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At least 19 recordsLinked to original sources
PubMed1995

[Morphologic changes in the lens epithelium in patients with age-induced cataract, radiation and steroid cataract and cataract following eye contusion].

The lens epithelium of the human eye plays a crucial role in the pathogenesis of primary and secondary cataract. Sixty hematoxylin-eosinstained lens epithelia were examined using a light microscope. Cell parameters were compared to one another in the various age groups of patients, between patients with secondary cataract (radiation cataract, steroid cataract and traumatic cataract) and patients with senile cataract, and between male and female patients. The t-test was used for statistical comparison. The median cell density was 3116.5 cells/mm2. The median nucleus-plasma ratio was 1:2.74. Patients with secondary cataract had a larger medium cell and nucleus area as well as a higher nucleus-plasma ratio and a lower cell density than patients with senile cataract. A part from degenerative and proliferative cell changes we found various cell types. The age of patients and the cause of cataract correlate with morphometric changes of lens epithelium cells. However, there was no correlation between specific cytologic changes and causes of cataract.

Adolescent↗
PubMed1984

Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method: II. Staged simplification of cataract classification.

One thousand nine hundred and seventy-six cataracts extracted intracapsularly were classified according to the system adopted by the Cooperative Cataract Research Group (CCRG) Consortium. A nine-stage protocol for simplifying the classification data is presented. The method of simplifying the basic CCRG classification emphasizes anatomic similarities among lenses. Simplification is indicated when small numbers of cataracts in any class provide insufficient statistical power to allow detection of scientifically or clinically important differences in rates between comparison groups, if such differences exist; however, simplification unavoidably obscures the anatomic, biochemical, and biophysical features of individual cataracts. Age-specific characteristics of this population of 1976 cataracts are used to demonstrate the effects of the simplification process. The preponderance of mixed cataracts and the relative scarcity of pure cataracts are documented, and the implications of these numbers for cataract research are presented.

Age Factors↗
PubMed2001

Age-related utilisation of cataract surgery in Sweden during 1992-1999. A retrospective study of cataract surgery rate in one-year age groups based on the Swedish National Cataract Register.

PURPOSE: To study the utilisation and increase of first eye cataract surgery in one-year age groups between 60 and 90 years of age during 1992-1999. METHODS: Data was extracted from the National Swedish Cataract Register (NCR) that covers about 93.2% of all cataract extractions performed in Sweden during 1992-1999. The total number of living persons in each one-year age group was collected from the Year Book of Statistics in Sweden (1993-2000). RESULTS: The number of cataract extractions in Sweden increased by 54.8% from 1992 to 1999. The rates of first eye cataract surgery in one-year age groups between 60 and 90 years of age were different for females and males and this difference did not change during a 37% increase of the surgery volume from 1992 to 1999. The rate of first eye cataract surgery increased significantly both for females (+29.4%) and males (+27.2%) during 1992 to 1999 in Sweden. CONCLUSION: The rate of first eye cataract surgery increased significantly from 1992 to 1999 but the gender difference in age-related utilisation of surgery remained unchanged. The increase in rate was about the same in all age groups.

Age Distribution↗
PubMed1994

National outcomes of cataract extraction. Retinal detachment and endophthalmitis after outpatient cataract surgery. Cataract Patient Outcomes Research Team.

BACKGROUND: A near-total shift to cataract extraction on an outpatient basis occurred as a result of an administrative ruling by the Health Care Financing Administration. No national study has been conducted to assess the possible effects of that decision on clinical outcomes of surgery. The authors compared the rates of retinal detachment (RD) repair and hospitalization for endophthalmitis after extracapsular cataract extraction (ECCE) (including phacoemulsification) in 1986 and 1987 with those following inpatient cataract extraction in 1984. METHODS: Using the 5% random sample of Medicare beneficiaries, we analyzed the claims of all individuals 66 years of age or older who underwent ECCE by nuclear expression or phacoemulsification in 1986 and 1987. A total of 57,103 patients were identified and followed to the end of 1988. Cumulative probability of RD repair and hospitalization for endophthalmitis was calculated by standard lifetable methods. These findings were compared with the cumulative probability of the same complications in a cohort of 330,000 patients who underwent cataract extraction on an inpatient basis in 1984. RESULTS: In the 1986-to-1987 cohort, the cumulative probability of RD within 3 years after cataract surgery was 0.81% and the cumulative probability of endophthalmitis within 1 year was 0.08%. The rate of RD is similar to that which we previously reported for 330,000 patients who underwent inpatient surgery in 1984, but the rate of endophthalmitis is significantly lower in the 1986-to-1987 outpatient cohort (0.08% versus 0.12%; z = 2.42; P = 0.01). CONCLUSIONS: The shift to outpatient cataract surgery was accompanied by no significant increase in the probability of RD repair and possibly a significant decrease in the rate of hospitalization for endophthalmitis.

Aged↗
PubMed1984

Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method: III. The association of nuclear color (sclerosis) with extent of cataract formation, age, and visual acuity.

Nineteen hundred and seventy-six immature human cataracts extracted intracapsularly were classified according to the Cooperative Cataract Research Group (CCRG) method of cataract classification. Data on cataract location and extent, nuclear color, preoperative visual acuity, age, and sex were organized and stored in the PROPHET system. The data were examined for relationships between nuclear color (sclerosis) and the age of the cataractous lens, the extent of opacification in seven anatomical regions including the degree of nuclear opacification and the preoperative visual acuity. Nuclear color correlates with age in a curvilinear manner. Nuclear yellowing increases gradually with increasing nuclear opacification, but the color change is so slight as to be useless for the purposes of inferring the intensity of nuclear opacification from the color of the nucleus. There is no association between the extent of anterior cortical, equatorial cortical, posterior cortical, subcapsular or supranuclear opacification, and nuclear color. Nuclear color impairs vision only for the range dark yellow through black. These data justify the recommendation that nuclear color be abandoned as the single index of the severity of any type of senile cataractous change.

Age Factors↗
PubMed2001

[Complicated cataract: Part II: complicated cataract in glaucoma. Part II: Complicated cataract in retinal degenerative disorders].

The paper shows pathognomonique cases of complicated cataracts concerning the prognostic aspects of surgical treatment. The article presents surgical methods of treating patients with secondary cataract in high myopia and glaucoma. Modern diagnostic methods are discussed, how to choose the safest surgical technique and to reach the desired postoperative refraction. More effective ways of cataract surgery in patients with glaucoma and in high myopia are suggested.

Cataract↗
PubMed2000

Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters.

PURPOSE: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract. METHODS AND MATERIALS: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment. RESULTS: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 x 8 or 2 x 5 Gy TBI, from patients receiving 2 x 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 x 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 x 6 Gy group might also have been caused to a significant extent by steroid treatment. The percentage of patients with high-grade cataract was lower in allogeneic transplanted patients without steroid treatment for GVHD than in autologous transplanted patients: 35% versus 48%. An explanation for this could be pretransplant therapy containing high-dose steroids. CONCLUSIONS: After high-dose-rate TBI in one or two fractions, steroids for GVHD influence latency time of a cataract and are of great importance for the severity the cataract finally attains. Although a cataract will develop in all patients, a clinically important high-grade cataract is relatively infrequent in patients not treated with steroids. Pretransplant therapy might also influence final severity of cataract.

Adolescent↗
PubMed1993

Cataract development and cataract surgery in patients with juvenile rheumatoid arthritis-associated iridocyclitis.

PURPOSE: The authors used an aggressive stepladder, steroid-sparing, therapeutic algorithm in the care of patients with iridocyclitis associated with juvenile rheumatoid arthritis (JRA) to preserve vision, limit cataract formation, and improve probability of successful visual rehabilitation when cataract surgery became necessary. METHODS: The authors treated 60 patients with JRA-associated iridocyclitis with topical and regional corticosteroids, systemic nonsteroidal anti-inflammatory drugs, systemic steroids, and systemic immunosuppressive chemotherapy to achieve total quiescence of intraocular inflammation. Cataract surgery (phacoemulsification extracapsular cataract extraction) combined with pars plana vitrectomy was performed on those eyes with cataract sufficient to limit visual acuity to 20/200 or less, after maintenance of complete freedom from inflammation for at least 3 months. The incidence of cataract development and the visual outcome of cataract surgery were analyzed in those patients for whom a minimum follow-up of 1 year was available. RESULTS: Eventually, 10 of the 60 patients required systemic immunosuppressive chemotherapy in the stepladder therapeutic approach to achieve complete abolition of all active inflammation. Of 72 phakic eyes without cataract, significant cataract developed in 13 (18%) while under our care. The average postoperative stable visual acuity in this group was 20/40. Sixteen eyes of 12 additional patients had visually significant cataract at the time of our first evaluation of them. The average postoperative stable visual acuity in this group of patients after cataract surgery was 20/40. CONCLUSIONS: Iridocyclitis associated with JRA is an insidiously blinding disease, with 12% of individuals affected by this problem eventually blinded by the inflammatory consequences to the eye. A therapeutic philosophy of complete intolerance for active inflammation and limited tolerance for chronic steroid use may offer the most realistic hope for the next step in progress to prevent blindness in this patient population. The results of this study suggest that such a therapeutic attitude results in diminished cataract prevalence and decreased prevalence of vision-limiting retinal pathology, with resultant improved visual outcome of the cataract surgery which is eventually needed in a small proportion of the patients.

Adolescent↗
PubMed2003

Validity of a personal and family history of cataract and cataract surgery in genetic studies.

PURPOSE: To determine the accuracy of a history of cataract and cataract surgery (self-report and for a sibling), and to determine which demographic, cognitive, and medical factors are predictive of an accurate history. METHODS: All participants in the Salisbury Eye Evaluation (SEE) project and their locally resident siblings were questioned about a personal and family history of cataract or cataract surgery. Lens grading at the slit lamp, using standardized photographs and a grading system, was performed for both SEE participants (probands) and their siblings. Cognitive testing and a history of systemic comorbidities were also obtained for all probands. RESULTS: Sensitivity of a history of cataract provided on behalf of a sibling was 32%, specificity 98%. The performance was better for a history of cataract surgery: sensitivity 90%, specificity 89%. For self-report of cataract, sensitivity was also low at 55%, with specificity at 77%. Self-report of cataract surgery gave a much better performance: sensitivity 94%, specificity 100%. Different cutoffs in the definition of cataract had little impact. Factors predicting a correct history of cataract included high school or greater education in the proband (odds ratio [OR] = 1.13, 95% confidence interval [CI]1.02-1.25) and younger sibling (but not proband) age (OR = 0.94 for each year of age, 95% CI 0.90-0.99). Gender, race and Mini-Mental Status Examination (MMSE) result were not predictive. CONCLUSIONS: Whereas accurate self and family histories for cataract surgery may be obtainable, it is difficult to ascertain cataract status accurately from history alone.

Aged↗
PubMed2001

Direct optometrist referral of cataract patients into a pilot 'one-stop' cataract surgery facility.

OBJECTIVES: To determine the feasibility of a) direct optometrist referral of patients with cataract, and b) combined assessment with same day cataract surgery ('one stop' cataract surgery). METHODS: Evaluation of 169 patients referred directly by optometrists into a pilot 'one stop' cataract surgery facility. RESULTS: Of 169 referrals, 160 patients (94.7%) were given confirmed appointments for the 'one stop' cataract service and 9 patients (5.3%) were appointed conventionally. Of 160 patients attending the 'one stop' cataract service, 154 patients (96.3%) underwent cataract surgery at the same visit, in 4 patients (2.5%) cataract surgery was indicated but deferred and in 2 patients (1.3%) cataract surgery was not indicated. The referral was supplemented with information regarding the patient's medical history forwarded by the general practitioner for 3 patients (1.8%). There were no systemic or sight-threatening complications. 151 patients (98.1%) achieved a visual acuity of 6/12 or better at a mean of 31 days post-operatively. CONCLUSION: Optometrists can accurately predict the need for cataract surgery and refer directly into a pilot 'one stop' cataract surgery facility, without the need for general practitioner involvement. 'One stop' cataract surgery is feasible; benefits to the patient include the abolition of the need to visit the general practitioner for consultation and referral, and the hospital for pre-assessment.

Ambulatory Surgical Procedures↗
PubMed1992

[Measuring scattered light with the Opacity Lensmeter 701 in normal eyes and eyes with cataracts. Correlation between scattered light and cataract-induced vision loss].

In 50 eyes with nuclear cataract, posterior subcapsular cataract and cortical cataract and 34 normal eyes, the amount of scattered light was determined using the Opacity Lensmeter 701 to determine its accuracy in distinguishing between clear and cataractous lenses. Taking as a basis the manufacturer's statement that normal lenses show Opacity Lensmeter readings of less than 25 and that cataractous lenses show Opacity Lensmeter readings of more than 30, 94% of the nuclear cataract cases, 62% of the posterior subcapsular cases and 66% of the cortical cataract cases were identified as being pathologically opaque. Of the normal eyes, 88% had an Opacity Lensmeter reading of less than 25. Among the types of cataract examined, a significant linear relationship (P < 0.05) between visual acuity loss due to cataract and scattered light measurements could be found only in eyes with nuclear cataract, with the individual results heavily scattered around the linear regression. In the case of nuclear cataracts, measuring scattered light with the Opacity Lensmeter is suitable for making general statements on visual loss due to cataract for a whole group of patients. However, in individual cases the results can only be used together with other clinical examinations.

Adult↗
PubMed1999

By the way, doctor... I am 83 and my vision is going. I gave up driving years ago, but it is getting so I can't see faces across the room and reading is a strain. Because I have a condition called Fuchs' corneal dystrophy, as well as cataracts, my doctor says I need to consider having both a cataract operation and corneal transplant. But I am worried about the long recovery period. Couldn't I just get by with the cataract operation, which I understand has a recovery period of only a few days?

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Aged↗
PubMedDate not supplied

Congenital cataract surgery in children with cataract as an isolated defect and in children with a systemic syndrome: a comparative study.

PURPOSE: To compare visual acuity outcome in two groups of children who underwent congenital cataract surgery. The first group is one in which an isolated cataract occurred; the second group is one in which cataract occurred in conjunction with a systemic disease. METHODS: A review of 46 charts: 36 children (50 eyes) with congenital cataract as an isolated defect, and 10 children (16 eyes) with cataract as part of a systemic disease. RESULTS: One third of the eyes with isolated cataract had postoperative visual acuity better than 6/12, although none of the patients in the syndrome group had visual acuity better than 6/12. This difference was statistically significant (p = 0.01). Of the various ocular pathologies associated with congenital cataract, only nystagmus was found to be more prevalent in the syndrome group (40%) as compared with the isolated cataract group (11%) (p = 0.05). Surgery was performed during the first 2 years of life in 54% of the eyes in the isolated cataract group, and in 87% of the eyes in the syndrome group (p = 0.01). There was no difference in the prevalence of the postoperative complications between the two groups. CONCLUSION: Children who underwent congenital cataract surgery developed poorer visual acuity if the cataract was a part of a systemic disease as compared with children without a systemic syndrome.

Abnormalities, Multiple↗
PubMed1997

LOCS III versus the Oxford Clinical Cataract Classification and Grading System for the assessment of nuclear, cortical and posterior subcapsular cataract.

PURPOSE: To compare two methods of cataract grading for nuclear cataract, cortical cataract and posterior subcapsular cataract. METHODS: The Melton Eye Study is an English community-based epidemiological study of the natural history of eye disease in people aged 55 to 74 years. The lenses of both eyes of 560 subjects were graded at the slit lamp using two cataract grading systems. The Oxford Clinical Cataract Classification and Grading System (OCCCGS) employs standard diagrams and Munsell colour samples for the grading of cortical, posterior subcapsular and nuclear cataract. The Lens Opacities Classification System III (LOCS III) uses photographic transparencies of the lens as standards. In both systems a decimalised score is assigned. We also graded the LOCS III standard images using the OCCCGS. Interobserver variation was calculated for both grading systems. Linear calibration lines are plotted for each type of lens opacity. RESULTS: The relationship between LOCS III and OCCCGS for nuclear cataract and posterior subcapsular cataract is linear. The relationship for cortical cataract is linear once the LOCS III scores are squared. The intervals between the LOCS III images when ranked by the human eye using the OCCCGS are linear. Interobserver variation for both systems is good. CONCLUSIONS: The linear calibration lines may be used to convert from one system to another and will be useful in comparing studies or performing meta-analysis. These results show that data from cataract studies using different clinical grading schemes can be compared.

Aged↗
PubMed1983

Epidemiologic aspects of cataract surgery. III: Frequencies of diabetes and glaucoma in a cataract population.

A Danish data source was examined to determine age and sex specific rates of diabetes and glaucoma in a large cataract extracted population. Comparisons with population rates were done. An excess prevalence of diabetes in the cataract population below 70 years was found. For cataract extracted males and females below the age of 40 years, the diabetes prevalence was 15 to 25 times the prevalence in a general population. This prevalence excess decreases with age to normal levels at 75 years of age. Furthermore, we found higher relative frequencies of diabetes among cataract extracted females than among males. Mean age at time of surgery was significantly lower for the diabetic cataract patients. Also for primary glaucoma, an excess prevalence was found in the cataract population. For cataract extracted males and females aged 40 to 49 years the glaucoma frequency was 4-5 times the frequency in a general population. This excess relative frequency decreases with age. The glaucomatous cataract patients have a higher mean age at the time of cataract surgery. A large number of factors seems to contribute to the excess frequencies of diabetes and glaucoma found in the cataract extracted population.

Adult↗