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PubMed2005

Combined effect of probucol and insulin on cataracts of diabetic rats fed a high cholesterol diet.

We investigated the effects of long-term treatment with probucol, a hypolipidemic agent with antioxidative action, insulin, or their combination on cataracts of streptozotocin-induced diabetic rats fed a high cholesterol diet. Each rat was checked for cataracts at 0, 1, 2, 4, 8, 12 and 15 weeks after streptozotocin injection. Cataracts were observed from 8 weeks in untreated hypercholesterolemic and diabetic rats and the incidence of catarats increased to 100% by 15 weeks. The incidence of cataracts in rats treated with probucol, insulin and their combination was first seen at 12, 12 and 15 weeks, respectively, and was 86%, 63% and 33%, respectively, at 15 weeks. The preventive effects of both agents alone and their combination on the cataracts were confirmed by histopathological evaluation of eyeballs. The combined treatment with both agents markedly improved hyperglycemia, hyperlipidemia and increased serum lipid peroxide levels. These results indicate that the combined treatment with probucol and insulin is useful in preventing the development and progression of diabetic cataracts.

Animals↗
PubMed2004

Molecular genetics of age-related cataract.

Advances in molecular biological and genetic technology have greatly accelerated elucidation of the genetic contribution to age-related cataract. Epidemiological studies have documented tendencies for cataracts to occur more frequently in relatives of cataract patients than in the general population, genetic studies have demonstrated contributory roles of some specific genes in age related cataract in small populations, and molecular studies have shown changes in expression of specific genes in cataractous lenses. Together, these studies are beginning to provide a conceptual framework for understanding age-related cataracts.

Aged↗
PubMed2004

Identification and functional clustering of global gene expression differences between age-related cataract and clear human lenses and aged human lenses.

We have examined the gene expression profiles of young, old and cataractous human lenses in order to differentiate those gene expression changes specific for cataract from those also associated with lens aging. Differentially expressed transcripts were identified by oligonucleotide microarray analysis and clustered according to their known functions. Four hundred and twelve transcripts that are increased and 919 transcripts that are decreased were identified at the 2-fold or greater level between epithelia isolated from cataract relative to clear lenses while 182 transcripts that are increased and 547 transcripts that are decreased were identified at the 2-fold or greater level between young and old lens epithelia. Comparison of the cataract gene expression changes with those detected in lens aging revealed that only 3 transcripts exhibited similar trends in gene expression. These data suggest that cataract- and age-specific changes in gene expression do not overlap and provide evidence for multiple cataract- and age-specific gene expression changes in the human lens.

Aged↗
PubMed2005

Secreted leukocyte protease inhibitor is present in aqueous humours from cataracts and other eye pathologies.

Previous studies identified serine, cysteine and metalloproteases in normal aqueous humours (AH) and suggested that a balance between proteases and their inhibitors may play a role in the modulation of the AH outflow. We aimed to determine whether secretory leukocyte protease inhibitor (SLPI), a serine protease inhibitor, is present in AH of patients with cataract and other eye pathologies. AH was collected from 117 cataract patients of which 55 were diagnosed with more when one eye disease: cataract only (n=62), pseudoexfoliation (PEX) (n=26), glaucoma (n=6), diabetes retinopathy (n=4), iritis-uveitis (n=4) and macular degeneration (n=28). The total protein in AH was determined by a Bradford assay and SLPI was analyzed by Western blot and ELISA methods. The average concentration of total protein and SLPI in AH samples was 160+/-15 microg/ml (n=117, +/-SEM) and 500+/-94 pg/ml (n=105), respectively. The cataract patients with additional eye disease(s) showed higher protein levels (201+/-35 microg/ml) than cataract (controls) (128+/-31 microg/ml), P<0.01. It is noteworthy that no correlation was found between SLPI and the total protein concentrations in AH, but SLPI was positively correlated with age (r=0.2, P<0.05). No statistical difference in SLPI levels was found between controls (cataract) and other pathologies, while patients with iritis/uveitis had higher SLPI levels compared to those with diabetes (P<0.05). We show here for the first time that SLPI is present in AH and may play a role as well as serve as a marker in pathological states.

Aged↗
PubMed2004

Improvement in cognitive impairment after cataract surgery in elderly patients.

PURPOSE: To evaluate whether cognitive impairment improves in elderly patients who have cataract surgery with intraocular lens (IOL) implantation. SETTING: Kouki Hospital, Yamaguchi, Japan. METHODS: A prospective observational study evaluated patients' scores on the Revised Hasegawa Dementia Scale (HDS-R) and the HDS-R minus 1 item regarding immediate regeneration (ie, function of vision and memory). Twenty patients (6 men, 14 women) with cognitive impairment had cataract surgery in 1 eye between March 1996 and July 2001 at Kouki Hospital, Japan. The mean age of the patients was 81.8 years (range 61 to 90 years). Twenty patients (4 men, 16 women) with cognitive impairment who did not have cataract surgery were selected as a control. The mean age in the control group was 84.3 years (range 70 to 93 years). The HDS-R was administered twice between March 1996 and July 2001. RESULTS: The mean HDS-R scores in the cataract surgery group improved from 12.5 points +/- 5.3 (SD) preoperatively to 16.6 +/- 6.2 points postoperatively; the improvement was significant (t = -5.02; P<.0001). After cataract surgery, the grade of cognitive impairment improved in 12 patients (60%), was unchanged in 7 (35%), and was worse in 1 (5%). CONCLUSION: Cataract surgery improved cognitive impairment in elderly Japanese patients.

Aged↗
PubMed2004

Risk factors for failure of simultaneous penetrating keratoplasty and cataract extraction.

OBJECTIVE: To evaluate the indications, complications, and outcomes of simultaneous cataract extraction and penetrating keratoplasty (PKP) and the risk factors for failure of the procedure. SETTING: Tertiary referral medical center. METHODS: In a retrospective noncomparative interventional case series, the charts of 66 consecutive patients (70 eyes) who had simultaneous PKP and cataract extraction using the same surgical technique were reviewed. RESULTS: The mean follow-up was 32.4 months (range 6 to 125 months). The primary corneal graft remained clear in 48 eyes (69%) and failed in 22 eyes (31%). Sixteen eyes with a failed graft (73%) had 1 or 2 repeat keratoplasties; 8 (50%) were successful. At the end of follow-up, 56 eyes (80%) had a clear corneal graft. Nine eyes (41%) with a failed primary graft and 2 eyes (4%) with a clear primary graft had intracapsular cataract extraction (P<.001); 13 eyes (59%) and 46 eyes (96%), respectively, had extracapsular cataract extraction (P<.001). All eyes with a failed primary graft and 18 eyes (37%) with a clear primary graft had postoperative complications (P<.001). Eyes with a failed graft had more postoperative surgical interventions (P<.001). There were no statistical differences between eyes with clear grafts and eyes with failed grafts in sex, age, indications for surgery, corneal graft diameter, intraoperative vitreous loss, and intraocular lens placement. CONCLUSIONS: Intracapsular cataract extraction, postoperative complications, and postoperative surgical interventions may increase the risk for graft failure in simultaneous cataract extraction and PKP. Intraocular lens implantation did not increase the risk for graft failure.

Adolescent↗
PubMed2004

Cataract surgery in sympathetic ophthalmia.

PURPOSE: To analyze the results of cataract surgery in patients with sympathetic ophthalmia. SETTING: Sankara Nethralaya, Medical Research Foundation, Chennai, India. METHODS: This study comprised 66 patients (132 eyes) with sympathetic ophthalmia seen at the uveitis referral clinic between January 1990 and July 2001; 42 eyes (31.8%) had cataract. Cataract surgery was performed in 17 sympathizing eyes and 1 exciting eye (17 patients). The records of these 18 eyes were retrospectively analyzed. Three eyes had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, 6 eyes had ECCE without IOL implantation, and 9 eyes had phacoemulsification with IOL implantation. The mean follow-up was 28.7 months (range 3 to 60 months). RESULTS: The causes of sympathetic ophthalmia were penetrating trauma (n = 8 eyes), ocular surgery (n = 6), perforated corneal ulcer (n = 2), and cyclocryotherapy (n = 1). The most common cataract type, present in 7 eyes (38.8%), was mixed (posterior subcapsular and posterior polar). Visual acuity improved after surgery in 13 eyes (72.2%). The main factors impairing visual recovery were submacular scar and optic atrophy, which were sequelae of the sympathetic ophthalmia. Posterior capsule opacification was noted in 14 eyes (77.7%); it was visually significant in 6 eyes. There was no significant difference in postoperative inflammation or disease reactivation between the 3 types of surgery. CONCLUSIONS: Cataract extraction in cases of sympathetic ophthalmia can be safely and successfully performed with vigilant preoperative and postoperative control of inflammation, careful surgical planning, and meticulous surgical technique. The final visual outcome, however, depends on the posterior segment complications of the disease.

Adolescent↗
PubMed2005

Results of cataract extraction after implantable contact lens removal.

PURPOSE: To evaluate the visual results following insertion of implantable contact lenses (ICLs) in ametropic eyes and the development of subcapsular opacification with visual loss and to examine the anterior capsule, including the subcapsular tissue alteration, by light microscopy. SETTING: Department of Ophthalmology, Schlosspark-Klinik, affiliated hospital of the Charité Berlin, Humbold University, Berlin, Germany. METHODS: A prospective noncomparative interventional case series of anterior subcapsular cataracts in 9 of 127 (7.1%) patient eyes receiving ICLs to correct myopia and hyperopia was studied. The cataracts were phacoemulsified due to visual loss, and an intraocular lens (IOL) was implanted in the bag. After capsulorhexis, the anterior capsule was withdrawn for light microscopy examination. Visual acuity in each eye was measured before and after ICL implantation and before and after cataract extraction. The age range of cataract patients was 39 to 53 years. RESULTS: Implantable contact lens removal and phacoemulsification with IOL implantation for emmetropia resulted in an increased visual acuity compared to initial vision. Four of 28 hyperopic eyes (14.3%) developed subcapsular central opacification after ICL implantation, whereas 5 of 99 myopic patients (5.1%) developed opacifications. CONCLUSIONS: Patients should be informed prior to ICL implantation, there is a possibility of secondary subcapsular cataract formation and vision reduction. Although the posterior chamber inlay as well as the cataract can be removed and better acuity can be restored, a possible complication due to the ICL implantation cannot be avoided and the accommodation in young patients lost.

Adult↗
PubMed2004

Anti-cataract activity of Pterocarpus marsupium bark and Trigonella foenum-graecum seeds extract in alloxan diabetic rats.

Long-term complications are frequently encountered in diabetes mellitus and are difficult to treat. This study was undertaken to assess the effect of three antidiabetic plants on the development of cataract in rats. An aqueous extract of Pterocarpus marsupium Linn bark (PM, Hindi name: Vijaysar) (1 g kg(-1) day(-1)), Ocimum sanctum Linn leaves (OS, Hindi name, Tulsi) (200 mg kg(-1) day(-1)) and alcoholic extract of Trigonella foenum-graecum Linn seeds (FG, Hindi name, Methi) (2 g kg(-1) day(-1)) were given to alloxan (120 mg kg(-1)) diabetic rats until the development of cataract. Serum glucose and body weight were monitored at regular intervals while cataract was examined through naked eye as well as slit lamp at 75, 100 and 115 days after alloxan administration. Administration of all the three plant extracts exerted a favorable effect on body weight and blood glucose, the effects were best with PM followed by FG and OS. On the course of cataract development, PM followed by FG exerted anti-cataract effect evident from decreased opacity index while OS failed to produce any anti-cataract effect in spite of significant antihyperglycemic activity.

Alloxan↗
PubMed2004

Polymorphism of estrogen metabolism genes and cataract.

Cataract is the leading cause of visual impairment in older adults in the world. Age-related lens opacities are common and are frequent causes of loss of vision. The incidence of cataract increases significantly with increasing age in women only. The onset coincides with estrogen deficiency that occurs after menopause. Hormone replacement therapy has proven beneficial to selected postmenopausal women. Estrogen effects on biological system are modulated via the estrogen receptors (ER) and/or estrogen metabolites. Although ER have been detected in ocular tissue, whether ER polymorphism is related to cataract is not known at present. The polymorphisms of estrogen metabolizing enzymes are also related to the serum concentration and activity of estrogen. Polymorphism such as cytochrome P450c17 (A2/A2), cytochrome P450c1A (vt/vt) will result in increased formation of catechol estrogen, while people with catechol-O-methyltransferase (COMT) polymorphism COMT (L/L) will have decreased metabolism of catechol estrogen and decreased level of methoxyestradiol. COMT was also involved in tamoxifen metabolism which may further decrease the activity of COMT in breast cancer patients treated with tamoxifen. It is known that a 4-7% increase in cataract was found in tamoxifen-treated breast cancer patients than non-user. The 7.0% COMT (L/L) genotype in general population corresponded well with the 4-7% of cataract formation in tamoxifen-treated breast cancer patients. Our hypothesis is that breast cancer patients with COMT (L/L) genotype may be at increased risk of cataract formation after tamoxifen treatment.

Biomarkers, Tumor↗
PubMed2004

Changes in plasma membrane Ca2+ -ATPase expression and ATP content in lenses of hereditary cataract UPL rats.

The UPL rat is a newly developed hereditary cataract model. We previously found that Ca2+ concentrations in UPL rat lenses increase with the development of cataract, and that the administration of disulfiram and aminoguanidine ameliorates the increase in Ca2+ and the development of cataract in UPL rats. In this study, we determined the expression and activity of plasma membrane Ca2+-ATPase (PMCA) in lenses of normal and UPL rats. We also determined the ATP content in UPL rat lenses and the effects of disulfiram and aminoguanidine administration. Expression of PMCA mRNA in UPL rat lenses, determined by a reverse transcription-PCR method, increased during the development of cataract. Ca2+-ATPase activity in UPL rat lenses also increased with the progression of lens opacification. On the other hand, ATP decreased markedly in UPL rat lenses, and the administration of disulfiram and aminoguanidine attenuate the ATP decrease. These results suggest that an ATP decrease cause cataract development and an increased Ca2+ may upregulate PMCA expression in UPL rat lenses. Disulfiram and aminoguanidine attenuate the decrease in ATP, resulting in a delay in cataract development.

Adenosine Triphosphate↗
PubMed2001

Probability of Nd:YAG laser capsulotomy after cataract surgery in Olmsted County, Minnesota.

PURPOSE: To estimate the cumulative probability of Nd:YAG laser posterior capsulotomy after cataract extraction in a geographically defined population. METHODS: Rochester Epidemiology Project databases were used to identify retrospectively all Nd:YAG laser posterior capsulotomies performed on Olmsted County, Minnesota, residents who had previously undergone cataract extraction between 1988 and 1996, inclusive. Demographic data and potential risk factors for laser, including age, sex, surgical technique, year of surgery, and intraocular lens material, were obtained by chart review or by retrieval from computer databases. The cumulative probability of Nd:YAG laser posterior capsulotomy was calculated by Kaplan-Meier estimates, and risk factors were analyzed using the Cox proportional hazards model. RESULTS: A total of 925 Nd:YAG laser posterior capsulotomies were identified after 3541 cataract extractions in 2718 patients. The cumulative probability of Nd:YAG laser posterior capsulotomy after cataract surgery was 6% (95% confidence interval = 5% to 7%) at 1 year, increasing to 38% (35% to 40%) at 9 years. Young age at the time of surgery (P =.02), polymethylmethacrylate intraocular lens material (P <.001), earlier year of surgery (P <.001), and extracapsular extraction (in comparison with phacoemulsification, P <.001) were found to increase significantly the risk of subsequent Nd:YAG laser posterior capsulotomy. Women tended to have a greater probability of Nd:YAG laser posterior capsulotomy (P =.17), but this difference was not statistically significant. CONCLUSIONS: Nd:YAG laser posterior capsulotomy was common after cataract surgery but infrequent during the first postoperative year. Prolonged follow-up is necessary in investigations of the effects of new cataract surgery technologies on the probability of capsulotomy.

Adolescent↗
PubMed2003

The effect of cataract on Accumap multifocal objective perimetry.

PURPOSE: To determine the effect of visually significant cataract on Accumap multifocal objective perimetry. DESIGN: Interventional case series. METHODS: Fifteen eyes of 15 adult patients who underwent standard outpatient phacoemulsification cataract surgery with posterior chamber intraocular lens insertion with subsequent improvement of best-corrected visual acuity underwent Accumap testing before and after cataract extraction. Patients had no other ophthalmic disease or other conditions that may have affected visual evoked potentials. Results were analyzed statistically. RESULTS: Visually significant cataract was associated with a statistically significant reduction of mean Accumap amplitudes within the central 107 degrees (zone 1, P =.002; zone 2, P =.003; zone 3, P =.001) but did not affect the outer two zones (zone 4, P =.074; zone 5, P =.931). CONCLUSIONS: Accumap visual fields may be affected by visually significant cataract. Multifocal objective perimetry defects in the central 10 degrees should be interpreted with caution in patients with cataract.

Aged↗
PubMed2003

Surgical management of cataracts in children with juvenile rheumatoid arthritis-associated uveitis.

PURPOSE: To evaluate outcomes of cataract surgery with posterior chamber intraocular lens (IOL) implantation with or without trabeculectomy in children with juvenile rheumatoid arthritis (JRA)-associated uveitis. DESIGN: Interventional case series. METHOD: Retrospective chart review of five patients aged 12 years or younger with JRA-associated uveitis who underwent cataract surgery with posterior chamber IOL with or without trabeculectomy at the Cleveland Clinic Foundation from December 1995 to October 2001. RESULTS: Four female patients and one male patient ranging from age 7 to 12 years were identified. One patient had bilateral involvement; six eyes were included in the study. Three eyes underwent cataract extraction with posterior chamber IOL, and three underwent combined cataract surgery with posterior chamber IOL and trabeculectomy. Median age at surgery was 8.5 years, with a median follow-up of 43.5 months. Four of five children (five eyes) were on systemic methotrexate immunosuppressive therapy for a median length of 1.25 years before surgery. Two of five patients (three eyes) were also on additional systemic immunosuppressive or anti-inflammatory treatments. All eyes received frequent topical corticosteroid therapy for a median of 2 weeks preoperatively and 8.5 weeks postoperatively. A final postoperative Snellen visual acuity of 20/40 or better was achieved in all children. A median final visual acuity improvement of 7 Snellen lines was observed after cataract surgery. CONCLUSIONS: With adequate long-term preoperative and postoperative control of intraocular inflammation with systemic immunosuppressive therapy in addition to intensive topical corticosteroid treatment, children with JRA-associated uveitis can demonstrate favorable surgical outcomes after cataract surgery with posterior chamber IOL.

Administration, Topical↗
PubMed2003

Socioeconomic and lifestyle factors and the 10-year incidence of age-related cataracts.

PURPOSE: To investigate the association of socioeconomic and lifestyle factors with incidence of age-related cataracts. DESIGN: Population-based longitudinal epidemiologic study. METHODS: Persons aged 43 to 86 years (n = 4,926) living in Beaver Dam, Wisconsin, were examined in 1988 to 1990, 1993 to 1995, and 1998 to 2000. Medical histories were obtained, and photographs of the lenses were taken at each visit. Photographs were graded according to standard protocols. RESULTS: Socioeconomic and lifestyle factors considered were income, education, occupation, smoking, alcohol, caffeine, and multivitamin use. After adjustment for age and sex, income (or education) was inversely and smoking was directly related to the 10-year cumulative incidence of nuclear cataract. None of the factors were significantly associated with incident cortical or posterior subcapsular cataract. We found no evidence in these analyses to suggest that history of multivitamin use altered the relationships of smoking to the incidence of cataracts. In models adjusting for all other significant risk factors, the individual significance values for each individual factor differed little from the models adjusting only for age and sex. CONCLUSIONS: Incident nuclear cataract was associated with income and smoking 10 years earlier. There were no significant lifestyle exposures associated with incident cortical and posterior subcapsular cataract.

Adult↗
PubMed1997

Cardiovascular disease, selected cardiovascular disease risk factors, and age-related cataracts: the Beaver Dam Eye Study.

PURPOSE: To examine the associations of cardiovascular disease and selected cardiovascular disease risk factors with the prevalence of age-related cataract. METHODS: We conducted a population-based prevalence study of adults aged 43 to 86 years (n = 4,926) in Beaver Dam, Wisconsin. An ocular examination including lens photographs, medical history, height and weight measurement, blood testing, and photograph grading was performed according to standard protocols. RESULTS: Age and sex influenced most of the relationships between risk variables and cataract. Many relationships apparent in univariate analyses were not significant when controlling for confounders. In multivariate models, higher glycated hemoglobin was significantly and consistently associated with increased risk of nuclear cataract in women. For cortical cataract, higher serum high density lipoprotein cholesterol was associated with decreased risk in women. For posterior subcapsular cataract, men with higher ratios of total to high-density lipoprotein cholesterol were at increased risk. History of cardiovascular disease was not associated with cataracts in persons with or without diabetes after controlling for additional risk indicators. CONCLUSIONS: Some risk factors for cardiovascular disease were associated with increased frequency of age-related lens opacities. Age and sex influenced these relationships but did not entirely explain them. Longitudinal follow-up is necessary to determine antecedent-consequent relationships that may suggest causal associations.

Adult↗
PubMed1995

Cataract in infants treated with argon laser photocoagulation for threshold retinopathy of prematurity.

PURPOSE: Previous studies of lens opacities occurring after argon laser photocoagulation for retinopathy of prematurity indicate that the lens in these laser-treated eyes may be at risk for cataract. We studied the occurrence of permanent, visually significant cataracts in four infants after laser therapy for retinopathy of prematurity. METHODS: The records of 51 consecutive patients (100 eyes) treated only with argon laser photocoagulation for threshold retinopathy of prematurity at our institution were reviewed. Patient characteristics and treatment variables were compared between infants who developed cataracts and those who did not. RESULTS: Complete opacification of the lens nucleus and cortex developed in six eyes of four patients between 19 and 99 days after laser therapy. An additional patient developed a transient, focal, anterior capsular, and subcapsular opacity in one eye that cleared by one month postoperatively. Eyes that developed permanent cataracts were noted to have a prominent anterior tunica vasculosa lentis at the time of treatment. After laser therapy, these eyes developed hyphema, shallowing of the anterior chamber, corneal edema, and progressive opacification of the lens. When compared with eyes that did not develop cataract, no statistically significant difference in number of burns, zone or clock hours of extraretinal proliferation, birth weight, gestational age, or age at treatment was found. CONCLUSIONS: Cataract is a potential vision-threatening complication of argon laser photocoagulation that must be considered before choosing a treatment modality for infants with threshold retinopathy of prematurity.

Cataract↗
PubMed1982

Protein and electrolyte alterations in human senile cataract.

Water content, wet and dry weights of the crystalline lens, and protein, free amino acid and electrolyte levels in serum, aqueous humour and lens were determined in patients with nuclear senile cataract and at the different stages of the maturation of cortical cataract. In immature senile cortical cataract wet weight and sodium contents of the lens were significantly higher while potassium levels were low when compared with the nuclear cataract. With the maturation of cortical cataract water content, wet weight and sodium concentrations of the crystalline lens significantly increased while protein, free amino acid and potassium levels decreased. The possible role of these changes in various types of cataracts is discussed.

Aged↗