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PubMed1993

Bone marrow transplantation and cataract development.

OBJECTIVES: To evaluate risk factors for the development of posterior subcapsular cataract following bone marrow transplantation (BMT) and the results of patients undergoing cataract extraction. DESIGN: Retrospective case-control study. SETTING: Tertiary referral center. PATIENTS: Three hundred sixty-six patients (59% male, 41% female) undergoing BMT at one institution who survived for at least 1 month and underwent full ophthalmologic examination. Risk factors were then compared between patients who developed posterior subcapsular cataract and those who did not. INTERVENTION: Cataract surgery in six eyes of four patients. MAIN OUTCOME MEASURE: Formation of posterior subcapsular cataract. Data were obtained on all patients for type of BMT, pretransplantation regimen, underlying malignancy, demographic background, complications of BMT, and medications. RESULTS: Forty (10.9%) of 366 patients developed posterior subcapsular cataract. By univariate analysis, cataract formation was associated with total body irradiation, chronic graft-vs-host disease, the use of allogeneic bone marrow, and the total dose and duration of corticosteroid therapy. Multivariate analysis revealed that the total dose and duration of corticosteroid therapy were the most important risk factors, while total body irradiation was not a statistically significant risk factor. Cataract surgery was performed in six eyes of four patients, all of whom developed visual acuities of 20/40 or better. CONCLUSION: Posterior subcapsular cataract following BMT is uncommon and rarely requires surgery. Total dose and duration of corticosteroid therapy are the most important risk factors for development of cataract, but total body irradiation is not a statistically significant risk factor.

Adolescent↗
PubMed2002

Impact of cataract surgery on motor vehicle crash involvement by older adults.

CONTEXT: Motor vehicle crash risk in older drivers is elevated in those with cataract, a condition that impairs vision and is present in half of adults aged 65 years or older. OBJECTIVE: To determine the impact of cataract surgery on the crash risk for older adults in the years following surgery, compared with that of older adults who have cataract but who elect to not have surgery. DESIGN, SETTING, AND PATIENTS: Prospective cohort study of 277 patients with cataract, aged 55 to 84 years at enrollment, who were recruited from 12 eye clinics in Alabama from October 1994 through March 1996, with 4 to 6 years of follow-up (to March 1999). MAIN OUTCOME MEASURE: Police-reported motor vehicle crash occurrence involving patients who elected to have surgery compared with those who did not. RESULTS: Comparing the cataract surgery group (n = 174) with the no surgery group (n = 103), the rate ratio for crash involvement was 0.47 (95% confidence interval, 0.23-0.94), adjusting for race and baseline visual acuity and contrast sensitivity. The absolute rate reduction associated with cataract surgery was 4.74 crashes per million miles of travel. CONCLUSIONS: In our sample, patients with cataract who underwent cataract surgery and intraocular lens implantation had half the rate of crash involvement during the follow-up period compared with cataract patients who did not undergo surgery. Cataract surgery thus may have a previously undocumented benefit for older driver safety, reducing subsequent crash rate.

Accidents, Traffic↗
PubMed1997

Cell types of secondary cataract: an immunohistochemical analysis with antibodies to cytoskeletal elements and macrophages.

BACKGROUND: The study was carried out to identify cell types of secondary cataract after extracapsular cataract extraction and implantation of an intraocular lens. METHODS: Twenty-five formalin-fixed, paraffin-embedded pseudophakic human eyes with secondary cataract, obtained at autopsy, were studied and compared to a specimen from an anterior subcapsular cataract with a panel of six monoclonal antibodies (MAbs, to vimentin, cytokeratin (CK) 8 and 18, desmin, alpha-smooth muscle actin, and the CD68 epitope of macrophages by the avidin-biotinylated peroxidase complex (ABC) method. RESULTS: MAb Vim 3B4 to vimentin immunolabeled spindle-shaped cells in 16 of 17 central plaques of secondary cataract as well as cells in all 16 Soemmering's ring cataracts. Spindle-shaped cells reacted with MAb CAM 5.2 to CK 8 in 13 of 18 eyes, but only one specimen was labeled with MAb CY-90 to CK 18. No immunoreaction was seen with MAb D33 to desmin, whereas MAb 1A4 to alpha-smooth muscle actin immunolabeled spindle-shaped cells in 15 of 18 plaques of secondary cataract. Macrophages were seen with MAb PG-M1 in 13 of 19 secondary cataracts. In the anterior subcapsular cataract, spindle-shaped cells under a wrinkled but otherwise intact capsule reacted with MAb Vim 3B4 to vimentin, MAb CAM 5.2 to CK 8, and MAb 1A4 to alpha-smooth muscle actin. CONCLUSION: Spindle-shaped cells in secondary and anterior subcapsular cataracts react with antibodies to vimentin, CK 8 and alpha-smooth muscle actin, suggesting them to be metaplastic epithelial cells that derive from the lens epithelium. alpha-Smooth muscle actin persists in them at least 10 years postoperatively, but CK 8 starts to disappear after 3 years. Macrophages are one possible modulator of this transdifferentiation.

Aged↗
PubMed1983

Cataract: the leading cause of blindness and vision loss in Africa.

Senile cataract is a non-preventable disease of aging, having its biggest impact in the over-60 age group. Published clinic and hospital data, population-based surveys and World Health Organization estimates indicate that 1.2% of the entire population of Africa is blind, and that cataract causes 36% of this blindness. Ocular disease and ophthalmic manpower status questionnaires mailed to every African country in 1982 by the International Eye Foundation support these contentions, and further demonstrate that cataract is the biggest single cause of blindness on the continent. Taking the population of Africa as a whole, this means that 6,000,000 people are blind, and that 2,000,000 of them are blind due to cataract. As this form of blindness is so closely related to aging, an estimate of the annual incidence of the condition can be made. One method is to use the formula I = P/D, where I = annual incidence, P = overall prevalence and D = duration of the condition. A 5-year survival has come to be a commonly used estimate in developing world epidemiology for the longevity of a person who becomes blind due to senile onset cataracts. In Africa then, I = P/D = 2,000,000/5 = 400,000 people blinded annually by cataract. An alternate method for this computation is to multiply the number of people entering the 60 and above age group annually by 0.08. This factor is derived from knowing the prevalence of cataract blindness in this age group, the life expectancy on becoming 60, and the number of people turning 60 annually. This gives an annual incidence of 160,000 and would signify that the development of cataract blindness does not reduce longevity. Follow-up prevalence surveys in the same population group will tell us which method (if either) is correct. The average number of cataract operations done annually by each ophthalmologist in Africa is surprisingly low, 120. The two most cost-effective ways of raising the number of cases done are: (1) shorten the average hospital stay, and (2) train more ophthalmic clinical officers to perform cataract surgery.

Africa↗
PubMed1995

Cataract surgery and intraocular lens implantation in children.

PURPOSE: To evaluate visual outcome and complications after extracapsular cataract extraction with posterior chamber intraocular lens implantation in children. METHODS: Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed on 20 eyes of 19 patients with traumatic cataract, ten eyes with unilateral congenital or developmental cataract, and 15 eyes (eight patients) with bilateral developmental cataract. Nd:YAG posterior capsulotomy was performed in the early postoperative period as indicated. RESULTS: Fourteen (70%) of 20 eyes with traumatic cataract had best-corrected pseudophakic visual acuity of 20/40 or better. When we excluded four eyes with macular injuries from analysis, 14 (87%) of 16 eyes had visual acuity of 20/40 or better. In patients with bilateral cataract in whom vision was quantified by Snellen acuity (nine eyes of five patients), nine of nine eyes had best-corrected pseudophakic visual acuity of 20/40 or better. In the remaining three patients, six of six eyes had central steady and maintained fixation. Visual outcome was poorest in patients with unilateral cataract (ten eyes); one eye had best-corrected pseudophakic visual acuity of 20/40; two eyes, 20/60; two eyes, 20/70; one eye, 20/100; and two eyes, 20/200. One additional eye had central steady maintained fixation and noncentral fixation. Five of ten eyes had four or more lines improvement in visual acuity. Postoperative complications occurred in five eyes, each of which had traumatic cataract. Three eyes developed iris capture, one eye had a postoperative intraocular hemorrhage, and another developed a dense secondary membrane. In 45 postoperative postoperative eyes, 27 (60%) received one Nd:YAG laser posterior capsulotomy. A second Nd:YAG laser posterior capsulotomy was performed in 11 (41%) of these 27 eyes. CONCLUSIONS: Extracapsular cataract extraction with posterior chamber intraocular lens implantation in children can be accomplished in selected patients, with generally favorable results. However, many of the patients in this series remain potentially amblyogenic, and long-term follow-up may temper our present visual results.

Adolescent↗
PubMed1998

Is current eye-care-policy focus almost exclusively on cataract adequate to deal with blindness in India?

BACKGROUND: India's National Programme for Control of Blindness focuses almost exclusively on cataract, based on a national survey done in the 1980s which reported that cataract caused 80% of the blindness in India. No current population-based data on the causes of blindness in India are available. We assessed the rate and causes of blindness in an urban population in southern India. METHODS: We selected 2954 participants by stratified, random, cluster, systematic sampling from Hyderabad city. Eligible participants were interviewed and given a detailed ocular assessment, including visual acuity, refraction, slitlamp biomicroscopy, applanation intraocular pressure, gonioscopy, dilatation, grading of cataract, stereoscopic fundus assessment, and automated-threshold visual fields. FINDINGS: 2522 participants, including 1399 aged 30 years or more, were assessed. 49 participants (all aged > or =30 years) were blind (presenting distance visual acuity <6/60 or central visual field <200 in the better eye). The rate of blindness among those aged 30 years or more, adjusted for age and sex, was 3.08% ([95% CI 1.95-4.21]). Causes included cataract (29.7%), retinal disease (17.1%), corneal disease (15.4%), refractive error (12.5%), glaucoma (12.1%), and optic atrophy (11.0%). 15.7% of the blindness caused by visual-field constriction would have been missed without visual-field examination. Also without visual-field and detailed dilated-fundus assessments, blindness attributed to cataract would have been overestimated by up to 75.8%. If the use of cataract surgery in this urban population was half that found in this study, which simulates the situation in rural India, cataract would have caused 51.8% (39.4-64.2) of blindness, significantly less than the 80% accepted by current policy. INTERPRETATION: Much of the blindness in this Indian population was due to non-cataract causes. The previous national survey did not include detailed dilated-fundus assessment and visual-field examination which could have led to overestimation of cataract as a cause of blindness in India. Policy-makers in India should encourage well-designed population-based epidemiological studies from which to develop a comprehensive long-term policy on blindness in addition to dealing with cataract.

Adult↗
PubMed1990

A unilateral cataract produces a relative afferent pupillary defect in the contralateral eye.

The relative afferent pupillary defect (RAPD) was measured with neutral density filters in ten patients, each of whom had a dense cataract in one eye only. In each instance, the cataract reduced visual acuity to counting fingers or worse, whereas visual acuity in the other eye was 20/25 or better. All patients with mature or nuclear cataracts had a measureable RAPD in the other eye (mean, 0.44 log unit). In each instance, after extraction of the cataract, the RAPD disappeared. Thus, a dense cataract causes an RAPD in the contralateral eye by increasing the pupillomotor effectiveness of the stimulus light and that this is the reason why even a brunescent cataract does not cause an RAPD in the same eye. In addition, two clinical cases are reported. One case records the development of a cataract in an eye with a preexisting RAPD resulting from optic neuritis; as the cataract became more opaque, the afferent defect became smaller and finally was reversed. The other case shows that a traumatic cataract can produce an RAPD in the contralateral eye. Thus, when an afferent pupillary defect is seen in an eye with a cataract, a visual pathway defect in that eye should definitely be suspected.

Adult↗
PubMed1995

Potential vision tests in patients with cataracts.

PURPOSE: To determine the limits of usefulness of the potential acuity meter (PAM) and the laser interferometer (LI) in determining potential visual acuity in various severities and types of cataracts. METHODS: The study included 48 patients (67 eyes) who were undergoing cataract surgery and who had PAM and LI tests. The 67 eyes were grouped into (1) eyes with cataracts only (45 eyes) and (2) eyes with cataracts and other ocular diseases (22 eyes). Group 1 eyes were subdivided into two groups according to their Lens Opacities Classification System II (LOCS II) grading: 1a eyes (moderate cataracts) had an LOCS II grade of nuclear opalescence (NO) < 4 and cortical opacity (C) < 5 and posterior sub-capsularcataract (P) < 4, and group 1b eyes (severe cataracts) had an LOCS II grade of NO = 4 or C = 5 or P = 4. The accuracy of the PAM and LI was estimated separately for each group. RESULTS: For moderate cataracts, the accuracy of the PAM was 100% and of the LI was 92%. For severe cataracts, the accuracy of the PAM was 52% and of the LI was 79%. Both instruments tended to underestimate visual outcome more in eyes with posterior subcapsular cataracts. For eyes with other ocular diseases, the LI tends to overestimate the probable visual outcome more than the PAM, especially in patients with poor retinal function. CONCLUSIONS: Several factors such as preoperative visual acuity of 20/200 or worse, the type and severity of the cataract, and coexisting retinal disorders may affect the accuracy of the PAM and LI tests, and these should be considered when interpreting predicted vision, especially in preoperative counseling of patients.

Adult↗
PubMed1999

Influence of cataract surgery on progression of lens opacities in the fellow eye.

OBJECTIVE: To evaluate whether, in the Italian-American natural history study, cataract surgery in one eye influences the incidence/progression rate of lens opacities in the fellow eye. DESIGN: Follow-up study of age-related cataract. PARTICIPANTS: A total of 1399 participants with age-related cataracts were regularly followed for 5 years and cataract status evaluated by the Lens Opacities Classification System II on slit-lamp and retroillumination lens photographs. A total of 228 participants had cataract surgery in 1 eye during the study period, and 192 had sufficient follow-up visits to be included in the analysis. MAIN OUTCOME MEASURE: The incidence/progression of cataract was defined as two or more consecutive visits with a severity grade greater than the baseline grade. RESULTS: When entered into a Cox model, incidence/progression of specific cataract types was not associated with cataract surgery on the fellow eye and was not significantly different from that observed in participants who had no cataract surgery. CONCLUSIONS: Cataract extraction does not influence incidence/progression rate of specific lens opacities in the fellow eye.

Aged↗
PubMed2000

Potential acuity meter accuracy in cataract patients.

PURPOSE: To determine potential acuity meter (PAM) accuracy in patients with cataract as the only ocular disease. SETTING: Hospital de Clínicas de Porto Alegre, Brazil. METHODS: This prospective study comprised 74 eyes with cataract. Patients with other ocular pathology diagnosed before or after surgery, as well as those with complicated surgeries, were excluded. All patients had PAM evaluation before surgery; these results were compared to the final postoperative visual acuity. Patients were divided into 4 cataract groups based on the Lens Opacity Classification System II: Group 1, early cataracts (nuclear opalescence [NO] 1 and/or posterior subcapsular cataracts [P] 1 and/or cortical opacity [C] < 2); Group 2, definite cataracts (NO2 and/or C2, with or without P1); Group 3, posterior cataracts (P2 or P3); Group 4, mature cataracts (N3 and/or C > or = 3, with or without P1). The PAM result was considered accurate if it was within 2 lines of the postoperative best spectacle-corrected visual acuity (BSCVA) 3 months after surgery. RESULTS: All patients had a BSCVA of 20/20. Accuracy of the PAM was 58.3% in Group 1, 50.0% in Group 2, 27.8% in Group 3, and 6.7% in Group 4 (P =.000 017). Patient age did not influence the results. CONCLUSIONS: The PAM may be used as a complementary tool in evaluating early and nondense cataracts; however, patients should not be excluded as candidates for cataract surgery based solely on PAM results.

Cataract↗
PubMed1999

Immunocytochemical features of lens after cataract tissue--signalling molecules (growth factors, cytokines, other signalling molecules), cytoskeleton proteins, cellular and extracellular matrix proteins.

UNLABELLED: We examined the immunocytochemical features of after cataract tissue and cataractous lens epithelium prior to cataract surgery and at the time of surgery. METHODS: This study included 23 cases. Antibodies against the following antigens were used: epidermal growth factor (EGF), EGF receptor (EGF-R), fibroblast growth factor (FGF), FGF receptor (FGF-R), transforming growth factor (TGF)-beta, TGF-beta receptor II (TGF-beta -RII), insulin-like growth factor (IGF)II, platelet derived growth factor (PDGF)-AB, interleukin (IL)-6, IL-1 receptor II, tumor necrosis factor (TNF)-alpha, tissue plasminogen activator (TPA), prostaglandin (PG) E2, plasminogen activator inhibitor (PAI)-1, alpha smooth muscle actin (alpha-SMA), keratin, vimentin, myosin, fibronectin, laminin, types I, II, III, IV, V and VI collagen (Col), and lens epithelial cells (LECs). RESULTS: The following substances were present in posterior and anterior capsular fibrosis of after cataract: EGF, EGF-R, FGF, FGF-R, TGF-beta, TGF-beta-RII, IGF-II, PDGF-AB, IL-6, IL-1RII, TNF-alpha, PGE2, PAI-1, alpha-SMA, keratin, fibronectin, laminin, Type I col, Type II to VI col and LECs. Elschnig's pearls of after cataract expressed FGF-R, TNF-alpha, laminin and LECs. Soemmering's ring of after cataract tissue expressed EGF, FGF, FGF-R, IL-1RII, TPA, PAl-1, keratin and LECs. The following substances were present in cataractous lens epithelium prior to cataract surgery: EGF, EGF-R, FGF, FGF-R, TGF-beta-RII, IL-1-RII, TNF-alpha, PAI-1, keratin, laminin and LECs. The following substances were present in the lens epithelium of anterior capsules collected at the time of cataract surgery: EGF, EGF-R, FGF, FGF-R, TGF-beta, TGF-beta-RII, IGF-II, IL-6, IL-1-RII, TNF-alpha, PGE2, keratin, fibronectin, laminin, Type IV Col and LECs. CONCLUSIONS: These results prove that many kinds of signalling molecules and proteins exist in the process of after cataract formation.

Aged↗
PubMed1998

Diabetic cataract in children.

PURPOSE AND METHODS: Adolescent patients with insulin-dependent diabetes mellitus (IDDM) were retrospectively analyzed for the occurrence and possible predisposing factors of diabetic cataract in a population-based series of some 600 pediatric diabetics followed up during the years 1975-1995. RESULTS: Six patients (1%) needed cataract surgery. At the diagnosis of cataract they were 9.1-17.5 years old, and the duration of diabetes was between 0 months and 3 years 11 months. The type of cataract was similar in all patients characterized by bilateral snowflake type cortical deposits and posterior subcapsular cataract. Four of the six patients had at least a six-month history of diabetic symptoms before the treatment was started, and five patients had ketoacidosis at initial admission to hospital. In one of the 11 operated eyes diabetic retinopathy was observed immediately after surgery. Three patients developed proliferative retinopathy within 7-10 months after the operation, after 6.3-11.8 years of diabetes. CONCLUSIONS: The prevalence of diabetic cataract was around 1% in the pediatric diabetic population. In the pathogenesis of cataract long duration of diabetic symptoms and ketoacidosis prior to the commencement of treatment may be of significance. Good metabolic control after diagnosis did not protect for cataract. Diabetic cataract can safely be treated by modern surgical techniques, but close monitoring of the fundi for retinopathy after the operation is crucial, as proliferative retinopathy may develop rapidly after cataract surgery despite relatively short duration and acceptable metabolic control of diabetes.

Adolescent↗
PubMed2005

Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics.

PURPOSE: To investigate intraocular pressure (IOP) and ocular haemodynamics following small incision cataract surgery. METHODS: Systemic and ocular haemodynamics, and IOP, were measured pre-operatively and 1 month post-operatively, in 25 eyes of 25 patients (mean age 72.6+/-7.9 years) scheduled for small incision cataract surgery and intraocular lens implantation; these values were compared to an untreated age-matched healthy group (n=25, mean age 72.3+/-5.0 years). For each eye, the Ocular Blood Flow Analyser (OBFA, Paradigm Inc., UT, USA) was used to obtain measurements of IOP, pulsatile ocular blood flow (POBF), pulse volume (PV), ocular pulse amplitude (PA), and pulse rate (PR). Systemic blood pressure measurements were obtained at each visit. Pre- and post-operative values for the cataract group were compared using repeated measures analysis of variance, and compared to the normal group using analysis of variance. RESULTS: Pre-operatively, IOP was significantly higher in the cataract group compared to the age-matched normal control group (P<0.001). Cataract surgery resulted in a significant 16.7% reduction in IOP (P=0.001). Consequently, the post-operative IOP in the cataract group was similar to that of the normal group (P>0.05). Both pre- and post-operative POBF and PV values for the cataract group were significantly lower than for the normal age-matched group (P<0.0125). Small incision cataract surgery led to an 8.3% post-operative increase in POBF (P=0.0118) and 15.5% increase in PV (P<0.001). No changes in PA or PR were evident. CONCLUSION: These data suggest that cataract patients exhibit higher IOP and reduced ocular perfusion characteristics compared to an age-matched normal healthy group. Following cataract surgery, IOP reduced and ocular pulsatility improved.

Aged↗
PubMed1980

[Secondary cataract in aphakic children (author's transl)].

Extracapsular extraction of infantile cataract often leads to the development of secondary cataract. The object of this paper is to describe conditions leading to secondary cataract. Between 1960 and 1976, 251 children up to 12 years of age with bilateral congenital cataract were treated and followed up. Surgery was performed on 305 eyes (171 children). The total number of surgical interventions amounted to 707. In 125 cases, the occurrence of secondary cataract necessitated a second operation. Only through the posterior capsulotomy we were able to provide permanently clear optic media. In 85% of the cases with primary intact posterior capsules a secondary cataract operation was necessary within four years; in infants secondary cataract developed especially quickly. In 68 cases capsulotomy was accomplished during the primary surgical intervention. -- Traumatically induced aphakias were also investigated. In 441 cases with perforating injuries, 221 cases presented with considerable damage to the lens. Because of further complications a functional aphakia could only be achieved in 77 cases. Secondary cataract surgery was performed in 40 cases. -- The risk of late complications increases with insufficient application of atropine in the postoperative period, thereby inducing the formation of posterior synechiae. In the few cases where retinal detachment was observed, a vitreous prolapse into the anterior chamber, with the appearance of anterior synechias, was always present. -- Our observations led us to the following conclusions: Secondary cataract is an unavoidable consequence in cases where the posterior capsule remains intact. Since the preservation of an intact posterior capsule should remain the goal of the first intervention, the invariable occurrence of the secondary cataract should not be looked upon as a complication but rather as an inevitable condition to be treated in a mandatory second operation.

Aphakia↗
PubMed2000

Relations of body fat distribution and height with cataract in men.

BACKGROUND: Cataract is the leading cause of blindness worldwide. Body mass index (BMI; in kg/m(2)) is a risk factor for cataract, but other anthropometric measurements may also be important. OBJECTIVE: We tested relations of alternative measures of body size, including height and waist-to-hip ratio (WHR), as well as BMI, with cataract. DESIGN: This was a prospective follow-up study. We analyzed data from 20271 participants in the Physicians' Health Study who did not have cataract at baseline and for whom there was complete information on weight, height, and other risk factors. For analyses concerning WHR, we excluded 3121 additional men for whom we did not have these measurements, assessed at the ninth year of follow-up. The main outcome measures were incident cataract and cataract surgery. RESULTS: Among the 17150 men for whom there were complete data, we confirmed an incident cataract in 1727 during an average of 14 y of follow-up. In proportional hazards regression models that adjusted for many known or suspected risk factors, higher BMI [rate ratio (RR) = 1.25 for >/=27.8 compared with <22, P: for trend = 0. 03], height (RR = 1.23 for >/=184 cm compared with </=170 cm, P: for trend = 0.02), and WHR (RR = 1.31 for top compared with bottom quintile, P: for trend = 0.003) were each independently associated with incident cataract. CONCLUSIONS: In addition to BMI, both height and abdominal adiposity are independent risk factors for cataract. These relations are biologically plausible and, if causal, suggest that prevention of obesity and beneficial lifestyle changes resulting in weight loss and reduction of central obesity would lessen the incidence and costs of cataract.

Adipose Tissue↗
PubMedDate not supplied

Posterior capsular opacification in diabetic and nondiabetic canine patients following cataract surgery.

Posterior capsular opacification (PCO) is the most common postoperative complication of contemporary cataract surgery. Limited information is available regarding PCO formation and factors that influence PCO development in the dog. Two hundred sixty-five eyes (144 from diabetic dogs and 121 from dogs with breed-related cataracts) were prospectively evaluated for PCO formation for up to 12 months postoperatively. The mean age of all dogs in the study was 7.77 years and diabetic dogs were significantly older than dogs with breed-related cataracts. There were 73 males (61 neutered, 12 intact) and 74 females (70 neutered, 4 intact) in the study. Statistical analysis was performed based on age, breed/size, gender, stage of cataract at the time of surgery, PCO score at each time point, breed-related vs. diabetic cataract, right eyes compared to left eyes, and presence/absence of uveitis. Age and gender did not significantly influence PCO formation. Small and medium-sized breeds developed significantly more PCO in comparison to the large/giant breeds at 2 weeks and 2-4 months postoperatively, but the differences were not significant at later time points. There was an overall significant increase in PCO formation in eyes with early immature cataracts when compared to other stages of cataract up to 4 months postoperatively but not at later time points. There were no statistical differences in PCO score at 6 months or at 1 year postoperatively in eyes with breed-related and diabetic cataracts. Right eyes did not differ from left eyes in PCO score. PCO score significantly increased over time in breed-related and diabetic groups and in the overall population. No difference was found in the degree of PCO formation in eyes with inflammation prior to or after surgery compared with those without inflammation. In summary, age, gender, presence of inflammation, and cause of cataract (breed-related vs. diabetes mellitus) do not influence the development of PCO in canine cataract dogs. Small and medium-sized breeds develop significant PCO earlier than larger breeds. It is important to note that all eyes from all dogs in this study developed PCO in a time dependent manner.

Animals↗
PubMed2005

Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania.

BACKGROUND: Childhood cataract is a leading cause of blindness in children in eastern Africa. High quality surgical services have been established at a few tertiary facilities in the region; however, there appears to be delay in presentation to hospital. METHODS: Parents or guardians of all children presenting to KCMC Hospital or CCBRT Hospital with congenital (recognised since birth or within the first year) or developmental (cataract leading to reduction in vision after 1 year of age) cataract were interviewed regarding the actions taken (and timing of these) before coming to hospital. Demographic information was also collected. For analysis children were grouped as either late presenters (more than 12 months after recognition) or not late presenters (within 12 months of recognition) and predictors of late presentation were assessed. RESULTS: Among 178 children (74 congenital cataract and 104 developmental cataract) analysed, the mean delay between recognition by the caregiver and presentation to hospital was 34 months, almost 3 years. The median delay was 18 months-9 months for congenital cataract and 24 months for developmental cataract. Long delay in presentation was associated with having developmental cataract, living far from the hospital, and low socio-educational status of the mother. Among children with congenital cataract, having another sibling increased the likelihood of early presentation. CONCLUSION: Delay in presentation remains a significant problem for children needing surgery for congenital or developmental cataract. Parents who have multiple children may be more likely to seek early treatment, possibly because their expectations of achievable sight at a young age are based on previous experience of their older children. Educational efforts should aim to reach the most "unreachable" (those living the furthest from the hospital and having the lowest socio-educational status of the mother).

Cataract↗
PubMed1997

Pseudoexfoliation syndrome and secondary cataract.

AIM/BACKGROUND: The pseudoexfoliation (PEX) syndrome is frequently associated with impairment of the blood-aqueous barrier. This study analysed if this might stimulate secondary cataract following cataract extraction. METHODS: This historical cohort study included 197 eyes of 197 patients (99 with and 98 without PEX) that underwent extracapsular cataract extraction with posterior chamber lens implantation (PMMA optic) between 1985 and 1991. Secondary cataract was defined as opacification of the axial posterior capsule and decrease of visual acuity by two or more lines. Mean follow up was 23.8 months. For statistical analysis, the Kaplan-Meier method and multivariate Cox regression analysis were used. RESULTS: Secondary cataract was observed within 24 months in 35% (SD 7%) of all eyes, and was significantly more frequent in eyes with PEX (45 (11)%) than in eyes without PEX (24 (9)%, p < 0.03). Eyes with diabetes mellitus (n = 32) showed a significantly lower frequency of secondary cataract (11 (11)%) than eyes without diabetes mellitus (39 (8)%, p < 0.01). The influences of sex, open angle glaucoma, type of cataract, surgeon, positioning of IOL, and phacoemulsification versus nuclear expression on secondary cataract did not reach statistical significance. CONCLUSION: The higher frequency of secondary cataract could be considered as another potential complication of cataract surgery in eyes with PEX.

Aged↗