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Smoking and cataract: review of causal association.

Several risk factors for the development of cataract have been identified. This review evaluates epidemiologic literature that has examined tobacco smoking as a risk factor for cataract formation using established causality criteria. Twenty-seven studies were included in this review. Evidence suggests that smoking has a 3-fold increase on the risk for incident nuclear cataract development. There was also evidence of dose response, temporal relationship, and reversibility of effect. There was limited evidence of an association between smoking and posterior subcapsular cataract, but little or no association with cortical cataract. Thus, the literature review indicated a strong association between smoking and the development of cataract, particularly nuclear cataract. The association fulfills the established criteria for causality. The association between smoking and other types of cataract is less distinct and requires further evaluation.

Cataract↗

Ingestion of IH636 grape seed proanthocyanidin extract to prevent selenite-induced oxidative stress in experimental cataract.

PURPOSE: To investigate whether dietary supplementation with IH636 grape seed proanthocyanidin extract (GSPE) prevents selenite-induced cataract. SETTING: Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey. METHODS: Thirty Spraque-Dawley rat litters were put randomly into 3 groups. In group 1 (n = 10), sodium selenite (30 nmol/g body weight) was injected subcutaneously on postpartum day 10. In group 2 (n = 10), sodium selenite (30 nmol/g body weight) was injected on postpartum day 10 and oral GSPE (100 mg/kg body weight) was given for 1 week after sodium selenite injection. Only subcutaneous saline was injected in group 3 (control, n = 10). The development of cataract was assessed for 3 weeks, and its density was graded and photographed with a slitlamp. Removed rat lenses were analyzed for glutathione (GSH) and malondialdehyde (MDA). RESULTS: All of the rats in group 1 had cataract between stage 6 and stage 3. In group 2, only 5 of 10 eyes had cataract between stage 3 and stage 2 and no cataract occurred in the remaining 5 rats. The difference between mean cataract stages in group 1 and group 2 was significant (P<.05). The mean GSH level in group 1 was significantly lower than in group 2 and controls (P<.05). The mean MDA level in group 1 was significantly higher than in group 2 and controls (P<.05). CONCLUSIONS: IH636 grape seed proanthocyanidin extract effectively suppressed cataract formation in rats. Routine consumption of grape seed proanthocyanidin extract in the form of food or dietary supplement may offer a prophylactic measure against onset and progression of cataract.

Administration, Oral↗

Posterior capsule opacification after combined cataract surgery and vitrectomy.

PURPOSE: To compare the degree of posterior capsule opacification (PCO) after combined cataract surgery and vitrectomy and after cataract surgery alone in age-matched control patients and in patients with and without diabetes mellitus (DM). SETTING: Sugita Eye Hospital, Nagoya, Japan. METHOD: In a prospective study, patients were divided into 2 groups: those having cataract surgery alone (cataract group) and those having combined cataract and vitrectomy surgery (combined group). The 2 groups were further divided into patients without DM (non-DM subgroup) and patients with DM (DM subgroup). The PCO rates were determined 3, 6, and 12 months after surgery using the POCO system. RESULTS: In the cataract group, the non-DM subgroup and the DM subgroup each comprised 42 eyes of 42 patients. In the combined group, the non-DM subgroup comprised 26 eyes of 26 patients and the DM subgroup, 23 eyes of 23 patients. In the cataract group, the PCO rate in the DM subgroup was significantly higher than in the non-DM subgroup at every postoperative examination (P<.05). In the non-DM subgroup, the PCO rate was significantly higher at every postoperative examination in patients having combined surgery than in patients having cataract surgery alone (P<.05). In the combined group, the PCO rate did not differ significantly between the non-DM subgroup and the DM subgroup. CONCLUSION: Even patients without DM must be carefully monitored for PCO development after combined surgery.

Aged↗

The epidemiology of acute endophthalmitis after cataract surgery in an Asian population.

OBJECTIVE: To describe the incidence, risk factors, and clinical outcome of acute endophthalmitis after cataract extraction in a multiethnic Asian population. DESIGN: Prospective case series. PARTICIPANTS: All patients with cataract extractions performed at the Singapore National Eye Center from 1996 to 2001. METHODS: Data on patients with acute endophthalmitis cases presenting within 6 weeks after cataract surgery were prospectively collected in a standardized format. MAIN OUTCOME MEASURES: Acute endophthalmitis after cataract surgery. RESULTS: During the study period, 44 803 cataract operations (25 476 phacoemulsification and 19 327 extracapsular cataract extractions) were performed. There were 34 cases of acute endophthalmitis (average annual incidence of 0.076%), 21 of which were culture positive (average annual incidence of 0.040%). In multivariate analysis, risk of endophthalmitis was associated with phacoemulsification technique (relative risk [RR], 1.9; 95% confidence interval [CI], 0.9, 3.9; P = 0.10 for all endophthalmitis cases; RR, 3.1; 95% CI, 1.1, 9.4; P = 0.04 for culture-positive endophthalmitis cases) and the occurrence of intraoperative posterior capsule rupture (RR, 8.0; 95% CI, 3.1, 20.7; P<0.001 for all endophthalmitis cases; RR, 11.0; 95% CI, 3.7, 23.9; P<0.001 for culture-positive endophthalmitis cases). After a median follow-up of 234 days, half of the eyes achieved a final best-corrected visual acuity of 20/40. Predictors of this visual acuity included baseline acuity of counting fingers or better, culture-negative endophthalmitis, or infection caused by coagulase-negative Staphylococcus. CONCLUSION: The incidence of acute endophthalmitis after cataract extraction in Singapore is consistent with rates reported elsewhere. The phacoemulsification technique is associated with a higher risk of acute culture-positive endophthalmitis compared with extracapsular cataract extraction. Intraoperative posterior capsule rupture is associated with an 8- to 11-fold higher risk of acute endophthalmitis, suggesting that these eyes should be closely monitored for signs of infection in the immediate postoperative period.

Acute Disease↗

Cortical, but not posterior subcapsular, cataract shows significant familial aggregation in an older population after adjustment for possible shared environmental factors.

PURPOSE: To quantify the risk for age-related cortical cataract and posterior subcapsular cataract (PSC) associated with having an affected sibling after adjusting for known environmental and personal risk factors. DESIGN: Sibling cohort study. PARTICIPANTS: Participants in the ongoing Salisbury Eye Evaluation (SEE) study (n = 321; mean age, 78.1+/-4.2 years) and their locally resident siblings (n = 453; mean age, 72.6+/-7.4 years) were recruited at the time of Rounds 3 and 4 of the SEE study. INTERVENTION/TESTING METHODS: Retroillumination photographs of the lens were graded for the presence of cortical cataract and PSC with the Wilmer grading system. The residual correlation between siblings' cataract grades was estimated after adjustment for a number of factors (age; gender; race; lifetime exposure to ultraviolet-B light; cigarette, alcohol, estrogen, and steroid use; serum antioxidants; history of diabetes; blood pressure; and body mass index) suspected to be associated with the presence of cataract. RESULTS: The average sibship size was 2.7 per family. Multivariate analysis revealed the magnitude of heritability (h(2)) for cortical cataract to be 24% (95% CI, 6%-42%), whereas that for PSC was not statistically significant (h(2) 4%; 95% CI, 0%-11%) after adjustment for the covariates. The model revealed that increasing age, female gender, a history of diabetes, and black race increased the odds of cortical cataract, whereas higher levels of provitamin A were protective. A history of diabetes and steroid use increased the odds for PSC. CONCLUSIONS: This study is consistent with a significant genetic effect for age-related cortical cataract but not PSC.

Aged↗

Molecular genetic basis of inherited cataract and associated phenotypes.

Congenital cataract is a leading cause of visual disability in children. Inherited isolated (non-syndromic) cataract represents a significant proportion of cases and recently many causative genetic mutations have been identified. Inherited cataract is known to be clinically and genetically heterogeneous. Eleven clear-cut cataract phenotypes have been described. Cataract may be inherited as autosomal dominant, autosomal recessive, or X-linked recessive traits, and 12 loci and 15 specific genes associated with inherited isolated cataract have been identified to date; it is likely that more genes remain to be discovered. The identification of remaining genes will not only improve our understanding of the mechanism of cataract formation but will shed new light on the developmental biology and biochemistry of the lens. Furthermore, it is possible that some of these genes will be implicated in the more common age related cataract, which also has a genetic component to its etiology.

Cataract↗

Cataract and hearing loss in a population-based study: the Beaver Dam studies.

PURPOSE: Cataract and hearing loss are each common at older ages and together may influence the ability to function independently and affect the sense of well-being. For these reasons, we sought to estimate the risk factors for comorbidity of age-related cataract and hearing loss. METHODS: A cross-sectional evaluation of a population-based cohort of older adults was conducted in Beaver Dam, Wisconsin, for presence of age-related cataract and hearing loss. The study evaluation included taking standardized medical histories, measuring blood pressures, and obtaining blood specimens. Standardized photographs, which were graded according to well-defined protocols to assess the presence of nuclear, cortical or posterior subcapsular cataract, were taken. Audiometric testing was performed according to well-defined study protocols. RESULTS: Any type of cataract in combination with hearing loss in either ear was frequent, occurring in 27.8% of the population overall and increasing consistently with age. Nuclear and posterior subcapsular cataract in combination with hearing loss occurred more often in men. Lifestyle factors that were associated with at least one cataract-hearing loss end point in at least one sex were history of heavy drinking and smoking. CONCLUSIONS: In this community, older adults appear to be at high risk of cataract and hearing loss. Although risk is strongly associated with age, some elective exposures appear to influence risk. It is possible that modification of certain lifestyle habits may alter these risks.

Age Factors↗

Autosomal dominant zonular cataract with sutural opacities in a four-generation family.

PURPOSE: We identified and examined four generations of a family with coexisting autosomal dominant zonular cataracts and sutural opacities and sought to determine their genetic basis. METHODS: Twenty-four of the 48 members in the family were examined. Systemic and ocular histories were obtained, and a detailed ophthalmic examination was performed. From each individual, 20 ml of blood was drawn for linkage studies with microsatellite markers in regions to which zonular cataracts had previously been localized (chromosomes 1, 2, and 16). RESULTS: Individuals of the first generation were reportedly asymptomatic. Several members of the second generation had morphologically identical zonular cataracts. Affected members of the third generation showed morphologic heterogeneity, with the zonular opacity varying from a uniform lamella to a segregation of dots. A high degree of consanguinity in the second generation suggested recessive inheritance with a pseudodominant inheritance pattern. However, examination of one member of the asymptomatic first generation disclosed senile cataractous changes superimposed on a faint zonular cataract enclosing sutural opacities and a pulverulent fetal nucleus. The latter findings were reconfirmed to be present in affected members of all generations, suggesting an autosomal dominant mode of inheritance. Initial efforts at linkage analysis excluded the gene locus causing this cataract from the Duffy, haptoglobin, and gamma-crystallin regions. CONCLUSIONS: The cataract in this family is both phenotypically and genetically distinct from previously described and mapped cataracts.

Adolescent↗

Pupillography of relative afferent pupillary defect contralateral to monocular mature cataract.

CASE REPORT: Few previous reports have documented a relative afferent pupillary defect (RAPD) in the eye contralateral to a dense unilateral cataract. We report pupillographic findings of a 55-year-old man with a mature cataract in the left eye and an RAPD in the right eye, whose RAPD disappeared after cataract surgery in his left eye. Using binocular infrared video pupillography, we recorded the pupillary responses of the two eyes simultaneously during an automated swinging flashlight test before and after the cataract surgery. The average contraction amplitude in both eyes was significantly larger when the unaffected left eye was stimulated before the cataract surgery, but this difference in contraction amplitude disappeared after surgery on the left eye. COMMENTS: An RAPD was shown quantitatively with a pupillographic technique in the eye contralateral to a mature cataract, confirming previous studies that indicate a dense cataract may produce a small but definite RAPD in the contralateral eye. Such an RAPD associated with a dense cataract must be taken into consideration when evaluating patients with unilateral visual loss.

Cataract↗

Decreased caspase-3 activity in human lens epithelium from posterior subcapsular cataracts.

Apoptosis has been implied in normal lens development in the embryo as well as in lens fibre differentiation. It has also been suggested to play a role in non-congenital cataract and in the formation of posterior subcapsular opacification, but data on the presence of apoptosis in human lens epithelium from cataractous lenses are scarce and conflicting. The present study aimed to investigate apoptosis in lens epithelium from patients undergoing cataract surgery. The amount of apoptosis detected was correlated to age, gender, type of cataract, medications and disease. Moreover, the ability of human lens epithelial cells in culture to respond to the apoptosis-inducing agent staurosporin by activation of caspase-3 was investigated. Human lens capsulotomy specimens were collected immediately after surgery, frozen and later analysed with respect to caspase-3 activity, using the fluorogenic substrate Ac-DEVD-AMC. Generally, the activity of caspase-3 detected in this manner was very low and in 23% of the specimens it was non-detectable. However, there were differences in caspase activity between lens epithelial cells from different types of cataract, where samples from lenses with posterior subcapsular cataract exhibited significantly lower caspase-3 activity than lenses with a clear subcapsular zone. Age, gender or medications did not show any correlation with caspase activity but human capsulotomy specimens from diabetic patients exhibited significantly lower caspase-3 activity. Staurosporin caused a concentration-dependent increase in caspase activity in cultured human lens epithelial cells and the amount of apoptotic nuclei was also increased as viewed by staining with Hoechst 33342, showing chromatin condensation and nuclear fragmentation. Similar results were obtained when fresh human lens capsulotomy specimens were exposed to 1000 nM staurosporin for 24 hr. To conclude, the present data indicate that human lens epithelial cells have the ability to respond to apoptosis-inducing agents with caspase-3 dependent apoptosis, and that even though the general level of apoptosis in human lens epithelium in vivo is low, there are differences in caspase-3 activity levels in lenses with or without posterior subcapsular cataract. The latter finding supports previous studies indicating that this type of cataract may result from defective differentiation, in which apoptosis may play an important role.

Apoptosis↗

Epithelial transdifferentiation and cataract in the human lens.

Anterior subcapsular cataracts cause a serious loss of vision and are normally associated with ocular trauma, inflammation or clinical skin conditions. They appear to be accompanied by epithelial cell growth and transdifferentiation where unscheduled production of a number of proteins, including alpha smooth muscle actin (alpha-sma), occurs. Clinical studies have also revealed an up-regulation of the TGFbeta signalling pathway in such cataracts. The present study, using phase contrast and immunofluorescent techniques, was undertaken to investigate the extent of alpha-sma expression in traumatic cataracts, in capsulorhexis specimens obtained during cataract surgery and in aged human lenses from donor eyes. The donor lenses were also exposed to trauma or TGFbeta in culture to observe their relative contribution to alpha-sma production. Dense anterior subcapsular cataracts were relatively rare (<1%), but all showed a pronounced up-regulation of alpha-sma, which was located both in anterior cells of normal appearance and in nucleated fibroblastic cells lying beneath the anterior epithelium. Surprisingly, more than 50% of capsulorhexis specimens from mature cataracts showed expression of alpha-sma, although to a limited extent. Alpha-sma was not expressed in any of the clear donor lenses and culture for 8 days in EMEM did not induce expression. Interestingly, unlike their young animal counterparts, human lenses failed to show the presence of alpha-sma when exposed to 10 ng ml(-1) TGFbeta. However, after culture, lenses with pre-existing cortical opacities did express alpha-sma, as did clear lenses subjected to injury or trauma. It appears that the greater the stress, the greater is the expression of alpha-sma. Cataract, and especially cortical cataract, should therefore be seen as associated with stress-induced signalling pathways in the lens that lead to the transdifferentiation of the anterior epithelial cells.

Actins↗

Cataract surgery in South West Thames Region: an analysis of age-adjusted surgery rates and length of stay by district.

Although the frequency of cataract surgery has increased in the UK, the demand is still not being met. There is no evidence of whether Regional Health Authorities are meeting the national target of 150 cataract operations per 100,000 population. This paper describes variations in age-standardised rates of cataract surgery and lengths of hospital stay (LOS) between the 13 health districts in South West Thames Regional Health Authority (SWTRHA). A retrospective analysis of cataract surgery performed on South West Thames (SW Thames) residents during 1990 was undertaken using the Korner hospital activity data system. The residents of SW Thames Region had 6,729 cataract operations in 1990, producing an overall surgery rate of 266 per 100,000 resident population. Two-thirds of the operations were performed on women, and the greatest number of operations were in the 75-79 and 80-84 year age bands. Women aged over 75 had significantly higher age-specific surgery rates than their male counterparts. The mean age for women was 76.6 years and for men 71.9 years; 12% of cases had a length of stay less than a day (day cases) and 49% were discharged within two days. There were substantial variations in LOS between health districts. Age-adjusted rates revealed significant variations between districts, four of which had rates below the regional average. The crude cataract surgery rate for SW Thames residents has increased threefold since 1975. Women have a significantly higher rate of surgery, which may be due to social factors. Variations in LOS between districts cannot be explained by difference in age structure and may be caused by local custom and practice. It is possible for national, regional and district cataract rates to be calculated, and they are a useful indicator of how the need for cataract surgery is being met in the population.

Age Factors↗

Erythrocyte glyceraldehyde-reductase levels in diabetics with retinopathy and cataract.

The activity levels of glyceraldehyde reductase, an aldose-reductase-like enzyme present in the erythrocyte, were determined in 104 subjects, who were divided into five groups--diabetics with retinopathy and cataract, diabetics with retinopathy and no cataract, diabetics with no retinopathy and no cataract, non-diabetics with senile cataract, and non-diabetic normal controls. Diabetics with retinopathy and cataract had significantly higher mean enzyme activity levels than normal control subjects (2.5 fold increase, p < 0.001); so had diabetics with retinopathy but no cataract (2 fold, p < 0.01) and patients with senile cataract (1.5 fold, p < 0.05). Juvenile diabetics had a significantly higher enzyme level than maturity onset diabetics. There was no significant difference in glyceraldehyde reductase between normal controls and diabetics without retinopathy or cataract, and no significant difference in polyol-dehydrogenase activity levels between any group studied. Enzyme activity did not correlate with age or glycosylated haemoglobin (HbA1c) levels. The increase in levels of erythrocyte glyceraldehyde reductase were due to increased amounts of active enzyme, rather than to elaboration of new kinetic pathways.

Aged↗

Drug use and five-year incidence of age-related cataracts: The Beaver Dam Eye Study.

OBJECTIVE: To evaluate incident cataract after a 5-year interval with respect to medication use. DESIGN: Population-based incidence study. MAIN OUTCOME: Incident cataract judged from standard photographs. SETTING: Study subjects were adults 43 to 86 years of age in 1988 to 1990 and again in 1993 to 1995. All participants were examined and interviewed, and photographs were taken. All procedures and grading were done by protocols at both examinations. All medications in current use, prescribed as well as over-the-counter, were brought to the examination site, and the names were recorded at that time. RESULTS: There were 678 drug preparations (active ingredients) being used at the baseline examination. Significantly lower incidences of nuclear cataracts 5 years later occurred in those who took thiazide diuretics (odds ratio [OR] = 0.79, 95% confidence interval [CI] 0.63, 1.00) and aspirin (OR = 0.76, 95% CI 0.61, 0.95) at the baseline examination. There were significantly more incident cortical cataracts in those taking oral steroids (OR = 2.59, 95% CI 1.45, 4.62), amitriptyline (OR = 2.03, 95% CI 1.09, 3.79), oral hypoglycemic agents (OR 2.06, 95% CI 1.23, 3.44), and insulin (OR = 3.38, 95% CI 1.61, 7.08). There were significantly more incident posterior subcapsular cataracts in those taking potassium-sparing diuretics (OR = 2.13, 95% CI 1.42, 3.18) and oral hypoglycemic agents (OR = 2.89, 95% CI 1.57, 5.33). Considering past use with never and current use did not alter the patterns of associations. We were not able to separate the effects of antihypertensive or diuretic agents from that of hypertension. However, hypoglycemic agents were no longer associated with any cataract type after stratifying by diabetes status. CONCLUSIONS: Although many different medications were being used at the baseline examination in the Beaver Dam Eye Study cohort, few were associated with incident cataract. However, with the high frequency of use of medications and the possibility that effects of current exposure may occur in the future, it is reasonable to follow this and other older cohorts for the development of cataract.

Adult↗

Effectiveness of monitored anesthesia care in cataract surgery.

OBJECTIVE: To determine the need for monitored anesthesia care in cataract surgery by evaluating the incidence of intervention by anesthesia personnel and by looking for associated risk factors. DESIGN: Nonrandomized, prospective case series with analysis of consecutive cataract surgery cases. PARTICIPANTS: A total of 1006 consecutive cataract surgery patients at an ambulatory surgery center over a 6-month period. METHODS: Routine cataract surgery was performed with the patient under local anesthesia. A detailed questionnaire was completed by the anesthesia personnel at the conclusion of each phase (before, during, and after) of cataract surgery. MAIN OUTCOME MEASURES: Age, medical history, and preoperative electrocardiogram (EKG) were analyzed as predictors for intervention by anesthesia personnel. The nature of the patient's problem and the type of intervention by anesthesia personnel were recorded. RESULTS: In 1006 consecutive cataract surgery cases, intervention by anesthesia personnel was required in 376 (37.4%) cases. No preoperative identifying characteristics were found to be reliable predictors of the need for intervention. There were no statistically significant differences in preoperative EKG and some medical conditions such as heart disease, diabetes, and thyroid disease between patients who received intervention and those who did not. Certain subgroups of patients did show a statistically significantly greater incidence of intervention, including systemic hypertensives (41.4%) versus nonhypertensives (34.5%) (P = 0.030), patients with pulmonary disease (49.3%) versus no pulmonary disease (36.5%) (P = 0.043), patients with renal disease (68.8%) versus no renal disease (36.9%) (P = 0.019), and patients with cancer (61.9%) versus no cancer (36.3%) (P = 0.001). Intervention was also required in 61.1 % of patients younger than 60 years of age compared to 36.5% of those patients 60 years of age and older (P = 0.005). CONCLUSIONS: Because intervention is required in more than one third of cataract surgery cases and the authors cannot reliably predict those patients at risk, monitored anesthesia care seems justified in cataract surgery with the patient under local anesthesia.

Adult↗

Socioeconomic status, mortality, and the development of cataract at a young age.

It has been hypothesized that senile cataract may serve as a marker for generalised tissue aging, since structural changes occurring in the proteins of the lens during cataract formation are similar to those which occur elsewhere as part of the aging process. An earlier analysis we carried out to test this hypothesis revealed a strong age-dependent relationship between undergoing cataract surgery and subsequent mortality. Relative risks for dying over 9 yr of follow-up were particularly increased for individuals who had developed cataract requiring operation between the ages of 50-65. This finding prompted us to test the hypothesis that younger patients undergoing surgery for cataract (those in which surgery was undertaken at 50-65 yr of age) would tend disproportionately to be resident in areas of generally lower socioeconomic status. A population-based linked health data resource containing data on all hospital separations in the province of British Columbia was used to examine this hypothesis. Linkage to Canadian census data was used to assign a socioeconomic decile to the area of residence for all individuals in British Columbia who either did, or did not, undergo cataract surgery over a 3 yr period, and were aged 50-95. Relative to those who resided in the highest socioeconomic areas, odds ratios for undergoing cataract surgery between 50 and 65 yr of age were significantly greater than 1 for the four lowest socioeconomic deciles. This association was observed despite a conservative bias in our setting that favoured those of higher socioeconomic status tending to receive earlier treatment. The results of this ecologic study prompt consideration of whether factors which have the dual attributes of being correlates of socioeconomic status and implicated in the development of cataract may play a role in mediating the processes involved in the well known association of socioeconomic status and mortality.

Age Factors↗

Lack of correlation between intraocular inflammation and after-cataract formation in the rabbit eye.

PURPOSE: To determine whether an increased or reduced inflammatory response following cataract surgery influences the development of after-cataract. SETTING: Department of Preclinical Ophthalmology, Pharmacia, Uppsala, Sweden. METHODS: Rabbits that had had cataract surgery were given endotoxin, ovalbumin, dexamethasone, or diclofenac. Aqueous humor, leukocytes, and prostaglandin E(2) (PGE(2)) were analyzed, and the wet weight of the after-cataract was determined. RESULTS: The wet weight of the after-cataract was unaffected by endotoxin and 67% lower in the eyes treated with ovalbumin than in the control eyes on day 56. Aqueous humor concentrations of leukocytes and PGE(2) were 94% and 87% lower in the group treated with dexamethasone than in the control group on day 7, and the concentration of PGE(2) was 98% lower in the diclofenac group; however, the wet weight of the after-cataract was unaffected by both treatments. CONCLUSION: This study suggests that an increased inflammatory response does not increase the development of after-cataract and a reduction in the inflammatory response does not reduce the development of after-cataract.

Animals↗

After-cataract and secondary glaucoma in the aphakic infant rabbit.

PURPOSE: To study the association between after-cataract and secondary glaucoma after lensectomy and 5-fluorouracil treatment in an experimental infant rabbit model. SETTING: St Erik Eye Hospital, Karolinska Institute, Stockholm, Sweden. METHODS: Lensectomy was performed in both eyes of 16 3-week-old rabbits. One randomly selected eye in each rabbit was injected with 2.5 mg of 5-fluorouracil (5-FU) at surgery and 5.0 mg the day after surgery to reduce the formation of after-cataract. Axial length, corneal thickness, corneal diameter, and intraocular pressure were measured preoperatively and 4 times during the 6 months following surgery. Six months after surgery, the wet weight of the after-cataract was determined. RESULTS: In 16 aphakic eyes treated with 5-FU, no or a minimal amount (<0.001 g) of after-cataract developed. None of the eyes showed signs of secondary glaucoma. Of 16 aphakic eyes not treated with 5-FU, 10 developed considerable amounts of after-cataract (>0.10 g); 8 of these developed glaucoma. The other 6 eyes had no or minimal after-cataract and did not develop secondary glaucoma. The relationship between after-cataract and secondary glaucoma was statistically significant. CONCLUSION: A significant relationship between the amount of after-cataract and the development of secondary glaucoma was found in aphakic infant rabbit eyes.

Animals↗