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[Impact of cataract surgery on intraocular pressure after filtering operation due to primary open angle glaucoma and secondary glaucoma in pseudoexfoliation syndrome].

PURPOSE: To analyse the impact of cataract surgery after filtering operation on the intraocular pressure (IOP) due to primary open angle glaucoma (pOAG) versus secondary open angle glaucoma in pseudoexfoliation syndrome (PEX). The regulation of IOP was evaluated on the basis of criteria of advanced glaucoma intervention study (AGIS). PATIENTS AND METHODS: Retrospectively 95 eyes of 95 patients (53 x pOAG, 36 x clear cornea approach [group 1] and 17 x corneoscleral tunnel [group 2]; 42 x PEX, 30 x clear cornea approach [group 3] and 12 x corneoscleral tunnel [group 4]) were included. The IOP and antiglaucomatous eye drops were analysed before filtering operation, before cataract surgery and on average 33 months after cataract surgery. RESULTS: In all groups there was a significant reduction of IOP after filtering operation by 8.7 mm Hg on average and no significant difference of IOP before and after cataract surgery. At no time there was a significant difference in IOP between the four subgroups. According to criteria of the AGIS study 34 % of group 1, 29 % of group 2, 36 % of group 3 and 17 % of group 4 had an IOP lower than 14 mm Hg before cataract surgery. After cataract surgery only 31 % of group 1, 18 % of group 2, 13 % of group 3 and 8 % of group 4 met this criterion. CONCLUSION: On first glance sequential cataract surgery after filtering operation seems to have no clinically relevant impact on the IOP, neither with regard to the type of glaucoma nor in respect of the approach for cataract surgery. However, if IOP is evaluated based on the criteria of the AGIS, primary open angle glaucoma with clear cornea approach appears to yield superior results in contrast to secondary open angle glaucoma in pseudoexfoliation syndrome with corneoscleral tunnel concerning the regulation of intraocular pressure.

Aged↗

[Cataract surgery in patients with end-stage glaucoma].

BACKGROUND: The purpose of this study was to assess the benefit of cataract surgery in patients with advanced cataract and glaucoma. METHODS: In a prospective study, we investigated 12 consecutive patients (12 eyes). Inclusion criteria were the diagnosis of cataract and end-stage glaucoma with a cup-disc ratio (CD) of 0.9-1.0 and marked visual field defects with partially preserved central function. Preoperatively, at the third postoperative day and after 6 months (2-11 months), the visual acuity (V), the intraocular pressure (IOP), the number of antiglaucomatous drugs and the visual fields were assessed. Furthermore, the surgical procedure and possible complications were noted. In all patients cataract surgery was performed with topical anaesthesia. RESULTS: 10 patients were treated with cataract surgery alone, whereas 2 patients underwent combined cataract and glaucoma surgery. The mean visual acuity improved significantly from 0.3 to 0.5 (p = 0.007). Additionally a significant intraocular pressure reduction of 4.4 mm Hg (p = 0.007) was observed. The number of antiglaucomatous drugs decreased from 1.5 preoperatively to 0.8 postoperatively. The mean deviation (MD) improved from -27.5 dB up to -26.4 dB (p = 0.036) after 6 months. CONCLUSION: Patients with progressive cataract and end-stage glaucoma can benefit from cataract surgery. Although marked visual field defects were present, an increase in visual acuity as well as a decrease of intraocular pressure may be achieved without worsening of the visual fields.

Aged↗

[Cataract surgery in patients with retinitis pigmentosa].

BACKGROUND: Because of the retinal alterations visual acuity of patients with retinitis pigmentosa is more affected by loss of contrast than in normal persons. Therefore cataract in retinitis pigmentosa (mostly posterior subcapsular cataract) leads earlier to decreasing visual acuity than is expected from the lens opacity. In a retrospective study we have looked up all patients with retinitis pigmentosa and cataract which were operated between 1989 and 1997 at our department. PATIENT AND METHODS: Between 1989 and 1997 50 eyes of 36 patients (21 female, 15 male; mean age 51 +/- 11.4 years) with the diagnosis of retinitis pigmentosa and cataract underwent extracapsular cataract extraction and IOL-implantation. In a retrospective study we studied all case histories of these patients. Mean follow up time was 1.2 +/- 1.2 years. RESULTS: Preoperative visual acuity was 0.1 +/- 0.1, best postoperative visual acuity was 0.3 +/- 0.2. Visual field was not affected by cataract-surgery. Postoperative complications were not found. 2/3 of all patients were satisfied with the postoperative visual acuity, 1/3 of all patients did not give comments. CONCLUSION: In patients with retinitis pigmentosa cataract surgery leads to significant increase of visual acuity. Cataract extraction should not be with held from patients with retinal dystrophy.

Adult↗

[Biometry of the lens with respect to age and cataract morphology. Evaluation of Scheimpflug photos of the anterior segment].

Thickness of the lens, cortex and nucleus or nucleus with supranuclear layer, respectively, were determined for 58 controls aged 11-69 years (115 lenses), and for 175 patients aged 30-86 years with different types of cataract (247 lenses). Measurements of the densitograms of Scheimpflug photos (taken along the optical axis, magnified 10-fold) were performed, accurate to 0.5 mm (corresponding to 0.05 mm original size). The cataractous lenses were grouped in 5 morphological classes and 3 degrees of opacification (density according to the Scheimpflug photos). As regards normal lenses, the present authors' findings correspond to earlier findings of Niesel et al. (1976). Deviations from the normal pattern are found in typical cortical cataract (water-cleft and spokes cataract, wedge-shaped cataract) where nucleus and nucleus with supranuclear layer are thinner than the normal lenses, while with nuclear cataracts and mixed types the opposite is the case. In eyes with posterior cortical opacities no increase in the thickness of the anterior cortex is found with aging. With the true nuclear cataracts the increase in the thickness of the anterior cortex is negligible. The degree of opacification is closely related to an increase in the thickness of the nucleus and supranuclear layer, which implies a decrease in the thickness of the anterior cortex. Water-clefts and spokes of larger size cause the anterior cortex to become thinner. In eyes with wedge-shaped cataracts the different degrees of opacification did not affect the parameters measured.

Adolescent↗

Risk of cataract among users of intranasal corticosteroids.

BACKGROUND: Oral corticosteroid users are at increased risk of cataract, but the risk among intranasal corticosteroids users is unknown. OBJECTIVE: Our purpose was to describe the risk of cataract among users of intranasal steroids. METHODS: A retrospective observational cohort study of cataract incidence was conducted among users of oral and intranasal steroids identified from the United Kingdom-based General Practice Research Database with a nested case-control analysis to control for confounding factors. The study population included 286,078 subjects aged less than 70 years old drawn from 350 general practices in England and Wales. Patients were classified as users of only intranasal corticosteroids, users of only oral corticosteroids, and nonusers of either medication. Computerized medical records were used to identify cases of cataract. Two hundred twenty-five cases were randomly selected for validation against general practitioners' held referral and hospitalization letters. RESULTS: The incidence rate of cataract (1.0/1000 person-years) among users of intranasal corticosteroids was similar to the incidence rate among nonusers. However, oral corticosteroid users were at higher risk of cataract (2.2/1000 person-years). Approximately 70% of intranasal corticosteroid exposure was to beclomethasone dipropionate only; the event rate in this group was similar to that in the unexposed group. Cataract risk did not increase with the number of prior prescriptions for intranasal corticosteroids. CONCLUSION: The use of intranasal corticosteroids was not associated with an increased risk of cataracts in this study population.

Administration, Intranasal↗

The nutritional teamwork approach: prevention and regression of cataracts in rats.

WE HAVE TAKEN ADVANTAGE OF A NEWLY ASSIMILATED PRINCIPLE IN NUTRITION: no nutrient by itself should be expected to prevent or cure any disease; nutrients as such always work cooperatively in metabolism as a team.By feeding galactose-containing diets to young rats, cataracts are regularly produced. When, however, we furnished galactose-fed animals with what may be considered a well balanced, full team of nutrients, cataract prevention was accomplished. On four galactose-containing diets supplied with a full team of nutrients, not a single cataract developed in 24 rats (48 eyes). On four diets using the same dietary galactose challenge, accompanied with inadequate nutritional teams, 47 out of 48 eyes developed cataracts. Diets of intermediate quality induced the development of intermediate numbers of cataracts. Cataracts once formed were regressed slowly and incompletely by shifting the animals to a diet similar to that which had previously been found to protect against cataract formation. The significance of these findings for nutritional research and for attacks on the problems of human cataracts and other ailments is discussed.

Animals↗

A-scan quantitative echography of senile cataracts and correlation with phacoemulsification parameters.

PURPOSE: To study the echographic appearance of various types of senile cataracts using a-scan quantitative echography and correlate these findings with phacoemulsification parameters indicating surgical lens hardness. METHODS: The study involved 71 eyes with senile cataracts and 20 additional eyes with normal human lenses. Cataract and clear lenses were studied using A-scan quantitative echography and with a tissue sensitivity gain setting of 74 db. We assessed the lens internal reflectivity in the A-scan echograms within a range of 0% to 100%, and calculated the mean of all spikes. All eyes with cataract underwent clear corneal phacoemulsification. At the end of the operation we recorded the phacoemulsification time and mean percent power. We determined the correlations of echographic and phacoemulsification data. RESULTS: Quantitative echography in the 71 studied eyes with cataract revealed acoustic reflections having various configurations according to the biomicroscopic type of cataract, i.e. cortical, nuclear, corticonuclear, brunescent, white intumescent. The mean of all echographic spikes within the cataract lenses varied from 3% (in some brunescent very sclerotic lenses) to 53%. Echographic reflections were not observed in the A-scan echograms of 20 additional eyes with normal human lenses. The mean of internal lens spikes correlated negatively with phacoemulsification time (p < 0.001; r = -0.703) and mean percent phacoemulsification power (p < 0.001; r = -0.57). CONCLUSIONS: The results indicate that A-scan quantitative echography may be used as an adjunctive tool in the preoperative evaluation of cataracts, particularly in cases with compromized visualization of the lens (small pupil, corneal opacities).

Aged↗

Myopic refractive shift caused by incident cataract: the Blue Mountains Eye Study.

PURPOSE: To assess the myopic shift in refraction caused by incident cataract in the Blue Mountains Eye Study (BMES) population. METHODS: Five-year prospective follow-up of the BMES, initially performed in 1992. After 5 years, 2335 survivors (75.1%) of 3654 baseline BMES participants were re-examined. Refractive change was assessed by age, sex, incident cataract type and baseline refraction. Slit-lamp and retroillumination lens photographs were graded for presence of incident cataract and signs of previous cataract surgery. Objective and subjective refractions were performed. RESULTS: In a multivariate model, age (p < 0.0001), incident nuclear cataract (p < 0.0003), hyperopia (p < 0.0009), incident posterior subcapsular cataract (p < 0.0027) and incident cortical cataract (p < 0.025) were factors associated with a relatively modest myopic refractive shift (0.34 diopters). Baseline myopia and gender were not associated with refractive change over the follow-up period. A myopic shift in refraction occurred most frequently in older (> or = 70 years) than younger (< 70 years) participants. CONCLUSIONS: Older age, baseline hyperopia and all types of incident cataract were principal factors found associated with myopic refractive shift over 5 years in an older population.

Aged↗

The effect of resveratrol in experimental cataract model formed by sodium selenite.

PURPOSE: To investigate if resveratrol can prevent sodium selenite-induced experimental cataract model in rats. METHODS: Forty-eight Spraque-Dawley rat pups were divided into 3 treatment groups: (1) normal saline-% 5 ethanol injected i.p. on postpatum day 10; (2) Na selenite (30 nmol/g body wt) injected s.c on day 10; (3) Na selenite s.c on day 10+resveratrol (40 mg/kg) i.p on days 10-13. On day 21, cataract development was graded by slit-lamp examination and photography. Encapsulated lenses and erythrocytes were analyzed for reduced glutathione (GSH) and malondialdehyde (MDA), a marker of lipid peroxidation. Lenses were also analyzed for total nitrite (TN). RESULTS: All control lenses in group 1 were clear. In group 2, all rats developed cataracts (grade 3-grade 6), whereas in group 3, only 9 of 16 rats developed cataracts (grade 2-grade 3). The difference of cataract frequency between groups 2 and 3 was statistically significant (p<0.05). Group 3 lenses and erythrocytes had higher mean GSH and lower mean MDA levels than those in group 2 (p<0.05). TN was highest in group 3 and lowest in group 1 (p<0.05). CONCLUSIONS: Resveratrol suppressed selenite-induced oxidative stress and cataract formation in rats. This protective effect was supported by higher GSH and lower MDA in lens and erythrocytes. The presence of oxidative stress in selenite cataract development and its prevention by resveratrol support the possibility that high natural consumption of resveratrol in food can help prevent human senile cataract.

Animals↗

Decreased glucose-6-phosphate-dehydrogenase (G6PD) activity and risk of senile cataract in Taiwan.

G6PD deficiency may render afflicted individuals more susceptible to certain degenerative diseases. To clarify the relationship between G6PD deficiency and cataract, blood G6PD activity was determined in patients with cataract in Taiwan. The cases and hospital-based controls were recruited from the medical outpatient department and from the physical checkup department at Chang Gung Memorial Hospital, respectively. A questionnaire survey was used to determine associations between cataracts and their risk factors. G6PD activity in fresh RBC was quantitatively measured and genomic DNA was extracted from lymphocyte nuclei. The mean blood G6PD activity among cataract patients (278.1 U/10[12] RBC) was similar to that of normals (288.0 U/10[12] RBC). No statistically significant difference in the distribution of G6PD activities as grouped by an increment of 100 U/[10, 12] RBC was observed between cataract patients and normal subjects. The predominant forms of G6PD gene mutation (cDNA 1376 G to T and 95 A to G) were both found in the patients with cataract. The adjusted odds ratio for cataract was 1.21 for every decrement of 100 U/10[12] RBC of G6PD activity in these subjects. These data indicate that G6PD activity is not a potential risk factor for senile cataract in Taiwan.

Aged↗

The gamma-crystallins and human cataracts: a puzzle made clearer.

Despite the fact that cataracts constitute the leading cause of blindness worldwide, the mechanisms of lens opacification remain unclear. We recently mapped the aculeiform cataract to the gamma-crystallin locus (CRYG) on chromosome 2q33-35, and mutational analysis of the CRYG-genes cluster identified the aculeiform-cataract mutation in exon 2 of gamma-crystallin D (CRYGD). This mutation occurred in a highly conserved amino acid and could be associated with an impaired folding of CRYGD. During our study, we observed that the previously reported Coppock-like-cataract mutation, the first human cataract mutation, in the pseudogene CRYGE represented a polymorphism seen in 23% of our control population. Further analysis of the original Coppock-like-cataract family identified a missense mutation in a highly conserved segment of exon 2 of CRYGC. These mutations were not seen in a large control population. There is no direct evidence, to date, that up-regulation of a pseudogene causes cataracts. To our knowledge, these findings are the first evidence of an involvement of CRYGC and support the role of CRYGD in human cataract formation.

Amino Acid Sequence↗

Outbreak of toxic anterior segment syndrome following cataract surgery associated with impurities in autoclave steam moisture.

BACKGROUND: Toxic anterior segment syndrome (TASS), a complication of cataract surgery, is a sterile inflammation of the anterior chamber of the eye. An outbreak of TASS was recognized at an outpatient surgical center and its affiliated hospital in December 2002. METHODS: Medical records of patients who underwent cataract surgery during the outbreak were reviewed, and surgical team members who participated in the operations were interviewed. Potential causes of TASS were identified and eliminated. Feedwater from autoclave steam generators and steam condensates were analyzed by use of spectroscopy and ion chromatography. RESULTS: During the outbreak, 8 (38%) of 21 cataract operations were complicated by TASS, compared with 2 (0.07%) of 2,713 operations performed from January 1996 through November 2002. Results of an initial investigation suggested that cataract surgical equipment may have been contaminated by suboptimal equipment reprocessing or as a result of personnel changes. The frequency of TASS decreased (1 of 44 cataract operations) after reassignment of personnel and revision of equipment reprocessing procedures. Further investigation identified the presence of impurities (eg, sulfates, copper, zinc, nickel, and silica) in autoclave steam moisture, which was attributed to improper maintenance of the autoclave steam generator in the outpatient surgical center. When impurities in autoclave steam moisture were eliminated, no cases of TASS were observed after more than 1,000 cataract operations. CONCLUSION: Suboptimal reprocessing of cataract surgical equipment may evolve over time in busy, multidisciplinary surgical centers. Clinically significant contamination of surgical equipment may result from inappropriate maintenance of steam sterilization systems. Standardization of protocols for reprocessing of cataract surgical equipment may prevent outbreaks of TASS and may be of assistance during outbreak investigations.

Anterior Eye Segment↗

Relative importance of aldose reductase versus nonenzymatic glycosylation on sugar cataract formation in diabetic rats.

The relative importance of sorbitol formation versus nonenzymatic glycosylation and advanced glycosylation end products (AGEs) on sugar cataract formation was examined in diabetic rats. Diabetes was experimentally induced in young, 50 g rats with streptozotocin, and aldose reductase inhibitors were administered in the diet for up to 8 weeks at concentrations of 0.06% for tolrestat or ponalrestat and 0.0125% for AL-1576. Cataract formation was monitored by hand-held slit lamp for up to 11 weeks. Lens polyol levels were monitored by GLC, glycosylated protein levels were spectrophotometrically determined, and AGE products were estimated by fluorescence measurements and ELISA. Sugar cataract formation was observed in all untreated diabetic rats while cataract formation was inhibited in all diabetic rats treated with the AR inhibitors. Lens sorbitol levels were reduced in all ARI-treated rats. Glycosylated lens protein levels were elevated in the diabetic rats, and these levels were not significantly lower in the non-cataractous lenses from ARI-treated diabetic rats. Fluorescence measurements of the lens proteins revealed increased lens AGE levels in all diabetic rats, and these were slightly reduced in the aldose reductase inhibitor treated diabetics. With ELISA, immunoreactive AGEs were only detected in cataractous lenses from the untreated diabetic rats. Immunoreactive AGEs were not detected in the clear lenses of the aldose reductase inhibitor treated diabetics or in the non-diabetic controls. These results support the concept that sugar cataract formation is initiated by the aldose reductase catalyzed intracellular accumulation of polyols and that these sugar cataracts can be prevented through inhibition of aldose reductase.

Aldehyde Reductase↗

Model of risk of cortical cataract in the US population with exposure to increased ultraviolet radiation due to stratospheric ozone depletion.

The authors modeled the possible consequences for US cataract incidence of increases in ultraviolet B radiation due to ozone depletion. Data on the dose-response relation between ocular exposure to ultraviolet B radiation and cortical cataract were derived from a population-based study (the Salisbury Eye Evaluation Project, Salisbury, Maryland) in which extensive data on cataract and ultraviolet radiation were collected in persons aged 65-84 years. Exposure estimates for the US population were derived using estimated ultraviolet radiation fluxes as a function of wavelength. US Census data were used to obtain the age, ethnicity, and sex distribution of the population. Predicted probabilities of cataract were derived from the age-, sex-, and ethnicity-specific ocular ultraviolet exposure data and were modeled under conditions of 5-20% ozone depletion. The analysis indicated that by 2050, the prevalence of cortical cataract will increase above expected levels by 1.3-6.9%. The authors estimate that with 5-20% ozone depletion, there will be 167,000-830,000 additional cases of cortical cataract by 2050. Because of the high prevalence of cataract in older persons, at a 2003 cost of 3,370 dollars per cataract operation, this increase could represent an excess cost of 563 million dollars to 2.8 billion dollars.

Age Distribution↗

Detection of anti-lens crystallin antibody in dogs with and without cataracts.

OBJECTIVE: To determine if antilens crystallin (ALC) serum and aqueous humor antibodies were present in normal dogs and dogs with cataracts, whether antibody incidence varied with stage of cataract, and whether antibody titer had a relationship to the presence of lens-induced uveitis. METHODS: Serum and aqueous humor samples were obtained from normal dogs and dogs with cataracts. Lens crystallin was separated by SDS-polyacrylamide gel electrophoresis (SDS-PAGE), and antilens crystallin antibodies were detected by Western immunoblot analysis. An indirect ELISA using crystallin protein as antigen was also used to detect antilens crystallin antibodies in serum and aqueous humor. Test groups included normal, incipient, immature, mature, hypermature and diabetic cataract. RESULTS: SDS-PAGE identified bands with molecular weights of lens crystallin subunits. Western immunoblotting demonstrated reaction between canine serum and these protein bands. The five canine serum samples that reacted with crystallin subunits on Western blots had corresponding reactivity on the ELISA. All aqueous humor samples (30) were negative. Serum ALC antibodies were detected in 59.3% (16/27) of controls, 66.7% (16/24) of incipients, 50.0% (10/20) of immatures, 37.9% (11/29) of matures, 28.6% (6/21) of hypermatures, and 26.7% (4/15) of diabetics. Serum ALC antibodies were detected in 43.1% (47/109) of all cataract samples. There was a statistically significant negative association between the presence (P = 0.004) and maturity (P = 0.004) of cataract and presence of ALC serum antibodies. In the immature and hypermature cataract groups, there was a statistically significant negative association between ALC serum antibody titer and severity of uveitis (95% confidence interval). CONCLUSIONS: There is a negative association between the presence (P = 0.004) and maturity (P = 0.004) of cataract and presence of ALC serum antibodies.

Animals↗

Identification of mutations in HSF4 in dogs of three different breeds with hereditary cataracts.

Cataracts are a leading cause of blindness in both dogs and humans. Mutations in several genes have been associated with inherited forms of human cataract, but no mutations have been identified as the cause of any form of canine inherited cataract. We have used a candidate gene approach to investigate 20 genes, known to be associated with cataract in humans, for their potential association with the development of hereditary cataract (HC) in dogs. We have identified mutations in the HSF4 gene in Staffordshire Bull Terriers, Boston Terriers and Australian Shepherds affected by HC. Interestingly, different mutations in this single gene may be causing a recessive form of cataract in Staffordshire Bull Terriers and Boston Terriers and a dominant cataract in Australian Shepherds. Identification of the mutations that cause HC in these three breeds provides a method of controlling the disease within populations at risk using a simple diagnostic test, and also establishes cataract in these breeds as models for their human counterparts.

Animals↗

The use of accurate visual acuity measurements in clinical anti-cataract formulation trials.

A standardized visual acuity technique is presented for use in anti-cataract drug trials. Ferris Logmar charts were used in repeatability studies of vision, visual acuity and pinhole visual acuity measurements for twenty normal subjects (mean (+/- SD) age 64 +/- 6.3 years). Visual acuity measurements were shown to be the most repeatable and thought to be the most suitable for monitoring cataract progression. Repeated visual acuity measurements were made on 29 cataractous eyes of 15 subjects (mean (+/- SD) age 67.8 +/- 7.2 years). A Logmar score change of 0.1 (one line) was shown to be a statistically significant change. This value can be used in statistical analyses of drug efficacy. The normal data gives a mean Logmar visual acuity of 1.15 (Snellen equivalent 6/5). This indicates the inadequacy of using 6/6 as a norm value for visual acuity, even for older patients. As the possibility of reversal of cataract theoretically exists in the early stages of cortical and capsular cataracts, patients with small amounts of these types of cataract are ideal patients for anti-cataract formulation trials. The normal visual acuity results indicate that the inclusion criteria for clinical trials can include patients with cataracts with visual acuity as good as 6/6.

Aged↗

Selenium concentrations in serum, lens and aqueous humour of patients with senile cataract.

Selenium (Sc) is a trace element which incorporates into the selenoenzyme glutathion peroxidase. Cataractogenesis may be caused either by the excess or deficiency of this trace element. More recently, its potential of becoming a possible environmental pollutant has been emphasized. In an attempt to reveal the relationship of this element with cataractogenesis, we detected its level in 48 serum, 36 lens and 9 aqueous humour samples of 48 patients with senile cataract, comparing the results with appropriate controls. Selenium levels (mean +/- SD) of cataractous patients were found to be 0.28 +/- 0.04 microgram/ml (CI: 0.27 to 0.29 microgram/ml) in sera (controls: 0.32 +/- 0.04 microgram/ml; CI: 0.30 to 0.34 microgram/ml, p < 0.0001), 5.43 +/- 3.07 microgram/g dry weight (CI: 4.43 to 6.43 microgram/g dry weight) in lens (controls: 4.43 +/-2.53 microgram/g dry weight; CI: 2.78 to 6.08 microgram/g dry weight; p=0.374) and 0.19 +/- 0.06 microgram/ml (CI:0.15 to 0.23 microgram/ml) in aqueous humour samples (controls: 0.31 +/-0.12 microgram/ml; CI: 0.24 to 0.38 microgram/ml, p = 0.02). When patient subgroups were analyzed, serum Se levels were found to be 0.28 +/- 0.05 microgram/ml (CI: 0.26 to 0.30 microgram/ml in the nuclear cataract and 0.28 +/- 0.02 microgram/ml (CI: 0.27 to 0.30 microgram/ml) in the cortical cataract. Lens Se levels, on the other hand, were detected as 5.91 +/- 3.56 microgram/g dry weight (CI:4.49 to 7.33 microgram/g dry weight) in the nuclear cataract and 4.47 +/- 1.40 microgram/g dry weight (CI: 3.68 to 5.26 microgram/g dry weight) in the cortical cataract. It is anticipated that decreased Se in aqueous humour and sera of patients with senile cataract may reflect defective antioxidative defense systems which may lead to the formation of cataract.

Aged↗