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Morya AK, Nishant P, Ramesh PV, Sinha S, Heda A, Salodia S, Prasad R. Intraocular lens selection in diabetic patients: How to increase the odds for success. World J Diabetes 2024; 15:1199-1211. [DOI: 10.4239/wjd.v15.i6.1199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/23/2024] [Accepted: 04/23/2024] [Indexed: 06/11/2024] Open
Abstract
The incidence of cataracts is significantly higher in diabetic individuals, particularly in younger age groups, with rates quadrupled in those under 65 and doubled in those over 65 compared to non-diabetics. Cataract surgery in diabetic patients poses many challenges: Poor epithelial healing, decreased corneal sensitivity, increased central corneal thickness, decreased endothelial cell count, variable topography, poor pupillary dilatation, anterior capsular phimosis, posterior capsular opacification (PCO), chances of progression of diabetic retinopathy (DR), zonular weakness, and vitreous prolapse and diabetic macular edema. Selection of an appropriate intraocular lens (IOL) is crucial for visual rehabilitation and monitoring DR. The choice of IOL in diabetic cataract patients is a challenging scenario. Square-edge IOLs are favored for their capacity to mitigate PCO, whereas hydrophilic counterparts may incur calcification in the setting of proliferative DR. The advisability of premium IOLs for achieving spectacle independence warrants judicious evaluation, particularly in the presence of advanced retinopathy. Optimal IOL placement within the capsular bag is advocated to minimize postoperative complications. Rigorous preoperative assessment and informed patient counseling regarding IOL options are indispensable for optimizing surgical outcomes. This review article covers various aspects regarding the choice of IOLs in different case scenarios and complications in the diabetic population.
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Affiliation(s)
- Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Prateek Nishant
- Department of Ophthalmology, ESIC Medical College, Patna 801113, Bihar, India
| | - Prasanna Venkatesh Ramesh
- Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Sony Sinha
- Department of Ophthalmology-Vitreo-Retina, Neuro-Ophthalmology and Oculoplasty, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Aarti Heda
- Department of Ophthalmology, National Institute of Ophthalmology, Pune 411000, Maharashtra, India
| | - Sarika Salodia
- Department of Safety, Global Medical Safety, Lundbeck, Singapore 307591, Singapore
| | - Ripunjay Prasad
- Department of Ophthalmology, RP Eye Institute, Delhi 110001, India
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Agarkar S, Chandrasekaran A, Panicker GJ, Raman R. Cataract surgery outcomes in children and adolescents with type 1 diabetes mellitus. J AAPOS 2024:103926. [PMID: 38719142 DOI: 10.1016/j.jaapos.2024.103926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/16/2024] [Accepted: 02/11/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE To report the outcomes of cataract surgery in children and adolescents with type 1 diabetes mellitus. METHODS The medical records of all pediatric patients (<18 years of age) with a diagnosis of type 1 diabetes mellitus who had undergone surgery for cataract between January 2000 and December 2019 at a tertiary care center were reviewed retrospectively. RESULTS A total of 27 eyes of 15 patients who met the inclusion criteria were included. Median age at cataract surgery was 13 (IQR, 9.5-16) years, and median follow-up was 3.8 (IQR, 1.25-7.2) years, with 11 eyes followed for more than 5 years. Visual acuity improved from a median preoperative value of 0.8 (IQR, 0.55-1.3) logMAR to 0.15 (IQR, 0-0.45) logMAR at final follow-up. Posterior capsular visual axis opacification in 40.7% and diabetic retinopathy in 14.8% were the common complications requiring additional intervention, including laser capsulotomy and panretinal photocoagulation, respectively. CONCLUSIONS Cataract surgery in children and adolescents with type 1 diabetes leads to improvement in visual acuity. Proliferative diabetic retinopathy can lead to poor visual outcomes in these children. Visual axis opacification occurs at similar rates with or without primary posterior capsulorhexis.
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Affiliation(s)
- Sumita Agarkar
- Pediatric Ophthalmology and Strabismus Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
| | - Akila Chandrasekaran
- Pediatric Ophthalmology and Strabismus Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Gayathri J Panicker
- Pediatric Ophthalmology and Strabismus Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rajiv Raman
- Department of Vitreoretinal services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Cunha M, Elhaddad O, Yahalomi T, Avadhanam V, Tole D, Darcy K, Levinger E, Tuuminen R, Achiron A. Type 1 and type 2 diabetes predisposed to higher Nd:YAG capsulotomy rates following cataract surgery: analysis of 53,471 consecutive cases. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00057-7. [PMID: 38513717 DOI: 10.1016/j.jcjo.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/01/2024] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE To assess the effect of diabetes type on Nd:YAG capsulotomy rates following cataract surgery. DESIGN A retrospective cohort study. METHODS All patients who underwent cataract extraction at the Department of Ophthalmology, Bristol Eye Hospital, Bristol, UK, between 2003 and 2017 were included. The Nd:YAG capsulotomy rate following cataract surgery was assessed and compared between nondiabetic, type 1 diabetes (T1D), and type 2 diabetes (T2D) patients. Multivariate Cox regression analysis controlling for age and sex was used to estimate hazard ratios for Nd:YAG laser capsulotomies. RESULTS Included were 53,471 consecutive cataract surgeries. Overall, 42,651 eyes (79.8%) were in nondiabetic patients, 823 eyes (1.5%) were in T1D patients, and 9,997 eyes (18.7%) were in T2D patients. The mean follow-up time was 6.8 ± 4.2 years. In univariate analysis, the eyes of T1D patients (p < 0.001) and T2D patients (p = 0.003) had significantly higher Nd:YAG laser capsulotomy rates than the eyes of nondiabetic patients. In Cox regression analysis adjusted for the patient's age and sex, DM1 (HR 1.692, 95%CI 1.390-2.059, P<0.001) and DM2 (HR 1.157, 95%CI 1.075-1.244, P<0.001) remained significantly predictive for higher Nd:YAG laser capsulotomy rates. CONCLUSION In our large cohort study, patients with T1D and T2D were predisposed to high risk for Nd:YAG capsulotomy following cataract surgery. This study may be beneficial and raise awareness regarding the assessment of posterior capsular opacification development in pseudophakic diabetic patients, particularly those with T1D. The significance of ophthalmology screening for diabetes individuals is further supported by this issue.
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Affiliation(s)
- Mariana Cunha
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Medical School, São Paulo State University (UNESP), São Paulo, Brazil
| | - Omar Elhaddad
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom; Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Tal Yahalomi
- Department of Ophthalmology, Samson Assuta Ashdod Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel.
| | - Venkata Avadhanam
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Derek Tole
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Kieran Darcy
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Eliya Levinger
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland; Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland
| | - Asaf Achiron
- Tel-Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Eggermont RL, Witteman AM, van Erkelens JA, Vermeulen K, Vunderink L, Reus NJ. Nd:YAG laser capsulotomy rates in the Netherlands: practice variation and association with physician practice styles. J Cataract Refract Surg 2023; 49:373-377. [PMID: 36729037 DOI: 10.1097/j.jcrs.0000000000001118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/06/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE To determine the practice variation in the rate of Nd:YAG laser capsulotomy within 1 year after cataract surgery and to identify possible associations with physician practice styles. SETTING All hospitals and private clinics in the Netherlands. DESIGN Retrospective observational study. METHODS In the national medical claims database, we identified all laser capsulotomies performed in the Netherlands within a year after cataract surgery in the years 2016 and 2017. Centers with the lowest and highest percentages of Nd:YAG laser capsulotomies were interviewed on their physician practice styles related to the development of posterior capsule opacification. RESULTS The incidence of Nd:YAG laser capsulotomy varied between 1.2% and 26.0% in 2016 (median 5.0%) and between 0.9% and 22.7% in 2017 (median 5.0%). The rate of capsulotomy was highly consistent over time for each center (Pearson correlation coefficient, 0.89, P < .001). In general, ophthalmology centers with a high rate of Nd:YAG laser capsulotomy more often did not (routinely) polish the posterior lens capsule, performed cortex removal with coaxial irrigation/aspiration (I/A, instead of bimanual), and more often used hydrophilic intraocular lenses (IOLs) (compared with only using hydrophobic IOLs). CONCLUSIONS We found a significant practice variation in performing Nd:YAG laser capsulotomy within 1 year after cataract surgery in the Netherlands. Routinely polishing the posterior capsule, using bimanual I/A, and the use of hydrophobic IOLs are associated with a lower incidence in Nd:YAG laser capsulotomy. Incorporating these practice styles may lower the practice variation and thus prevent added medical burden for the patient and decrease costs.
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Affiliation(s)
- Rogier L Eggermont
- From the Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Eggermont, Reus); Department of Ophthalmology, The Rotterdam Eye Hospital, Rotterdam, the Netherlands (Eggermont); Department of Medical Advice, VGZ Health Insurance Company, Eindhoven, the Netherlands (Witteman); Vektis, Zeist, the Netherlands (van Erkelens); Department of Innovation and Advice, CZ, Health Insurance Company, Tilburg, the Netherlands (Vermeulen); Zorgverzekeraars Nederland, Zeist, the Netherlands (Vunderink)
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Abstract
PURPOSE OF REVIEW Given the epidemiology and demographic trends of diabetes mellitus and cataracts, ophthalmologists are likely to encounter patients with both comorbidities at an increasing frequency. Patients with diabetes represent a higher risk population than healthy patients for cataract surgery. In this review, we discuss key risks and risk-mitigation practices when performing cataract surgery on these patients. RECENT FINDINGS Patients with diabetes continue to represent a high-risk surgical population: Nagar et al. suggest a dose-dependent relationship may exist between number of intravitreal injections and likelihood of posterior capsular rupture. However, novel treatments are improving outcomes for patients with diabetes. Several studies have reported intracameral phenylephrine/ketorolac may reduce the incidence of post-operative cystoid macular edema while others have discussed the efficacy of pre-treatment and post-treatment with intravitreal bevacizumab on improving cataract surgery outcomes in patients with diabetic retinopathy. Pre-operatively, ophthalmologists should perform an enhanced evaluation, consider timing and lens selection decisions, and complete any appropriate pre-operative treatment. Peri-operatively, surgeons should be aware of pupillary dilation adjustments, combination surgery options, and potential complications. Post-operatively, clinicians should address pseudophakic cystoid macular edema, diabetic macular edema, diabetic retinopathy, and posterior capsular opacification.
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Affiliation(s)
| | - Christina A Mamalis
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA
| | - Sumitra S Khandelwal
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA.
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Rankenberg J, Rakete S, Wagner BD, Patnaik JL, Henning C, Lynch A, Glomb MA, Nagaraj RH. Advanced glycation end products in human diabetic lens capsules. Exp Eye Res 2021; 210:108704. [PMID: 34302851 DOI: 10.1016/j.exer.2021.108704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
Advanced glycation end products (AGEs) accumulate with age in human lens capsules. AGEs in lens capsules potentiate the transforming growth factor beta-2-mediated mesenchymal transition of lens epithelial cells, which suggests that they play a role in posterior capsule opacification after cataract surgery. We measured AGEs by liquid chromatography-mass spectrometry in capsulorhexis specimens obtained during cataract surgery from nondiabetic and diabetic patients with and without established retinopathy. Our data showed that the levels of most AGEs (12 out of 13 measured) were unaltered in diabetic patients and diabetic patients with retinopathy compared to nondiabetic patients. There was one exception: glucosepane, which was significantly higher in diabetic patients, both with (6.85 pmol/μmol OH-proline) and without retinopathy (8.32 pmol/μmol OH-proline), than in nondiabetic patients (4.01 pmol/μmol OH-proline). Our study provides an explanation for the similar incidence of posterior capsule opacification between nondiabetic and diabetic cataract patients observed in several studies.
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Affiliation(s)
- Johanna Rankenberg
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA
| | - Stefan Rakete
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA; Present Address: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital LMU, Munich, Germany
| | - Brandie D Wagner
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA; Colorado School of Public Health, Aurora, CO, USA
| | - Jennifer L Patnaik
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA
| | - Christian Henning
- Institute of Chemistry-Food Chemistry, Martin-Luther-University Halle-Wittenberg, 06120 Halle/ Saale, Germany
| | - Anne Lynch
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA
| | - Marcus A Glomb
- Institute of Chemistry-Food Chemistry, Martin-Luther-University Halle-Wittenberg, 06120 Halle/ Saale, Germany
| | - Ram H Nagaraj
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA; School of Pharmacy, University of Colorado, Aurora, CO, USA.
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Effect of Nd: YAG laser capsulotomy on the risk of retinal detachment after cataract surgery: A systematic review and meta-analysis. J Cataract Refract Surg 2021; 48:238-244. [PMID: 34538778 DOI: 10.1097/j.jcrs.0000000000000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/20/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT We aimed to evaluate the impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy on the incidence of pseudophakic retinal detachment (RD). The PubMed and Embase databases were searched for meta-analysis. Subgroup analyses were conducted according to study location, number of cases, mean follow-up time, and cataract procedure. The final analysis included 11 studies with 309 cases of RD in 65,117 eyes undergoing cataract surgery. Among them, 8,232 eyes underwent Nd:YAG capsulotomy. Our analysis demonstrated an increased risk of RD with Nd:YAG laser capsulotomy (RR=1.57; 95%CI, 1.17-2.12; P=0.003; HR=1.64; 95%CI, 1.03-2.62; P=0.04). Subgroup analysis suggested somewhat stronger associations in Asian (RR=4.54; 95%CI, 2.20-9.38; P<0.0001) than in non-Asian populations (America, P=0.12; Europe and others, P=0.21), and with extracapsular cataract extraction (RR=2.97; 95%CI, 1.83-4.83; P<0.0001) than with phacoemulsification (P=0.95). To conclude, Nd:YAG laser capsulotomy may be associated with an increased risk of pseudophakic RD.
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Diabetic retinopathy and diabetic macular oedema pathways and management: UK Consensus Working Group. Eye (Lond) 2021; 34:1-51. [PMID: 32504038 DOI: 10.1038/s41433-020-0961-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The management of diabetic retinopathy (DR) has evolved considerably over the past decade, with the availability of new technologies (diagnostic and therapeutic). As such, the existing Royal College of Ophthalmologists DR Guidelines (2013) are outdated, and to the best of our knowledge are not under revision at present. Furthermore, there are no other UK guidelines covering all available treatments, and there seems to be significant variation around the UK in the management of diabetic macular oedema (DMO). This manuscript provides a summary of reviews the pathogenesis of DR and DMO, including role of vascular endothelial growth factor (VEGF) and non-VEGF cytokines, clinical grading/classification of DMO vis a vis current terminology (of centre-involving [CI-DMO], or non-centre involving [nCI-DMO], systemic risks and their management). The excellent UK DR Screening (DRS) service has continued to evolve and remains world-leading. However, challenges remain, as there are significant variations in equipment used, and reproducible standards of DMO screening nationally. The interphase between DRS and the hospital eye service can only be strengthened with further improvements. The role of modern technology including optical coherence tomography (OCT) and wide-field imaging, and working practices including virtual clinics and their potential in increasing clinic capacity and improving patient experiences and outcomes are discussed. Similarly, potential roles of home monitoring in diabetic eyes in the future are explored. The role of pharmacological (intravitreal injections [IVT] of anti-VEGFs and steroids) and laser therapies are summarised. Generally, IVT anti-VEGF are offered as first line pharmacologic therapy. As requirements of diabetic patients in particular patient groups may vary, including pregnant women, children, and persons with learning difficulties, it is important that DR management is personalised in such particular patient groups. First choice therapy needs to be individualised in these cases and may be intravitreal steroids rather than the standard choice of anti-VEGF agents. Some of these, but not all, are discussed in this document.
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Factors Affecting Posterior Capsule Opacification in the Development of Intraocular Lens Materials. Pharmaceutics 2021; 13:pharmaceutics13060860. [PMID: 34200928 PMCID: PMC8230425 DOI: 10.3390/pharmaceutics13060860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 01/01/2023] Open
Abstract
Posterior capsule opacification (PCO) is the most common complication arising from the corrective surgery used to treat cataract patients. PCO arises when lens epithelial cells (LEC) residing in the capsular bag post-surgery undergo hyper-proliferation and transdifferentiation into myofibroblasts, migrating from the posterior capsule over the visual axis of the newly implanted intraocular lens (IOL). The developmental pathways underlying PCO are yet to be fully understood and the current literature is contradictory regarding the impact of the recognised risk factors of PCO. The aim of this review is firstly to collate the known biochemical pathways that lead to PCO development, providing an up-to-date chronological overview from surgery to established PCO formation. Secondly, the risk factors of PCO are evaluated, focussing on the impact of IOLs’ properties. Finally, the latest experimental model designs used in PCO research are discussed to demonstrate the ongoing development of clinical PCO models, the efficacy of newly developed IOL technology, and potential therapeutic interventions. This review will contribute to current PCO literature by presenting an updated overview of the known developmental pathways of PCO, an evaluation of the impact of the risk factors underlying its development, and the latest experimental models used to investigate PCO. Furthermore, the review should provide developmental routes for research into the investigation of potential therapeutic interventions and improvements in IOL design in the aid of preventing PCO for new and existing patients.
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Haykin V, Oscar A, Dimitrova V, Petkova I, Zdravkov Y, Kostova S, Veleva N, Mitev V, Isaeva A. Bioimage analysis of cell physiology of primary lens epithelial cells from diabetic and non-diabetic cataract patients. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2020.1861978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Vasil Haykin
- Clinic of Ophthalmology, University “Alexandrovska” Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Alexander Oscar
- Clinic of Ophthalmology, University “Alexandrovska” Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Violeta Dimitrova
- Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Iva Petkova
- Clinic of Ophthalmology, University “Alexandrovska” Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Yani Zdravkov
- Clinic of Ophthalmology, University “Alexandrovska” Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Stanislava Kostova
- Clinic of Ophthalmology, University “Alexandrovska” Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Nevyana Veleva
- Clinic of Ophthalmology, University “Alexandrovska” Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Vanyo Mitev
- Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Antonia Isaeva
- Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
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11
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Oscar A, Haykin V, Dimitrova V, Petkova I, Zdravkov Y, Kostova S, Veleva N, Mitev V, Elenkov C, Isaeva A. Protein kinase CK2 in TGFβ-induced lens epithelial-mesenchymal transition. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2021.2003720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Affiliation(s)
- Alexander Oscar
- Clinic of Ophthalmology, University ‘Alexandrovska’ Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Vasil Haykin
- Clinic of Ophthalmology, University ‘Alexandrovska’ Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Violeta Dimitrova
- Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Iva Petkova
- Clinic of Ophthalmology, University ‘Alexandrovska’ Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Yani Zdravkov
- Clinic of Ophthalmology, University ‘Alexandrovska’ Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Stanislava Kostova
- Clinic of Ophthalmology, University ‘Alexandrovska’ Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Nevyana Veleva
- Clinic of Ophthalmology, University ‘Alexandrovska’ Hospital, Sofia, Bulgaria
- Department of Ophthalmology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Vanyo Mitev
- Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | | | - Antonia Isaeva
- Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
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12
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Toffoletto N, Saramago B, Serro AP. Therapeutic Ophthalmic Lenses: A Review. Pharmaceutics 2020; 13:36. [PMID: 33379411 PMCID: PMC7824655 DOI: 10.3390/pharmaceutics13010036] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/09/2020] [Accepted: 12/17/2020] [Indexed: 12/17/2022] Open
Abstract
An increasing incidence of eye diseases has been registered in the last decades in developed countries due to the ageing of population, changes in lifestyle, environmental factors, and the presence of concomitant medical conditions. The increase of public awareness on ocular conditions leads to an early diagnosis and treatment, as well as an increased demand for more effective and minimally invasive solutions for the treatment of both the anterior and posterior segments of the eye. Despite being the most common route of ophthalmic drug administration, eye drops are associated with compliance issues, drug wastage by lacrimation, and low bioavailability due to the ocular barriers. In order to overcome these problems, the design of drug-eluting ophthalmic lenses constitutes a non-invasive and patient-friendly approach for the sustained drug delivery to the eye. Several examples of therapeutic contact lenses and intraocular lenses have been developed, by means of different strategies of drug loading, leading to promising results. This review aims to report the recent advances in the development of therapeutic ophthalmic lenses for the treatment and/or prophylaxis of eye pathologies (i.e., glaucoma, cataract, corneal diseases, or posterior segment diseases) and it gives an overview of the future perspectives and challenges in the field.
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Affiliation(s)
- Nadia Toffoletto
- Centro de Química Estrutural, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (B.S.); (A.P.S.)
| | - Benilde Saramago
- Centro de Química Estrutural, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (B.S.); (A.P.S.)
| | - Ana Paula Serro
- Centro de Química Estrutural, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (B.S.); (A.P.S.)
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
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13
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Fișuș AD, Findl O. Capsular fibrosis: a review of prevention methods and management. Eye (Lond) 2019; 34:256-262. [PMID: 31804626 DOI: 10.1038/s41433-019-0723-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/27/2019] [Accepted: 11/13/2019] [Indexed: 02/02/2023] Open
Abstract
Opacification of the posterior capsule caused by residual lens epithelial cells (LEC) is still the most frequent long-term complication of cataract surgery. Beside the opacification of the visual axis with posterior capsule opacification (PCO), resulting in a decrease in visual function, fibrotic changes may also have a mechanical effect on intraocular lens (IOL) position such as axial shift, decentration, tilt and capsule striae. In this article, two types of capsular fibrosis are explored, on the one hand the anterior capsule fibrosis and on the other hand PCO. Results from clinical trials concerning their causes, natural course, incidence, influencing factors and possible methods of prophylaxis are presented.
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Affiliation(s)
- Andreea D Fișuș
- Department of Ophthamology, Vienna Institute for Research in Ocular Surgery - Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria.,George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, Târgu-Mureș, România
| | - Oliver Findl
- Department of Ophthamology, Vienna Institute for Research in Ocular Surgery - Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria.
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Factors Associated with the Development of Posterior Capsule Opacification Requiring Yttrium Aluminum Garnet Capsulotomy. Optom Vis Sci 2019; 96:492-499. [DOI: 10.1097/opx.0000000000001396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Diabetes and Phacoemulsification Cataract Surgery: Difficulties, Risks and Potential Complications. J Clin Med 2019; 8:jcm8050716. [PMID: 31137510 PMCID: PMC6572121 DOI: 10.3390/jcm8050716] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 02/07/2023] Open
Abstract
Diabetes mellitus is one of the most prevalent chronic diseases worldwide. Diabetic patients are at risk of developing cataract and present for surgery at an earlier age than non-diabetics. The aim of this study was to review the problems associated with cataract surgery in a diabetic patient. Corneal complications in diabetic patients include delayed wound healing, risk of developing epithelial defects or recurrent erosions due to the impairment of epithelial basement membranes and epithelial-stromal interactions. Diabetic patients present lower endothelial cell density and their endothelium is more susceptible to trauma associated with cataract surgery. A small pupil is common in diabetic patients making cataract surgery technically challenging. Finally diabetic patients have an increased risk for developing postoperative pseudophakic cystoid macular edema, posterior capsule opacification or endophthalmitis. In patients with pre-proliferative or proliferative diabetic retinopathy, diabetic macular edema or iris neovascularization adjunctive therapy such as an intravitreal anti-vascular endothelial growth factor injection, can inhibit exacerbation related to cataract surgery.
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16
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Kiziltoprak H, Tekin K, Inanc M, Goker YS. Cataract in diabetes mellitus. World J Diabetes 2019; 10:140-153. [PMID: 30891150 PMCID: PMC6422859 DOI: 10.4239/wjd.v10.i3.140] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus (DM) is a chronic systemic disease that has increases in prevalence over time. DM can affect all ocular structures, with cataract being the most common ocular complication. Cataract is the leading cause of blindness worldwide. Due to several mechanisms, there is an increased incidence of cataract formation in the diabetic population. Advancements in technology have now made cataract surgery a common and safe procedure. However, the diabetic population is still at risk of vision-threatening complications, such as diabetic macular edema (ME), postoperative ME, diabetic retinopathy progression, and posterior capsular opacification.
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Affiliation(s)
- Hasan Kiziltoprak
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara 06240, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van 65400, Ercis, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van 65400, Ercis, Turkey
| | - Yasin Sakir Goker
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara 06240, Turkey
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17
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Wu S, Tong N, Pan L, Jiang X, Li Y, Guo M, Li H. Retrospective Analyses of Potential Risk Factors for Posterior Capsule Opacification after Cataract Surgery. J Ophthalmol 2018; 2018:9089285. [PMID: 30174947 PMCID: PMC6098918 DOI: 10.1155/2018/9089285] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 06/23/2018] [Accepted: 07/17/2018] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To evaluate the potential risk factors of posterior capsule opacification (PCO) after cataract surgery. METHODS Data on PCO patients diagnosed from September 2015 to May 2017 were obtained from the Department of Ophthalmology at Qingdao Municipal Hospital, Qingdao, China. The factors associated with PCO were assessed using Pearson's χ2 test for univariate analyses and logistic regression for multivariate analyses. RESULTS Eyes (652) from 550 patients were enrolled in this study. All patients were diagnosed with PCO/non-PCO and had <3 years of follow-up after surgery. The numbers of PCO and non-PCO were 108 eyes and 544 eyes, respectively. Statistically significant associations with PCO were found for age at the time of surgery (χ2 = 78.504; p < 0.001), diabetes (χ2 = 4.829; p=0.028), immune diseases (χ2 = 4.234; p=0.004), high myopia (χ2 = 5.753; p=0.016), lens nucleus hardness (χ2 = 11.046; p=0.026), surgery type (χ2 = 11.354; p=0.001), a history of vitrectomy (χ2 = 4.212; p=0.004), ocular inflammation (χ2 = 6.01; p=0.009), and the intraocular lens (IOL) type (χ2 = 8.696; p=0.003). Multivariable data analyses using logistic regression analyses of the variables showed that age at the time of surgery <60 years, diabetes, lens nucleus hardness of III-V, extracapsular cataract extraction (ECCE), postvitrectomy, and hydrophilic IOLs were significant independent risk factors associated with PCO. CONCLUSIONS Age <60 years, diabetes, lens nucleus hardness of III-V, ECCE, postvitrectomy, and a hydrophilic IOL were significantly associated with the formation of PCO. Estimation of the incidence of and risk factors for PCO should help in patients counseling and in the design of treatment protocols to reduce or prevent its development.
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Affiliation(s)
- Shuang Wu
- Qingdao Municipal Hospital Affiliated to Qingdao University, No. 5 Donghaizhong Road, Shinan District, Qingdao, Shandong, China
| | - Nianting Tong
- Department of Ophthalmology, Qingdao Municipal Hospital, No. 5 Donghaizhong Road, Shinan District, Qingdao, Shandong, China
| | - Lin Pan
- Dalian Medical University, No. 9 Lushunnan Road, Dalian, Liaoning, China
| | - Xiaohui Jiang
- Department of Ophthalmology, Qingdao Municipal Hospital, No. 5 Donghaizhong Road, Shinan District, Qingdao, Shandong, China
| | - Yanan Li
- Qingdao Municipal Hospital Affiliated to Qingdao University, No. 5 Donghaizhong Road, Shinan District, Qingdao, Shandong, China
| | - MeiLing Guo
- Qingdao Municipal Hospital Affiliated to Qingdao University, No. 5 Donghaizhong Road, Shinan District, Qingdao, Shandong, China
| | - Hehuan Li
- Qingdao Municipal Hospital Affiliated to Qingdao University, No. 5 Donghaizhong Road, Shinan District, Qingdao, Shandong, China
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18
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Alberdi T, Mendicute J, Bascarán L, Barandika O, Ruiz-Ederra J. Anterior and posterior capsule densitometry levels after femtosecond laser-assisted cataract surgery. Int J Ophthalmol 2018; 11:623-628. [PMID: 29675381 DOI: 10.18240/ijo.2018.04.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 12/12/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To analyze and compare five different variables over one year follow-up (1wk, 1, 3, 6 and 12mo): anterior capsule (AC), and posterior capsule (PC) area densitometry values, AC and PC linear densitometry values, and AC opening area reduction ratio after femtosecond laser-assisted cataract surgery. METHODS This was a prospective comparative study. Seventy-one patients underwent femtosecond laser-assisted cataract surgery on single eye between June 2014 and December 2015. A 5.0 mm diameter laser assisted anterior capsulotomy was performed on all eyes. In every post-surgery evaluation, AC opacificaction (ACO) and PC opacification (PCO) density levels were provided by Oculus Pentacam®HR using area and linear densitometry methods. Digital images were captured with a slit-lamp Topcon photographic camera and IMAGEnet® 5 software. The AC opening area on the digital images was measured using the Sketchandcalc area calculator and converted to reduction ratio levels. RESULTS Using Pearson correlation coefficient (PCC), we found no correlation (r=-0.091, P=0.46) in the twelfth month assessment between the evolution of ACO area densitometry values and PCO area densitometry values considered as independent variables. We found no correlation, using PCC (r=-0.096, P=0.43) between the evolution of ACO linear densitometry values and PCO linear densitometry values, in the twelfth month visit, working both as independent variables. AC linear densitometry levels and AC area densitometry levels continued to grow strongly from sixth to twelfth months. Analysis of the values of AC opening area reduction ratio (1wk, 1, 3, 6, 12mo) revealed statistically significant differences between the values of successive examinations but the magnitude of the change decreased. In the final period of monitoring between six and twelve months the magnitude of change was low. CONCLUSION Our results show strong increases of Scheimpflug ACO densitometry values from the sixth to the twelfth month while capsulorhexis area reduction ratio levels displayed a considerable decrease. We found no correlation between ACO area and linear densitometry values and PCO area and linear densitometry values, in the twelfth month examination, working as independent variables.
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Affiliation(s)
- Txomin Alberdi
- Department of Ophthalmology, Donostia University Hospital, Donostia-San Sebastian 20014, Spain
| | - Javier Mendicute
- Department of Ophthalmology, Donostia University Hospital, Donostia-San Sebastian 20014, Spain
| | - Lucía Bascarán
- Department of Ophthalmology, Donostia University Hospital, Donostia-San Sebastian 20014, Spain
| | - Olatz Barandika
- Biodonostia Health Research Institute, Donostia-San Sebastian 20014, Spain
| | - Javier Ruiz-Ederra
- Biodonostia Health Research Institute, Donostia-San Sebastian 20014, Spain
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Abstract
Diabetes is a chronic systemic disease that affects nearly one in eight adults worldwide. Ocular complications, such as cataract, can lead to significant visual impairment. Among the worldwide population, cataract is the leading cause of blindness, and patients with diabetes have an increased incidence of cataracts which mature earlier compared to the rest of the population. Cataract surgery is a common and safe procedure, but can be associated with vision-threatening complications in the diabetic population, such as diabetic macular edema, postoperative macular edema, diabetic retinopathy progression, and posterior capsular opacification. This article is a brief review of diabetic cataract and complications associated with cataract extraction in this population of patients.
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Affiliation(s)
- Scott R Peterson
- a Joslin Diabetes Center , Beetham Eye Institute , Boston , MA , USA.,b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| | - Paolo A Silva
- a Joslin Diabetes Center , Beetham Eye Institute , Boston , MA , USA.,b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| | - Timothy J Murtha
- a Joslin Diabetes Center , Beetham Eye Institute , Boston , MA , USA.,b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
| | - Jennifer K Sun
- a Joslin Diabetes Center , Beetham Eye Institute , Boston , MA , USA.,b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA
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20
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Kossack N, Schindler C, Weinhold I, Hickstein L, Lehne M, Walker J, Neubauer AS, Häckl D. German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2017; 26:81-90. [PMID: 29416961 PMCID: PMC5794811 DOI: 10.1007/s10389-017-0851-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Aim Cataract extraction is one of the most frequent surgeries in Germany. In most cases, the clouded natural lens is replaced by a hydrophobic or hydrophilic acrylic intraocular lens (IOL) implant. The most common long-term complication after cataract surgery is the development of a posterior capsule opacification (PCO). Although no precise real world data are available, published evidence suggests a lower risk for PCO development for hydrophobic acrylic IOLs compared to hydrophilic acrylic IOLs. Therefore, in the present study we assessed real world data on the impact of different IOL material types on the incidence of post-operative PCO treatment. Subject and methods In this retrospective study, we included 3,025 patients who underwent cataract extraction and implantation of either an acrylic hydrophobic or hydrophilic IOL in 2010. We assessed clinical outcomes and direct costs in a 4-year follow-up period after cataract surgery from a statutory health insurance (SHI) perspective in Germany. Results PCO that required capsulotomies occurred significantly (p < 0.0001) less frequent in patients who had received a hydrophobic IOL (31.57% of 2,078 patients) compared to the group with hydrophilic IOL implants (56.6% of 947 patients) and costs per patient for postoperative treatment in a 4-year follow-up were 50.03 € vs. 87.81 € (i.e. 75% higher in the latter group, p < 0.0001). Conclusion Considering the high prevalence of cataract, the economic burden associated with adverse effects of cataract extraction is of great relevance for the German SHI. Hydrophobic lenses seem to be superior regarding both medical and economic results.
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Affiliation(s)
- Nils Kossack
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Christian Schindler
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Ines Weinhold
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | | | | | - Jochen Walker
- InGef Institut für angewandte Gesundheitsforschung, Berlin, Germany
| | | | - Dennis Häckl
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
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21
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Shaikh AR, Mirani AH, Memon MS, Fahim MF. Visual outcome after phacoemulsification with lens implant in diabetic and non-diabetic patients; A comparative study. Pak J Med Sci 2017; 33:691-694. [PMID: 28811796 PMCID: PMC5510128 DOI: 10.12669/pjms.333.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To compare the visual outcomes of phacoemulsification surgery with intraocular lens (IOL) in persons with and without diabetes at end of follow-up. Methods: This was a comparative, cross sectional, observational study with Non-probability, purposive sampling. After approval from “Research Ethical Committee of Isra Post-graduate Institute of Ophthalmology Karachi, 92 patients with cataract in one eye were selected. Patients were divided into two groups. Group A consisted of 48 diabetics and group B consisted of 44 non- diabetics with or without diabetes in the age group ≥ 30 years were included. Patients with small Pupil, Pseudo exfoliation Syndrome, Diabetic Retinopathy, and positive history of Uveitis, Glaucoma, and Macular Degeneration were excluded. Data analysis was performed by SPSS Version 20.0. Results: Best Corrected Visual Acuity (BCVA) in diabetic patients improved from 0.813 ± 0.181 Log MAR pre operatively to 0.183 ± 0.143 after the period of six months post-operatively. Corresponding results in non-diabetics were 0.66 ± 0.31 and 0.08 ± 0.092 Log Mar (P value = 0.001). If WHO criteria was considered, 87.5% diabetics and 92% non-diabetics achieved normal vision (Log Mar 0 to 0.5; ≥ 6/12,) on the first post-operative day. Remaining 12.5% diabetics and 8% non-diabetics achieved moderate vision (0.6 to 1 Log MAR) on first post-operative day improving to normal vision within a week. Conclusion: Visual outcomes in diabetics after phacoemulsification with intra ocular lens implant is almost as good as that in non-diabetic patient if the diabetics have no retinopathy and have good glycemic control.
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Affiliation(s)
- Abdul Rashid Shaikh
- Abdul Rashid Shaikh, Department of Ophthalmology, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
| | - Abdul Haleem Mirani
- Abdul Haleem Mirani, Department of Ophthalmology, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
| | - Muhammad Saleh Memon
- Muhammad Saleh Memon, Isra Ophthalmic Research & Development Center, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
| | - Muhammad Faisal Fahim
- Muhammad Faisal Fahim, Isra Ophthalmic Research & Development Center, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
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22
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Goyal S, Hardin J, Uwaydat SH, Ellabban AA, Warner DB, Sallam AB. Review and update of cataract surgery in the diabetic eye. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1351296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Sunali Goyal
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Cornea and External Diseases, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Joshua Hardin
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Retina, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - David B. Warner
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Cornea and External Diseases, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Retina, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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23
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Saha S, Gantyala SP, Aggarwal S, Sreenivas V, Tandon R, Goswami R. Long-term outcome of cataract surgery in patients with idiopathic hypoparathyroidism and its relationship with their calcemic status. J Bone Miner Metab 2017; 35:405-411. [PMID: 27465913 DOI: 10.1007/s00774-016-0767-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 06/26/2016] [Indexed: 12/26/2022]
Abstract
Cataract is a cardinal manifestation of hypoparathyroidism. Although patients with hypoparathyroidism require cataract surgery at a younger age than individuals without hypoparathyroidism, there is limited information on the outcome of this surgery. We assessed long-term complications of cataract surgery in patients with idiopathic hypoparathyroidism (IH) and its relationship with their clinical and biochemical parameters. Twenty-seven patients with IH and 25 nonhypoparathyroid controls with a minimum follow-up of 2 years after cataract surgery were assessed for visual acuity, intraocular pressure, lens centricity, Nd:YAG laser capsulotomy, and the severity of posterior capsular opacification (PCO) and anterior capsular opacification. High-resolution optical slit-lamp images were analyzed by an ophthalmologist. Patients with IH had cataract surgery at a younger age than controls (34.0 ± 16.4 years vs 58.0 ± 11.2 years, P < 0.001). A higher proportion of IH patients had dense white PCO (75.0 % vs 39.4 %, P = 0.004), Nd:YAG laser capsulotomy (44.2 % vs 10.0 %, P = 0.001), anterior capsular opacification (97.7 % vs 84.2 %, P = 0.03), and a decentric lens (28.3% vs 2.6 %, P = 0.001) at a comparable time after surgery (8.6 ± 6.1 years vs 8.7 ± 6.8 years, P = 0.85). On regression analysis, the severity of PCO in IH correlated only with male sex and not with other factors, including serum total calcium and inorganic phosphorus levels at the baseline and during follow-up. To conclude, patients with IH are likelier than individuals without IH to develop PCO and to require Nd:YAG laser capsulotomy after cataract surgery. Proper precautions should be taken during surgery to minimize this complication in IH.
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Affiliation(s)
- Soma Saha
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Shiva Prasad Gantyala
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sameer Aggarwal
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vishnubhatla Sreenivas
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Radhika Tandon
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Ravinder Goswami
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Lee JS, Chung CC, Lin KK, Yu KH, Kuo CF, See LC. Time trends in cataract surgery and after-cataract laser capsulotomy in Taiwan: A population-based retrospective cohort study. Int J Surg 2016; 36:265-273. [DOI: 10.1016/j.ijsu.2016.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 11/15/2022]
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