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Luo J, Zhang M, Chen Y, Zhang G, Zhou T, Kang L, Chen X, Guan H. Comprehensive analysis of the miRNA-mRNA regulatory network involved in spontaneous recovery of an H 2O 2-induced zebrafish cataract model. Exp Eye Res 2024; 240:109820. [PMID: 38340946 DOI: 10.1016/j.exer.2024.109820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To identify the hub miRNAs and mRNAs contributing to the spontaneous recovery of an H2O2-induced zebrafish cataract model. METHODS Zebrafishes were divided into three groups, i.e., Group A, which included normal control fish (day 0), and Groups B and C, where fish were injected with 2.5% hydrogen peroxide into the anterior chamber and reared for 14 and 30 days, respectively. Fish eyes were examined by stereomicroscope photography and optical coherence tomography (OCT). RNA profiles of fish lenses were detected by RNA sequencing. Differentially expressed genes (DEGs) and differentially expressed miRNAs (DEmiRs) were identified among three groups. The DEGs and DEmiRs, which changed in opposite positions between "B vs. A" and "C vs. B" were defined as ODGs (opposite positions changed DEGs) and ODmiRs (opposite positions changed DEmiRs). Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) analysis were carried out by R language. The protein-protein interaction network (PPI) was constructed using STRING. Potential targets of miRNAs were obtained using miRanda. miRNA-mRNA networks were constructed by Cytoscape. RESULTS The fish lens opacity formed on day 14 and recovered to transparent on day 30 after injection. Compared to group B, 1366 DEGs and 54 DEmiRs were identified in group C. "C vs. B" DEGs were enriched in gene clusters related to development and oxidative phosphorylation. Target genes of DEmiRs were enriched in clusters such as development and cysteine metabolism. Among three groups, 786 ODGs and 27 ODmiRs were identified, and 480 ODGs were predicted as targets of ODmiRs. Target ODGs were enriched in pathways related to methionine metabolism, ubiquitin, sensory system development, and structural constituents of the eye lens. In addition, we established an ODmiRs-ODGs regulation network. CONCLUSION We identified several hub mRNAs and altered miRNAs in the formation and reversal of zebrafish cataracts. These hub miRNAs/mRNAs could be potential targets for the non-surgical treatment of ARC.
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Affiliation(s)
- Jiawei Luo
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, Jiangsu, China
| | - Mu Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, Jiangsu, China
| | - Yanhua Chen
- Nantong Center for Disease Control and Prevention, Nantong, 226001, Jiangsu, China
| | - Guowei Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, Jiangsu, China
| | - Tianqiu Zhou
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, Jiangsu, China
| | - Lihua Kang
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, Jiangsu, China
| | - Xiaoqing Chen
- Department of Party Committee Personnel Work, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
| | - Huaijin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, 226001, Jiangsu, China.
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Hashimi M, Amin HA, Zagkos L, Day AC, Drenos F. Using genetics to investigate the association between lanosterol and cataract. Front Genet 2024; 15:1231521. [PMID: 38440190 PMCID: PMC10910428 DOI: 10.3389/fgene.2024.1231521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Background: Cataract is one of the most prevalent causes of blindness worldwide. Whilst surgery is the primary treatment for cataracts, it is not always an available option, particularly in developing countries. Non-surgical methods of treatment would increase treatment availability for more patients. Several studies have investigated how topical application of oxysterols, such as lanosterol, may break down aggregated proteins and restore lens transparency. However, the results are conflicting and inconclusive. Aim: In this study, we focus on combining genetic evidence for associations between lanosterol related genetic variation and cataract to explore whether lanosterol is a potentially suitable drug treatment option. Method: Using data from 45,449 available cataract cases from the UK Biobank, with participant ages ranging from 40-69, we conducted a genetic association study (GWAS) to assess the risk of cataract. Cataract cases were defined using diagnostic and operation codes. We focused on genetic variants in the lanosterol synthase gene region. We also compared our results with previously published genetic associations of phytosterol-to-lanosterol ratios. Finally, we performed a genetic risk score analysis to test the association between lanosterol within the cholesterol synthesis pathway and the risk of cataract. Results: No statistically significant single nucleotide polymorphisms (SNPs) associations with cataract were observed in the gene region of lanosterol synthase at a multiple testing adjusted significance threshold of p < 0.05/13. The comparison between cataract risk and genetic association of 8 phytosterol-to-lanosterol GWAS results also showed no evidence to support lanosterol's protective properties for cataract risk. No statistically significant association was found between the lanosterol within the cholesterol synthesis pathway genetic risk score and cataract outcomes (OR = 1.002 p = 0.568). Conclusion: There was no evidence observed for genetic associations between lanosterol and cataract risk. Our results do not support lanosterol's potential role in treating cataracts. Further research may be needed to address the effect of lanosterol on specific cataract subtypes.
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Affiliation(s)
- Munisa Hashimi
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Hasnat A. Amin
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Loukas Zagkos
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Alexander C. Day
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, London, United Kingdom
| | - Fotios Drenos
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
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Jiang C, Melles RB, Sangani P, Hoffmann TJ, Hysi PG, Glymour MM, Jorgenson E, Lachke SA, Choquet H. Association of Behavioral and Clinical Risk Factors With Cataract: A Two-Sample Mendelian Randomization Study. Invest Ophthalmol Vis Sci 2023; 64:19. [PMID: 37459064 PMCID: PMC10362921 DOI: 10.1167/iovs.64.10.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
Purpose To investigate the association of genetically determined primary open-angle glaucoma (POAG), myopic refractive error (RE), type 2 diabetes (T2D), blood pressure (BP), body mass index (BMI), cigarette smoking, and alcohol consumption with the risk of age-related cataract. Methods To assess potential causal effects of clinical or behavioral factors on cataract risk, we conducted two-sample Mendelian randomization analyses. Genetic instruments, based on common genetic variants associated with risk factors at genome-wide significance (P < 5 × 10-8), were derived from published genome-wide association studies (GWAS). For age-related cataract, we used GWAS summary statistics from our previous GWAS conducted in the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort (28,092 cataract cases and 50,487 controls; all non-Hispanic whites) or in the UK Biobank (31,852 cataract cases and 428,084 controls; all European-descent individuals). We used the inverse-variance weighted (IVW) method as our primary source of Mendelian randomization estimates and conducted common sensitivity analyses. Results We found that genetically determined POAG and mean spherical equivalent RE were significantly associated with cataract risk (IVW model: odds ratio [OR] = 1.04; 95% confidence interval [CI], 1.01-1.08; P = 0.018; per diopter more hyperopic: OR = 0.92; 95% CI, 0.89-0.93; P = 6.51 × 10-13, respectively). In contrast, genetically determined T2D, BP, BMI, cigarette smoking, or alcohol consumption were not associated with cataract risk (P > 0.05). Conclusions Our results provide evidence that genetic risks for POAG and myopia may be causal risk factors for age-related cataract. These results are consistent with previous observational studies reporting associations of myopia with cataract risk. This information may support population cataract risk stratification and screening strategies.
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Affiliation(s)
- Chen Jiang
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, California, United States
| | - Ronald B. Melles
- KPNC, Department of Ophthalmology, Redwood City, California, United States
| | - Poorab Sangani
- KPNC, Department of Ophthalmology, South San Francisco, California, United States
| | - Thomas J. Hoffmann
- Institute for Human Genetics, UCSF, San Francisco, California, United States
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, United States
| | - Pirro G. Hysi
- King's College London, Section of Ophthalmology, School of Life Course Sciences, London, United Kingdom
- King's College London, Department of Twin Research and Genetic Epidemiology, London, United Kingdom
- University College London, Great Ormond Street Hospital Institute of Child Health, London, United Kingdom
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, United States
| | - Eric Jorgenson
- Regeneron Genetics Center, Tarrytown, New York, United States
| | - Salil A. Lachke
- Department of Biological Sciences, University of Delaware, Newark, Delaware, United States
- Center for Bioinformatics and Computational Biology, University of Delaware, Newark, Delaware, United States
| | - Hélène Choquet
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, California, United States
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Andrews ALMM, Kafarnik C, Fischer MC. Prevalence and outcome of lens capsule disruption IN routine canine cataract surgery: A retrospective study of 520 eyes (2012-2019). Vet Ophthalmol 2023. [PMID: 37028938 DOI: 10.1111/vop.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVE To investigate the prevalence and surgical outcome of lens capsule disruption (LCD) in dogs undergoing cataract removal. ANIMALS STUDIED Medical records of 924 eyes undergoing phacoemulsification were analyzed retrospectively. PROCEDURES Routine cataract surgeries with or without LCD were included. Any LCD other than routine anterior capsulorhexis was defined as LCD and classified according to location and etiology. Odds ratios (OR) were calculated for maintaining vision, implantation of an artificial intraocular lens (IOL), and enucleation. RESULTS In total, 520 eyes were included. A LCD occurred in 145 eyes (27.8%; 145/520) and affected the posterior (85.5%; 124/145), anterior (6.2%; 9/145), and equatorial lens capsule (4.8%; 7/145) and at multiple locations (3.4%; 5/145). The etiology of the LCD was spontaneous preoperative in 41 eyes (28.3%; 41/145), accidental intraoperative in 57 eyes (39.3%; 57/145), and planned in 47 eyes (32.4%; 47/145). Disruption did not increase the odds of enucleation (OR = 1.48, 95% confidence interval [CI] 0.56-3.67; p = .36). The presence of LCD significantly increased the risk of losing vision 1 year post-operatively (OR = 8.17, 95% CI 1.41-84.93; p = .007) associated with retinal detachment. However, this was not present at 2 years follow-up or in PCCC cases at any time point. An IOL was implanted in 108 eyes (108/145; 75.2%) with LCD and in 45/47 (95.7%) eyes with a PCCC. CONCLUSION Increased surgeon awareness of possible intraoperative, accidental LCDs is important, as LCDs were relatively common and associated with increased odds for vision loss after 1 year in the present study. A prospective study investigating the causes of intraoperative, accidental LCD is warranted.
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Affiliation(s)
- Amy L M M Andrews
- Queen Mother Hospital for Animals, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, United Kingdom
| | - Christiane Kafarnik
- Queen Mother Hospital for Animals, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, United Kingdom
| | - Maria-Christine Fischer
- Queen Mother Hospital for Animals, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, United Kingdom
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Advances in drug therapy and delivery for cataract treatment. Curr Opin Ophthalmol 2023; 34:3-8. [PMID: 36484206 DOI: 10.1097/icu.0000000000000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Cataract is one of the leading causes of blindness worldwide and surgery is the only available treatment. Pharmacological therapy has emerged as a potential approach to combat the global shortage of surgery due to a lack of access and resources. This review summarizes recent findings in pharmacological treatment and delivery, focusing on drugs that target oxidative stress and the aggregation of crystallins. RECENT FINDINGS Antioxidants and oxysterols have been shown to improve or reverse lens opacity in cataract models. N-acetylcysteine amide and N-acetylcarnosine are two compounds that have increased bioavailability over their precursors, alleviating the challenges that have come with topical administration. Studies have shown promising results, with topical N-acetylcarnosine clinically decreasing lens opacity. Furthermore, lanosterol, and more recently 5-cholesten-3b,25-diol (VP1-001), have been reported to combat the aggregation of crystallins in vivo and ex vivo . Delivery has improved with the use of nanotechnology, but further research is needed to solidify these compounds' therapeutic effects on cataracts and improve delivery methods to the lens. SUMMARY Although further research in drug dosage, delivery, and mechanisms will need to be conducted, pharmacologic therapies have provided new strategies and treatments for the reversal of cataracts.
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Chen X, Xu J, Chen X, Yao K. Cataract: Advances in surgery and whether surgery remains the only treatment in future. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2021; 1:100008. [PMID: 37846393 PMCID: PMC10577864 DOI: 10.1016/j.aopr.2021.100008] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/27/2021] [Accepted: 10/12/2021] [Indexed: 10/18/2023]
Abstract
Background Cataract is the world's leading eye disease that causes blindness. The prevalence of cataract aged 40 years and older is approximately 11.8%-18.8%. Currently, surgery is the only way to treat cataracts. Main Text From early intracapsular cataract extraction to extracapsular cataract extraction, to current phacoemulsification cataract surgery, the incision ranges from 12 to 3 mm, and sometimes to even 1.8 mm or less, and the revolution in cataract surgery is ongoing. Cataract surgery has transformed from vision recovery to refractive surgery, leading to the era of refractive cataract surgery, and premium intraocular lenses (IOLs) such as toric IOLs, multifocal IOLs, and extended depth-of-focus IOLs are being increasingly used to meet the individual needs of patients. With its advantages of providing better visual acuity and causing fewer complications, phacoemulsification is currently the mainstream cataract surgery technique worldwide. However, patient expectations for the safety and accuracy of the operation are continually increasing. Femtosecond laser-assisted cataract surgery (FLACS) has entered the public's field of vision. FLACS is a combination of new laser technology and artificial intelligence to replace fine manual clear corneal incision, capsulorhexis, and nuclear pre-fragmentation, providing new alternative technologies for patients and ophthalmologists. As FLACS matures, it is being increasingly applied in complex cases; however, some think it is not cost-effective. Although more than 26 million cataract surgeries are performed each year, there is still a gap in the prevalence of cataracts, especially in developing countries. Although cataract surgery is a nearly ideal procedure and complications are manageable, both patients and doctors dream of using drugs to cure cataracts. Is surgery really the only way to treat cataracts in the future? It has been verified by animal experiments that lanosterol therapy in rabbits and dogs could make cataract severity alleviated and lens transparency partially recovered. Although there is still much to learn about cataract reversal, this groundbreaking work provided a new strategy for the prevention and treatment of cataracts. Conclusions Although cataract surgery is nearly ideal, it is still insufficient, we expect the prospects for cataract drugs to be bright.
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Affiliation(s)
- Xinyi Chen
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Jingjie Xu
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Xiangjun Chen
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
| | - Ke Yao
- Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China
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Zhu D, Wong A, Gupta R, Li AS. Patterns of cataract surgery-related litigations in the United States from 2000-2020. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1962296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Daniel Zhu
- Department of Ophthalmology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Vitreoretinal Consultants of New York, Great Neck, NY, USA
| | - Amanda Wong
- Department of Ophthalmology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Vitreoretinal Consultants of New York, Great Neck, NY, USA
| | - Rohun Gupta
- Department of Ophthalmology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Vitreoretinal Consultants of New York, Great Neck, NY, USA
| | - Albert S. Li
- Vitreoretinal Consultants of New York, Great Neck, NY, USA
- Northwell Health Eye Institute, Department of Ophthalmology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA
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Abstract
The extended depth-of-focus intraocular lenses (EDOF IOLs) represent one of the most exciting advancements in the field of lens surgery. EDOF IOLs promise an excellent visual experience, minimizing visual disturbances (ie, halos and glare) commonly associated with multifocal IOLs. The pros and cons of EDOF IOLs should be evaluated in comparison with other more traditional multifocal or monofocal IOLs. The aim of this review is to provide the most current information regarding EDOF IOLs for power calculating formulas, refractive outcomes, incidence of photic phenomena, and patient satisfaction.
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Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss. J Ophthalmol 2021; 2021:6691904. [PMID: 34221495 PMCID: PMC8225442 DOI: 10.1155/2021/6691904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/03/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes (P > 0.05). Conclusions Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.
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WITHDRAWN: Intelligent microscopy to improve cataract surgery. Med Hypotheses 2020. [DOI: 10.1016/j.mehy.2020.110017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zhao J, Yu J, Wang T, Mban B. Ciliary sulcus implantation of intraocular lens in manual small incision cataract surgery complicated by large posterior capsule rupture. Exp Ther Med 2018; 17:1470-1475. [PMID: 30680030 DOI: 10.3892/etm.2018.7074] [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: 11/10/2015] [Accepted: 01/08/2018] [Indexed: 01/03/2023] Open
Abstract
The present study aimed to evaluate the safety and efficiency of ciliary sulcus implantation of intraocular lens (IOL) in patients that had undergone manual small incision cataract surgery (MSICS) complicated by large posterior capsule rupture (LPCR). A total of 11 eyes taken from 11 patients in Brazzaville, Republic of the Congo, that had experienced LPCR following MSICS were included in the current study. A rigid single-piece IOL (5.5 mm optic, 12.50 mm overall length) was implanted into the ciliary sulcus. Postoperative follow-up assessments evaluated visual acuity, anterior segment biomicroscopy, IOL centration and position, and fundus biomicroscopy. The median follow-up time was 3.7 months (range, 2-6 months). All patients experienced vision improvement: Uncorrected visual acuity 2 months following surgery was 0.3-0.5 in 9 patients and >0.5 in 2 patients. Postoperative complications included pronounced anterior segment inflammation (1 patient), mild corneal endothelium edema (3 patients), residual cortex (1 patient) and intraocular pressure elevation (1 patient). Significant IOL decentration and tilt were not observed in any patients. The results of the present study indicate that ciliary sulcus implantation of a rigid single-piece IOL may be a feasible and effective method of treating patients that have experienced LPCR complications following cataract surgery, as it provides satisfactory visual acuity outcomes. Appropriate intraoperative management may reduce the incidence of postoperative complications.
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Affiliation(s)
- Jinrong Zhao
- Department of Refractive Surgery Centre, Tianjin Eye Hospital, Tianjin 300121, P.R. China
| | - Jinguo Yu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Tiecheng Wang
- Department of Cataract, Tianjin Medical University Eye Hospital and The College of Optometry and Ophthalmology, Tianjin 300384, P.R. China
| | - Bertin Mban
- Department of Ophthalmology, Sino-Congo Friendship Hospital, Brazzaville B.P. 869, Republic of the Congo
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Intravitreal Phacoemulsification Through Corneal Incision for Management of Posteriorly Dislocated Lens Material After Complicated Cataract Surgery: A New Surgical Technique. Retina 2018; 39 Suppl 1:S50-S53. [PMID: 29979455 DOI: 10.1097/iae.0000000000002240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Davvalo Khongar P, Pralits JO, Soleri P, Romano M, Repetto R. A study of the mechanical forces on aphakic iris-fixated intraocular lenses. J Biomech Eng 2018; 140:2686535. [PMID: 30029265 DOI: 10.1115/1.4040588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Indexed: 11/08/2022]
Abstract
Iris-fixated aphakic intraocular lenses (IFIOL) are used in cataract surgery, when more common intraocular lenses cannot be adopted because of the absence of capsular bag support. These lenses can be implanted either on the poste- rior or the anterior surface of the iris. In this work we study whether one of these options is preferable over the other from the mechanical point of view. In particular, we focus on the forces that the IFIOL transmits to the iris, which are asso- ciated with the risk of lens dislocation. We study the prob- lem numerically and consider aqueous flow induced by sac- cadic rotations in the cases of an IFIOL in the anterior and posterior side of the iris. The IFIOL considered is the Arti- san Aphakia +30.0 D lens (IFIOL) produced by Ophtec BV. We perform the simulations in OpenFOAM. We find that the forces transmitted by the aphakic IFIOL to the iris are sig- nificantly higher in the case of posterior implantation. This suggests that lens implantation on the posterior surface of the iris might be associated with a higher risk of lens disloca- tion, when an inadequate amount of iris tissue is enclavated during implantation.
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Affiliation(s)
- Peyman Davvalo Khongar
- Deptartment of Civil, Chemical and Environmental Engineering, University of Genoa, 16145, Genoa, Italy
| | - Jan O Pralits
- Deptartment of Civil, Chemical and Environmental Engineering, University of Genoa, 16145, Genoa, Italy
| | | | - Mario Romano
- Department of Biomedical Sciences, Humanitas University, Rozzano - Milano, Italy
| | - Rodolfo Repetto
- Deptartment of Civil, Chemical and Environmental Engineering, University of Genoa, 16145, Genoa, Italy
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Application of 25 MHz B-Scan Ultrasonography to Determine the Integrity of the Posterior Capsule in Posterior Polar Cataract. J Ophthalmol 2018; 2018:9635289. [PMID: 29785304 PMCID: PMC5896256 DOI: 10.1155/2018/9635289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/18/2018] [Indexed: 11/27/2022] Open
Abstract
Purpose To report the application of 25 MHz B-scan ultrasonography (MHzB) to determine the integrity of the posterior capsule (PC) in posterior polar cataract (PPC). Methods Patients with whom PPC was clinically diagnosed using slit lamp microscopy who underwent 25 MHzB before phacoemulsification were retrospectively reviewed. The status of the PC was determined by 25 MHzB before phacoemulsification and confirmed during cataract surgery. Results In total, 21 eyes in 14 clinically diagnosed PPC patients were enrolled in this study. Out of 25 MHzB images, 19 PCs were found to be intact, while 2 showed dehiscence before cataract surgery. During phacoemulsification, 17 PCs were observed to be intact, while 4 PCs showed posterior capsule rupture (PCR). These 4 PCR cases included the above 2 eyes, in which preexisting dehiscence was detected by 25 MHzB. The other 2 PCR cases showed high reflectivity between high echoes in posterior opacities and the PC, indicating synechia between the PPC and PC. Conclusion This is the first report to show that 25 MHzB can be used to clearly visualize the status of the PC in PPC. These results, in turn, could be used to select the appropriate treatment and to thereby avoid further complications during PPC surgery.
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Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS. Cataracts. Lancet 2017; 390:600-612. [PMID: 28242111 DOI: 10.1016/s0140-6736(17)30544-5] [Citation(s) in RCA: 494] [Impact Index Per Article: 70.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/27/2016] [Accepted: 02/02/2017] [Indexed: 12/11/2022]
Abstract
An estimated 95 million people worldwide are affected by cataract. Cataract still remains the leading cause of blindness in middle-income and low-income countries. With the advancement of surgical technology and techniques, cataract surgery has evolved to small-incisional surgery with rapid visual recovery, good visual outcomes, and minimal complications in most patients. With the development of advanced technology in intraocular lenses, the combined treatment of cataract and astigmatism or presbyopia, or both, is possible. Paediatric cataracts have a different pathogenesis, surgical concerns, and postoperative clinical course from those of age-related cataracts, and the visual outcome is multifactorial and dependent on postoperative visual rehabilitation. New developments in cataract surgery will continue to improve the visual, anatomical, and patient-reported outcomes. Future work should focus on promoting the accessibility and quality of cataract surgery in developing countries.
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Affiliation(s)
- Yu-Chi Liu
- Cornea and Refractive Surgery Group, Singapore Eye Research Institute, Singapore; Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore
| | - Mark Wilkins
- Department of Cornea and External Eye Disease, Moorfields Eye Hospital, London, UK
| | - Terry Kim
- Department of Cornea and External Disease, Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Boris Malyugin
- Department of Cataract and Implant Surgery, S Fyodorov Eye Microsurgery State Institution, Moscow, Russia
| | - Jodhbir S Mehta
- Cornea and Refractive Surgery Group, Singapore Eye Research Institute, Singapore; Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore; Department of Clinical Sciences, Duke-NUS Medical School, Singapore.
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Kang S, Park S, Park E, Lim J, Seo K. Influence of an intentionally induced posterior lens capsule rupture on the real-time intraocular pressure during phacoemulsification in canine ex vivo eyes. Vet Ophthalmol 2017; 21:35-41. [PMID: 28503796 DOI: 10.1111/vop.12475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the changes in the intraocular pressure (IOP) following an intentionally induced posterior lens capsule rupture (PLCR) during phacoemulsification in enucleated canine eyes. Furthermore, to compare the IOPs between different stages of phacoemulsification for two different bottle heights (BH). PROCEDURES Coaxial phacoemulsification was performed using a venturi-based machine at a 60 or 90 cm BH. A pressure transducer, inserted into the anterior chamber through the peripheral cornea, monitored real-time IOP. For one half of the lens, the sculpt-segment removal (SS) was followed by irrigation/aspiration (IA). The PLCR was intentionally created, and the SS and IA were repeated on the residual lens fragments. RESULTS For the 60 cm BH, the mean IOP following the PLCR was significantly higher than before the PLCR during SS (28.30 ± 12.56 and 38.71 ± 9.43 mmHg before and after PLCR, respectively) and IA (42.76 ± 12.46 and 47.88 ± 7.10 mmHg before and after PLCR, respectively) stages (P < 0.001). For the 90 cm BH, the mean IOP following the PLCR was also significantly higher than before the PLCR during SS (33.39 ± 11.09 and 58.17 ± 6.89 mmHg before and after PLCR, respectively) and IA (62.39 ± 12.46 and 72.04 ± 8.59 mmHg before and after PLCR, respectively) stages (P < 0.001). CONCLUSIONS The occurrence of a PLCR led to an increase in IOP during both the SS and IA stages. The elevated IOP after the PLCR might be one of the most important factors for ocular tissue damage, as it reduces ocular perfusion. Additionally, the BH should be reduced following PLCR to prevent complications stemming from the raised IOP.
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Affiliation(s)
- Seonmi Kang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Sangwan Park
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Eunjin Park
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Jaegook Lim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - Kangmoon Seo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
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Abstract
PURPOSE OF REVIEW The article reviews the current literature on intraoperative techniques to properly manage anterior capsular tears during cataract surgery. RECENT FINDINGS Femtosecond laser-assisted cataract surgery creates a more consistent capsulorhexis than traditional capsulotomies, but can also present with new challenges. Irregularities, like microadhesions and tags, can lead to anterior tears if not properly treated. New technology, like the Zepto (Mynosys, Fremont, CA, USA) pulse precision capsulotomy, may produce a smoother edge and reduce the incidence of capsular tears. However, there are novel rescue techniques in the case that a tear-out does occur. SUMMARY Anterior capsular tears can occur at any stage of cataract surgery. The proper management of these tears will prevent them from extending into the posterior capsule and compromising the structural integrity of the capsular bag. This is essential for endocapsular placement of artificial lenses and for optimal visual outcomes for the patient.
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Affiliation(s)
- Joanne W Ho
- Shiley Eye Center, University of California, San Diego, La Jolla, California, USA
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