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PubMedDate not supplied

Rate of cataract formation in 343 highly myopic eyes after implantation of three types of phakic intraocular lenses.

PURPOSE: To assess the feasibility of using phakic intraocular lenses (PIOL) to treat high myopia, and evaluate the incidence of cataract, comparing three different lens types. METHODS: From 1989 to 2002, we implanted three different phakic intraocular lenses (PIOL) in 343 eyes of 232 patients; 231 eyes recieved an Ophtec (Worst-Fechner model, iris-claw), 89 an Adatomed (silicone posterior chamber), and 23 a Staar (posterior chamber, models V2, V3, V4). Average follow-up was 96.2 months for the Ophtec group, 31.5 months for the Adatomed group, and 19.3 months for Staar group. Eyes that subsequently developed cataract were studied for clinical evolution and had PIOL explantation and cataract extraction. RESULTS: Nuclear cataract developed in 7 of 231 eyes (3.04 %) with an Ophtec lens. Anterior subcapsular cataract developed with the two types of posterior PIOLs (Adatomed group: 38/89 eyes, 42.69%; Staar group: 3/23 eyes, 13.04%). Anterior subcapsular cataract in the Adatomed group developed more rapidly compared to the Staar group. We explanted 7 lenses in the Ophtec group, 16 lenses in the Adatomed group, and 2 lenses in the Staar group (models V2 and V3 only). Patient age older than 40 years at implantation of PIOLs and axial length greater than 30 mm were factors significantly related to nuclear cataract formation and the Ophtec lens. However, these two factors had a weaker correlation with the posterior phakic lenses (Adatomed, Staar) for high myopia than with the Ophtec lens. Postoperative best spectacle-corrected visual acuity remained stable after explantation, phacoemulsification, and posterior chamber lens implantation. CONCLUSIONS: Delayed cataract development and cataract type (nuclear) in patients with an Ophtec lens and the variables of patient age (>40 yr) and axial length (>30 mm) may considered prognostic factors. Other factors such as lens design, material, and placement probably influenced cataract formation in patients with the Adatomed and Staar PIOLs. The lens styles used in this study are no longer manufactured.

Adult↗
PubMed1993

Cataract formation after bone marrow transplantation.

OBJECTIVE: To evaluate the incidence, time course, and factors associated with cataract formation in bone marrow transplant recipients. DESIGN: Prospective cohort study. SETTING: University Hospitals, Basel, Switzerland. PATIENTS: 197 patients treated with allogeneic or autologous bone marrow grafts at least 180 days before the start of the study. INTERVENTION: Three regimens for bone marrow transplant were used: 74 patients received single-dose, total-body irradiation (TBI), 90 patients received fractionated TBI, and 33 received chemotherapy alone. RESULTS: Three and one half years after single-dose TBI, 51 of the 74 patients (69%) were alive and cataracts had developed in all of these 51 patients. Cataracts developed in 18 of the 90 (20%) patients treated with fractionated TBI, with an 83% (95% CI, 63% to 100%) risk for lens opacification at 6 years. Cataracts developed in only 1 of the 33 (3%) patients treated with chemotherapy alone. Incidence of cataracts is higher and lens opacification occurs earlier after single-dose TBI than after fractionated TBI (P < 0.01). With Cox regression analysis, the use of irradiation (relative risk, 21.0), the mode of irradiation (relative risk, 7.4), and the use of steroid treatment (relative risk, 2.9) for more than 3 months after bone marrow transplantation increased the risk for cataract formation. In contrast, age, sex, and chronic graft-versus-host disease did not influence the rate of cataract development. The probability of requiring cataract surgery after 6 years was 85% (CI, 75% to 95%) for the patients treated with single-dose TBI and 20% (CI, 0% to 49%) for those prepared with fractionated irradiation. CONCLUSIONS: Patients treated with TBI, regardless of fractionation, are likely to have cataracts within 10 years, and some will need surgical repair. Long-term steroid treatment accelerates cataract formation. Preventive measures, such as lens shielding during TBI, should be considered.

Adolescent↗
PubMed2000

Development and repair of cataract induced by ultraviolet radiation.

BACKGROUND: Several epidemiological investigations show a correlation between cataract development and the dose of ultraviolet radiation (UVR) received. It is experimentally well established that exposure of animal eyes to UVR induces cataract. Most cataracts develop as a gradual increase in lens opacity. Despite this, current estimations of toxicity for cataract are based on the concept that cataract is a binary event. Moreover, current exposure limits for UVR are based on subjective inspections with slit lamp microscopy. PURPOSE: The first purpose of the present study was to determine a statistically defined maximum acceptable dose for ultraviolet radiation-induced cataract based on quantitative data of forward light scattering in lenses. The second purpose was to find possible explanations for light scattering by investigating the morphology and the refractive index distribution in the lens. The third purpose was to describe the development of cataract after UVR on the cellular level. METHODS: Six-week-old, female Sprague-Dawley rats received UVR unilaterally in vivo. The radiation from a high pressure mercury lamp was collimated, passed through a water filter and an interference filter or a monochromator (lambdaMAX = 300 nm), and projected onto the cornea. The exposure time was 15 min. The exposure dose ranged between 0.1 and 20 kJ/m2 and the animals were kept between 6 hours and 32 weeks after exposure. The extracted lenses were photographed and forward light scattering was measured. Other methods included light microscopy, fluorescence microscopy, transmission and scanning electron microscopy, freeze-fracture and microradiography. RESULTS AND CONCLUSIONS: From a long-term experiment, it was concluded that UVR-exposed lenses scatter light more than their contralaterals and that a higher dose induces more light scattering. After exposure to 5 kJ/m2, the mean forward light scattering remains unchanged between 1 and 32 weeks. Earlier observations, taken together with the current findings, indicate that the optimal time to detect low dose UVR-induced cataract is one week after exposure in rats. The intensity of forward light scattering increases exponentially with increased UVR dose between 0.1 and 14 kJ/m2. Based on this continuous dose-response, a method to determine a maximum acceptable dose to avoid UVR-induced cataract was developed. The statistically defined lower limit of pathologic light scattering is projected on the dose-response function. The dose corresponding to that point can be estimated and was suggested to be called the Maximum Acceptable Dose (MAD). Two low dose UVR exposures with 0 or 6 h intervals between the exposures produce the same degree of lens opacification. When the second exposure follows 24 or 48 h after the termination of the first, lenticular damage increases. Repair processes between 24 and 48 h after exposure appear to be sensitive to UVR, and an additional exposure during this time may aggravate cataract development. Lenses exposed to UVR grow more slowly than their non-exposed contralaterals. This decrease in lens growth was more pronounced with increasing dose. Low doses led to decreased water content in the lens whereas high doses led to swelling. At 6 months after low dose UVR exposure, no global change of the refractive index was found. However, local variations of the refractive index induce a subtle cortical light scattering. In vivo low dose UVR induces programmed cell death which peaks 24 h post-exposure and involves the entire lens epithelium. Dead cells are removed from the epithelium by phagocytosis. This leads to disintegration of the lens epithelium, associated with flake-like opacities at the lens surface. After one week, the epithelium and the equatorial parts of superficial lens fibers contain extracellular spaces. The extracellular spaces together with locally disarranged fibers produce a corrugated opaque lens surface and equatorial opacities. Within several weeks after ex

Animals↗
PubMed2000

Polymorphic glutathione S-transferases as genetic risk factors for senile cortical cataract in Estonians.

PURPOSE: To investigate the possible association between glutathione S-transferase GSTM1, GSTM3, GSTT1, and GSTP1 polymorphism and the occurrence of age-related cataracts in Estonian patients. METHODS: Patients with cortical (155), nuclear (77), posterior subcapsular (120), mixed type (151) of senile cataract and control individuals (202) were phenotyped for GSTM1 and GSTT1 by enzyme-linked immunosorbent assay and genotyped for GSTM3 and GSTP1 by polymerase chain reaction. RESULTS: The frequency of the GSTM1-positive phenotype was significantly higher in the cortical cataract group (60.6%) than in the controls (45.0%) with odds ratio of 1.88 (95% CI, 1.23-2.94; P = 0.004). The cortical cataract risk associated with the GSTM1-positive phenotype was increased in carriers of the combined GSTM1-positive/GSTT1-positive phenotype (OR = 1.99; 95% CI, 1.30-3.11; P = 0.002) and the GSTM1-positive/GSTM3 AA genotype (OR = 2.28; 95% CI, 1.51-3.73; P < 0.001). The highest risk of cortical cataract was observed in patients having all three susceptible genotypes (OR = 2.56; 95% CI, 1.59-4.11; P < 0.001). Also, a significant interaction between the presence of the GSTP1* A allele and cortical cataract was found with prevalence of the GSTP1* A allele among the cortical cataract cases compared with the controls. Ninety-five percent of subjects with cortical cataract had the GSTP1 (AA, AB, or AC) genotype, whereas in controls 87% of persons had a genotype with GSTP1*A allele (OR = 3.1; 95% CI, 1.31-7.35; P = 0.007). In contrast to the GSTP1*A allele, the presence of the GSTP1*B allele in one or two copies leads to decreased cortical cataract risk (OR = 0.09 for GSTP1 BB genotype). CONCLUSIONS. The GSTM1-positive phenotype as well as the presence of the GSTP1*A allele may be a genetic risk factor for development of cortical cataract.

Adult↗
PubMed2000

Diabetes, fasting blood glucose and age-related cataract: the Blue Mountains Eye Study.

AIMS: To examine the relationship between diabetes and the presence of cortical, nuclear and posterior subcapsular (PSC) cataract in a defined older population, while controlling for known cataract risk factors. METHODS: Slit-lamp and retroillumination lens photographs were taken on 3654 participants attending the population-based Blue Mountains Eye Study during 1992-94. Masked grading of the photographs was performed using the Wisconsin Cataract Grading System. RESULTS: 217 subjects (5.9% of the population) had previously diagnosed diabetes and 66 (1.8%) had diabetes diagnosed from fasting blood glucose measurements. Cortical cataract, PSC and past cataract surgery were associated with known diabetes in age-sex adjusted models. However, only PSC (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.0-3.1) and past cataract surgery (OR 2.5, CI 1.5-4.2) remained statistically significantly associated with diabetes after further adjustment for other known cataract risk factors. Increasing therapy, as an index of diabetes severity (oral or insulin treatment, compared to treatment by diet alone), was associated with a markedly increased risk of PSC (OR 5.4). CONCLUSIONS: These findings support previous research showing that diabetes has a harmful effect on the lens. The markedly increased risk for PSC may also have been reflected in the association found between diabetes and past cataract surgery. Contrary to findings from the Beaver Dam Eye Study, we found only a weak association with cortical cataract, which was not statistically significant after adjusting for other known cataract risk factors.

Aged↗
PubMed2001

Relation between size at birth and age-related cataract.

PURPOSE: To determine whether poor fetal growth, as determined by size at birth, is associated with an increased risk of age-related cataract. METHODS: A total of 741 men and women born in Sheffield, England between 1922 and 1930 and whose size at birth was available were traced and invited to take part in the study. Of these, 392 (53%) attended for ophthalmic examination. Lens opacity in these volunteers was graded using the Lens Opacities Classification System (LOCS) III. RESULTS: After adjusting for age, gender, gestational age, and risk factors for cataract there were no consistent associations between size at birth and age-related cataract. However, the odds ratio for nuclear cataract (opalescence) among subjects whose birth weight was more than 8 lb was 2.4 (95% CI 1.2 to 5.0) compared with those who weighed under 6 lb 12 oz at birth. Risk of cortical cataract by contrast fell with increasing birth weight, but the trend was not significant and became weak after adjusting for gestational age and other risk factors for cataract. No relation was evident between risk of posterior subcapsular cataract and size at birth. CONCLUSIONS: There is no consistent association between size at birth and age-related cataract. The higher risk of nuclear cataract with increased birth weight was contrary to the expected trend. The apparent difference in direction of the relation between birth weight and different subtypes of cataract may be a chance finding but warrants further exploration.

Aged↗
PubMed2001

[Influence of cyclosporin on steroid-induced cataract].

PURPOSE: To study the effect of cyclosporin on steroid-induced cataract in patients after renal transplantation. SUBJECTS AND METHODS: 140 patients who received renal transplantation and ophthalmological examinations before and over 12 months after surgery at Kanazawa Medical University were investigated retrospectively. The subjects were divided into the following two groups: the conventional therapy group(Group C) who were administered azathioprin and methylprednisolone and the triple therapy group(Group T) who were administered azathioprin, methylprednisolone and cyclosporin. There were 73 subjects in group C and 67 in group T. Judgement of steroid cataract followed Crew's classification and steroid cataract was diagnosed when vacuoles or opacity were seen in the posterior subcapsular region. Subjects that had any lens opacity before renal transplantation were excluded. RESULTS: The total dose of systemic steroid during the first year and in the final observation period in group T was significantly higher than in group C. The prevalence of steroid cataract was 55% and 63% for the 1st year, 72% and 89% for the 2nd year, 74% and 92% for the 3rd year and 83% and 96% for the 5th year in groups C and T, respectively. By the third year, the rate of subjects whose corrected visual acuity was less than 0.8 or who received cataract surgery was significantly higher in group T than in group C. There was no significant difference in the total dose between the subjects with cataract over grade I and those of grade 0 and I in both groups C and T. In group C, the total dose of steroid pulse therapy was significantly higher in the subjects with steroid cataract over grade I than in those with grade 0 and I. CONCLUSIONS: Using cyclosporin, although the total dose of systemic steroid was decreased, the rate of steroid cataract increased. Cyclosporin may accelerate the development of steroid cataract. Steroid pulse therapy is considered to be a risk factor for developing steroid cataract.

Adolescent↗
PubMed2001

[Hereditary hyperferritinemia syndrome and cataract].

UNLABELLED: Hereditary hyperferritinemia cataract is a recently described autosomal dominant syndrome, characterized by bilateral cataracts and elevated level of serum ferritin. PATIENTS: Three members of a family were investigated for cataract and hyperferritinemia. A 30-year-old woman had elevated serum ferritin levels and bilateral cataracts. She was treated for hemochromatosis, but serum iron and transferrin saturation were normal. Her two sons, nine and five years old, also had a high ferritin level and bilateral cataracts. RESULTS: The ferritin level was 1200 micrograms/L in the woman's serum, and respectively, 974 and 965 micrograms/L in the two boys' serum. The mother had a visual acuity of 8/10 in the right eye and 5/10 in the left eye. The cataract comprised fine crystalline cortical opacities, extending axially. The two sons had 7 to 8/10 in both eyes. No other ophthalmic abnormality was noted. These patients were heterozygous for a 16 bp deletion on the L-ferritin gene. DISCUSSION: Ferritin is an iron storage ubiquitous protein present in every cell. In hyperferritinemia cataract syndrome, serum iron and transferrin saturation are normal, and the elevated serum ferritin level is the consequence of an autosomal dominant disorder. The cataract is made up of the accumulation of small opacities disposed radially and more numerous on the outside edges, with relatively good visual acuity. The size of the cataract seems to be correlated to the serum ferritin level. In hemochromatosis, hyperferritinemia is related to increased iron stores and is not associated with cataracts.

Adult↗
PubMed2002

[Pseudophakic retinal detachment in relation to complications of cataract surgery].

The authors made a retrospective study in a group of 14 patients operated in 1999 on account of pseudophakic detachment of the retina (D.R.). They followed up risk factors of development of D.R. in conjunction with complications of cataract surgery. The investigated factors comprised patients sex and age, type of cataract operation and type of implanted lens, complications of cataract surgery, time interval between cataract surgery and the development of D.R., pre-operative and postoperative visual acuity and type of operation of D.R. In the group there was a significant ratio of men (71.4%), the mean age was 60.28 years and 78.6% of the patients were referred to our department. Phaćoemulsification with implantation of IOL was made in 57% of the patients, extracapsular extraction with implantation of IOL in 47%. The authors did not find a significant difference between the type of cataract surgery with regard to the development of D.R. A posterior chamber intraocular lens was implanted in 71% eyes of the group while an anterior chamber intraocular lens was used only in 29% of the eyes in the group. Complications of cataract surgery were above all ruptures of the posterior capsule (64%). Dislocation of the lens into the vitreous body during surgery was recorded only in one case (7%) a non-complicated operation of cataract was recorded in 28%, incl. one case (7%) where D.R. was preceded by laser capsulotomy. The mean time interval between cataract operation and D.R. was 20.7 months. The visual acuity before surgery of D.R. was 0.24 while after surgery it was 0.31. In 50% patients a cryosurgical procedure was used in operation of D.R., pars plana vitrectomy as the first operation of D.R. was used in 50% of the group. Adherence of the retina after the first operation was achieved in 64.2% eyes, after re-operation in 85.7% eyes. The authors did not find a significant difference between the type of cataract surgery and type of implanted lens as regards anatomical and functional results of surgery of D.R. Proliferative vitreoretinopathy and dysfunction of the photoreceptors were the main cause of anatomical and functional failure the operation of D.R. in the group. The number of pseudophacic D.R. after laser capsulotomy did not exceed the number of D.R. after non-complicated cataract surgery in the investigated group.

Cataract Extraction↗
PubMed2002

[The evaluation of estradiol and FSH serum levels in menopausal women with primary cataract].

PURPOSE: The aim of the study was to compare the serum levels of estradiol and follicle-stimulating hormone (FSH) in young women with cataract and control group. MATERIAL AND METHODS: We were evaluating levels of estradiol and FSH in 31 women (aged 31 to 54 years; mean age 46.2 years) operated due to senile cataract and in 31 women (aged 37 to 53 years; mean age 44.2 years) without clinical evidence of cataract--control group. We excluded all subjects with cataract of non-senile origin with other factors predisposing to cataract development (i.e. diabetes, hypoparathyroidism, myopia, glaucoma, injury, roentgen radiation, drugs, family prevalence). The serum levels of hormones were evaluated between 19th and 21st day of menstruation cycle using immunoenzymatic assay. All patients had negative history of estrogen use. Subjects underwent a detailed eye examination including: visual acuity, tonometry, slit lamp biomicroscopy and direct ophthalmoscopy after pupil dilatation with 1% Tropicamide. RESULTS: There was significant difference of mean serum levels of estradiol and FSH between patients and control group, but no significant difference of mean age. There was significant dependence between menopausal syndrome symptoms and occurrence of cataract (p = 0.00001). There was also significant dependence between hormones' levels typical for menopause and occurrence of cataract (p = 0.00026). We found significant negative correlation (R = -0.6370, p = 0.00027) between estradiol and FSH, and positive correlation (R = 0.46267, p = 0.0088) between age and FSH, in patients with cataract. No significant correlations were noted in control group. CONCLUSIONS: Lack of other predisposing factors and young age of patients allow to establish a conclusion, that occurrence of cataract in this group may be associated with menopausal period changes and lack of protective action of estrogens. It seems to be important, to take special ophthalmology care of premenopausal women with menopausal syndrome symptoms. It requires continuation of studies, to assess the possibility of protective role of hormone replacement therapy, to prevent cataract development.

Adult↗
PubMed2003

Prevalence and determinants of diabetic retinopathy and cataracts in West African type 2 diabetes patients.

OBJECTIVE: To quantify the prevalence of, and risk factors for, diabetic retinopathy and cataracts in patients with type 2 diabetes, and their spouse controls, enrolled from 5 centers in 2 West African countries (Ghana and Nigeria). METHOD: The analysis cohort was made up of 840 subjects with type 2 diabetes, and their 191 unaffected spouse controls, who were enrolled and examined in Lagos, Enugu, and Ibadan, in Nigeria, and in Accra and Kumasi, in Ghana. A diagnosis of diabetic retinopathy was made only where a participant had a minimum of one microaneurysm in any field, as well as exhibiting hemorrhages (dot, blot, or flame shaped), and maculopathy (with or without clinically significant edema). RESULTS: Average duration of diabetes was 7.0 years, and mean age at diagnosis was 46.5 years. Prevalence of diabetic retinopathy was 17.9%. Cataracts were present in 44.9% of the patients with type 2 diabetes, and in 18.3% of spouse controls. The risk of developing retinopathy increased more than 3-fold for patients at the highest fasting plasma glucose (FPG) level (OR=3.4; 95% CI, 1.8-6.3), compared to patients at the lowest FPG level. The odds ratios for persons with diabetes for 10 years or more, compared to persons with diabetes for less than 5 years, was 7.3 (95% CI, 4.3-12.3) for retinopathy, and 2.6 (95% CI, 1.5-4.5) for cataracts. CONCLUSIONS: Cataracts were a more important cause of vision impairment than was diabetic retinopathy in this cohort. The prevalence of cataracts in patients with diabetes was more than twice that of their spouse controls, indicating that type 2 diabetes is an important risk factor for cataract formation. Individuals who developed type 2 diabetes at an earlier age were more likely to develop both diabetic retinopathy and cataracts. A strong positive association was observed between FPG level, duration of diabetes, and risk of retinopathy and cataracts. The low prevalence of retinopathy and cataracts observed within the first 5 years of diagnosis of diabetes in this cohort, suggests that intensive blood glucose control may reduce the risk of the development and progression of retinopathy and cataracts. In this regard, early eye examination, preferably at first presentation of elevated blood glucose, is highly recommended.

Adult↗
PubMed1992

Contrast and glare sensitivity. Association with the type and severity of the cataract.

PURPOSE: Contrast and glare sensitivity tests are now being used as adjuncts to visual acuity in the assessment of visual function. Limited data are available on the associations of the former tests with cataract type and severity. The aim of the study is to assess these associations using standardized techniques. METHODS: Contrast sensitivity tests (using the Pelli-Robson chart) and glare sensitivity tests (using the Vistech MCT 8000) were done on 128 patients with cataracts and no other ocular disease and on 29 control volunteers. The cataracts were graded using the Lens Opacities Classification System II (LOCS II). Data from the left eyes were analyzed using logistic regression models. RESULTS: Contrast sensitivity loss was associated with cataract severity for cortical (P less than 0.0001) and posterior subcapsular (P = 0.0001) cataracts and with decreased visual acuity (P = 0.0001). Night and day glare sensitivity were each associated only with increased severity of posterior subcapsular cataracts (P less than or equal to 0.003) and with decreased visual acuity (P less than 0.001). Additional analyses showed that contrast and glare sensitivity were similar in eyes with no cataracts and early cataracts. CONCLUSION: These results suggest that the Pelli-Robson Chart and the Vistech MCT 8000 are good techniques for evaluating visual function in moderate to advanced cataracts. However, for early cataracts, other techniques need to be explored to assess visual function loss.

Adult↗
PubMed2003

The role of patient age and intraocular gases in cataract progression following vitrectomy for macular holes and epiretinal membranes.

PURPOSE: To evaluate the rate of increase in nuclear sclerosis and posterior subcapsular cataracts in eyes as a function of patient age and use of intravitreal gas at the time of vitrectomy. METHODS: Nuclear sclerotic cataracts and posterior subcapsular cataracts were graded on a scale of 0 to 4.0 in 301 consecutive eyes prior and subsequent to vitrectomy for macular holes, epiretinal membranes, or vitreomacular traction syndrome. Linear regression analysis was performed to compare the rate of change in cataract score. RESULTS: Nuclear sclerotic cataracts showed minimal increase in patients younger than 50 years of age following vitrectomy (.13 grades per year). Nuclear sclerotic cataracts increased at a rate of .7 to .9 grades per year (mean, .812) in patients from age 50 to 60, 60 to 70, 70 to 80, and 80+ years, even though the baseline nuclear sclerosis scores were progressively greater for each decade. The increase in nuclear sclerotic cataracts in patients younger than 50 years was significantly less (P<.001) than in patients 50 years or older. The fellow nonsurgical eyes of patients 50 years or older also showed smaller increases in nuclear sclerotic cataracts over time (.091 to .342 grades per year; mean, .139). Eyes with intraocular gas use had a higher rate of nuclear sclerosis progression (.8 grades per year) compared to eyes without intraocular gas bubbles (.5 grades per year) (P<.001). Posterior subcapsular cataract scores showed minimal or no increases in all groups. CONCLUSIONS: Patients older than 50 years have a similar rate of increase in nuclear sclerotic cataracts independent of age. The rate is sixfold greater than in patients younger than 50 years and also sixfold greater than the progression of nuclear sclerosis in the fellow nonsurgical eyes. Intravitreal gas bubbles cause nuclear sclerosis to increase by 60%, compared to eyes without use of a gas bubble.

Aged↗
PubMed2004

[Evaluation of corneal endothelium following cataract surgery in diabetic patients].

PURPOSE: The aim of this study was to evaluate the influence of cataract surgery on the condition of corneal endothelium, in diabetic patients. MATERIAL AND METHODS: We examined 103 patients (103 eyes) after cataract surgery (64 women and 39 men), at the age between 49 and 89. In our study we didn't involve any patients with intra or post-surgery complications. Using Specular Microscope SP-1000 corneal endothelium was examined before cataract surgery and in the long-term follow-up: 7, 30 and 90 days after surgery. The patients were divided into two groups: suffering from diabetes (54) and matched control group--non-diabetic patients with cataract (49). The same patients were also divided depending on the type of surgical technique: phacoemulsification (42) or extracapsular cataract extraction (61). RESULTS: The mean percent loss of corneal endothelium cells, due to surgery in diabetic patients was: 11.31% after 7 days, 13.99% after 30 and 15.38% after 90 days. In the control group: 5.45% after 7 days, 8.66% after 30 and 11.33% after 90 days. The mean percent loss of corneal endothelium cells after phacoemulsification was: 10.10% after 7 days, 13.21% after 30 and 15.87% after 90 days; after extra-capsular cataract extraction: 6.84% after 7 days, 9.71% after 30 and 11.48% after 90 days. Differences between mean value of corneal endothelial cells in diabetic patients compared with control group, were statistically essential 7 and 30 days after cataract surgery, and near such assessment 90 days after surgery. There were no statistically essential differences between endothelial cells density in both operated groups, in relation to type of operation (phacoemulsification and extra-capsular cataract extraction). CONCLUSIONS: Above results are the evidence, that cataract surgery is a big trauma for cornea, especially for its endothelium. The operation is mainly dangerous for patients suffering from diabetes. The surgeon should be aware of the above threat during cataract surgery in diabetic patients, and therefore should express high level of caution, irrespective of the technique of operation.

Aged↗
PubMed2004

Clinical description and genome wide linkage study of Y-sutural cataract and myopia in a Chinese family.

PURPOSE: To describe the clinical characteristics of a Y-sutural cataract associated with myopia in a large Chinese family and to identify the causative gene and mutation. METHODS: An autosomal dominant Y-sutural cataract and myopia were identified in members of a large family of Han ethnicity living in southern China. Ophthalmological examinations were performed and a medical history was taken. Blood samples were collected for DNA isolation. A genome wide scan was performed using markers spaced at about 10 cM intervals for genotyping and two point linkage analysis. Candidate genes were sequenced. RESULTS: Bilateral lens opacities, the only sign of cataract in early childhood and the most prominent sign in all affected individuals, involved the entire anterior Y and posterior inverted Y sutures, showing a feather duster like appearance. The Y-sutural cataract in this family mapped to an 11.4 cM (13.5 Mb) region between D3S3606 and D3S1309 on chromosome 3q22 with a maximum lod score of 5.7 at theta=0 for D3S1292. Sequence analysis of the beaded filament structural protein 2 (BFSP2) gene identified a previously described c.697_699delGAA (E233del) mutation which was present in all individuals with Y-sutural cataract but not in unaffected individuals and controls. Myopia, observed in 10 out of 12 cataract patients and significantly higher than that in unaffected offspring and siblings (1 out of 8), was independently mapped to a 61.2 cM (59 Mb) region between D3S3606 and D3S1262 on 3q21.3-q27.2 with maximum lod score of 3.79. CONCLUSIONS: This Y-sutural cataract is caused by an E233del mutation in BFSP2 which provides additional evidence supporting mutations in BFSP2 as a cause for cataract and demonstrates phenotypic variability in cataracts caused by BFSP2. The Y-sutural opacity in the lens might be the typical and earliest sign for cataract caused by the BFSP2 mutation. In addition, these results demonstrate a myopia susceptibility locus in this region, which might also be associated with the mutation in BFSP2.

Adolescent↗
PubMed2006

[Effects of matrix metalloproteinase-3, osteopontin, and tissue inhibitor of metalloproteinase-1 in the formation of cataract].

OBJECTIVE: To investigate the expression and significance of matrix metalloproteinase-3 (MMP-3), osteopontin (OPN) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in human lens epithelial cells (LECs) of cataract. METHODS: The MMP-3, OPN, and TIMP-1 expressions in LECs of anterior subcapsular cataract (31 cases), nuclear cataract (28 cases) and normal lens (12 cases) were detected by immunohistochemistry, respectively. RESULTS: The MMP-3 expression in anterior subcapsular cataract was significantly higher than that in nuclear cataract and normal lens (chi2=31.49, 34.479; P=0.000); but there was no statistic significance between nuclear cataract and normal lens (chi2=2.449, P=0.118). The OPN expression in anterior subcapsular cataract was also significantly higher than that in nuclear cataract and normal lens (chi2=29.450, 15.889; P=0.000). There was no significant difference in the TIMP-1 expression among the 3 groups (P>0.05). Positive correlation was found between MMP-3 and OPN in LECs of anterior subcapsular cataract (r=0.381, P=0.035). But no significant correlation was found among MMP-3, OPN, and TIMP-1 (r=0.121, -0.289; P=0.516, 0.114). CONCLUSION: Increased expression of MMP-3 and OPN and the expression imbalance between MMP-3 and TIMP-1 may play a critical role in the pathogenesis of anterior subcapsular cataract.

Adult↗
PubMed2006

Thioredoxin, thioredoxin reductase, and alpha-crystallin revive inactivated glyceraldehyde 3-phosphate dehydrogenase in human aged and cataract lens extracts.

PURPOSE: To investigate whether mammalian thioredoxin (Trx) and thioredoxin reductase (TrxR), with or without alpha-crystallin can revive inactivated glyceraldehyde 3-phosphate dehydrogenase (GAPDH) in both the cortex and nucleus of human aged clear and cataract lenses. METHODS: The lens cortex (including capsule-epithelium) and the nucleus were separated from human aged clear and cataract lenses (grade II and grade IV) with similar average age. The activity of GAPDH in the water-soluble fraction after incubation with or without Trx or/and TrxR for 60 min at 30 degrees C was measured spectrophotometrically. In addition, the effect of a combination of Trx/TrxR and bovine lens alpha-crystallin was investigated. RESULTS: GAPDH activity was lower in the nucleus of clear lenses than in the cortex, and considerably diminished in the cataractous lenses, particularly in the nucleus of cataract lenses grade IV. Trx and TrxR were able to revive the activity of GAPDH markedly in both the cortex and nucleus of the clear and cataract lenses. The percentage increase of activity in the cortex of the clear lenses was less than that of the nucleus in the presence of Trx and TrxR, whereas it was opposite in the cataract lenses. The revival of activity in both the cortex and nucleus from the cataract lenses grade II was higher than that of the grade IV. Moreover, Trx alone, but not TrxR, efficiently enhanced GAPDH activity. The combination of Trx and TrxR had greater effect than that of either alone. In addition, alpha(L)-crystallin enhanced the activity in the cortex of cataract grade II with Trx and TrxR present. However, it failed to provide a statistically significant increase of activity in the nucleus. CONCLUSIONS: This is the first evidence to show that mammalian Trx and TrxR are able to revive inactivated GAPDH in human aged clear and cataract lenses, and alpha-crystallin helped this effect. The inactivation of GAPDH during aging and cataract development must be caused in part by disulphide formation and in part by unfolding, and can be recovered by reducing agents and a molecular chaperone.

Adult↗
PubMed2007

Effect of the isoflavone genistein against galactose-induced cataracts in rats.

Worldwide, ocular cataracts are a major cause of human blindness. A key goal of cataract-related research is to identify simple, cost-efficient but effective ways to prevent cataract formation or progression. Genistein is a naturally occurring dietary isoflavone with well-documented estrogenic, antioxidant, and protein tyrosine kinase inhibitor activity, which in turn modulates the activity of several enzymes involved in cell signaling and proliferation. Furthermore, many isoflavones have been shown to be potent inhibitors of aldose reductase, which is an important rate-limiting enzyme in the process of cataract induction in the metabolic disease galactosemia. In order to assess the potential for genistein to mitigate cataract formation, we have studied its effects in the animal model of dietary galactose-induced cataracts in adult male rats. Our experimental hypothesis was that dietary genistein would prevent or delay the progression of cataracts induced by high dietary intake of galactose. Our results show that the isoflavone genistein was not able to completely prevent galactose-induced cataract formation, but genistein did delay the progression of cataracts induced by dietary galactose. In addition, we found that dietary galactose decreased concentrations of serum somatostatin, while adding genistein decreased the serum glucose level but increased the serum testosterone level. As an initial inquiry into the mechanisms by which the partial protective effect of genistein could be mediated, we found that genistein increased the expression of connexin (Cx) 43 in the lens but did not affect the expression of soluble guanylyl cyclase (sGC) subunits. This finding suggests that the partial protective effect of genistein on cataract induction appears to be unrelated to sGC but may be mediated by enhanced expression of Cx43 and changed metabolic state.

Animals↗