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PubMed1989

The Emory mouse cataract: increased accumulation of calcium during cataractogenesis.

Total calcium and total protein contents have been determined in Emory mouse cataracts from 6 to 19 months of age and also in age-matched Cataract-resistant control lenses. The normal lens calcium is about 0.006 micrograms/mg fresh lens weight; in cataracts the value increases from about 0.02 in beginning cataracts to 0.4 in severe cataracts. Calcium does not increase with age in control lenses. Elevation of calcium levels never precedes initial cataractous changes and is most probably a secondary change. This mouse cataract, unlike human senile cataracts, invariably accumulates calcium and the magnitude is roughly proportional to the severity of cataract. It appears to be a simpler and more homogenous type than human cataract and is therefore more suitable for biochemical studies.

Aging↗
PubMed1987

Analysis of glucose levels during glucocorticoid-induced cataract formation in chick embryos.

When 15-day-old developing chick embryos were administered hydrocortisone hemisuccinate sodium (HC; 0.25 mumol/egg), the content of glucose in the lens markedly increased from around 6 hr, and reached about 25-30-fold above the matched control at 24-48 hr. Thereafter, the glucose level declined and returned to the control level by 100 hr. The profile of lenticular glucose levels was similar to that of the appearance and disappearance of lens opacification. Prednisolone, as well as HC, produced cataract and the elevation of glucose in the lenses. Cortexolone and cortisone, which have weak or negligible glucocorticoid activity in developing chick embryo, could neither produce cataract nor the elevation of glucose in the lenses. An attempt was made to find similarity between this glucocorticoid-induced cataract and sugar cataract known in mammals. In both control and HC-induced cataract (stage IV-V) obtained 48 hr after HC administration, sorbitol, fructose, and glycosylation of protein could not be detected. Dehydration was observed in HC-induced cataractous lens. These data demonstrate that the glycosylation of lenticular protein and the accumulation of polyol were not involved in glucocorticoid-induced cataract formation in developing chick embryos. These results suggest a relationship between the elevation of glucose and cataract formation. However, when cataract formation was blocked by ascorbic acid treatment, the glucose level remained high. Therefore, any relationship between glucose level and cataract may be complex or indirect.

Animals↗
PubMed1981

Senile cataracts: evidence for acceleration by diabetes and deceleration by salicylate.

A method is described for determining the natural progression of senile cataracts in humans and whether certain factors accelerate or decelerate this progression. The method consists in plotting the age of the patient against the degree of opacity of the cataract to find the regression relation. A comparison of cataracts from diabetic and nondiabetic patients revealed that diabetes accelerated senile cataract formation, so that there was a difference of 9.6 years in the age of the two groups with more dense cataracts. Plasma tryptophan levels, which are increased in cataract patients, are lowered by acetylsalicylic acid (ASA). In this study ASA decelerated cataract formation in diabetic and nondiabetic patients. Among the nondiabetic patients cataract formation in a group with osteoarthritis was delayed by an average of 10 years. Deceleration of cataract formation resulting from ASA administration may reduce the need for surgical removal of cataracts.

Age Factors↗
PubMed1980

Cataract-webbed trait in Peromyscus. II. Biomicroscopy and histology of eyes.

A longitudinal biomicroscopic study of lenses and fundi of over 2,000 Peromyscus maniculatus (deer mice) which have cataracts as an autosomal recessive trait has been correlated with histologic development of cataracts. By selective breeding, early-onset cataracts (Type I), which are frequently associated with abnormal closure of the fetal fissure and hyaloid vascular abnormalities, have been separated from later-onset (Type II) cataracts, which are more heterogeneous. Type I cataracts occur in syndactylous deer mice, develop rapidly, and histologically may show backward migration of disrupted lens bow cells before lens opacity is apparent biomicroscopically. Posterior subcapsular cataracts then develop and spread centrally and inferonasally to the equatorial area and then to the entire equator. The nucleus opacifies in either a "shell" pattern or as isolated dots. Anterior cortical opacification progresses to mature cataract. Histologically, abnormal migration and proliferation of lens epithelium and enlargement and vacuolar degeneration of the basal (posterior) process of cortical lens fibers are early changes in Type I cataracts. Disruption of the lens bow with failure of differentiation and inward turning of lens epithelium to become lens fibers occurs concurrently. Type II cataracts may follow the developmental pattern of Type I but are rarely associated with severe hyaloid vascular abnormalities and progress more slowly. About 6% of animals develop diabetes, which is not associated with the cataract-webbed trait.

Animals↗
PubMed2004

Comparative study of serum Na(+ )and K(+ ) levels in senile cataract patients and normal individuals.

Many factors such as aging, changes in blood electrolytes levels, and possibly family history are involved in senile cataract formation. Changes in serum electrolytes levels can induce changes in aqueous electrolytes levels and effect on lens metabolism and probably cataract formation. In this paper, we study serum level of Na(+ )and K(+) in senile cataract patients and normal individuals. Methods and materials: 155 senile cataract patients scheduled for cataract surgery in eye clinic of Rasoul hospital and 155 normal individuals were selected. Serum Na(+) and K(+) levels were measured by Flame Photometry technique and means compared between two groups by t-test. Results: 1. Mean serum Na(+) level in senile cataract patients and normal individuals was 144.96 +/- 6.04 mEq/lit and 140.88 +/- 2.27 mEq/lit respectively, and there was statistically significant difference (P<0.0001). 2. Mean serum K(+) level in senile cataract patients and normal individuals was 4.20 +/- 0.34 mEq/lit and 4.15 +/- 0.32 mEq/lit respectively, and there was no statistically significant difference. Conclusion: Serum Na(+ )level in senile cataract patients was higher than normal individuals in this study. This result might suggest that diets with high Na(+) content are a risk factor for age-related cataract formation, as high Na(+) content of the diet leads to high level of serum Na(+), which in turn contributes to formation of age-related cataract.

Journal Article↗
PubMed2003

Cataracts and glaucoma in patients with oculocerebrorenal syndrome.

BACKGROUND: Oculocerebrorenal syndrome is an X-linked recessive hereditary oculocerebrorenal disorder characterized by congenital cataract, mental retardation, and Fanconi syndrome of the proximal renal tubules. Other ocular findings include glaucoma, corneal opacity (keloid), enophthalmos, and hypotonia. OBJECTIVE: To describe the treatment of 7 patients (14 eyes) with bilateral cataracts associated with oculocerebrorenal syndrome. Method Retrospective review. RESULTS: Seven patients with oculocerebrorenal syndrome had visually significant bilateral cataracts detected on their first full ophthalmic examination. All underwent bilateral cataract surgery. The mean age (of 14 eyes) at cataract extraction was 1.25 (median, 1.1) months. Glaucoma diagnosis and treatment were more variable. The mean age (of 11 eyes) at glaucoma diagnosis was 24.1 (range, 0.2-70.0) months: the mean age was 0.2 month (of 4 eyes) when glaucoma was diagnosed before cataract extraction, and the mean age was 37.7 months (of 7 eyes) when glaucoma was diagnosed after cataract extraction. All eyes were followed up for a mean of 100.8 (range, 38-190) months. Main Outcome Measure Treatment of 7 patients (14 eyes) with bilateral cataracts associated with oculocerebrorenal syndrome. CONCLUSIONS: Early identification and surgical removal of cataracts is recommended in patients with oculocerebrorenal syndrome. Despite this, visual acuity results will only rarely be better than 20/70, and nystagmus is likely. Patients should be monitored closely and regularly for changes in intraocular pressure, optic nerve cupping, and refractive error to rule out the development of glaucoma.

Cataract↗
PubMed1991

Low-dose aspirin and risks of cataract in a randomized trial of US physicians.

Observational studies have raised the question of a possible benefit of aspirin on the development of cataract. The Physicians' Health Study, a randomized double-masked placebo-controlled trial among 22,071 male physicians, aged 40 to 84 years, provided the opportunity to collect information about whether low-dose aspirin therapy (325 mg on alternate days) affects the development or extraction of cataract. There were 173 age-related cataracts among those physicians assigned to aspirin therapy and 180 among those given placebo (relative risk, 0.95; 95% confidence interval, 0.74 to 1.22). Cataract extractions were less frequent in the aspirin than in the placebo group, but this difference was not statistically significant (relative risk, 0.80; 95% confidence interval, 0.56 to 1.15). Among younger men (aged 40 to 59 years), the relative risks were 0.62 (95% confidence interval, 0.40 to 0.94) for cataract development and 0.67 (95% confidence interval, 0.38 to 1.31) for cataract extraction. These randomized trial data tend to exclude any large benefit of aspirin. While the overall findings concerning cataract development seem to be null, the data on extraction of age-related cataract, while not statistically significant, cannot exclude a possible small to moderate benefit of alternate-day aspirin therapy on the extraction of age-related cataract.

Adult↗
PubMed2007

Coverage, utilization and barriers to cataract surgical services in rural South India: results from a population-based study.

OBJECTIVES: To determine the cataract surgical coverage, utilization and barriers to cataract surgery in a rural taluk of south India. STUDY DESIGN: A cross-sectional, community-based survey. METHODS: A house-to-house survey was carried out in 15 villages that were selected by cluster sampling during January to October, 2002. A total of 1505 people aged 50 years and above were tested for visual acuity (VA) and their eyes examined. Cataract surgical coverage was calculated for people and eyes, and for VA levels of <3/60 and <6/60. Information about details of cataract surgery and barriers to cataract surgery were collected using a pre-designed proforma. RESULTS: Cataract surgical coverage was 63% (people) and 51% (eyes) for VA<3/60 compared with 49% (people) and 36% (eyes) for VA<6/60. Of 109 operated eyes, 51.2% of operations were carried out in private hospitals and 33.3% in voluntary/charitable hospitals. Inability to afford the operation (22.9%) and fear of the operation (19.2%) were the main barriers to cataract surgery. CONCLUSIONS: The reasons for underutilization of government hospitals are to be investigated. Awareness of low-cost cataract intraocular lens (IOL) non-governmental organization (NGO) surgery and free-of-cost NGO services available in the region needs to be raised. Barriers to cataract surgical services should be addressed by community-based health-education programmes to improve the uptake of existing services.

Aged↗
PubMed2003

Incidence and progression of cataract in the Melbourne Visual Impairment Project.

PURPOSE: To determine the 5-year incidence and progression of cataract and cataract surgery in the Melbourne Visual Impairment Project. DESIGN: Prospective cohort study. methods: Demographic information including race, sex, age, and education level was collected at baseline. Cortical cataract was defined as 4/16 or greater opacity; progression was defined as a more than 2/16 increase. Nuclear cataract was defined as Wilmer standard grade 2 or higher; progression was defined as more than 0.5 increase. Posterior subcapsular (PSC) cataract was defined as opacity 1 mm(2) or greater; progression was defined as greater than 1 mm(2) increase. results: Of the 3040 participants eligible to attend follow-up examinations, 2594 (85% of those eligible) participated. The mean age of participants at follow-up was 62.5 years, and 55% were female. The percentage of patients who had at least one lens extracted over 5 years increased from 0.5% of those aged 40 to 49 years at baseline to 35.7% of those aged 80 years or more at baseline. The overall incidence of the three types of cataract was as follows: cortical 7.7% (95% confidence limits [CL] = 5.8-9.8), nuclear 16.4% (95% CL = 12.1-20.8), and PSC 7% (95% CL = 5.3-8.7). The overall progression of cataract was cortical 14.3% (95% CL = 10.2-18.3), nuclear 19.3% (95% CL = 15.9-22.7), and PSC 20% (95% CL = 8.7-31.1). The incidence and progression rates increased significantly by age, but the rates were not significantly different by sex. CONCLUSION: These cataract incidence data confirm the public health importance of cataract in Australia. The data also support the need to plan both primary prevention program and adequate surgical services to meet the anticipated increase in demand with the aging population.

Adult↗
PubMed1999

Population-based assessment of the outcome of cataract surgery in an urban population in southern India.

PURPOSE: To assess the outcome of cataract surgery in an urban population in southern India. METHODS: As part of a population-based cross-sectional epidemiologic study, the Andhra Pradesh Eye Disease Study, 2,522 people of all ages, including 1,399 individuals 30 years of age or older, from 24 clusters representative of the population of Hyderabad in southern India underwent a detailed interview and ocular evaluation including logarithm of minimal angle of resolution (logMAR) visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, dilation, cataract grading, aphakia/pseudophakia status, and stereoscopic fundus evaluation. Automated threshold visual fields and slit-lamp and fundus photography were performed when indicated by standardized criteria. Very poor outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity worse than 20/200, and poor outcome was defined as visual acuity worse than 20/60 to 20/200. RESULTS: In subjects 50 years of age or older, after adjustment for age and sex distribution, the rate of having had cataract surgery in one or both eyes was 14.6% (95% confidence interval [CI], 11.4% to 17.8%). Of 131 eyes (91 subjects) that had undergone cataract surgery, 28 (21.4%; 95% CI, 14.4% to 28.4%) had very poor outcome and another 40 (30.5%; 95% CI, 22.6% to 38.4%) had poor outcome. The very poor outcome in 20 (71.4%) of 28 eyes and poor outcome in 23 (57.5%) of 40 eyes could be attributed to surgery-related causes or inadequate refractive correction. With multivariate analysis, very poor outcome as a result of surgery-related causes or inadequate refractive correction was more likely to be associated with intracapsular cataract extraction than with extracapsular cataract extraction (odds ratio, 9.34; 95% CI, 2.49 to 35.06) in subjects belonging to the lowest socioeconomic status (odds ratio, 4.92; 95% CI, 1.16 to 20.93) and with date of surgery 3 or fewer years before the survey than with more than 3 years (odds ratio, 4.52; 95% CI, 1.33 to 15.39). Also, very poor or poor outcome as a result of surgery-related causes or inadequate refractive correction was associated with women (odds ratio, 2.55; 95% CI, 1.06 to 6.16). CONCLUSIONS: The very high rate of very poor and poor visual outcome, predominantly as a result of surgery-related causes and inadequate refractive correction, in this urban population of India suggests that more attention is needed to improve the visual outcome of cataract surgery. In order to deal with cataract-related visual impairment in India, as much emphasis on surgical quality, refractive correction, and follow-up care is necessary as on the number of surgeries.

Adult↗
PubMed2002

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

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

Cataract↗
PubMed1993

Long-term visual results and complications in children with aphakia. A function of cataract type.

PURPOSE: Previous studies of outcome in children with aphakia have approached the data by grouping patients according to features such as age at surgery, type of procedure, or some other common attribute. The purpose of this study is to identify factors predictive for visual outcome and complications in pediatric patients with cataracts. METHOD: One hundred seventy-four eyes in 118 patients underwent lensectomy and anterior vitrectomy for congenital or juvenile cataracts. All received early optical correction, occlusion therapy when necessary, and follow-up for at least 6 months. Visual outcome and complications were analyzed statistically to determine predictive factors. Features analyzed included cataract type, laterality, age at onset, follow-up, and corneal size. RESULTS: Statistical analysis showed that the most important predictor of long-term visual outcome and complications is cataract type. Visual outcome differed significantly by cataract type, with best results in the lamellar and posterior lentiglobus groups. Unilateral cases had a mean acuity lower than bilateral cases. Other factors, such as age at surgery and corneal size, were less predictive but closely linked to cataract type. Complications, such as aphakic glaucoma, also were more closely linked to the type of cataract than to other variables. CONCLUSION: The results indicate that an important determinant of long-term outcome and complications in aphakic children is cataract type. Other features were found to be closely correlated to cataract type and were not independently significant.

Age Factors↗
PubMed1997

Glaucoma and ocular hypertension in pediatric patients with cataracts.

BACKGROUND: The pathogenesis of open-angle glaucoma and ocular hypertension in patients who have undergone surgical correction of their congenital cataracts remains undetermined. This study examines the prevalence of glaucoma and ocular hypertension in a population of patients who did not undergo surgical correction of their pediatric cataracts. METHODS: Fifty-eight eyes of 41 patients had cataracts before 2.5 years of age and were followed up until at least 5 years of age without operative correction. The patients were studied for the following parameters: age at diagnosis, type of cataract, etiology, bilaterality, optic nerve head cup-to-disc ratio, intraocular pressures, and reason why the patient did not undergo an operation. Glaucoma was defined as the presence of glaucomatous optic nerve head cupping with intraocular pressures of greater than 22 mm Hg. Ocular hypertension was defined as intraocular pressures greater than 22 mm Hg with no optic nerve changes. RESULTS: Nine of the 58 eyes had cataracts caused by persistent hyperplastic primary vitreous. The average age to the last intraocular pressure measurement was 19 years (range 5 to 48 years). Closed-angle glaucoma developed in two patients with persistent hyperplastic primary vitreous. Neither open-angle glaucoma nor ocular hypertension developed in any patients. CONCLUSION: Pediatric cataracts not of the persistent hyperplastic primary vitreous type were not associated with ocular hypertension or glaucoma in the absence of surgical cataract correction. In eyes with persistent hyperplastic primary vitreous cataracts, spontaneous closed-angle glaucoma developed in two of nine patients and open-angle glaucoma developed in none. Surgical cataract correction, or the aphakic state that follows such operations, may be responsible for pediatric aphakic glaucoma.

Adolescent↗
PubMed2002

Cataracts in New World camelids (llamas, alpacas, vicuñas, and guanacos).

Cataracts are the most frequently seen lens diseases in New World camelids. The causes of cataracts are unknown in many animals, but cataracts secondary to intraocular inflammation seem to be common. Congenital or juvenile-onset cataracts, if another cause is not apparent, should be considered as possibly caused by heredity, and the affected animals should not be bred. Persistent hyaloid vascular anomalies may also have an important role in cataract formation and could be heritable or caused by an in utero disturbance. Pedigree analyses, test breedings, and possibly DNA studies of llamas with cataracts will be required to determine their potential heritability in these species. Cataract surgery can be done successfully in camelids. It is important to evaluate the posterior segment with B scan ultrasonography before surgery in animals in which the posterior segment previously has not been seen. This evaluation allows the surgeon to better prepare for the presence of hyaloid vascular anomalies. Use of phacoemulsification, gentle tissue handling, liberal use of anti-inflammatory medications and endothelial protectants (BSS + and viscoelastics) during surgery has increased the success rate of this surgery in camelids. Unlike cataract surgery in dogs and horses undergoing, cataract surgery, in camelids seems to be important to remove much of the posterior lens capsule. This removal prevents severe capsular fibrosis and subsequent vision loss. There is evidence that a posterior capsulectomy and anterior viterectomy can help prevent postoperative glaucoma. Research needs to be done to see whether these species have an increased risk for ciliary-block glaucoma.

Animals↗
PubMed1999

A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women.

BACKGROUND: Oxidation of lens proteins plays a central role in the formation of age-related cataracts, suggesting that dietary antioxidants may play a role in prevention. However, the relation between specific antioxidants and risk of cataract remains uncertain. OBJECTIVE: Our objective was to examine prospectively the association between carotenoid and vitamin A intakes and cataract extraction in women. METHODS: A prospective cohort of registered female nurses aged 45-71 y and free of diagnosed cancer was followed; in 1980, 50461 were included and others were added as they became 45 y of age for a total of 77466. Information on nutrient intake was assessed by repeated administration of a food-frequency questionnaire during 12 y of follow-up. RESULTS: During 761762 person-years of follow-up, 1471 cataracts were extracted. After age, smoking, and other potential cataract risk factors were controlled for, those with the highest intake of lutein and zeaxanthin had a 22% decreased risk of cataract extraction compared with those in the lowest quintile (relative risk: 0.78; 95% CI: 0.63, 0.95; P for trend = 0.04). Other carotenoids (alpha-carotene, beta-carotene, lycopene, and beta-cryptoxanthin), vitamin A, and retinol were not associated with cataract in multivariate analysis. Increasing frequency of intakes of spinach and kale, foods rich in lutein, was associated with a moderate decrease in risk of cataract. CONCLUSIONS: Lutein and zeaxanthin and foods rich in these carotenoids may decrease the risk of cataracts severe enough to require extraction.

Adolescent↗
PubMed1998

Management of coincidental corneal disease and cataract.

The status of the cornea is crucial to a good outcome with cataract extraction. Preexisting corneal disease must be managed appropriately to get the high quality results that we have come to expect with modern day cataract surgery. It is now more common to perform cataract surgery on patients who have had previous corneal refractive surgery, and in these patients intraocular lens power calculation is more challenging. Complications following cataract surgery and lens implantation that involve the cornea are uncommon because of advances in surgical techniques. Corneal complications can include mechanical or toxic injury of the endothelium, stripped Descemet's membrane, epithelial toxicity and disruption, infectious keratitis, or epithelial ingrowth. Endothelial cell survival after cataract extraction and lens implantation is still the major concern. Healing of the cornea following clear corneal incisions has become more important, as this technique is used more frequently. There are several recent studies looking at the results of clear corneal incisions performed for cataract surgery. Patients with ocular surface disease still require extra lubrication and management of blepharitis to prevent epithelial toxicity at the time of surgery as well as postoperatively. Clear corneal cataract extraction and lens implantation cause minimal disruption of the conjunctiva, allowing cataract surgery to be performed in patients with severe ocular surface disease such as ocular cicatricial pemphigoid. Overall, modern day cataract extraction is very safe for the cornea.

Cataract↗
PubMed2005

Cataract surgery in Fuchs' dystrophy.

PURPOSE OF REVIEW: Corneal decompensation after cataract surgery can occur in patients with Fuchs' endothelial dystrophy. This paper reviews the pathogenesis of corneal edema in Fuchs' dystrophy, the preoperative and perioperative risk factors for corneal endothelial cell loss during cataract surgery, and indications for cataract surgery alone or cataract surgery combined with keratoplasty for patients with visually significant cataracts and Fuchs' dystrophy. RECENT FINDINGS: Accelerated loss of corneal endothelial cells in Fuchs' dystrophy is multifactorial, with apoptosis and altered gene regulation of aquaporin proteins playing a role. Preoperative factors contributing to decreased endothelial cell count include age, sex, diabetes, a history of ocular trauma or inflammation, and contact lens wear. Intra-operative measures shown to protect endothelial cells include the use of the soft-shell viscoelastic technique for very dense cataracts, efficient cataract removal techniques (phaco-chop, use of oscillatory handpiece), and surgery by an experienced surgeon. A triple procedure should be performed with preoperative corneal epithelial decompensation and considered with preoperative pachymetry greater than 640 mum. Otherwise, it is reasonable to attempt cataract surgery alone with proper patient education. SUMMARY: Fuchs' dystrophy is a progressive disorder. Cataract surgery in the setting of Fuchs' dystrophy can be performed successfully, especially when the surgeon is aware of the preoperative and intraoperative factors that affect the number of functioning endothelial cells. All patients should be aware of the progressive nature of this disease and the possibility of keratoplasty at some point in their lifetime.

Cataract↗
PubMed1997

Cataract surgery reduces subjective visual disability.

PURPOSE: The present study examines the impact of cataract on visual disability (VD) and how cataract surgery alters VD. METHODS: Fifty-six patients were assessed pre- and at 3 months post cataract surgery. Cataract severity was measured with the Lens Opacities Classification System III (LOCS III). Visual disability was assessed by questionnaire. The relationship between LOCS III scores and total VD score was examined with linear regression. Repeated measures analysis of variance was used to determine whether the pre- and postoperative VD scores were different. RESULTS: The VD score was found to relate more closely to the LOCS III score in the least affected eye than in the most affected eye. The VD score is related to nuclear opacity (P = 0.01), and posterior subcapsular cataract (PSC; P = 0.0004), but not to cortical cataract (P = 0.51) (r2 = 0.43). The VD score is significantly greater before surgery (mean +/- SD) 1.81 +/- 0.67) than after (1.19 +/- 0.21; P < 0.001). CONCLUSIONS: Nuclear and PSC cataracts cause more visual disability than cortical cataracts. Visual disability is significantly reduced by cataract surgery.

Cataract↗