Global multi-site, prospective analysis of cataract surgery outcomes following ICHOM standards: the European CAT-Community.

PURPOSE: To evaluate in a large sample of patients from 10 different European centers the results of cataract surgery, characterizing the relationship between patient-reported outcomes (PROMs) and clinician-reported outcome measures (CROMs). METHODS: Prospective non-interventional multicenter observational descriptive study analyzing the clinical outcomes of a total of 3799 cases undergoing cataract surgery (mean age: 72.7 years). In all cases, the cataract surgery standard developed by the International Consortium for Health Outcomes Measurements (ICHOM) was used to register the clinical data. Three-month postoperative visual acuity and refraction data were considered CROMs, whereas Rasch-calibrated item 2 (RCCQ2) and total Catquest-9SF score (CQ) were considered PROMs. RESULTS: Postoperative corrected distance visual acuity (CDVA) was 0.3 logMAR or better in 88.7% (2505/2823) of eyes. Mean differences between preoperative and postoperative RCCQ2 and CQ scores were -3.09 and -2.39, respectively. Visual function improvement with surgery was reported by 91.5% (2163/2364) of patients. Statistically significant, although weak, correlations of postoperative CDVA with postoperative refraction, PROMs, and complications were found (0.133 ≤ r ≤0.289, p < 0.001). A predictive model (R2: 0.254) of postoperative CDVA considering 10 variables was obtained, including preoperative CDVA, different ocular comorbidities, age, gender and intraoperative complications. Likewise, another predictive model (R2: 0.148) of postoperative CQ considering a total of 14 variables was obtained, including additionally preoperative CQ, target refraction and previous surgeries. CONCLUSIONS: Cataract surgery provides an improved functional vision in most of patients although this improvement can be limited by ocular comorbidities and complications. The relationship between PROMs and CROMs is multifactorial and complex.

Aqueous Humour Cytokine Changes with Intravitreal Dexamethasone Implant Injection for Diabetic Macular Edema.

Purpose: To assess changes in aqueous humor (AH) levels of cytokines following dexamethasone intravitreal implant (DEX) injection for diabetic macular edema (DME).Methods: Sixteen DME and cataract cases series study. Anterior chamber AH sampling was performed at baseline at DEX injection time (T1), cataract surgery 8 weeks afterward (T2), and whenever DME relapsed (T3) in order to assess changes in IL-1ß, IL-3, IL-6, IL-8, IL-10, MCP-1, IP-10, TNF-α, and VEGF levels.Results: IP-10 and MCP-1 levels significantly decreased at T2 (p = .034 and p = .044, respectively) compared to baseline (T1). Relapsed DME cases (T3) showed significantly higher levels of IL-6 (p = .028), IL-8 (p = .005), IP-10 (p = .013) and MCP-1 (p = .005) compared to T2.Conclusion: IP-10 and MCP-1 AH levels seem to be related to DEX intraocular action, decreasing after injection and increasing when DME relapses. In addition, IL-6 and IL-8 may play a role in DME late evolution and clinical relapse beyond DEX effect.

Novel molecular diagnostic system of limbal stem cell deficiency based on MUC5AC transcript detection in corneal epithelium by PCR-reverse dot blot.

PURPOSE: To evaluate the sensitivity and specificity of a PCR-strip system based on reverse dot blot for detection of MUC5AC mRNA in corneal epithelium samples from patients with limbal stem cell deficiency (LSCD), and to determine the correlation with clinical diagnosis. METHODS: We obtained 87 corneal impression cytology (IC) samples from 55 subjects (37 patients clinically diagnosed with LSCD and 18 control subjects). Total RNA was extracted from each IC sample and retrotranscribed to cDNA. MUC5AC mRNA transcript was amplified by a customized RT-PCR assay and detected in PCR strips based on reverse dot blot hybridization and in agarose gels. Conjunctival IC samples were used as positive controls. RESULTS: Forty-four of 45 corneal IC samples obtained from patients clinically diagnosed with LSCD were positive for MUC5AC, whereas 34 of 42 corneal ICs from healthy subjects were negative for MUC5AC. Four healthy corneas were found MUC5AC positive, and four rendered inconclusive results. A correlation of 91.4% (P < 0.001) between molecular testing and clinical diagnosis was found. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the PCR-strip system were 98%, 89%, 92%, and 97%, respectively. CONCLUSIONS: Corneal epithelium MUC5AC transcript detection by reverse dot blot PCR-strip is a highly sensitive technique for LSCD diagnosis. The test results strongly correlate with clinical diagnosis of characterized LSCD cases. The PCR-strip system may be used for early detection, and for the detection of mild cases of LSCD, and constitutes an objective clinical tool for the monitoring of treatments and surgical decisions.

Ocular adverse events of systemic inhibitors of the epidermal growth factor receptor: report of 5 cases.

PURPOSE: To describe the ocular effects associated with the administration of the systemic epidermal growth factor receptor (EGFR) inhibitors panitumumab and erlotinib. DESIGN: Retrospective, noncomparative interventional case series. PARTICIPANTS: Ten eyes of 5 patients in treatment with systemic EGFR inhibitors, 4 patients with erlotinib for end-stage lung carcinoma, and 1 patient with panitumumab for end-stage colorectal cancer. METHODS: Data collected from charts included gender, age at presentation, systemic disease, and clinical presentation in each eye. MAIN OUTCOME MEASURES: Demographics on presentation and clinical findings. RESULTS: Multiple epithelial defects were observed in all 10 eyes, corneal melting and thinning were observed in 3 eyes of 2 patients, 2 eyes of 1 patient presented with lower lid ectropion, and 2 eyes of 2 patients presented with corneal perforation, both requiring a penetrating keratoplasty. CONCLUSIONS: Severe ocular side effects, including corneal perforation, may be associated with the use of the EGFR inhibitors panitumumab and erlotinib.

Chromium recovery from exhausted baths generated in plating processes and its reuse in the tanning industry.

Chromium plating used for functional purposes provides an extremely hard, wear and corrosion resistant layer by means of electrolytic deposition. Typical layer thicknesses range between 2.5 and 500 µm. Chromium electroplating baths contain high concentrations of Cr(VI) with chromium trioxide (CrO(3)) as the chromium source. When because of technical or economic reasons a bath gets exhausted, a waste containing mainly chromium as dichromate as well as other heavy metals is generated. Chromium may then be purified for use in other industrial processes with different requirements. In this work, a sustainable system for using galvanic wastes as reagents in the leather tanning industry, thus reducing quantity of wastes to be treated, is presented. Metal cations present in the chromium exhausted bath were precipitated with NaOH. Then, the solution containing mainly soluble Cr(VI) was separated. By means of sodium sulphite in acidic conditions, Cr(VI) was reduced to Cr(III) as chromium (III) sulphate. From chromium (III) sulphate a basic Cr(III) sulphate may be obtained, which is one of most used compounds in the tanning industry. Cr(III) concentration in the final solution allows its reuse without concentration, but with a slight dilution.

Semi-dynamic leaching tests of nickel containing wastes stabilized/solidified with magnesium potassium phosphate cements.

Herein is presented a study on the long-term leaching behaviour of nickel containing wastes stabilized/solidified with magnesium potassium phosphate cements. Two different semi-dynamic leaching tests were carried out on monolithic materials: ANS 16.1 test with liquid-to-solid ratio (L/S) of 10 dm(3) kg(-1) and increasing renewal times, and ASTM C1308 test with liquid-to-solid ratio (L/S) of 100 dm(3) kg(-1) and constant renewal time of 1 day. ASTM C1308 provides a lower degree of saturation of the leachant with respect to the leached material. The effectiveness of magnesium potassium phosphate cements for the inertization of nickel was proved. XRD analyses showed the presence of bobierrite on the monolith's surface after the leaching test, which had not been detected prior to the leaching test. In addition, the calculated cumulative release of the main components of the stabilization matrix (Mg(2+), total P and K(+)) was represented versus time in logarithmic scale and it was determined if the leaching mechanism corresponds to diffusion. Potassium is released by diffusion, while total phosphorous and magnesium show dissolution. Magnesium release in ANS 16.1 is slowed down because of saturation of the leachant. Experimental results demonstrate the importance of L/S ratio and renewal times in semi-dynamic leaching tests.

Leaching behaviour of magnesium phosphate cements containing high quantities of heavy metals.

Stabilization/solidification (S/S) is one of the most employed techniques for treating liquid wastes containing heavy metals. Magnesium potassium phosphate cements have been used in recent years as stabilizing agents with positive results. However, little information is available about the retention of the metals by magnesium potassium phosphate cements matrices with the exception of the results of compliance tests. In this work, several pastes were prepared by reaction between low grade MgO and KH(2)PO(4) in the presence of different heavy metal nitrate solutions (containing Cd(II), Cr(III), Cu(II), Ni(II), Pb(II) or Zn(II)). In all cases, the initial metal content of the dissolution was 25 g dm(-3) and the oxide-phosphate ratio of the pastes was (50:50) in weight. Four different leaching tests were conducted on magnesium potassium phosphate cement pastes: simple batch test (EN 12457-2), equilibrium leaching test, availability test (NEN 7371) and acid neutralization capacity test (ANC). The metal leachate concentration was determined by means of ICP-MS. The stabilization of metals was successful in all cases, although the immobilizing system shows a better behaviour for Pb(II) and Cr(III) under acidic or neutral conditions.

Effect of heavy metals and water content on the strength of magnesium phosphate cements.

In this paper the mechanical properties of magnesium potassium phosphate cements used for the Stabilization/Solidification (S/S) of galvanic wastes were investigated. Surrogate wastes (metal nitrate dissolutions) were employed containing Cd, Cr(III), Cu, Ni, Pb or Zn at a concentration of 25 g dm(-3) and different water-to-solid (W/S) ratios (0.3, 0.4, 0.5 and 0.6 dm(3)kg(-1)) have been employed. Cements were prepared by mixing hard burned magnesia of about 70% purity with potassium dihydrogen phosphate. Compressive strength and tensile strength of specimens were determined. In addition the volume of permeable voids was measured. It was found that when comparing pastes that the volume of permeable voids increases and mechanical strength decreases with the increase of water-to-solid ratio (W/S). Nevertheless pastes with the same material proportions containing different metals show different mechanical strength values. The hydration products were analyzed by XRD. With the increase of water content not previously reported hydration compound was detected: bobierrite.

Explantation of intraocular lenses in children with juvenile idiopathic arthritis-associated uveitis.

We report the outcome in 2 eyes of 2 patients with juvenile idiopathic arthritis-associated uveitis who had intraocular lens (IOL) explantation. The primary reason for explantation was persistent and uncontrolled inflammation with secondary cystoid macular edema.