear region is observed. However after an additional 48 hours, the nuclear region becomes opaque. The loss of transparency is accompanied by a large uptake of H2O which occurs gradually over the 96 hour period, complete loss of glyceraldehyde phosphate dehydrogenase (GPD) activity, almost complete loss of non-protein thiol and a slight decrease in protein thiol. Control lenses show no change other than the establishment of a new non-protein thiol base line approximately 60% lower than 0 time levels. The Alcon glutathione peroxidase type mimic, AL-3823A, completely eliminates almost all of the H2O2 induced effects and the lens remains transparent. Utilizing a more severe photochemical model than may be anticipated physiologically with 10 microM riboflavin and exposure to daylight fluorescent lamps, significant concentrations of superoxide and low levels of OH. are produced as well as extraordinarily high concentrations of H2O2 ranging from about 400 to 1000 microM. As with the H2O2 model, opacification begins at the equator but the cataract develops more rapidly, the lens being completely opaque by 68 hours. Hydration, GPD activity, non-protein and protein thiol all decrease more rapidly than in the H2O2 model. AL-3823A prevents loss of transparency until approximately 92 hours and markedly decreases changes in other parameters. At 92 hours, slight loss of transparency is observed. Catalase is somewhat less effective. AL-3823A is shown to also significantly decrease superoxide levels. The marked delay in the onset of changes in lens biochemistry and physiology in the severe photochemical stress model and the maintenance of normal parameters in the H2O2 model in the presence of AL-3823A suggests that such compounds may prevent cataract caused by oxidative stress under physiological conditions.

Animals↗

PubMed2001

[Complicated cataract. Part I: complicated cataract in uveitic patients].

The paper shows pathognomonique cases of complicated cataracts concerning the prognostic aspects of surgical treatment. The article presents methods of treatment in cases with uveitic cataract. Modern diagnostic methods are discussed, how to choose the safest surgical technique and to reach the desired postoperative refraction. More effective ways of cataract surgery in uveitis patients are proposed.

Cataract↗

PubMed2001

[Clinical and histopathologic analyses of after cataract in rabbit eyes having undergone three different cataract surgeries].

OBJECTIVE: To discuss the surgical method which can efficiently prevent the occurrence of after cataract. METHODS: Eighteen experimental rabbits were randomly divided into 3 groups. Group A was treated with phacoemulsification, group B with phacoemulsification combined with posterior continuous curvilinear capsulorhexis (PCCC) and Group C phacoemulsification combined with PCCC and anterior vitrectomy. Post-operatively, all the surgical eyes were checked with slit lamp microscope and ophthalmoscope. At the post-operative 3 months, histopathologic examinations were performed. RESULTS: There were no post-operative complications, such as retinal detachment, cystoid macular edema, etc. There were Elschnig's pearls and fibers in the peripheral area of the posterior capsule, and the amount was about the same in the 3 groups. There were Elschnig's pearls and fibers at the central area in group A. The fibrous membrane grew from the edge of the PCCC in group B. But in group C, the central area of the posterior capsule was clear, and there was no obvious pathological changes. CONCLUSION: Phacoemulsification combined with PCCC and anterior vitrectomy is a safe cataract surgical method which can effectively prevent the formation of after cataract.

Animals↗

PubMed2002

Cataract- and lens-specific upregulation of ARK receptor tyrosine kinase in Emory mouse cataract.

PURPOSE: The Emory mouse is a well-characterized model for age-onset cataract. The purpose of the present study was to identify differentially expressed genes between pre- and postcataract Emory mouse lenses. METHODS: Eyes were extracted from Emory mice at 3 weeks (precataract) and 7.5 months (postcataract) of age, and lenses were dissected. Lens RNA was compared for gene expression differences by RT-PCR differential display, and transcripts exhibiting altered levels of gene expression were cloned and identified by sequencing. The levels of two transcripts were further evaluated by RT-PCR in 3-week- and 7.5-month-old lenses and the remainder of the eye. The same transcripts were also measured in lenses from three non-Emory mouse strains (FVB/N, 129Sv, and CD1) ages 4 weeks to 11.5 months. RESULTS: Three transcripts were identified as exhibiting altered levels of gene expression between 3-week- and 7.5-month-old Emory mouse lenses. These encoded alphaA-crystallin (decreased), betaA3/A1-crystallin (decreased), and adhesion-related kinase (ARK) receptor tyrosine kinase (increased). Decreased alphaA-crystallin and increased ARK expression were not detected in lenses isolated from three non-Emory mouse strains of similar age. Increased expression of ARK was not detected between 3-week- and 7.5-month-old Emory mouse eye nonlens tissues. CONCLUSIONS: The present data confirm that expression of the alphaA-crystallin gene is decreased in cataract in the Emory mouse lens relative to age-matched control lenses and they provide evidence for cataract- and lens-specific upregulation of the ARK receptor tyrosine kinase in the Emory mouse.

Aging↗

PubMed2004

[Phacotrabeculectomy in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation glaucoma].

PURPOSE: To compare the results obtained after phacotrabeculectomy followed by implantation of an intracapsular lens in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation open angle glaucoma. MATERIAL AND METHODS: The retrospective study covered 55 eyes with cataract and glaucoma. In 28 eyes, chronic open angle glaucoma was diagnosed, and in 27--pseudoexfoliation glaucoma. In all cases, phacoemulsification of the opacified lens was carried out, a foldable intraocular lens was implanted in the capsule, and the trabeculum was removed by means of a punch. Visual acuity, intraocular pressure and the ratio of applied anti-glaucoma drugs were subject to the assessment. RESULTS: The observation period was 12 months. Within the COAG patient group, the average visual acuity prior to the surgery was 0.2+/-0.24, and after one year from the surgery it increased to 0.82+/-0.22. For PEX glaucoma patients, the values were respectively 0.3+/-0.25 before the surgery and 0.75+/-0.29 a year after it. Considerable reduction of the intraocular pressure was also achieved: in the COAG patients--from 19.51+/-3.8 mm Hg to 16.6+/-1.6 mm Hg, and in PEX glaucoma patients--from 22.28+/-5.18 mm Hg to 17.6+/-2.33 mm Hg one year after the surgery. Also, the quantity of anti-glaucoma drugs applied in the study groups was significantly reduced. The anti-glaucoma drug ratio in the COAG patients dropped from 1.8 to 0 after the surgery, and in the PEX glaucoma patients--from 2.3 to 0.3. CONCLUSIONS: Phacotrabeculectomy is an efficient and safe surgical method, to be recommended for patients both with primary open angle glaucoma and with pseudoexfoliation glaucoma.

Cataract↗

PubMedDate not supplied

[Modeling the interaction of anti-cataract drugs with membranes of normal human crystalline lenses and those with cataracts].

Anti-cataract drugs ability to diffuse into the lens at different forms of cataract was studied on a model system. For this purpose the ability of these drugs to interact with monolayers of lipids from normal and cataract lenses was appreciated. It was shown that the equilibrium surface pressure developed by the drugs after their injection under the monolayer did not depend on whether normal or pathological lipids were used.

Adult↗

PubMed1991

Quality of life and cataracts: a review of patient-centered studies of cataract surgery outcomes.

In the next 10 years growing numbers of adults will be reaching the age at which senile cataracts typically develop. At the same time, pressure is strong to contain medical expenses. In order to formulate wise public policy in this area it is important to describe the effects of this treatment on the patient's quality of life. After a general discussion of research on patient-centered medical outcomes, 18 studies of patient-centered cataract surgery outcomes are reviewed. Then the findings, both direct outcomes (visual acuity, percentage visual impairment, complications, visual functioning, physical and mental functioning, general well-being, and satisfaction with care) as well as modifying factors (type of prosthesis, presurgical functional status, condition of fellow eye, other ocular pathology, comorbidity, age, gender, socioeconomic status, attitudes, and values) are summarized. The closing discussion summarizes findings, describes two studies underway, and suggests directions for future studies of cataract surgery effects.

Cataract Extraction↗

PubMed1990

[From cataract eyeglasses to the artificial lens--changes in cataract surgery].

After a brief retrospective on the millennia-old technique of luxation of an opaque lens, the radical changes happening in the past 10 to 20 years to cataract surgery are outlined as follows: Microsurgical extracapsular cataract extraction and artificial intracular lens implantation. Some of the consequences for patient and physician are shown, particularly the criteria for undergoing surgery: cataract surgery should be performed whenever the cristalline lens opacities cause marked visual impairment to the patient.

Cataract Extraction↗

PubMed1990

[One-stage extracapsular cataract extraction with sinusotrabeculotomy in patients with combined glaucoma and cataract].

The paper deals with the question about surgical treatment of patients with glaucoma associated with cataract. A new technique of one-stage extracapsular cataract extraction with sinusotrabeculotomy is proposed. Its main point is a change in the sequence of stages: stage I--opening of anterior lens capsule, stage II--antiglaucomatous operation, stage III--extraction of lenticular nucleus and masses through a corneal incision. The operation was made in 30 patients (31 ages). The follow-up period was 2 years. Normalization of intraocular pressure was achieved in all patients, in one eye--miotics had to be used. All patients showed a rise of visual functions: in 21 of 31 eyes vision rose to 0.3 and higher. In one patient vision fell after a year because of progression of the glaucomatous process in the presence of normal intraocular pressure. One-stage extracapsular cataract extraction with sinusotrabeculotomy can be made at any stage of glaucoma. By the authors' data, contraindications can be a rise of intraocular pressure above 40.0 mm Hg as well as the presence of a single eye and severe course of hypertonic disease.

Cataract Extraction↗

PubMedDate not supplied

Methodology for studies on medical therapy of cataracts: cataract-II.

The methodology for testing any possible effect of potential anti-cataract agents is described. This is based on slit lamp and ophthalmoscopic cataract classification and on visual acuity. The difficulties encountered in such studies are highlighted. The presented methodology is suggested to be fairly adequate in assessing usefulness of any possible medical therapy of cataracts.

Adult↗

PubMedDate not supplied

Topical glutathione therapy in senile cataracts. Cataract-III.

We undertook a prospective study in 66 cataract patients to study if topical glutathione has any effects on the progression of cataracts. The eye with more advanced cataract received topical glutathione drops q.i.d. and contralateral eye served as control. Only 32 patients completed the follow-up of three months or more. Data analysis revealed no beneficial effect of topical glutathione drops on any of the parameters studied. PSC opacity density in eyes treated with topical glutathione showed significant increase as compared to control eyes.

Administration, Topical↗

PubMedDate not supplied

Topical sulindac therapy in diabetic senile cataracts: cataract-IV.

Sulindac, a non-steroidal anti-inflammatory drug has been found to be a potent inhibitor of enzyme aldose reductase. We used sulindac topically in diabetic senile cataract patients to note if it effects the progression of cataracts. More of sulindac treated eyes maintained initial vision and fewer eyes had visual loss of up to two lines or more as compared to control eyes. The extent and density of different opacities showed less progression in sulindac treated eyes but it was not statistically significant except that the ophthalmoscopically observed density of opacity showed statistically very significant lesser mean increase in sulindac treated eyes. We suggest that sulindac is a potential drug which should be further evaluated in large double blind photodocumented studies in diabetic senile cataracts.

Administration, Topical↗

PubMed1981

New Cataract removal instrumentation and techniques: ii. laboratory phacofragmentation with the NASA-McGannon cataract fragmentor.

The NASA-McGannon cataract fragmentor, a newly designed mechanical phacofragmentor powered by compressed air, was tested on 100 eyes of old rabbits and on 50 dark brown nuclei of human cataracts that were implanted in the anterior chambers of rabbit eyes after the lenses had been removed. It was possible to eliminate the eddy current in the anterior chamber, reduce the requirement for infusion, and reduce the time of fragmentation both for rabbit lenses and for implanted hard nuclei of human cataracts. Iatrogenic damage to the iris and posterior capsule of the lens was noted in the early cases but not in the later ones, as the operators became more skillful in manipulating the instrument.

Animals↗

PubMed1981

Microtubules in experimental cataracts: disappearance of microtubules of epithelial cells and lens fibers in colchicine-induced cataracts.

Colchicine (1 approximately 2 X 10(-5) M), a microtubule inhibitor, was added to the organ cultures of rat crystalline lenses. 1. Wistar rats weighing 60-70 grams were used. Their crystalline lenses were cultured and the development of posterior subcortical cataracts became grossly evident in the 4-day-old culture. Corresponding to the posterior subcortical opacity which was macroscopically apparent, vacuole formation was noted in the posterior subcortical region under light microscopy. Layers of bladder cells also existed at the equator. 2. An organ culture was prepared from lenses of Wistar rats weighing 14 grams. On the second day, microtubules were observed in the epithelial cells and lens fibers of the control (normal) lens. In the colchicine (1 X 10(-5) M)-treated cataractous lenses, however, microtubules had disappeared both in the epithelial cells and in the lens fibers on the second day. The above findings suggested that the loss of microtubules had a significant effect on lens opacity in colchicine (1 X 10(-5) M)-treated experimental cataracts in vitro.

Animals↗

PubMed1993

[Cystoid macular edema and visual acuity with intracapsular cataract extraction and Choyce anterior chamber lens vs. extracapsular cataract extraction and posterior chamber lens in the partner eye].

A prospective study was conducted on 65 patients who had a cataract operation. One eye had intracapsular cataract extraction (ICCE) with a Choyce-IX anterior chamber lens (ACL) and the fellow eye extracapsular cataract extraction (ECCE) with a posterior chamber lens (PCL). To evaluate the cystoid macular edema (CME), a fluorescence angiogram was recorded on the day of discharge and after 6 months. The severity of the CME was classified in three stages (degrees I-III). At discharge, no eye had CME grade III. CME grade I or grade II was seen in the ICCE group in 23% and in the ECCE group in 7.6%. After 6 months one eye of each group showed CME grade III (1.5%). CME grades I and II were seen after ICCE in 13.8% and 7.8% while the eyes with ECCE presented CME in 6.1% of grade I and of grade II, respectively. Visual acuity (VA) in the eyes with grades I and II CME was the same as in eyes without CME. The VA (median) of the ICCE group was 0.8 and of the ECCE 0.7. Because of infection of the capsular bag (toxic lens syndrome), in one case the PCL together with the capsular bag had to be explanted after 7 months. As for visual acuity and clinically significant CME (grade III), there was no statistical difference between ICCE plus Choyce-IX ACL eyes versus ECCE plus PCL eyes in the same patient.

Aged↗

PubMed2003

Cost analysis of cataract surgery with intraocular lens implantation: a single blind randomised clinical trial comparing extracapsular cataract extraction and phacoemulsification.

A randomised single blinded clinical trial to compare the cost of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) between March and December 2000. A total of 60 patients were included in this study. The cost of a cataract surgery incurred by hospital, patients and households up to two months after discharge were included. The costs of training, loss of patients' income after discharge and intangible costs were excluded. Results showed that the average cost for one ECCE operation is RM1,664.46 (RM1,233.04-RM2,377.64) and for PEA is RM1,978.00 (RM1,557.87-RM3,334.50). During this short period of follow up, it can be concluded that ECCE is significantly cheaper than PEA by an average difference of RM 313.54 per patient (p < 0.001). Cost of equipment and low frequency of PEA technique done in HUKM were the two main reasons for the high unit cost of PEA as compared to ECCE.

Aged↗

PubMed2005

[Levofloxacin (oftaquix) a fluoroquinolone of a new generation in prevention of the postoperative endophthalmitis following uncomplicated cataract surgery--the study of the European Society of Cataract and Refractive Surgeons (ESCRS)].

Randomised multi-centre european clinical trial of antibiotic prophylaxis for endophthalmitis following cataract surgery - study has just begun in Poland. Poland is joining one of the largest prospective european clinical study of antibiotic prophylaxis and the largest in ophthalmology - the ESCRS endophthalmitis prophylaxis clinical trial. Up to 35 000 cataract patients are going to be recruited for this randomized, controlled, multi-centre study in 16 centres from 10 european countries. The goal is to reduce the incidence of endophthalmitis after cataract phacoemusification in Europe to less than 0.05% (less than 1 per 2 000 surgeries). The patients will be divided into four groups; different regimes of two antibiotics: cefuroxime injected intra-camerally and levofloxacine eye drops topically will be compared.

Administration, Topical↗

PubMed1998

Visual outcomes of cataract surgery in the United States, Canada, Denmark, and Spain. Report From the International Cataract Surgery Outcomes Study.

OBJECTIVE: To compare visual outcomes obtained following cataract surgery in 4 sites in North America and Europe where considerable differences in the organization of care and patterns of clinical practice have been previously described. METHODS: Patients scheduled for first eye-cataract surgery and aged 50 years or older were enrolled consecutively in a prospective multicenter study that collected clinical and patient interview data preoperatively and postoperatively. From the United States, 772 patients were enrolled; from the Province of Manitoba (Canada), 159; from Denmark, 291; and from the City of Barcelona (Spain), 200. Preoperative and 4-month postoperative visual acuity was obtained for 92% of the patients (n = 1291). RESULTS: The mean 4-month postoperative visual acuity of eyes operated on varied significantly across the 4 sites (P < .001) and had the following Snellen decimal fraction measurements: 0.49 in Barcelona, 0.65 in Denmark, 0.66 in Manitoba, and 0.74 in the United States. However, while crude visual acuity outcome figures varied significantly, no significant difference was observed across the 4 sites regarding the risk of poorer visual outcome after controlling for differences in age, preoperative visual acuity, and general health status for patients with no ocular comorbidity. Older age, poorer preoperative visual acuity, poorer preoperative general health status, and coexisting ocular comorbidity were predictors of a poorer visual outcome. CONCLUSION: A previously identified variation in treatment modalities across the 4 sites did not seem to affect patients' visual acuity outcomes.

Aged↗