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PubMed1993

Ultrasonographic abnormalities in the eyes of dogs with cataracts: 147 cases (1986-1992).

Records of 147 dogs with cataracts and that had an ultrasonographic examination of their eyes were reviewed. Ultrasonography was performed, using a real-time mechanical sector scanner (7.5 or 10.0 MHz transducer), after topical anesthesia of the cornea. Vitreous degeneration was diagnosed in 23% of the eyes examined. Retinal detachment was detected in 11% of all eyes, but was detected in 4% of eyes with immature cataracts, 6.5% of eyes with mature cataracts, and 19% of eyes with hypermature cataracts. In 66% of the eyes, the cataract was the only ultrasonographic abnormality found. Vitreous degeneration and retinal detachment were most often observed in eyes with a hypermature cataract, and were uncommon in eyes with an immature cataract. We concluded that ultrasonographic examination can detect abnormalities of the posterior segment when opacity of the anterior segment precludes complete ophthalmoscopic examination and that it is a quick and easy procedure for screening dogs for retinal detachment prior to cataract surgery.

Age Factors↗
PubMed1993

[Cataracts in a patient treated with busulfan (Mablin powder) for eight years].

Busulfan (Mablin powder) has been used in the treatment of chronic myelogenous leukemia for a long time. Although cataract is known to be an ocular side effect of prolonged Busulfan therapy, it has rarely been reported, especially in Japan. This report describes mature cataracts in a 59-year-old woman with chronic myelogenous leukemia, who had received a total dose of 2,249.7 mg Busulfan over eight years. In our department, the average age at the time of senile cataract operation was 72 years in men and 73.4 years in women during the past five years, so this patient was younger than the average senile cataract patient. A review of case reports, including the present one, suggests that Busulfan cataract characteristically develops rapidly in both eyes of young patients treated with a total dose of over 2,000 mg of Busulfan for more than four years. Busulfan cataracts have rarely been reported probably because cataract is regarded as senile and patients treated with Busulfan usually die before cataract appears.

Busulfan↗
PubMed1996

Cataract development in Atlantic salmon (Salmo salar L) in fresh water.

Irreversible bilateral cataracts were diagnosed by slit-lamp biomicroscopy in 178 of 200 farm-raised Atlantic salmon (Salmo salar L) fed a standard diet over a five-month period. Initial changes were anterior polar opacities, progressing to involve both the anterior and posterior cortex before changes in the lens nucleus were seen. The lens changes were recorded and given scores according to the severity of the cataracts. At each of 3 samplings, after 2, 4 and 5 months, 200 fish were measured, weighed and examined by slit-lamp biomicroscopy. At all 3 samplings, there was a significant correlation between body length and both cataract incidence and cataract severity. There was also a significant correlation between body weight and cataract incidence and severity for the 2 last samplings. There was a significant correlation between K-factor as a measure of the shape of the fish, and both cataract incidence and severity, at all 3 samplings. Evaluation of specific growth rate in the periods between the examinations showed that the rapidly-growing fish were most susceptible to cataract formation. After cataract developed, however, the growth rate slowed. Follow-up examination of severely affected fish 3 months after transfer to sea water showed a normal cortical zone in the periphery of the lens in 24 out of 28 fish.

Animals↗
PubMed1998

Involvement of aldose reductase in naphthalene cataract.

PURPOSE: The authors investigated the involvement of the enzyme aldose reductase (AR) in naphthalene cataract by using transgenic mice that overexpress AR. METHODS: Lenses from nontransgenic mice and from transgenic lines CAR222 and CAR648, with different levels of AR, were cultured in medium containing naphthalene-1,2-dihydrodiol (ND) with or without AR inhibitor AL1576. The morphology and progression rate of ND-induced cataract in these lenses were compared. RESULTS: Lenses from transgenic mice CAR222 and CAR648, but not their nontransgenic littermates, developed yellow pigment in the inner cortex when exposed to 50 microM ND, which was completely prevented by 0.2 mM AL1576. The yellow pigment developed faster and more intensely in the CAR648 lens, which has a higher AR level than CAR222. Under a high dose of 500 microM ND, both transgenic and wild-type mouse lenses developed ND-induced cataract, although the first sign of cataract was found in the outer cortex in transgenic lenses instead of the inner cortical region in wild-type lenses. In addition, the cataract was more severe and developed at a faster rate in transgenic mouse lenses. AL1576 showed only partial protection against the cataract induced by 500 microM ND. CONCLUSIONS: The findings showed that the progression rate of ND-induced cataract correlated with the level of lens AR and ND, indicating that AR was the key enzyme for the metabolism of ND in the process of naphthalene cataract development.

Aldehyde Reductase↗
PubMed1996

The visual deprivation and increase in axial length in patients with cataracts.

PURPOSE: To investigate the relationship between axial myopia and visual deprivation in patients with cataracts in their youth. METHODS: Forty myopic eyes of 25 cases had long deprivation of form vision due to cataracts during their youth. The axial length was measured by A-Scan ultrasound. RESULTS: The axial length is 2-6mm (mean: 3.7mm) longer than the other eyes in 10 patients with unilateral cataracts. Fifteen cases with bilateral cataracts had 25-29mm of axial length (mean of the right eyes 26.8mm and the left eyes: 26.7mm). Six cases with unilateral cataract had traumatic history at age from 2-9 years (mean: 5.1 years) and the duration of visual deprivation due to cataract was from 8 to 30 years (mean: 12 years). Thirteen cases with dilateral congenital cataract had 17.4 years (from 3 to 37 years) of visual deprivation. CONCLUSION: The deprivation of form vision due to cataracts in childhood leads to increase in axial length and myopia.

Adolescent↗
PubMed2006

Pseudophakic retinal detachment after phacoemulsification cataract surgery: Ten-year retrospective review.

PURPOSE: To determine the risk for rhegmatogenous retinal detachment (RRD) after phacoemulsification. SETTING: Private and public facility, Auckland, New Zealand. METHODS: A retrospective study of 1793 consecutive patients having cataract surgery by phacoemulsification was performed. Patients younger than 40 years were excluded, as were patients who had cataract surgery after ocular trauma. Patients having cataract surgery combined with other ocular procedures such as keratoplasty, glaucoma drainage surgery, or posterior segment surgery were similarly excluded. RESULTS: Rhegmatogenous retinal detachment occurred in 1.17% of the patients having cataract surgery. The risk was greater in patients younger than 50 years (5.17%) and less in those older than 70 years (0.64%). The median interval between cataract surgery and development of the retinal detachment was 39 months. The rate of retinal detachment was greater with complicated cataract surgery, but there was no increased risk for those eyes requiring neodymium:YAG laser capsulotomy. CONCLUSIONS: The overall risk for RRD after cataract surgery by phacoemulsification was small. However, in the younger patient, the risk for pseudophakic detachment was higher. In light of this finding, the requirement for cataract surgery in this group should be reassessed.

Adult↗
PubMed2000

Changes in cytoskeletal proteins in childhood cataract lenses

Purpose: Approximately 50% of congenital and childhood cataracts seen in the clinic is of undetermined origin. Biochemical analysis of the cataracts is rare. This study analyzes lens proteins to determine the mechanism of congenital and childhood cataracts. Method: We analyzed the lens proteins from 10 young patients after cataract operations, using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), densitometry analysis, and Western immunoblotting.Results: Densitometry of separated proteins showed a decrease in the high molecular protein bands of posterior subcapsular cataract (PSC). Specifically, spectrin (235 kDa), filensin (100 kDa), and vimentin (57 kDa) were absent from the SDS-PAGE of PSC. Increases in filensin and vimentin were observed in a Christmas tree cataract and lamellar cataracts. Western immunoblots confirmed the densitometry of SDS-PAGE.Conclusion: These results suggest that changes in cytoskeletal proteins may contribute to congenital and childhood cataracts.

Journal Article↗
PubMed1998

Cataract surgery combined with transpupillary silicone oil removal through planned posterior capsulotomy.

OBJECTIVE: The purpose of the study was to evaluate transpupillary removal of silicone oil combined with cataract surgery in patients after pars plana vitrectomy. DESIGN: A prospective case-control study. PARTICIPANTS: Fifty consecutive patients underwent cataract surgery combined with removal of silicone oil, which had served as intraocular tamponade after pars plana vitrectomy. In 28 patients, silicone oil was removed through a planned posterior capsulotomy, and in 22 patients, silicone oil was removed through pars plana sclerotomies. All patients were operated on by the same surgeon. INTERVENTIONS: Pars plana vitrectomy, cataract surgery, and silicone oil removal were performed. MAIN OUTCOME MEASURES: Frequencies of retinal redetachment, secondary cataract, cystoid macular edema, and vitreous hemorrhage; visual acuity; intraocular pressure; and duration of surgery and visual rehabilitation were measured. RESULTS: Frequencies of postoperative vitreous hemorrhage (1 of 28 [4%] vs. 10 of 22 [45%]) and secondary cataract (0 of 28 vs. 6 of 22 [27%]) were significantly lower (P < 0.05; chi-square test), and duration of surgery and visual rehabilitation were significantly shorter (P < 0.01) for patients with transpupillary silicone oil removal than for patients with drainage of silicone oil through pars plana sclerotomies. Rate of retinal redetachment (4 of 28 [14%] vs. 4 of 22 [18%]), time of retinal redetachment (36 +/- 32 postoperative days vs. 54 +/- 65 days), frequency of dislocated intraocular lenses (1 of 28 vs. 0 of 22), and postoperative visual acuity did not vary significantly between the two groups. Persisting comeal endothelial decompensation and clinically significant cystoid macular edema due to cataract surgery were not observed in any patient. CONCLUSIONS: Silicone oil removal can be combined with cataract surgery. In view of a decreased frequency of postoperative vitreous hemorrhage, reduced rate of secondary cataract, and shorter duration of surgery and visual rehabilitation, transpupillary drainage of silicone oil through a planned posterior capsulotomy compares favorably with removal of silicone oil through pars plana sclerotomies. Retinal redetachment usually occurs within the first 3 postoperative months.

Adolescent↗
PubMed1997

Patient comfort during cataract surgery with modified topical and peribulbar anesthesia.

PURPOSE: To evaluate patient comfort during cataract surgery performed using modified topical and peribulbar anesthesia. SETTING: Sunderland Eye Infirmary Cataract Treatment Centre, Sunderland, United Kingdom. METHODS: In this prospective study, 50 consecutive patients scheduled for cataract surgery with local anesthesia were randomly assigned to receive topical bupivacaine hydrochloride plus 0.1 mL subconjunctival lignocaine or standard peribulbar anesthesia. All surgery was performed by one surgeon using a scleral pocket bimanual phacoemulsification technique. Patients were asked to grade the pain experienced during administration of the anesthetic and during cataract surgery using a visual analog scale. RESULTS: No statistically significant difference in patient comfort was demonstrated between the two groups during cataract surgery (P < .4, Wilcoxon rank-sum test), and all patients were satisfied with the anesthesia. However, administration of topical bupivacaine was significantly less painful than peribulbar injections (P < .001, Wilcoxon rank-sum test). In eight patients in the topical anesthesia group, the cataract in the fellow eye was removed using peribulbar anesthesia; seven of these patients stated a preference for the modified topical method, while one patient thought there was no difference between the two methods. There was no difference between the groups in surgical complications, but 24% of the peribulbar group had a minor subconjunctival hemorrhage at the needle entry site. CONCLUSION: The modified topical technique provided satisfactory patient comfort during cataract surgery; it was comparable to the comfort achieved using peribulbar injections. The speed and ease of administering topical anesthesia coupled with the rapid visual recovery after surgery makes this method a suitable and safe choice for day-case phacoemulsification cataract surgery.

Administration, Topical↗
PubMed2006

Axial length, myopia, and the severity of lens opacity at the time of cataract surgery.

OBJECTIVE: To investigate the relationship between axial length, myopia of the eye, and the severity of lens opacity at the time of cataract surgery. METHODS: We retrospectively reviewed a consecutive series of 198 eyes of patients aged older than 50 years at Fukui University Hospital (Fukui, Japan) from June 2004 to December 2005. Patient age at the time of surgery, axial length, spherical equivalent, and the subtypes and severity of cataract (as classified according to the modification of the Lens Opacities Classification System, version III) were recorded. RESULTS: Axial length was significantly associated with age at the time of cataract surgery (P<.001). Regarding the severity of nuclear cataract, a significant correlation was seen between a higher score of nuclear cataract and longer axial length (P<.001). The relationship between the severity of nuclear cataract and spherical equivalent at the time of surgery showed a significant association between grading nuclear color and nuclear opalescence 4-6 and higher myopia (P<.001). CONCLUSION: An increase in axial length or myopia of the eye was associated with a lower mean age at the time of surgery and higher grade of nuclear cataract.

Aged↗
PubMed1980

Ultrastructure of human cataract in retinitis pigmentosa.

A second ultrastructural study of retinitis pigmentosa cataract showed differences from the previous case with respect to sex, age of cataract onset, age at time of cataract extraction, and mode of inheritance of retinitis pigmentosa. Furthermore, the cataract in the present study was limited clinically and preponderantly ultrastructurally to the posterior subcapsular area, which is typical of the location of cataracts associated with retinitis pigmentosa. The cataract was characterized by severe lens fiber disorganization, resulting in intricately distorted membrane configurations and varying cytoplasmic densities; however, "figure eight" configurations as noted in the other report were not observed. Aberrantly migrated epithelial cells were distributed unevenly in the posterior subcapsular zone. New capsular basement membrane, not mentioned in the other report, was conspicuous in our case. Thus, retinitis pigmentosa cataract may have diverse ultrastructural alterations.

Adult↗
PubMed1985

Incidence of cataract extraction in Pima Indians. Diabetes as a risk factor.

The incidence of visually disabling cataract was estimated by the rate of first cataract extraction in a population of Pima Indians in Arizona. The annual age-specific rates of cataract surgery (first and second eyes) were 3.7 to 5.9 times as high as the estimated US rates. Diabetes was a strong risk factor for first cataract surgery in all age and sex groups except in men aged 75 to 84 years. Overall, with age and sex controlled, the rate of first cataract surgery was 2.2 times as high (95% confidence interval, 1.3 to 3.9) in diabetic as in nondiabetic subjects. Cataract surgery was related to the duration and type of treatment of diabetes. Insulin-treated diabetics had about five times the rate of those with normal glucose tolerance. The rate of cataract surgery was lowest in subjects with normal glucose tolerance, somewhat higher in those with impaired glucose tolerance, and even higher with increasing duration of diabetes.

Adult↗
PubMed1988

Cataract extraction. Risk factors in a health maintenance organization population under 60 years of age.

Risk factors for cataract extraction in a young (less than 60 years of age) urban health maintenance organization population were evaluated in a case-control study. The subjects (72 case-control pairs) subscribed to the Kaiser Permanente Medical Care Program in the San Francisco Bay area and had cataract extraction between 1976 and 1980. All patients had visual acuity of at least 20/40 OU, documented before development of cataracts. Thirty-six (50%) of the 72 cataract extraction patients had at least one known risk factor for cataract formation, including trauma, intraocular inflammation, diabetes mellitus, syphilis, oral or topical steroid use, or previous eye surgery. Male patients were found to be a mean of 4.3 years younger than female patients, and diabetics were found to be a mean of 3.5 years older than nondiabetics. Variables found to be related to cataract extraction in univariate analysis included diagnosis of diabetes mellitus, a family history of cataracts, pulse rate, white blood cell count, and syphilis.

Adolescent↗
PubMed1994

Is age-related maculopathy associated with cataracts?

OBJECTIVE: To evaluate the relationship between three types of cataract or cataract surgery and age-related maculopathy. DESIGN: Population-based prevalence study. PARTICIPANTS: A total of 4926 people participating in The Beaver Dam Eye Study from 1988 through 1990. MAIN OUTCOME MEASURES: Grading of photographs for nuclear sclerosis, cortical cataract, and posterior subcapsular cataract and signs of age-related maculopathy was performed using standardized protocols. RESULTS: After adjusting for other risk factors, nuclear sclerosis was associated with increased odds of early age-related maculopathy (odds ratio [OR], 1.96; 95% confidence interval [CI], 1.28 to 3.01) but not of late age-related maculopathy (OR, 1.38; 95% CI, 0.52 to 3.63). Neither cortical nor posterior subcapsular cataracts were related to age-related maculopathy. There were increased odds of early age-related maculopathy in eyes that had undergone cataract surgery. CONCLUSION: These data suggest a possible commonly shared pathogenesis between nuclear sclerotic cataract and age-related maculopathy.

Adult↗
PubMed1996

Cataract patients in a defined Swedish population, 1986 to 1990. V. Postoperative retinal detachments.

OBJECTIVE: To estimate the risk of retinal detachment after cataract surgery. DESIGN: Prospective study from December 17, 1985, through December 31, 1992 of all cataract surgeries performed in a single referral region of the Lund (Sweden) Health Care District from December 17, 1985, through December 31, 1990. SETTING: The University Hospital of Lund. PATIENTS: Data were collected on 5878 consecutive cataract operations. The study population was complete enough to represent all cataract surgery in the referral region during this period. RESULTS: Two years after cataract surgery, the risk of retinal detachment was 0.18%. The follow-up period after cataract surgery in this study was up to 7 years, with a mean of 50.7 months (>4 years), and the total risk of retinal detachment or detachment-related conditions was 0.71%, all cases included. The relative risk of detachment was 4.9 after YAG laser capsulotomy. It changed by a factor of 1.3 with an increase in the axial length of 1 mm and by 0.94 for each added year of patient age. CONCLUSION: A young patient with axial myopia operated on because of cataract and postoperatively treated with YAG laser capsulotomy runs an important increased risk of developing retinal detachment.

Adolescent↗
PubMed1998

Transferrin in after-cataract and as a survival factor for lens epithelium.

The Fe-transport protein, transferrin (Tf), is synthesized and secreted by whole lenses and cultured lens epithelial cells. Because of Tf's central role in cell growth and proliferation, its participation in lens cell proliferation following cataract extraction was explored using a rabbit model of after-cataract. Varying amounts of the central anterior lens capsule were removed (0, 35, or 80%) following extraction of the lens. The Tf content of and secretion by after-cataract lens capsular sacs containing regenerated lens tissue was determined ex vivo at 0, 3, 5, 7 and 9 weeks post-surgery. In all cases Tf content of and secretion by the lens sacs was higher than that of their contralateral controls (whole lenses). Tf secretion was up to 5-fold higher and metabolic labeling studies indicated secretion of newly synthesized Tf. The sacs contained up to 10 times the concentration of Tf as the control lenses. Human lens after-cataract capsular bags also secreted Tf. The function of Tf as a survival factor was tested on cultured lens epithelial cells. Cells cultured in serum-free medium had a survival rate of only 20-34% if the medium was changed each day. If the medium was never changed during this period, the survival rate was 43-52%, suggesting secretion of essential growth factors by these cells. Addition of 200 microg ml-1 Tf to the medium during each daily change increased survival to levels attained when the medium was not changed. Addition of Tf antibodies to the culture medium during each daily change decreased cell survival to 14%. Apparently Tf acts as a survival factor for lens epithelia and its synthesis is up-regulated in after-cataract lens sacs. These factors suggest that Tf may play an important role in the pathogenesis of lens epithelial cell proliferation and after-cataract formation following cataract surgery.

Animals↗
PubMed1992

The WHO programme for the Prevention of Blindness and cataract in developing countries.

In 1990, the WHO Programme for the Prevention of Blindness estimated that there were 13.5 million unoperated cases of cataract in the world. More than 95% of this backlog is found in developing countries. A conservative estimate of incidence of blindness due to cataract as 1/1000 population/year demonstrates that most developing countries are still unable to provide cataract surgery to the annual load of new cases. The situation is particularly worrying in Africa, south of the Sahara, where only one out of ten cataract ever gets operated on. The WHO Programme has developed a primary health care strategy for the large-scale management of cataract. Identification of cases requiring surgery should be possible at the community level, through training of auxiliary staff. Referral for surgery at the district or province hospital level is possible in most cases, given manpower development. This implies a need for training of cataract surgeons in many developing countries. There should be one cataract surgeon per 250,000 population. Increasing surgical 'productivity' of existing ophthalmologists should be considered as well as improving management of intervention programmes.

Africa↗
PubMed1992

The role of Western ophthalmologists in dealing with cataract blindness in developing countries.

Of the estimated 35-40 million blindness worldwide, 17 million is caused by cataract and this proportion will double by year 2025. In Africa alone, it is estimated that there are about 3 million cataract blind. As life expectancy in Africa increases so will the incidence of cataract blindness. Existing resources of manpower and services cannot cope adequately with the present backlog of cataracts, let alone the anticipated increased load. The deployment of local ophthalmologists to deal with cataract load would be cost-effective in delivering appropriate eye care but the scarcity of ophthalmologists makes the option ineffective. The role of Western ophthalmologists will be considered in the provision of cataract surgical services and training of ophthalmic assistants, cataract surgeons and ophthalmologists.

Africa↗