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At least 1,531 records · Page 85Linked to original sources
PubMed1999

Cataract surgery complications in 1 year at an academic institution.

PURPOSE: To delineate all complication rates of cataract surgery and define normative rates, trends, and outliers as part of continuous quality management. SETTING: John A. Moran Eye Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. METHODS: All cataract surgeries done at the John A. Moran Eye Center from July 1, 1996, to June 30, 1997 (1 complete academic year) were reviewed for intraoperative complications using operative reports. Cases with documented preoperative zonular dehiscence, traumatic capsule breakage, previous vitreous in the anterior chamber, or an accompanying major secondary procedure (e.g., trabeculectomy, corneal transplantation) were eliminated from the study. Over this year, 1729 cataract surgeries were performed by 12 attending physicians, 3 fellows, and 4 residents. Cases of cataract removal with intraocular lens implantation ranged from 18 to 510 per surgeon. RESULTS: There were 44 cases (2.54%) of posterior capsule rupture, with 29 (1.68%) requiring vitrectomy. Most capsule breakages occurred during phacoemulsification. The Student t test showed no statistically significant difference in the incidence of capsule breakage among surgeons (incidence from 0% to 6.25%). All cases were started as phacoemulsification, with 6 conversions (0.35%) to planned extracapsular cataract extraction. CONCLUSIONS: In evaluating continuous quality management, no outliers were found within our center. Phacoemulsification was the part of cataract surgery most likely to cause posterior capsule rupture.

Academic Medical Centers↗
PubMed2000

Comprehensive method of analyzing the results of photoastigmatic refractive keratectomy for the treatment of post-cataract myopic anisometropia.

PURPOSE: To assess the efficacy, stability, and safety of photoastigmatic refractive keratectomy (PARK) in treating post-cataract myopic anisometropia to restore binocularity and to describe a comprehensive method for analyzing the results of refractive surgery. SETTING: St. Paul's Eye Center, Royal Liverpool Hospital, Liverpool, United Kingdom. METHODS: Nineteen patients (20 eyes) with post-cataract myopic anisometropia were treated with PARK using a VISX Twenty-Twenty laser and followed for 12 months. Cataract surgery had been performed between 10 and 144 months (mean 43.4 months) previously. A comprehensive method based on Long's matrix formalism and the vech operator of Harris, in addition to the nearest equivalent sphere and cylinder, was used to analyze the refractive data. RESULTS: The mean preoperative refraction in the post-cataract eyes was -4.79 +1.17 x 0.2 and in the fellow eyes, +0.02 +0.31 x 166. Twelve months after PARK, the postoperative refraction in the post-cataract eyes was -0.90 +0.65 x 2, a significant reduction (P = .15). This postoperative refraction was not significantly different from that in the fellow eye (P = .93). The pretreatment mean uncorrected visual acuity was 0.12. It improved to 0.41 at 12 months, at which time 52% of eyes achieved a visual acuity of 0.5 or better without correction. All patients regained binocularity. At 12 months, 2 eyes (11%) showed clinically unacceptable regression; 1 eye with grade 2 haze lost 1 line of corrected visual acuity. CONCLUSIONS: Photoastigmatic refractive keratectomy reduced post-cataract myopic anisometropia, allowing restoration of binocularity in all patients. Overall, the results in this elderly population with previous ocular surgery, posterior capsule thickening, and macular degeneration are not as satisfactory as those obtained from similar treatment of physiological myopia. Stability and postoperative complications are acceptable.

Adult↗
PubMed1999

Cataract progression in patients with atopic dermatitis.

PURPOSE: To evaluate the possible causes of cataract progression in Japanese patients with atopic dermatitis. SETTING: Department of Ophthalmology, Toyama Medical and Pharmaceutical University, Toyama, Japan. METHODS: This prospective study comprised 41 patients (81 eyes) with atopic dermatitis. Cataract progression was determined by photographs and visual acuity results. Mean follow-up was 2.5 years (range 1.0 to 3.5 years). RESULTS: Of 41 patients, 10 (24.4%) had progression of cataract. Of 81 eyes, 10 (12.3%) had slow progression and 9 (11.1%), rapid. Cataract progression was not statistically significantly related to patient sex or severity of systemic skin lesions but was to facial skin lesions. Soft contact lens wear and eye rubbing were also correlated with cataract progression. CONCLUSION: Patients with facial atopic dermatitis, contact lenses, or both may rub their eyes more frequently than those with lesions on other body parts, increasing their risk of cataract progression.

Adolescent↗
PubMed2003

Parenting stress among caregivers of children with congenital cataracts.

OBJECTIVE: To examine parenting stress among caregivers of young children with congenital cataracts and to assess whether diagnostic and/or treatment differences are associated with differences in perceived parenting stress. METHODS: Parents of 41 preschool-age children with congenital cataracts (13 with bilateral cataracts [BCCs] and 28 with unilateral cataracts [UCCs], of whom 14 were aphakic and 14 were pseudophakic) completed the Parenting Stress Index (PSI) and/or a disease-specific parental stress measure, ie, the Ocular Treatment Index (OTI). RESULTS: The 28-item OTI had excellent internal consistency (alpha = 0.94) and supported three of four a priori validity hypotheses. Parents of children with congenital cataracts reported normal parenting stress levels on the PSI. Parents of children with UCCs tended to report higher levels of stress, but not significantly so, than did parents of children with BCCs. Among parents of children with UCCs, those whose children were aphakic reported higher levels of stress on the OTI and all of the PSI subscales than did parents of pseudophakic children. These differences were statistically significant for two subscales (Adaptability [P =.03] and Mood [P =.01]). CONCLUSIONS: Although parents of children with congenital cataracts generally did not report increased parenting stress levels, clinicians should be aware that parenting stress can adversely impact patients' families. We did observe higher stress levels in parents with children who had UCCs and did not receive an intraocular lens-particularly stress related to their child's reaction to sensory stimulation and mood-compared with parents of pseudophakic children. Thus, clinicians may want to consider parenting stress levels when choosing a treatment for children with UCCs, especially because such stress has been associated with poor treatment compliance for children with other chronic conditions.

Adaptation, Psychological↗
PubMedDate not supplied

Genetic localization and phenotypic expression of X-linked cataract (Xcat) in Mus musculus.

Linkage data relative to the markers tabby and glucose-6-phosphate dehydrogenase are presented to locate X-linked cataract (Xcat) in the distal portion of the mouse X-chromosome between jimpy and hypophosphatemia. The human X-linked cataract-dental syndrome, Nance-Horan Syndrome, also maps closely to human hypophosphatemia and would suggest homology between mouse Xcat and human Nance-Horan Syndrome genes. In hemizygous males and homozygous females penetrance is complete with only slight variation in the degree of expression. Phenotypic expression in Xcat heterozygous females ranges from totally clear to totally opaque lenses. The phenotypic expression between the two lenses of a heterozygous individual could also vary between totally clear and totally opaque lenses. However, a correlation in the degree of expression between the eyes of an individual was observed. A variegated pattern of lens opacity was evident in female heterozygotes. Based on these observations, the site of gene action for the Xcat locus is suggested to be endogenous to the lens cells and the precursor cell population of the lens is concluded to be small. The identification of an X-linked cataract locus is an important contribution to the estimate of the number of mutable loci resulting in cataract, an estimate required so that dominant cataract mutagenesis results may be expressed on a per locus basis. The Xcat mutation may be a useful marker for a distal region of the mouse X-chromosome which is relatively sparsely marked and the X-linked cataract mutation may be employed in gene expression and lens development studies.

Animals↗
PubMed2004

Eye fluke-induced cataract formation in fish: quantitative analysis using an ophthalmological microscope.

We examined the parasite-induced cataract formation in rainbow trout (Oncorhynchus mykiss) using slit-lamp microscopy to determine the relationship between cataract intensity and number of Diplostomum spathaceum parasites that were established in the lens. Cataract intensity increased significantly with parasite burden, but was also affected by the pattern of exposure to the parasite cercariae. The slit-lamp methodology proved useful in scoring the cataracts since it provides a 3-dimensional view into the lens and gives an actual picture of the location and intensity of the cataracts, which allows detailed investigations of mechanisms underlying cataract formation in various fish species. Potential applications of the method in fish farming and parasitological studies are discussed.

Animals↗
PubMed2003

Mutations in galactose-1-phosphate uridyltransferase gene in patients with idiopathic presenile cataract.

Impaired activity of the enzyme galactose-1-phosphate uridyltransferase (GALT) has been proposed as a risk factor for idiopathic presenile cataract. A study was undertaken to determine the prevalence of the three most common mutations in the GALT gene (Q188R, K285N and N314D, including its variant Duarte-2) in a group of Slovenian patients with idiopathic presenile cataract. GALT activity was determined in the erythrocytes of 30 cataract patients. DNA was isolated from their blood and analysed for Q188R, K285N and N314D mutations and IVS5-24G>A intronic variation by means of polymerase chain reaction and digestion with restriction enzymes. The average GALT activity of the cataract group was 19.5+/-4.9 U/g Hb, which is lower than the normal range (p = 0.034). Frequencies of Q188R, K285N, N314D and Duarte-2 alleles in the cataract group were 0.00%, 5.0%, 11.7% and 3.3%, respectively. Only the frequency of the K285N mutation was significantly higher in the patient group than in the control group (p = 0.0244). Our results support the reported association of decreased GALT activity with idiopathic presenile cataract. Molecular analysis indicates that, in the Slovenian population, this association is linked to the K285N mutation, which is neonatally benign in heterozygotes.

Adult↗
PubMed1999

The occurrence of congenital cataract in western Sweden.

PURPOSE: To estimate the occurrence of congenital cataract in a Nordic country. METHODS: In 1980, we constructed a database in the Department of Ophthalmology, Göteborg University, containing basic data from all cases in western Sweden diagnosed with congenital cataract. By collecting and processing these data from 1980 onwards, we hoped to improve the management of congenital cataract treatment and to optimize the outcome of the treatment. RESULTS: In this study, the incidence of congenital cataract in the four western counties of Sweden was evaluated. The occurrence rate of all cases with congenital cataract during the study period was 36 cases per 100,000. The occurrence rate for dense bilateral and all unilateral cases were both 14 per 10,0000 each. CONCLUSION: There were no time-related changes in incidence of congenital cataract from 1980 until today, although there was a large variation in the yearly incidence.

Cataract↗
PubMed2001

Gender and referral to cataract surgery in Sweden.

PURPOSE: To investigate how cataract surgery was initiated and analyse possible gender difference in referral to surgery. METHODS: Consecutive patients scheduled for first eye cataract surgery at three Swedish community-run eye departments were interviewed concerning how surgery was initiated. RESULTS: 649 patients were interviewed and 63.2% were female. The number of patients referred to surgery by an earlier contact with a health care provider was 271 (41.8%) and the remaining 378 (58.2%) patients had actively requested advice or help because of visual problems caused by cataract and without a prior regular contact. 44.7% of female patients were referred through a health care provider they visited for reasons other than cataract and the corresponding number for male patients was 36.8%. This gender difference is statistically significant at the 5% level. CONCLUSION: A health care provider that patients visited for other problems than cataract referred female patients to cataract surgery to a significantly higher degree than male patients.

Cataract Extraction↗
PubMed1990

The increasing frequency of surgery for cataract.

The increasing frequency of cataract operation was investigated by examining the age related cataract extraction rates for Glasgow. Detailed analysis of case records of sample patients over the past decade was carried out to characterise trends in frequency of intraocular lens implantation, age of the patient at operation, preoperative visual acuity and rate of operation on the second eye. Between 1980 and 1987 the rate of cataract operation per thousand increased from 7.1 to 10.5 for patients aged 75 years and over and from 3.6 to 4.2 for those aged 65 to 74 years. There was a marked rise in the number of cataract operations relative to other eye operations between 1977 and 1988, from 19.3% to 37% and this increase was greatest in patients of 70 years and over. The same decade has seen intraocular lens implantation rise from 0% to 94.6% of cataract extractions. Visual acuity data show a significant trend towards operation at a better level of acuity in patients aged 70 years and over (p = 0.028) but not in younger age groups. There was no change in the visual acuity of the fellow eyes and no change in the frequency of operation on the second eye. It appears that cataract surgery is increasing more than can be predicted from the age of the population and this must be recognised in planning the future level of ophthalmology services.

Adult↗
PubMed1994

Water content, lens hardness and cataract appearance.

Hardening of a cataractous lens is associated with the clinical appearance of brunescence and advancing age. Alterations in the nature and concentration of proteins, lens fibre compaction and other biochemical changes may all be contributing factors towards increased hardness. As the nucleus confers most of the rigidity to the lens and water content decreases towards the centre of the nucleus, the hardness might be thought to be related to total water content. To study the relationship between water content, hardness and the clinical appearance of cataract, 135 lenses were obtained from eyes undergoing extracapsular cataract surgery. The cataracts were assessed and classified pre-operatively. Lens hardness was determined by a specially designed guillotine and water content was measured by weighing the lens before and after desiccation. A regression analysis was carried out to look at the variation of lens water content with hardness, degree of nuclear sclerosis, extent of cortical and posterior subcapsular cataract, vacuolation and age. Multivariate analysis of data demonstrated a relationship between lens hardness and lens water content, degree of nuclear sclerosis and age (R2 = 0.59). An association could not be detected between lens water content and age, degree of nuclear sclerosis, extent of cortical and posterior subcapsular cataract and vacuoles. This study suggests that hardening of the lens is reflected by a respective decrease in water content. Increased hardness is associated with coloration and advancing age.

Adult↗
PubMed1998

Age-related cataract and place of birth.

Cataract patient data from 13 Australian practitioners were analysed in order to compare the distribution of seven principal types of cataract in relation to gender, age and place of birth. Relative odds ratios were calculated for age-matched pairs of three identifiable ethnic groups and each type of cataract. The number of statistically significant relative odds ratios far exceeds the expectation due to chance. The results suggest a relatively greater risk for cortical cataract amongst younger when compared with older groups. In contrast, the relative odds ratios for nuclear cataract, independently of age, were consistently greater than unity when Australians or Northern Europeans were compared with Southern Europeans. There was no gender-based difference in cataract type distribution.

Age Distribution↗
PubMed1999

Impact of cataract surgery on visual acuity and subjective functional outcomes: a population-based study in Sweden.

PURPOSE: First, to determine the effects of cataract surgery on subjectively experienced visual function and visual acuity in a defined population, at a specific frequency of surgery. Secondly, to validate questionnaire data regarding the visual function of cataract patients. METHODS: A prospective population-based investigation of the subjective visual functional and visual acuity outcomes of cataract surgery over a 1 year time interval at one institution was conducted. All operated cases (n = 459) were grouped into three levels of visual impairment, according to the preoperative visual acuities of their better eyes. Subjective reading, TV watching, distance estimation and ability to orientate in unfamiliar surroundings, before and after surgery, were assessed using self-administered questionnaires. The subjective outcomes were related to the subjects' post-operative visual acuities. The statistical evaluations comprised analyses of variance, Yates'-corrected chi-squared tests, weighted kappa and correlation statistics. RESULTS: The pre-operative subjective visual disabilities of the patients were significantly correlated with the pre-operative visual acuities of the patients' better eyes. There was an improvement in subjective reading ability, distance estimation and ability to orientate in unfamiliar surroundings for most patients at all three pre-operative visual acuity levels. After surgery there was a stronger correlation between the subjective functional improvement and the increase in visual acuity for the operated eye than for the better eye. CONCLUSIONS: An incidence of cataract surgery of 3.3 per 1000 population for the year the present study was conducted seems not to be an over-utilisation of resources. Irrespective of the visual acuity level before cataract surgery, the vast majority of patients gain better subjective visual function and better acuity after surgery. It is possible to gain valid information from cataract surgery patients using a short questionnaire.

Activities of Daily Living↗
PubMed1999

Subjective visual experience during extracapsular cataract extraction and intraocular lens implantation under retrobulbar anaesthesia.

PURPOSE: To investigate the subjective visual experience of patients during cataract surgery under retrobulbar anaesthesia. METHODS: One hundred cataract patients who underwent routine extracapsular cataract extraction and intraocular lens implantation under retrobulbar anaesthesia were interviewed by the authors on the same day after their operation regarding their visual experience in the operated eye during surgery. RESULTS: Forty-three men and 57 women were included in the study. Their mean age was 68.4 years (range 40-87 years). Their pre-operative best corrected visual acuity ranged from 6/12 to perception of light. Eighty-four eyes had no other ocular pathology apart from cataract. Twenty patients reported no light perception during the surgery. The rest reported that they could see light (80 patients), one or more colours (56 patients), movements (39 patients), flashes (36 patients), instruments (16 patients) and/or the surgeon's fingers or hands (10 patients). The colours seen included red (29 patients), yellow (29 patients), green (12 patients), blue (11 patients) and orange (2 patients). Fifteen patients saw a spectrum of colours similar to that of the rainbow. Forty-four patients reported that the brightness of light changed during the operation. Five patients found their visual experience frightening. There was no correlation between those who found the experience frightening and the sex or age of patient, presence of coexisting ocular pathology, duration of operation, whether the operation was the first or second cataract operation in the patient, or the type of visual sensation experienced. CONCLUSION: Many patients undergoing cataract surgery under retrobulbar anaesthesia experience a variety of visual sensations that may be frightening in a small proportion of cases.

Adult↗
PubMed2000

Linkage analysis in an autosomal dominant 'zonular nuclear pulverulent' congenital cataract, mapped to chromosome 13q11-13.

PURPOSE: To determine by linkage analysis the chromosomal locus responsible for autosomal dominant congenital cataract (ADCC) in a four-generation Welsh pedigree. METHODS: The family pedigree was traced through two members of the family attending the hospital for treatment of their cataracts. Twenty-five members of the family were examined ophthalmologically and blood was collected with consent for genetic linkage analysis. RESULTS: Fifteen members of this family were known to have bilateral congenital cataracts, of whom 11 had a cataract extraction prior to examination. The youngest member of the pedigree was 5 years old and the oldest was 78 years old. Four children, unoperated at the time of this study, had a phenotypically identical morphology of their zonular pulverulent congenital cataracts. The known loci for congenital cataract were excluded. Significant lod scores for markers in the 13q11-13 region were detected with a Zmax of 3.59 D13S1236 (theta = 0.00). CONCLUSIONS: We report linkage of an ADCC of the zonular pulverulent type to chromosome 13q11-13 in a four-generation family.

Adolescent↗
PubMed2002

Mutant DNA-binding domain of HSF4 is associated with autosomal dominant lamellar and Marner cataract.

Congenital cataracts cause 10-30% of all blindness in children, with one-third of cases estimated to have a genetic cause. Lamellar cataract is the most common type of infantile cataract. We carried out whole-genome linkage analysis of Chinese individuals with lamellar cataract, and found that the disorder is associated with inheritance of a 5.11-cM locus on chromosome 16. This locus coincides with one previously described for Marner cataract. We screened individuals of three Chinese families for mutations in HSF4 (a gene at this locus that encodes heat-shock transcription factor 4) and discovered that in each family, a distinct missense mutation, predicted to affect the DNA-binding domain of the protein, segregates with the disorder. We also discovered an association between a missense mutation and Marner cataract in an extensive Danish family. We suggest that HSF4 is critical to lens development.

Amino Acid Sequence↗
PubMed2004

Cataract surgery after intravitreal injection of triamcinolone acetonide.

PURPOSE: To report the clinical outcome of patients undergoing cataract surgery after one or repeated intravitreal injections of triamcinolone acetonide as treatment of intraocular neovascular or oedematous diseases. METHODS: The interventional clinical case series study included all patients (n=22) who presented with cataract which had progressed after a single or repeated intravitreal injection of 25 mg of triamcinolone acetonide as treatment of exudative age-related macular degeneration (n=18) or diffuse diabetic macular oedema (n=4). Duration of the follow-up period was 3.76+/-4.99 months. With topical anaesthesia, the patients underwent standard cataract surgery including clear cornea incision, phakoemulsification and aspiration of the lens nucleus and cortex, and implantation of a foldable posterior chamber lens. The main outcome measures were frequencies of capsular rupture, vitreous loss, postoperative infectious endophthalmitis, secondary cataract, and decentration of the intraocular lens, visual acuity and intraocular pressure. RESULTS: Intraoperative dialysis of the lens zonules occurred in one (4.5%) eye and resulted in a loss of vitreous. Secondary cataract leading to Nd : YAG laser capsulotomy was observed in one (4.5%) eye. An optically significant decentration of the IOL or infectious endophthalmitis was not encountered in any patient. Visual acuity increased from 0.11+/-0.10 to 0.13+/-0.94 during the follow-up. Within 1 week after surgery, intraocular pressure was in the normal range in all the eyes. CONCLUSIONS: Cataract surgery after single or repeated intravitreal injection of 25 mg of triamcinolone acetonide does not harbour a markedly elevated frequency or a markedly changed profile of surgical complications.

Aged↗
PubMed2005

Downregulation of gene expression in the ageing lens: a possible contributory factor in senile cataract.

PURPOSE: To study the molecular characteristics of lens epithelial cells from patients with senile cataract by cDNA microarray technique. METHODS: Lens epithelial cells adhering to anterior capsules taken during cataract surgery collected from 108 patients, aged 56-92 years (senile cataract group), were pooled. Pooled epithelial cells of normal, noncataractous lenses from one patient with ocular trauma, one patient with lens subluxation, and 25 cadaveric eyes, all under the age of 55 years, served as a control. Total RNA was extracted by conventional methods from the two groups of cells, and a fluorescent probe was prepared for each group. The probes were hybridized on 9700 known human cDNA clones. Hybridized clones were analysed using a scanning laser and the results were processed by GEMTools (Incyte Genomics) software. RESULTS: A total of 1827 clones hybridized with the two probes. Of these, 400 showed differences of more than two-fold in gene expression between the two probes. Relative to controls, gene expression in the senile cataract lenses was upregulated in 318 clones and downregulated in 82. Three genes-filensin, inwardly rectifying potassium channel (IRPC), and pigment epithelium-derived factor (PEDF) were strongly downregulated (by 41.3-, 6.8-, and 5.9-fold, respectively) in senile cataract. CONCLUSIONS: Cataractogenesis is associated with numerous changes in the genetic profile of the lens epithelial cells. Since filensin, IRPC, and PEDF genes are known to have important roles in the physiology and morphology of the transparent lens, substantial downregulation of their expression might contribute to the formation of senile cataract.

Aged↗