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PubMed1997

Alcohol, smoking, and cataracts: the Blue Mountains Eye Study.

OBJECTIVE: To investigate the associations between alcohol consumption, tobacco smoking, and cataract. DESIGN: A population-based, cross-sectional study. SETTING: An urban community in the Blue Mountains, close to Sydney, Australia. PARTICIPANTS: Three thousand six hundred fifty-four people aged 49 to 97 years. The participation rate was 82%. MAIN OUTCOME MEASURES: Smoking history and details of current alcohol consumption were assessed by questionnaire. Lens photographs were taken and graded for presence and severity of cortical, nuclear, and posterior subcapsular cataracts. RESULTS: After adjusting for multiple potential confounders, people who had ever smoked cigarettes had a higher prevalence than nonsmokers of more severe nuclear (adjusted odds ratio [OR], 1.3; 95% confidence interval [CI], 1.1-1.6) and posterior subcapsular (adjusted OR, 1.5; 95% CI, 1.1-2.1) cataracts. The association between pipe smoking and nuclear cataract (adjusted OR, 3.1; 95% CI, 1.5-8.2) was stronger than the association with cigarette smoking. Alcohol consumption was associated with a reduced prevalence of cortical cataract: compared with people who did not drink, the adjusted OR for cortical cataract among people who drank at least 1 drink a day was 0.7 (95% CI, 0.6-0.9). Heavy alcohol consumption (> or =4 drinks a day) was associated with nuclear cataract in current smokers (adjusted OR compared with nondrinkers, 3.9; 95% CI, 0.9-16.6) but not in never smokers. CONCLUSIONS: Consistent with other studies, smoking was associated with a higher prevalence of nuclear and posterior subcapsular cataracts. The only adverse effect of alcohol was among smokers: people who smoked and drank heavily had an increased prevalence of nuclear cataract.

Aged↗
PubMed2003

Descriptive epidemiology of infantile cataracts in metropolitan Atlanta, GA, 1968-1998.

BACKGROUND: Infantile cataract is an important cause of childhood visual impairment. Surgery before 6 weeks of age is recommended for optimal visual outcome. Description of the epidemiologic characteristics of cataracts is important for an improved understanding of the condition. OBJECTIVES: To identify at-risk populations and facilitate successful treatment of patients with infantile cataracts. METHODS: Infants with cataracts diagnosed in the first year of life were identified using the Metropolitan Atlanta Congenital Defects Program, a birth defects surveillance program with active methods of case ascertainment, for the years 1968-1998. Several factors were analyzed, including year of birth, sex, race, maternal age, plurality (single vs multiple gestation), gestational age, birth weight, laterality, seasonality, and age at diagnosis. RESULTS: A total of 199 infants with cataracts were identified, for a rate of 2.03 per 10 000 births. In 117 infants (59%), cataracts occurred as an isolated defect; in 43 infants (22%), cataracts occurred as part of a syndrome; and in 39 infants (20%), additional, unrelated, major birth defects were also present. Rates were higher for low-birth-weight infants (those weighing <1500 g; risk ratio [RR], 6.01; 95% confidence interval [CI], 3.83-9.43) and preterm infants (RR, 1.70; 95% CI, 1.21-2.40). Of the cases that occurred as an isolated defect, 38% were diagnosed after 6 weeks. CONCLUSIONS: This population-based study provides 31 years of data from a diverse US population and allows identification of risk factors for infantile cataracts. The finding that a number of infants with cataracts continue to have their conditions diagnosed after 6 weeks of age emphasizes the need for direct ophthalmoscopic examination of the red reflex in the newborn period to facilitate early detection and improve outcomes.

Abnormalities, Multiple↗
PubMed1994

Protein alterations in age-related cataract associated with a persistent hyaloid vascular system in senescence-accelerated mouse (SAM).

The occurrence of age-related cataract associated with a persistent hyaloid vascular system is the most prominent feature in SAMP9, an inbred strain of Senescence-accelerated Mouse. To examine the cataractogenesis, we analysed protein changes in the process of cataract formation in the lens. The cataractous lenses showed a striking decrease in water-soluble protein content, in contrast to increases in the amount of water insoluble protein. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blots of water-soluble protein in the cataractous lenses showed additional high molecular weight beta-crystallin proteins of about 43 kDa, concomitant with decreased amounts of 29-kDa and 31-kDa beta-crystallins and 21-kDa gamma-crystallin, as compared with findings in normal lenses. Although there was no apparent difference between the patterns of SDS-PAGE of urea-soluble and urea-insoluble proteins isolated from cataractous and normal lenses, slightly increased reactivity of bands around 43 kDa against anti-beta-crystallin antibody was observed in cataractous lenses. The calcium content was elevated and activity of transglutaminase was increased in the cataractous lenses. While the molecular weight of beta-crystallin polymers cross-linked in vitro by exogenous transglutaminase was not completely compatible with those of high molecular weight beta-crystallins observed in the cataractous lenses, these findings do suggest the contribution of this enzyme to production of high molecular weight beta-crystallins and to insolubilization of these proteins in the cataractous lenses in SAMP9.

Aging↗
PubMed1996

Distribution and type of morphological damage in human nuclear age-related cataracts.

The distribution and type of fiber cell damage was evaluated in human age-related nuclear cataracts and in aged normal (non-cataractous) lenses. Ten age-related nuclear cataracts (53 to 89 years old) and four normal lenses (59 to 67 years old) were examined by electron microscopy of fixed Vibratome sections. Images from the adult, juvenile, fetal and embryonic nuclear regions were compared. Each cataractous lens contained a central region of increased light scattering which involved the embryonic and fetal regions with progressively less involvement in the juvenile and adult nuclear regions. Some damaged fiber cells were observed in all specimens, although damage was minor and infrequent in the normal lenses. Degeneration of single or groups of fiber cells was noted in all the adult nuclei of the cataractous lenses, becoming less frequent in the juvenile nuclei. The types of damage included localized voids, multilamellar membrane aggregates, globular bodies, enlarged cells and regions of highly convoluted membranes. The fetal and embryonic nuclei of the cataractous lenses exhibited rare and minor morphological defects, and were virtually identical to the equivalent regions of the normal aged lenses. Examination of cell interfaces in opaque regions of cataractous lenses revealed that the oldest fiber cells sustained apparent membrane loss. Extracellular spaces in the embryonic, fetal and juvenile regions of the cataractous lenses often contained dense deposits, presumably cytoplasmic material lost from adjacent fibers. The results indicate that the region of greatest nuclear opacity, located in the lens center, does not contain any significant cellular damage. This suggests that older fiber cells respond differently to pathological and senescent changes than younger cells made after fetal development. The observed loss of membranes and cytoplasmic material from the oldest fiber cells may be a contributory mechanism in the formation of age-related human nuclear cataracts.

Aged↗
PubMed1996

Modifications in lens protein biosynthesis signal the initiation of cataracts induced by buthionine sulfoximine in mice.

Cataract induction in preweanling mice by L-buthionine sulfoximine (BSO), an inhibitor of glutathione biosynthesis, was correlated with perturbations in vitro protein biosynthesis. These were detected by incubation of late precataract and early cataract lenses with 35S-labeled amino acids, followed by dissection of lenses into capsule-epithelium and decapsulated fiber fractions, further processing of the fibers into water-soluble, urea-soluble and urea-insoluble fractions, and analysis by 2D electrophoresis and fluorography. Most of the protein labeling in control lenses was in the water-soluble fiber and capsule-epithelium fractions (80% and 14% of total cpm, respectively). Labeling in all three fiber fractions was decreased by cataract induction. The urea-insoluble fraction displayed a transient increase in labeled high molecular weight basic protein, as labeling of polypeptide monomers decreased. Densitometric analysis of fluorograms from the water-soluble and urea-soluble fiber fractions revealed a sharp decrease in fiber gamma-crystallin polypeptide labeling preceding and accompanying early cataract development, a delayed decrease in labeling of alpha A-crystallin and increased relative percentage of several labeled beta-crystallin polypeptides, especially in the urea-soluble fraction. By contrast with diminished labeling of the fiber fractions during cataract initiation, protein labeling of the corresponding capsule-epithelium fraction was stimulated dramatically and persisted at reduced levels during early opacification (stage 3), when nearly all of the protein labeling in the lens was found in capsule-epithelium. Capsule-epithelium polypeptides showing increased labeling during cataract initiation included alpha A-crystallin, several acidic polypeptides of M(r) = 40-50 kDa and a group of neutral to mildly acidic polypeptides of M(r) = 20-28 kDa. this transient activation, which was relatively non-specific, may relate to previously reported observations of polyribosome accumulation in lens epithelium during initial development of BSO cataracts. The labeled capsule-epithelium preparations are known to include newly differentiating fibers near the lens equator as well as epithelial cells. Both of these cell populations survive in mature BSO cataracts. It is suggested that modifications of the normal pattern of gene expression in the lens may be involved in initiation of the mouse BSO cataract and its subsequent pattern of development.

Animals↗
PubMed1997

Progression of mouse buthionine sulfoximine cataracts in vitro is inhibited by thiols or ascorbate.

Mouse lens cultures were employed to study the progression of cataracts initiated by injection of buthionine sulfoximine, an inhibitor of glutathione (GSH) biosynthesis. Culture of lenses removed from untreated mice on postnatal day 7, for 48 hr in the presence of 4 mm BSO, resulted in only limited cataractous changes. To enable substantial progression of cataracts in vitro, it was therefore necessary to pretreat the mice with BSO prior to lens culture. A single injection of BSO (4 nmol mg-1 lens), administered on day 7, resulted in >90% depletion of lens GSH within 3 days, but no visible cataractous changes. The clear lenses were incubated for 29+/-1 hr at 37 degrees C in Medium HL-1, supplemented with EGF, insulin and Ca2+, in the presence or absence of BSO, and were scored for cataract development by previously described criteria. In the absence of BSO, only 4 of 10 lenses developed large opacities. However, in the presence of 4 mm BSO, 40 out of 45 experimental lenses developed opacities affecting at least 50% of the lens visual field and were scored as stages 1C-4, depending upon the extent and density of the cataracts. In addition, three lenses had opacities involving 20-50% of the field (stage 1B). By contrast, less than 10% of lenses from untreated mice incubated in the absence of BSO developed opacities. The cataracts developed in 4 mm BSO were accompanied by reduction of lens glutathione levels to <0.010 nmol mg-1 lens. They were almost completely prevented by 1 mm ascorbate, 2 mm GSH, 2 mm GSH monoethyl ester and 2 mm cysteamine. GSH and GSH ester maintained lens glutathione content between 0.1 and 0.2 nmol mg-1 in the presence of BSO, whereas ascorbate did not prevent near-total GSH depletion. The prevention of cataracts by thiols and ascorbate was confirmed by lens Na/K ratios not significantly different from those in control lenses. The above combination of GSH depletion in vivo by a single injection of BSO, followed 3 days later with lens culture in the presence of BSO, may yield a useful system to elucidate and control the biochemical mechanisms involved in oxidative cataract induction by this GSH-depleting agent.

Animals↗
PubMed1999

Fourier analysis of textural variations in human normal and cataractous lens nuclear fiber cell cytoplasm.

Variations in cytoplasmic texture of human normal and cataractous lenses were investigated with Fourier analysis. Fixed Vibratome sections of six normal transparent human lenses (age range 55-72 years) and six nuclear cataractous lenses (age range 66-89 years) were examined using transmission electron microscopy. Images were taken of the fiber cell cytoplasm and examined using linear optical density scans, Fourier transforms and autocorrelation analysis. The cytoplasm of normal human lenses was found to be smooth and homogeneous. Radially-averaged plots of Fourier transforms revealed a broad band of intensity over the range of 15-50 nm. Four of the six cataracts also had homogeneous cytoplasm without substantial density variations. Fourier transforms and radially-averaged plots were similar to those of the normal, although slightly lower in intensity for components</=20 nm. Two of the six cataracts had a slightly granular or textured cytoplasm that showed significant density variations. Fourier transforms and radially-averaged plots revealed significant intensity in the range>/=200 nm. Autocorrelation analysis supported the data obtained by Fourier transforms. Radially-averaged plots of the autocorrelation resultant displays detected only small structural units in the normal and non-textured cataractous cytoplasm, whereas larger structural units were detected in the textured cataractous cytoplasm. The appearance of the textured cataractous cytoplasm suggests that redistribution or loss of protein may be the cause of density variations in these types of cataracts. Importantly, these results indicate that some nuclear cataracts do not contain spatial fluctuations in the cytoplasm large enough to cause significant light scattering. The data suggest that nuclear cataractogenesis is a multi-factorial process involving minor alterations in cellular structure.

Aged↗
PubMed1982

[Glutathione content of the lens in various forms of cataract].

Both the electrolyte ratio (K greater than Na) and high glutathione content of the lenses are generally undisturbed in the brunescent nuclear cataract (cataracta brunescens), the primary grey nuclear cataract, and the supranuclear cataract (senile cortical cataract). The electrolyte ratio (Na greater than K) and greatly decreased glutathione content are also grossly pathological in the subcapsular cataract (cataracta complicata, posterior subcapsular cataract), especially in connection with a secondary grey nuclear cataract, the mature cataract (cataracta matura), and the intumescent cataract. Alteration of the electrolyte concentrations and the glutathione content may be the results of physical, anatomical, and various metabolic disorders.

Adult↗
PubMed2005

Changes in the lens epithelium with respect to cataractogenesis: light microscopic and Scheimpflug densitometric analysis of the cataractous and the clear lens of diabetics and non-diabetics.

BACKGROUND: We compared the human lens documented, using the Scheimpflug densitometry, with the light microscopic changes in the epithelium of the anterior central lens in patients with age-related cataract and diabetes mellitus type II and verified the findings on the control tissue of the clear eye lens. We wanted to determine the relevance of the lens epithelium in cataract formation in type II diabetics compared to non-diabetics. MATERIALS AND METHODS: One hundred fifty central lens capsules (138 cataract and 12 clear lenses) of type II diabetics (n=77, 45 female, 32 male) and non-diabetics (n=73, 41 female, 32 male) were examined by light microscope, regarding defined histomorphological parameters. Further criteria were duration of diabetes, diabetic retinopathy, cataract (PENTACAM, scheimpflug densitometric definition), protein content in the aqueous humour (laser flare meter 500 KOWA, tyndallometry), different blood parameters and glucose content in the aqueous humour. RESULTS: The mean cell density in the cataractous lens in type II diabetics was 3,951+/-528 cells/mm(2) and in non-diabetics 4,329+/-580 cells/mm(2) (P<0.001); in the clear lens it corresponded to 4,593+/-409 cells/mm(2) (type II diabetics) and 4,894+/-333 cells/mm(2) (non-diabetics, P=0.207). The cell density of the cataractous lens in type II diabetics (P=0.005) and in non-diabetics (P=0.035) is smaller than that of the clear lens. The cell area of the lens epithelium in the cataractous diabetic lens is larger (P<0.001) and the nucleus-plasma ratio is lower (P<0.001) than those of the clear non-diabetic lens. The increase in damage of the lens epithelium correlates with the decrease of cell density (P< 0.001), the increase of nucleus area and volume (P< 0.001), and the decrease of nucleus-plasma ratio (P< 0.001). Risk factors for the decrease of cell density are advanced age (P=0.015), type II diabetes (P=0.01), increase in glucose content in the aqueous humour (P=0.014), increase in blood sugar (P=0.003) and increase in glycosylated haemoglobin (P=0.039). CONCLUSIONS: The lens epithelium is primarily damaged in type II diabetics who develop age-related cataract. This might play an important role in cataract formation.

Adult↗
PubMed2001

Effect of cataract surgery on intraocular pressure in eyes with previous trabeculectomy.

PURPOSE: To determine the course of the intraocular pressure in eyes in which cataract surgery was performed after trabeculectomy. METHODS: This was a retrospective study of consecutive patients who were scheduled for routine cataract surgery. The patients had previously undergone glaucoma filtering surgery. Pre- and postoperative data were evaluated. Both the status of glaucoma and the increase in visual acuity were monitored. RESULTS: Patients operated on over a six-year period were enrolled. The mean interval between glaucoma surgery and cataract surgery was 58.1 months. The mean duration of follow-up after cataract surgery was 31.4 months, with a minimum of 12 months. The mean central visual acuity increased by 4 lines. Before cataract surgery, 53% of the eyes had complete success (group 1), while 28% had qualified success (group 2) and the remaining 19% were failures (group 3). From group 1, 61% remained a complete success until the last visit. No eye of group 1 developed a failure. In group 2, 23% were a complete success at the final follow-up, while 4% failed. In group 3, only 35% were failures while the remaining 65% were a complete or qualified success. CONCLUSIONS: Eyes with a well-controlled intraocular pressure following trabeculectomy seem to have a favorable prognosis after subsequent cataract surgery. Eyes with qualified success or failure before cataract surgery have a slight chance of improvement in intraocular pressure control. Cataract surgery had no markedly negative effect on the intraocular pressure overall. Performing trabeculectomy and cataract surgery at different times may still be a feasible option as opposed to combined procedures.

Adult↗
PubMed2002

Onset of cataract in early infancy associated with a 32G-->C transition in the iron responsive element of L-ferritin.

UNLABELLED: We describe the onset of cataract in early infancy in a family with hereditary hyperferritinaemia-cataract syndrome. The two probands presented with isolated hyperferritinaemia and had developed cataracts at the age of 18 months. Two members of their family with high ferritin levels (1270-1450 microg/l) had suffered from cataract since childhood. The mutation responsible was a 32G-->C change in the lateral bulge of the stem structure of the iron responsive element of the L-ferritin subunit gene. Mutations at this level cause particularly high ferritin levels, whereas the age of cataract onset and its severity are controversial subjects. In our family, early ophthalmic examination ruled out the possibility that cataract was due to age-related persistence of high ferritin levels in the lens and suggested that other factors may modulate the phenotype. CONCLUSION: cataract may appear early in hereditary hyperferritinaemia-cataract syndrome and this syndrome should be suspected and ferritin levels measured in all cases of cataract in children, even when the onset is in early infancy.

Adolescent↗
PubMedDate not supplied

Dominant cataract and recessive specific locus mutations in offspring of X-irradiated male mice.

Male mice were X-irradiated with 3.0 + 3.0 Gy or 5.1 + 5.1 Gy (fractionation interval 24 h). The offspring were screened for dominant cataract and recessive specific locus mutations. In the 3.0 + 3.0-Gy spermatogonial treatment group, 3 dominant cataract mutations were confirmed in 15 551 offspring examined and 29 specific locus mutations were recovered in 18 139 offspring. In the post-spermatogonial treatment group, 1 dominant cataract mutation was obtained in 1120 offspring and 1 recessive specific locus mutation was recovered in 1127 offspring. The induced mutation rate per locus, per gamete, per Gy calculated for recessive specific locus mutations is 2.0 X 10(-5) in post-spermatogonial stages and 3.7 X 10(-5) in spermatogonia. For dominant cataract mutations, assuming 30 loci, the induced mutation rate is 5.0 X 10(-6) in the post-spermatogonial stages and 1.1 X 10(-6) in spermatogonia. In the 5.1 + 5.1-Gy spermatogonial treatment group, 3 dominant cataract mutations were obtained in 11 205 offspring, whereas in 13 201 offspring 27 recessive specific locus mutations were detected in the spermatogonial group. In the post-spermatogonial treatment group no dominant cataract mutation was observed in 425 offspring and 2 recessive specific locus mutations were detected in 445 offspring. The induced mutation rate per locus, gamete and Gy in spermatogonia for recessive specific locus mutations is 2.8 X 10(-5) and for dominant cataract mutations 0.9 X 10(-6). In post-spermatogonial stages, the mutation rate for recessive specific locus alleles is 6.2 X 10(-5). In the concurrent untreated control group, in 11 036 offspring no dominant cataract mutation and in 23 518 offspring no recessive specific locus mutation was observed. Litter size and the number of carriers at weaning have been determined in the confirmation crosses of the obtained dominant cataract mutants as indicators of viability and penetrance effects. Two mutants had a statistically significantly reduced litter size and one mutant had a statistically significantly reduced penetrance.

Animals↗
PubMed2005

Age-related cataract progression in five mouse models for anti-oxidant protection or hormonal influence.

Five mouse models with known alterations of resistance to oxidative damage were compared by slit lamp examination for the presence and degree of advancement of age-related cataract in young adult and old animals along with wild type controls. A group of young and old normal C57BL/6Jax mice were examined first to constitute a standard, and they were found to exhibit age-related cataract development. Following this, four models on the C57BL/6 background with imposed genetic alterations affecting anti-oxidant enzyme presence or activity, and one outbred model in which a deletion blocked the growth hormone/IGF-1 axis, were similarly examined. There was no evidence of foetal or juvenile cataract development in any of these models, and an age-related severity for lens opacities was shown between young adult and old mice in all groups. Model 1, mice null for the anti-oxidant gene glutathione peroxidase-1 (GPX1) had significantly advanced cataracts in older mice vs. same age controls. In mouse model 2 hemizygous knockout of SOD2 (MnSOD) did not affect age-related cataract development. In model 3 combining the GPX1 and SOD2 deficiencies in the same animal did not advance cataract development beyond that of the GPX1 null alone. In model 4 the addition of anti-oxidant protection in the lens by transfection of human catalase targeted only to the mitochondria resulted in a significant delay in cataract development. The 5th model, growth hormone receptor knockout (GHR-/-) mice, also demonstrated a significant reduction in age-related cataract development, as well as dwarfism. These findings, in general, support the oxidative theory of age-related cataract development. The exception, the partial deletion of SOD2 in the hemizygous KO model, probably did not represent a sufficiently severe deprivation of anti-oxidant protection to produce pathologic changes in the lens.

Aging↗
PubMed2006

The natural history of glaucoma and ocular hypertension after pediatric cataract surgery.

INTRODUCTION: We sought to define the prevalence and natural history of ocular hypertension and glaucoma for at least a 10-year period after pediatric cataract surgery. METHODS: We conducted a prospective observational study of patients who received pediatric cataract surgery. Inclusion criteria included 2 directed ophthalmologic examinations performed at a minimum of 5 and 10 years after surgery. RESULTS: A total of 63 patients (22 with bilateral cataracts and 41 with unilateral cataracts) were examined at a median of 15.1 year (range, 10.3-21.3 years) after surgery. A majority of the subjects had glaucoma or ocular hypertension (ie, 59%; 37/63). Nineteen percent (12/63) had glaucoma (5/22 with bilateral cataracts and 7/41 with unilateral cataracts). Approximately half (7/12) had developed glaucoma during the first 5-year observational period and the remainder (5/12) developed it during the following observational period. Forty percent (25/63) of the patients had ocular hypertension in at least one aphakic eye (9/23 with bilateral cataracts and 16/40 with unilateral cataracts). The rate of progression from ocular hypertension to glaucoma over a mean observational period of 7.2 years (range, 6.2-8.1 years) was 23% (5/22). DISCUSSION: Patients who receive surgery for pediatric cataracts are at very high risk of developing ocular hypertension and glaucoma. Patients can develop late-onset glaucoma and ocular hypertension more than 10 years after surgery. Years of ocular hypertension may precede the diagnosis of late-onset glaucoma.

Adolescent↗
PubMed2006

Incidence and risk factors for glaucoma after pediatric cataract surgery with and without intraocular lens implantation.

PURPOSE: We sought to report the incidence of glaucoma in the eyes of children who underwent cataract surgery with and without intraocular lens implantation and to report the risk factors for developing glaucoma. METHODS: We undertook a retrospective review of pediatric cataract surgery charts, excluding traumatic cataract, aniridia and Lowe syndrome, steroid-induced cataract, lens subluxation, uveitis, retinoblastoma, radiation-induced cataract, retinopathy of prematurity, secondary IOL implantation, and patients with less than 1 month of postoperative follow-up. RESULTS: After pediatric cataract surgery, 10 (3.8%) of 266 eyes with primary intraocular lens implantation were diagnosed with glaucoma, whereas 8 (17.0%) of 47 aphakic eyes were diagnosed with glaucoma. During the initial analyses, we noted that all of the patients who developed glaucoma underwent cataract surgery when they were 4.5 months or younger. For all patients who underwent surgery during the first 4.5 months of their life, the glaucoma incidence was 24.4% (10/41) in children with pseudophakic eyes and 19.0% (8/42) in age-matched children with aphakic eyes (risk ratio=1.1, CI=0.7-1.9; P=.555). In patients who underwent surgery during the first 4.5 months of their life, the average age of the patients who developed glaucoma was not significantly different than those who did not develop glaucoma in pseudophakic eyes (2.0 months+/-1.4 vs. 1.9 months+/-1.0, P=.700) or aphakic eyes (2.6 months+/-1.5 vs. 1.4 months+/-0.9, P=.070). The corneal diameter of the eyes that developed glaucoma versus eyes that did not was not significantly different in patients with pseudophakic eyes (P=.860) or aphakic eyes (P=.254). Glaucoma was diagnosed in patients at an average of 8.6 months and 117.9 months after cataract surgery in those with pseudophakic eyes and aphakic eyes, respectively. CONCLUSIONS: Patients undergoing cataract surgery at an early age are at high risk for the development of glaucoma with or without an intraocular lens implant.

Age Factors↗
PubMed2004

Relative afferent pupillary defect in patients with asymmetric cataracts.

PURPOSE: To prospectively investigate the incidence, associated factors, and prognostic significance of relative afferent pupillary defects (RAPDs) in eyes with less severe cataract than in contralateral eyes. SETTING: Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Seoul, Korea. METHODS: Forty patients with asymmetric cataract and a differences of 3 or more lines of Snellen visual acuity between eyes had detailed ophthalmic examinations including visual acuity, slitlamp evaluation, a swinging flashlight test before and after cataract surgery, and color vision assessment. RESULTS: Twenty-three of 40 patients (58%) had an RAPD (mean extent 0.39 log unit +/- 0.17 [SD]) in the eye with less severe cataract. The RAPD resolved or switched to the other eye after cataract extraction. All 5 patients with a unilateral totally opaque lens had a contralateral RAPD, confirming the relationship between totally opaque cataracts and RAPDs. The difference in visual acuity between the 2 eyes did not differ between patients with RAPD and those without RAPD. There was no association between the presence of RAPD and postoperative visual acuity. CONCLUSIONS: More than half the patients with asymmetric cataract had an RAPD that resolved in the eye with less severe cataract after cataract extraction. All patients with a unilateral totally opaque lens had an RAPD. The presence of a preoperative RAPD was not related to postoperative visual acuity.

Adult↗
PubMed2005

Age and sex profile of patients having cataract surgery between 1986 and 2003.

PURPOSE: To investigate the age and sex profile of patients having cataract surgery by 2 consulting ophthalmic surgeons over an 18-year period. SETTING: Waterford Regional Hospital, Waterford, Republic of Ireland. METHODS: Operating theater logbooks were reviewed, and all patients having cataract surgery between January 1986 and December 2003 in Waterford Regional Hospital were identified. The following data were recorded for each patient: age, sex, and type of cataract surgery. Patients having cataract surgery were categorized according to the date of the procedure as follows: Group 1: 1986-1991; Group 2: 1992-1997; Group 3: 1998-2003. RESULTS: Eight thousand two hundred fifty-seven patients who had cataract surgery during the study period were identified. The mean age of patients was 72.32 years +/- 12.21 (SD) and 74.89 +/- 11.03 years of men and women, respectively. The age profile of patients having cataract surgery was statistically comparable in Groups 1, 2, and 3 (mean age; Group 1: 72.33 +/- 13.03 years; Group 2: 73.72 +/- 11.78 years; Group 3: 74.57 +/- 10.69 years), indicating that the age profile of patients did not change significantly with the passage of time (analysis of variance, F<1). The proportion of women having cataract surgery rose significantly over the duration of the study period (1986-1991: 55.13%; 1992-1997: 57.68%; 1998-2003: 59.43% (chi-square test, P<.01)). CONCLUSIONS: The age profile of 8257 patients having cataract surgery did not change over the 18-year study period. A small but significant increase in the proportion of women having cataract surgery was noted in latter years. This data is useful to those involved in health care planning.

Adolescent↗
PubMed2006

Determining whether delayed nonarteritic ischemic optic neuropathy associated with cataract extraction is a true entity.

PURPOSE: To evaluate cases of delayed nonarteritic anterior and posterior ischemic optic neuropathy after cataract extraction and to evaluate the need for centralized prospective reporting of nonarteritic ischemic optic neuropathy after cataract extraction. SETTING: Neuro-ophthalmology Clinics, University of Colorado Health Sciences Center and Denver Veterans Affairs Medical Center, Denver, Colorado, USA. METHODS: A retrospective review of all patients referred to the Neuro-ophthalmology Divisions, University of Colorado Health Sciences Center and Denver Veterans Affairs Medical Center, from January 2001 to October 2005 was performed. All patients with a diagnosis of nonarteritic anterior or posterior ischemic optic neuropathy were identified. Patients with ischemic optic neuropathy that occurred between 2 months and 12 months after cataract extraction were selected for evaluation. RESULTS: Six eyes with nonarteritic ischemic optic neuropathy that occurred 2 to 6 months after cataract extraction in 4 patients (2 bilateral nonarteritic ischemic optic neuropathy) and 1 eye with nonarteritic ischemic optic neuropathy that occurred after 6 months in 1 patient were identified. One patient had nonarteritic ischemic optic neuropathy in 1 eye 3 months after cataract extraction and 4 years later had nonarteritic ischemic optic neuropathy in the fellow eye 5 months after cataract extraction. Follow-up after the last cataract extraction was 1 to 3 years for all patients. CONCLUSIONS: Although an association between cataract extraction and delayed nonarteritic anterior and posterior ischemic optic neuropathy has been suggested, current data do not support a causal relationship. In addition, the window of postoperative susceptibility for delayed ischemic optic neuropathy after cataract extraction is unclear.

Aged↗