Ten-year outcomes of congenital cataract surgery performed within the first 6 months of life.

PURPOSE: In the spectrum of pediatric cataract, genuine congenital cataract poses challenges and has a poorer prognosis than developmental cataract. We investigated the long-term outcomes of congenital cataract surgery performed within the first 6 months of life. SETTING: Eleven ophthalmic surgical sites in Japan. METHODS: Medical charts were retrospectively reviewed for 216 eyes of 121 patients. The age at surgery was 2.9 ± 1.7 months, with follow-up duration 13.0 ± 2.3 years. The cohort consisted of 83 cases with bilateral aphakia, 12 with bilateral pseudophakia, 20 with unilateral aphakia, and 6 with unilateral pseudophakia. RESULTS: Surgical intervention within the critical period of visual system development (10 weeks for bilateral and 6 weeks for unilateral cases) led to significantly better final visual acuity than surgery conducted after this timeframe. The incidence of secondary glaucoma was similar between groups, while the occurrence of visual axis opacification was more frequent with earlier surgery. A forward stepwise multiple regression analysis revealed that the final visual acuity was significantly associated with laterality of cataract (better outcomes in bilateral cases), phakic status (with pseudophakia outperforming aphakia), presence of systemic and ocular comorbidities, and development of secondary glaucoma. Secondary glaucoma was significantly more prevalent in aphakic eyes than pseudophakic eyes. CONCLUSIONS: In patients with genuine congenital cataract, surgery within the critical period of visual development results in better final visual acuity, albeit with an increased risk of visual axis opacification. The use of intraocular lens with sophisticated surgical techniques shows promise even in congenital cataract surgery.

Long-term surgical outcomes of pediatric cataract-multivariate analysis of prognostic factors.

We assessed the 10-year postoperative outcomes of pediatric cataract patients who underwent surgery at the age of 6 years or younger. A retrospective review of medical charts was conducted for 457 eyes of 277 patients, with the age at surgery averaging 1.3 ± 1.5 years (mean ± SD) and the follow-up duration averaging 12.8 ± 2.4 years (ranging from 10 to 17 years). The cohort included 250 eyes of 125 cases with bilateral aphakia (age at surgery 0.5 ± 0.8 years), 110 eyes of 55 cases with bilateral pseudophakia (1.9 ± 1.6 years), 42 cases with unilateral aphakia (1.1 ± 1.3 years), and 55 cases with unilateral pseudophakia (2.6 ± 1.7). A forward stepwise multiple regression analysis revealed that the best-corrected visual acuity at the final visit was significantly associated with laterality of cataract (with bilateral cases showing better results compared to unilateral cases), presence of systemic comorbidities, presence of ocular comorbidities, development of glaucoma, and phakic status (with better results in the pseudophakia group than the aphakia group). The age at surgery did not significantly affect visual acuity outcomes. A multiple logistic regression analysis demonstrated that the incidence of secondary glaucoma was significantly linked to younger age at surgery, phakic status (higher in aphakic than pseudophakic eyes), and presence of systemic comorbidities. In conclusion, after pediatric cataract surgery, final visual acuity was better in patients with bilateral cataracts, those treated with an intraocular lens, and cases without systemic or ocular comorbidities and secondary glaucoma. The development of secondary glaucoma was linked to younger age at surgery, aphakic status, and presence of systemic comorbidities.

Serum levels of candidate microRNA diagnostic markers differ among the stages of non-small-cell lung cancer.

Circulating microRNAs (miRNAs) are promising markers for cancer diagnosis and prognosis. Numerous studies evaluating miRNAs as markers for non-small cell lung cancer (NSCLC) have been conducted in recent years; however, the majority of candidate markers proposed via individual studies were inconsistent and no marker miRNAs for the diagnosis of early stage NSCLC have been established. In the present study, miR-145, miR-20a, miR-21 and miR-223, which were previously reported as candidate diagnostic markers of NSCLC, were re-evaluated. The serum levels of these miRNAs were quantified in 56 patients with stage I-IV NSCLC using the TaqMan microRNA assays and separately compared the levels at each stage with those in 26 control patients. The level of miR-145 was significantly reduced in patients with NSCLC, regardless of clinical stage, and its level increased following tumor resection in patients with stage I-II disease. These results indicate that miR-145 is relevant as a diagnostic marker for stages I-IV NSCLC. Additionally, the levels of miR-20a and miR-21 demonstrated notable differences among patients at different clinical stages. These miRNAs distinguished patients in a number of, but not all, stages of NSCLC from cancer-free control patients. These results indicated that it is essential to analyze miRNA levels at each stage separately in order to evaluate marker miRNAs for NSCLC diagnosis.

Effects of optical diameter of intraocular lenses with intrascleral fixation on higher-order aberrations.

BACKGROUND: Intrascleral fixation of an intraocular lens (IOL) is used in eyes that lack capsular support. The aim of the study is to determine whether a larger optical diameter IOL will decrease the higher-order aberrations (HOAs) when the haptics are extended for intrascleral fixation than a smaller diameter IOL. METHODS: Three-piece acrylic IOLs with 6.0 mm optics (X-60, VA-60BBR) and 7.0 mm optics (X-70, VA-70 AD) were fixed at lengths of 13, 14, 15, 16, or 17 mm. A wavefront analyzer was used to measure the HOAs within the central 3.0 and 5.2 mm optic diameter. RESULTS: The astigmatic aberration within the central 5.2 mm was greater than that within the central 3.0 mm for all IOLs. The HOAs increased significantly with an extension of the IOLs with both optical diameters (P < 0.001). The coma aberration within the central 5.2 mm was greater than that within the central 3.0 mm but it did not increase with an extension of the haptics. The astigmatic aberration of the X-60 IOL was significantly greater than that of the X-70 only at an extension of 17 mm. The astigmatic aberration of the VA-70 AD was not significantly different from that of the VA-60BBR. The cylindrical power changed from 0.047 D in the X-60 to 0.118 D in the VA-70 AD when the IOLs were extended from 13 to 17 mm. CONCLUSION: When three-piece IOLs are highly extended for intrascleral fixation, the astigmatic aberration increases significantly. However, IOLs with 7 mm optics do not have less astigmatic and coma aberrations than IOLs with 6 mm optics.

Changes in higher-order aberrations of intraocular lenses with intrascleral fixation.

AIM: To determine the higher-order aberrations of intraocular lenses (IOLs) that are extended and fixed intrasclerally. METHODS: A computer-aided design system was used to calculate the length of an IOL when it was fixed to the sclera 2 mm posterior to the limbus in a Gullstrand eye model. An acrylic single-piece (SA60AT) or 2 three-piece IOLs (VA-60BBR; X-60) were fixed at lengths of 13, 14, 15 and 16 mm. A wavefront analyser was used to measure the higher-order aberrations within the central 3.0 and 5.2 mm optic diameters. RESULTS: The length of the IOL with the intrascleral fixation was calculated to be 13.9-14.9 mm in the eye model. The astigmatic aberration of the three-piece VA-60BBR and X-60 IOLs increased significantly with an extension of the IOLs within the central 5.2 mm (both p<0.001) but not that of the single-piece SA60AT IOL. The coma aberration of the VA-60BBR IOL increased significantly within the central 5.2 mm with an increase in the extension (p=0.001) but not that of the SA60AT and X-60 IOLs. The astigmatic and coma aberrations were significantly greater within the central 5.2 mm than within the central 3.0 mm for all IOLs (p<0.05). The cylindrical power increased from 0.034 D to 0.082 D with extensions from 13 to 16 mm. CONCLUSIONS: When three-piece IOLs are extended widely for intrascleral fixation, the astigmatic and coma aberrations increase but the degree of change should not alter the postoperative vision appreciably.

[Corneal astigmatism in children with congenital cataract].

PURPOSE: To investigate corneal astigmatism in children with congenital cataract before surgery. MATERIALS AND METHODS: We retrospectively reviewed the charts of 99 eyes of 62 patients (74 paired eyes and 25 single eyes) who had undergone congenital cataract surgery from March, 2000 to April, 2012. The mean age at surgery was 32.1 +/- 26.9 months. All eyes were examined using an autorefract-keratometer. Cases were divided into 3 groups according to the axis of astigmatism (with-the-rule, against-the-rule and oblique astigmatism). RESULT: The mean corneal astigmatism was 2.45 +/- 1.28 diopters (D) (range 0.25-6.87D). The prevalence of corneal astigmatism of 2.0 D or more was 65.7%. The most frequent was astigmatism with-the-rule (83.8%) (mean 2.64 +/- 1.25 D), oblique astigmatism was 11.1% (mean 1.43 +/- 0.98 D), and 5.1% of the cases had astigmatism against-the-rule (mean 1.55 +/- 1.07 D). The mean corneal astigmatism of the eye with cataract (2.46 D) was significantly higher than that of the normal eye (1.66 D) in unilateral cases. CONCLUSIONS: Children with congenital cataract had a high prevalence of large corneal astigmatism > or = 2.00D, that was generally with-the-rule. In the unilateral cataract patients, cataract eyes had higher corneal astigmatism than normal eyes.