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1.
Comput Math Methods Med ; 2022: 1037439, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35529272

RESUMO

In order to improve the effect of on-the-spot diagnosis of senile cataract, this paper combines the intelligent processor to explore the application of color Doppler ultrasound in the clinical analysis of senile cataract. Moreover, this paper measures and calculates the diameter, perimeter, area, volume, or velocity of blood flow reflected by color Doppler ultrasound images. In addition, this paper adopts the measurement method provided by composite measurement to design the intelligent processor. Each measurement analysis package is defined as an independent class, and the data, properties, and methods are encapsulated in a class, which is beneficial to the modular design of the program and the overall management of the system. The experimental results verify that the intelligent processor proposed in this paper has a certain effect in the clinical analysis of color Doppler ultrasound diagnosis of senile cataract.


Assuntos
Catarata , Ultrassonografia Doppler em Cores , Velocidade do Fluxo Sanguíneo , Catarata/diagnóstico por imagem , Humanos , Ultrassonografia Doppler em Cores/métodos
2.
Rom J Ophthalmol ; 66(1): 36-40, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35531447

RESUMO

Objective: Postoperative assessment of patients diagnosed with binocular cataract, who underwent two phacoemulsification treatments at different times, in terms of subjective experience of the two procedures. Material and method: The investigation is a prospective study based on patients of Ophthalmology Clinic of Mária Street in Budapest and the Ophthalmology Department in Târgu Mures, between January 2020 and April 2021. After surgery, the patients were surveyed using questionnaires. A total of 53 responses from patients who had undergone cataract removal in both eyes were processed. Data was processed using Microsoft Office Excel and GraphPad Prism 8.0.1. Results: A statistically significant difference (p = 0.0008) in pain was found between the two interventions, with patients reporting greater pain after the second surgery compared to the first treatment. The subjective increase of visual acuity was significantly different (p=0.0156) between the two surgeries. After the first treatment, 37 patients affirmed that their visual acuity met their expectations, but, by the second operation, this had dropped to 31. There was also a statistically significant difference between the individually perceived duration of the two treatments (p=0.0013), with the most frequently reported duration of the first phacoemulsification treatment being 10 minutes (43.4%), and the second eye treatment being 20 minutes (37.7%). Assessing the asymptomaticity, a significant difference (p = 0.009) was registered between the two treatments, the asymptomatic reduction for the second operation being decreased by 28.1%. Conclusion: Patients treated for binocular cataract had significantly worse subjective symptoms during the second treatment.


Assuntos
Catarata , Oftalmologia , Facoemulsificação , Catarata/etiologia , Humanos , Dor/etiologia , Satisfação do Paciente , Facoemulsificação/efeitos adversos , Estudos Prospectivos , Inquéritos e Questionários
3.
Rom J Ophthalmol ; 66(1): 61-68, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35531448

RESUMO

Objective: To analyze the utility and the nuances of implanting the B-HEX® Pupil Expander (Med Invent Devices, India) at various stages in small pupil phacoemulsification. Methods: This prospective interventional case series was undertaken to assess the utility of B-Hex in small pupil phacoemulsification under topical anesthesia. Our series comprised of 50 cataract cases with small pupils of various etiologies, operated by a single surgeon at our private practice, beginning February 2018. Cataract cases with pharmacological dilation of < 4 mm underwent phacoemulsification with B-Hex implantation. It was employed at the outset or interim, whenever the need arose. Results: The B-Hex ring is extremely handy and useful in small pupil phacoemulsification. The average age of our study cohort was 62 years. In 38 cases B-Hex was employed before making a capsulorhexis. Progressive pupillary constriction during nuclear disassembly warranted the utilization of the device in 9 cases, while the remaining 3 cases had a retained epi-nuclear plate or significant cortex and the ring was placed after nucleus removal. No significant complication was noted. Postoperatively, the pupil dimensions, notably the architecture, were maintained. No significant AC reaction was noted. Intraocular pressure was not high. Conclusion: Our experience showed that B-Hex is secure and easy to use under topical anesthesia. The learning curve is shallow and the technique is precise. B-Hex is truly an ace up the sleeve.


Assuntos
Extração de Catarata , Catarata , Facoemulsificação , Humanos , Pessoa de Meia-Idade , Miose/cirurgia , Facoemulsificação/métodos , Estudos Prospectivos
4.
BMC Ophthalmol ; 22(1): 199, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35501774

RESUMO

BACKGROUND: This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. METHODS: Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications. RESULTS: In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures. CONCLUSIONS: In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies.


Assuntos
Ambliopia , Catarata , Traumatismos Oculares , Ambliopia/complicações , Catarata/complicações , Criança , Pré-Escolar , Traumatismos Oculares/complicações , Traumatismos Oculares/cirurgia , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Centros de Atenção Terciária
5.
Ann Palliat Med ; 11(4): 1421-1430, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35523750

RESUMO

BACKGROUND: For patients with cataracts and retinopathy, phacoemulsification can improve the progress of the disease to a certain extent. However, the efficacy of phacoemulsification alone is often not ideal, and may even aggravate the prognostic effects, such as macular edema and slow visual recovery. Thus, an increasing number of clinicians have explored comprehensive therapy involving phacoemulsification combined with drug therapy, which has led to some research progress. However, there is still great controversy about the combined treatment. In this study, we performed a literature meta-analysis to systematically evaluate the clinical efficacy and safety of prophylactic intravitreal injection of bevacizumab combined with phacoemulsification for the treatment of cataracts complicated with retinopathy. METHODS: We searched the PubMed, Web of Science, Embase, and MEDLINE databases for English language papers related to these studies factors published between January 2001 and January 2021. The retrieved articles were screened and the quality of the included studies was evaluated. Meta-analysis was performed and RevMan5.3 was used to calculate the enhanced mean difference (MD). RESULTS: Six articles were finally included in this meta-analysis, involving a total of 325 cases with cataracts and retinopathy. The results showed that the best-corrected visual acuity at 1 month [MD =-0.06; 95% confidence interval (CI): (-0.09, -0.03); P=0.0002] and 3 months [MD =-0.09; 95% CI: (-0.11, -0.07); P<0.00001] in the preventive vitreous injection bevacizumab intervention group were significantly better than those of the control group (P<0.1). However, the best-corrected visual acuity at 6 months [MD =-0.02; 95% CI: (-0.07, 0.03); P=0.39] was not significantly different between these two groups (P>0.05). In addition, the central macular thickness of the preventive vitreous injection bevacizumab intervention group at 1 month after treatment [MD =-37.07; 95% CI: (-45.87, -28.27); P<0.00001], 3 months [MD =-15.26; 95% CI: (-23.87, -6.66); P=0.0005], and 6 months [MD =-26.77; 95% CI: (-37.51, -16.04); P<0.00001] were significantly different to the control group (P<0.05). DISCUSSION: The results of this study showed that prophylactic intravitreal injection of bevacizumab combined with phacoemulsification is a safe and effective treatment for patients with cataracts and retinopathy within 6 months after treatment.


Assuntos
Catarata , Retinopatia Diabética , Facoemulsificação , Bevacizumab/uso terapêutico , Catarata/complicações , Catarata/tratamento farmacológico , Retinopatia Diabética/tratamento farmacológico , Humanos , Facoemulsificação/métodos , Acuidade Visual
6.
BMC Ophthalmol ; 22(1): 208, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524189

RESUMO

BACKGROUND: Paediatric traumatic cataracts are an important but preventable cause of acquired blindness. Understanding the epidemiology of paediatric traumatic cataracts is a prerequisite for prevention. This study aimed to characterize the epidemiological profile of paediatric traumatic cataracts in southwest China. METHODS: The medical records of children (age range, 0-14 years old) who developed traumatic cataracts following open-globe injuries and were hospitalized at the Department of Ophthalmology at West China Hospital, between January 2011 and December 2020 were retrospectively analyzed. The demographic data, causes of injuries, posttraumatic complications, and visual acuity were recorded and analysed. RESULTS: A total of 716 eyes from 716 patients were analysed in this study, including 521 (72.8%) males and 195 females in a gender ratio of 2.67:1; 117 of the patients were of ethnic minorities. Paediatric traumatic cataracts occurred more frequently in winter (32.5%). Sharp metal objects (scissors/knives/needles/sheet metal/nails/darts) - induced ocular injuries accounted for the highest proportion, followed by botanical sticks (wooden sticks /bamboo sticks /bamboo skewers)-induced injuries, and then stationery items (pencils/pens/rulers/paper)-induced injuries. The majority (68.7%) of the patients were aged 2-8 years, and the peak range of age was 4 - 6 years. The injuries were a result of penetrating trauma in 64.9% of patients, and blunt force trauma in the remainder (35.1%). Additionally, 131 (18.3%) cases developed posttraumatic infectious endophthalmitis after injuries. Patients with eye injuries caused by needles (P < 0.001), wooden sticks (P = 0.016), and bamboo skewers (P = 0.002) were at a greater risk of developing infectious endophthalmitis. The most common identified foreign organism was Streptococcus, which accounted for 42% (21/50) of all culture-positive specimens and was sensitive to vancomycin. Among the children who were younger than 5 years, 44.4% (55/124) of those with traumatic cataracts presented a corrected distance visual acuity less than or equal to 0.1 after undergoing cataract surgery, but among the children who were older than 5 years, this proportion was significantly smaller, just 20.4% of children aged 6-10 years (P < 0.001) and 18.4% of children aged 11-14 years (P < 0.001). CONCLUSION: The main causative agents of paediatric traumatic cataracts in southwest China were sharp metal objects, botanical sticks, and stationery items. Specific preventive measures are essential to reduce the incidence of paediatric traumatic cataract.


Assuntos
Catarata , Endoftalmite , Ferimentos Oculares Penetrantes , Traumatismos Oculares , Adolescente , Catarata/complicações , Catarata/etiologia , Criança , Pré-Escolar , China/epidemiologia , Endoftalmite/complicações , Traumatismos Oculares/complicações , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/cirurgia , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
7.
Biochemistry (Mosc) ; 87(3): 225-241, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35526854

RESUMO

* The article is published as a part of the Special Issue "Protein Misfolding and Aggregation in Cataract Disorders" (Vol. 87, No. 2). ** To whom correspondence should be addressed. Cataract is a major cause of blindness. Due to the lack of protein turnover, lens proteins accumulate age-related and environmental modifications that alter their native conformation, leading to the formation of aggregation-prone intermediates, as well as insoluble and light-scattering aggregates, thus compromising lens transparency. The lens protein, α-crystallin, is a molecular chaperone that prevents protein aggregation, thereby maintaining lens transparency. However, mutations or post-translational modifications, such as oxidation, deamidation, truncation and crosslinking, can render α-crystallins ineffective and lead to the disease exacerbation. Here, we describe such mutations and alterations, as well as their consequences. Age-related modifications in α-crystallins affect their structure, oligomerization, and chaperone function. Mutations in α-crystallins can lead to the aggregation/intracellular inclusions attributable to the perturbation of structure and oligomeric assembly and resulting in the rearrangement of aggregation-prone regions. Such rearrangements can lead to the exposure of hitherto buried aggregation-prone regions, thereby populating aggregation-prone state(s) and facilitating amorphous/amyloid aggregation and/or inappropriate interactions with cellular components. Investigations of the mutation-induced changes in the structure, oligomer assembly, aggregation mechanisms, and interactomes of α-crystallins will be useful in fighting protein aggregation-related diseases.


Assuntos
Catarata , Cristalino , alfa-Cristalinas , Catarata/genética , Humanos , Cristalino/metabolismo , Chaperonas Moleculares/metabolismo , Mutação , Agregados Proteicos , alfa-Cristalinas/química , alfa-Cristalinas/genética , alfa-Cristalinas/metabolismo
8.
Biochemistry (Mosc) ; 87(2): 87-90, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35508904

RESUMO

This issue of Biochemistry (Moscow) is dedicated to the role of protein misfolding and aggregation in cataract development. In fact, many genetic mutations or chemical and physical deleterious factors can initiate alterations in the macrostructural order and proper folding of eye lens proteins, which in some cases result in the formation of large light-scattering aggregates, affecting the quality of vision and making lens more prone to cataract development. Diabetes mellitus, which is associated with oxidative stress and mass production of highly reactive compounds, can accelerate unfolding and aggregation of eye lens proteins. This journal issue contains reviews and research articles that describe the destructive effects of mutations and highly reactive metabolites on the structure and function of lens crystallin proteins, as well important molecules in the lens's natural defense system involved in protection against deleterious effects of the physical and chemical factors.


Assuntos
Catarata , Cristalinas , Cristalino , Catarata/patologia , Cristalinas/química , Cristalinas/genética , Cristalinas/metabolismo , Humanos , Cristalino/metabolismo , Moscou , Agregados Proteicos
9.
Biochemistry (Mosc) ; 87(2): 106-120, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35508906

RESUMO

The absence of cellular organelles in fiber cells and very high cytoplasmic protein concentration (up to 900 mg/ml) minimize light scattering in the lens and ensure its transparency. Low oxygen concentration, powerful defense systems (antioxidants, antioxidant enzymes, chaperone-like protein alpha-crystallin, etc.) maintain lens transparency. On the other hand, the ability of crystallins to accumulate age-associated post-translational modifications, which reduce the resistance of lens proteins to oxidative stress, is an important factor contributing to the cataract formation. Here, we suggest a mechanism of cataractogenesis common for the action of different cataractogenic factors, such as age, radiation, ultraviolet light, diabetes, etc. Exposure to these factors leads to the damage and death of lens epithelium, which allows oxygen to penetrate into the lens through the gaps in the epithelial layer and cause oxidative damage to crystallins, resulting in protein denaturation, aggregation, and formation of multilamellar bodies (the main cause of lens opacification). The review discusses various approaches to the inhibition of lens opacification (cataract development), in particular, a combined use of antioxidants and compounds enhancing the chaperone-like properties of alpha-crystallin. We also discuss the paradox of high efficiency of anti-cataract drugs in laboratory settings with the lack of their clinical effect, which might be due to the late use of the drugs at the stage, when the opacification has already formed. A probable solution to this situation will be development of new diagnostic methods that will allow to predict the emergence of cataract long before the manifestation of its clinical signs and to start early preventive treatment.


Assuntos
Catarata , Cristalinas , Cristalino , alfa-Cristalinas , Antioxidantes/metabolismo , Catarata/etiologia , Cristalinas/análise , Cristalinas/metabolismo , Humanos , Cristalino/metabolismo , Chaperonas Moleculares/metabolismo , Oxigênio/metabolismo , alfa-Cristalinas/análise , alfa-Cristalinas/química , alfa-Cristalinas/metabolismo
10.
Biochemistry (Mosc) ; 87(2): 131-140, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35508910

RESUMO

Loss of eye lens transparency due to cataract is the leading cause of blindness all over the world. While aggregation of lens crystallins is the most common endpoint in various types of cataracts, chaperone-like activity (CLA) of α-crystallin preventing protein aggregation is considered to be important for maintaining the eye lens transparency. Osmotic stress due to increased accumulation of sorbitol under hyperglycemic conditions is believed to be one of the mechanisms for diabetic cataract. In addition, compromised CLA of α-crystallin in diabetic cataract has been reported. However, the effect of sorbitol on the structure and function of α-crystallin has not been elucidated yet. Hence, in the present exploratory study, we described the effect of varying concentrations of sorbitol on the structure and function of α-crystallin. Alpha-crystallin purified from the rat lens was incubated with varying concentrations of sorbitol in the dark under sterile conditions for up to 5 days. At the end of incubation, structural properties and CLA were evaluated by spectroscopic methods. Interestingly, different concentrations of sorbitol showed contrasting results: at lower concentrations (5 and 50 mM) there was a decrease in CLA and subtle alterations in secondary and tertiary structure but not at higher concentrations (500 mM). Though, these results shed a light on the effect of sorbitol on α-crystallin structure-function, further studies are required to understand the mechanism of the observed effects and their implication to cataractogenesis.


Assuntos
Catarata , Diabetes Mellitus , Cristalino , alfa-Cristalinas , Animais , Cristalino/metabolismo , Chaperonas Moleculares/metabolismo , Ratos , Sorbitol/farmacologia , alfa-Cristalinas/química , alfa-Cristalinas/metabolismo , alfa-Cristalinas/farmacologia
11.
Transl Vis Sci Technol ; 11(5): 2, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35506930

RESUMO

Purpose: In femtosecond laser-assisted cataract surgery (FLACS), capsulorhexis can be performed with an ophthalmic viscosurgical device (OVD) filled in the anterior chamber. We aimed to investigate changes in the laser properties in various optical aspects, such as focal shifting, reflection, and absorption associated with OVD. Methods: Simulation was achieved by calculating the laser power attenuation due to reflection and spot size change using the Gullstrand eye model. Additionally, we calculated the absorption coefficient by measuring the laser power passing through the OVD with a laser meter and evaluated the effect of absorption by the OVD. Results: In our simulation, power attenuation due to reflection was a maximum of 0.07%, and power attenuation was 0.08% even when considering the change according to the incident angle. Power attenuation due to the change of the spot size at the focus was 0.005%. Owing to the absorption of the OVD, a power increase of up to 13.5% was required for an anterior chamber depth of 3.0 mm to obtain the same effect as the aqueous humor. Conclusions: The main reason for laser power attenuation associated with OVD was laser absorption through the OVD, and could also be caused by laser cavitation bubbles. To complete a safe capsulotomy during FLACS, the laser power should be increased appropriately, considering the absorption by the OVD in the anterior chamber. Translational Relevance: The study results can be applied to calculate the optimal femtosecond laser energy to achieve complete capsulotomy during FLACS in the presence of anterior chamber OVD.


Assuntos
Extração de Catarata , Catarata , Terapia a Laser , Capsulorrexe/métodos , Catarata/complicações , Extração de Catarata/métodos , Humanos , Terapia a Laser/métodos , Lasers
12.
Zhonghua Yan Ke Za Zhi ; 58(5): 321-325, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511657

RESUMO

Glaucoma following cataract surgery is one of the common complications after pediatric cataract surgery, and it is the main cause of "second blindness" in children. Since this atypical disease is difficult to diagnose and evaluate, it has been gradually paid more attention by clinicians. There are still some controversies and challenges related to the characteristics of the disease, diagnostic criteria, and treatment options. This article discusses the definition, diagnostic criteria, related risk factors, treatment strategies, follow-up, and prognoses of glaucoma following cataract surgery. Establishment of a diagnosis and treatment system can better improve the visual rehabilitation of pediatric cataract children.


Assuntos
Extração de Catarata , Catarata , Glaucoma , Baixa Visão , Cegueira/etiologia , Catarata/complicações , Catarata/terapia , Extração de Catarata/efeitos adversos , Criança , Seguimentos , Glaucoma/diagnóstico , Humanos , Estudos Retrospectivos , Baixa Visão/etiologia
13.
Zhonghua Yan Ke Za Zhi ; 58(5): 326-333, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511658

RESUMO

Cataract is the main cause of preventable visual impairment in children. Children requires special perioperative management because of their anatomical, physiological, behavioral, and developmental characteristics. In order to strengthen the standardized perioperative management of cataracts in children, the Chinese Cataract and Refractive Surgery Society has conducted a comprehensive discussion on the timing of surgery, surgical techniques, perioperative medications, and postoperative visual rehabilitation in children. The consensus has been reached to provide clinical guidance for Chinese ophthalmologists.


Assuntos
Extração de Catarata , Catarata , Oftalmologia , Procedimentos Cirúrgicos Refrativos , Baixa Visão , Catarata/terapia , Criança , China , Consenso , Humanos
14.
Zhonghua Yan Ke Za Zhi ; 58(5): 334-339, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511659

RESUMO

Objective: To investigate the influence of residual astigmatism on the postoperative visual acuity in cataract patients with implantation of an extended depth of focus intraocular lens (IOL). Methods: Retrospective cohort study. A total of 56 eyes of 56 cataract patients who underwent phacoemulsification combined with extended depth of focus IOL implantation from January 2019 to December 2020 at Eye & ENT Hospital of Fudan University were included. There were 29 males and 27 females in all patients, and the age was (65±9) years. Patients were divided into two groups according to their postoperative residual astigmatism: low astigmatism group (<0.75 D, 28 eyes) and high astigmatism group (0.75 to 1.50 D, 28 eyes). At 3 months after surgery, measurements were completed, including postoperative uncorrected distance (5 m) visual acuity, uncorrected intermediate (80 cm) visual acuity, uncorrected near (40 cm) visual acuity, best corrected visual acuity (all the visual acuity was converted to the logarithm of the minimum angle of resolution visual acuity), defocus curves, quick contrast sensitivity function, wavefront aberration, and VF-14 questionnaire scores. The independent samples t-test and Mann-Whitney U test were used for data analysis. Results: The low astigmatism group and high astigmatism group's uncorrected distance visual acuity [M (Q1, Q3)] were 0.05 (-0.06, 0.10), 0.08 (0.00, 0.22), their uncorrected intermediate visual acuity were 0.11 (0.00, 0.20), 0.14 (0.10, 0.21), their uncorrected near visual acuity were 0.28 (0.20, 0.32), 0.26 (0.20, 0.30), and their best corrected visual acuity were 0.17 (0.05, 0.30), 0.14 (0.04, 0.22), respectively. The differences were not statistically significant (all P>0.05). No significant difference was found in the defocus curves from +1.00 to -4.00 D, at intervals of +0.50 D, between the two groups (all P>0.05). No significant difference was found in the quick contrast sensitivity of low, middle and high frequency of dark vision between the low astigmatism group and high astigmatism group (all P>0.05), and the area under Log contrast sensitivity function of the two groups were 0.87±0.28 and 0.77±0.30 (P>0.05). The total whole-eye aberrations were 0.59±0.18 and 0.74±0.51, and the total higher-order aberrations were 0.30±0.13 and 0.37±0.25 in the two groups at 4.0-mm pupil diameter. The differences were not statistically significant when the total whole-eye aberration, total higher-order aberration, coma, cloverleaf aberration, and spherical aberration were compared (all P>0.05). The differences of the total VF-14 visual scores, near visual acuity scores and the distance visual acuity scores of the two groups were not statistically significant (all P>0.05). Conclusion: Cataract patients with residual postoperative astigmatism 0.75 to 1.50 D can obtain as good visual quality as those with postoperative residual astigmatism<0.75 D after implantation of an extended depth of focus IOL.


Assuntos
Astigmatismo , Catarata , Lentes Intraoculares , Facoemulsificação , Idoso , Astigmatismo/cirurgia , Catarata/terapia , Progressão da Doença , Feminino , Humanos , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos
15.
Zhonghua Yan Ke Za Zhi ; 58(5): 340-347, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511660

RESUMO

Objective: To understand the developmental characteristics of early ocular biological parameters in patients with congenital cataract. Methods: Retrospective case series study. The ocular biometry data such as the axial length, corneal curvature, anterior chamber depth and central corneal thickness of 169 patients under 3 years old who were diagnosed with congenital cataract in Eye Hospital of Wenzhou Medical University (Hangzhou Branch) from June 2016 to June 2020 were reviewed, and they were analyzed by 3 age groups. There were 87, 41, and 41 patients in three age groups, 1 to 6 months, 7 to 12 months, and 13 to 36 months, respectively; 108 patients with bilateral affected eyes and 61 patients with unilateral affected eyes were included; 84 patients with partial opacity lens and 85 patients with total opacity lens were included. The right eyes of the patients with bilateral congenital cataract were selected for analysis. Statistical analysis of ocular biological parameters between groups was performed using the independent samples t-test and paired samples t-test. Statistical analysis of the relationship between age in months and biological parameters was performed using the Pearson's correlation test. Results: The axial length at the age of 1 to 6 months in the affected eyes of patients with bilateral cataract was (17.59±1.19) mm, it was shorter than the affected eyes of patients with unilateral cataract [(18.18±1.34) mm], and the axial length in the affected eyes of patients with unilateral cataract were shorter than the healthy eyes [(19.01±0.93) mm]. At the age of 7 to 12 months, the axial length in the affected eyes of patients with unilateral cataract [(19.89±0.74) mm] was shorter than the healthy eyes [(20.48±0.43) mm]. The differences were statistically significant (t=-2.06, -5.62, -3.47, all P<0.05). The axial length in the affected eyes with partial opacity at the age of 1 to 6 months was shorter than those with total opacity [(17.43±1.14) mm vs. (18.06±1.29) mm; t=-2.38, P=0.020]. The difference in axial length (affected eyes vs. healthy eyes) was significantly correlated with the age in months in partial cataract (r=0.53, P=0.001). The corneal curvature in the affected eyes of patients with unilateral cataract was flatter than the healthy eyes at the age of 7 to 12 months [(42.41±1.82) D vs. (43.19±1.96) D; t=-2.29, P=0.038], but was steeper at the age of 13 to 36 months [(43.36±2.32) D vs. (42.55±1.88) D; t=2.17, P=0.043]. The anterior chamber depth in the affected eyes of patients with unilateral cataract was less than the healthy eyes at the age of 1 to 6 months [(2.44±0.37) mm vs. (2.58±0.33) mm; t=-2.08, P=0.048].The central corneal thickness in the affected eyes of patients with unilateral cataract was thicker than the healthy eyes both at the age of 1 to 6 months and 7 to 12 months [(555.26±46.95) µm vs. (541.85±40.78) µm, (542.93±27.63) µm vs. (530.93±30.36) µm; t=3.82, 2.26; P=0.001, 0.040]. Conclusions: Congenital cataracts maybe affect the early development of axial length, corneal curvature, anterior chamber depth and central corneal thickness. The degree of lens opacity maybe affecte the early axial length development. The axial length in eyes with partial opacity can be shorter than those with total opacity before the age of 6 months, and thereafter gradually outnumbered the latter.


Assuntos
Extração de Catarata , Catarata , Comprimento Axial do Olho , Biometria , Catarata/congênito , Criança , Pré-Escolar , Olho , Humanos , Lactente , Estudos Retrospectivos
16.
Zhonghua Yan Ke Za Zhi ; 58(5): 348-353, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511661

RESUMO

Objective: To investigate the relationship between corneal refractive power and anterior chamber parameters in age-related cataract patients with normal axial lengths and shallow anterior chambers. Methods: Retrospective case series study. Clinical data of 627 age-related cataract patients (627 eyes) with axial lengths between 22 mm and 24 mm and anterior chamber depths less than 2.20 mm treated in the Department of Ophthalmology of Peking University International Hospital from June 2018 to October 2021 were selected. There were 215 male patients and 412 female patients, with an average age of (75±10) years. According to the average corneal refractive power, eyes were divided into groups of keratometry (K)<42 diopters (D) (50 eyes), 42 D ≤K<45 D (398 eyes) and K ≥45 D (179 eyes). Axial length, anterior chamber depth, corneal diameter, anterior chamber volume and anterior chamber angle of 3 groups were recorded, and Spearman correlation analysis was used to analyze the correlation between parameters. The differences of parameters among different groups were compared by one-way analysis of variance or Kruskal-Wallis test, and multiple or pairwise comparisons using LSD-t test or Mann-Whitney U test. Results: There was a negative correlation between axial length and corneal refractive power in 627 eyes (r=-0.62, P<0.001). Corneal refractive power was positively correlated with anterior chamber depth (r=0.26, P=0.006), while in the K≥45 D group, corneal refractive power was also positively correlated with anterior chamber depth (r=0.23, P=0.025). Anterior chamber depth [M (Q1,Q3)] was 1.77 (1.64, 1.90) mm in the K<42 D group, 1.85 (1.70, 2.14) mm in the 42 D≤K<45 D group and 2.02 (1.81, 2.18) mm in the K≥45 D group. Multiple comparisons showed that there were significant differences in anterior chamber depth between the K<42 D group and the K≥45 D group, between the 42 D≤K<45 D group and the K≥45 D group (U=14 372.00, 18 226.00; both P<0.05). There was a negative correlation between corneal refractive power and corneal diameter in 627 eyes (r=-0.52,P<0.001), while in the 42 D≤K<45 D group and the K≥45 D group, corneal refractive power were also negatively correlated with corneal diameter (r=-0.20, -0.28; both P<0.05). Corneal diameter was (11.77±0.43) mm in the K<42 D group, (11.24±0.35) mm in the 42 D≤K<45 D group and (10.90±0.33) mm in the K≥45 D group, while there were significant differences in multiple comparisons (t=1.92, 2.96, 2.01; all P<0.05). There was no correlation between corneal refractive power and anterior chamber volume, or between corneal refractive power and anterior chamber angle in 627 eyes (all P>0.05). There was no significant difference both in anterior chamber volume and in anterior chamber angle among 3 groups (all P>0.05). Conclusion: For age-related cataract patients with normal axial lengths and shallow anterior chambers, the anterior chamber depth increase and the corneal diameter decrease with the increase of corneal refractive power, but there is no significant change in anterior chamber volume and anterior chamber angle.


Assuntos
Extração de Catarata , Catarata , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/anatomia & histologia , Biometria , Córnea/anatomia & histologia , Feminino , Humanos , Masculino , Refração Ocular , Estudos Retrospectivos
17.
Zhonghua Yan Ke Za Zhi ; 58(5): 354-359, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511662

RESUMO

Objective: To investigate the possible role of pyroptosis of lens epithelial cells (LECs) in the occurrence of diabetic cataract. Methods: Experimental research. A total of 70 cataract lens anterior capsule and aqueous humor samples were obtained from 70 eyes (70 patients) with cataracts in the operation room of Tianjin Medical University Eye Hospital between March 2020 and November 2020. Patients were divided into the non-diabetic and diabetic groups, with 35 patients (35 eyes) in each group. The expressions of Nod like receptor protein 3 (NLRP3), cysteine-aspartic proteases 1 (caspase-1) and Gasdermin D protein (GSDMD) in the lens anterior capsule were detected by Western blotting, real-time quantitative PCR and immunohistochemical staining. Interleukin (IL)-1ß and IL-18 inaqueous humor were detected by enzyme-linked immunosorbent assay (ELISA). The independent sample t-test was used for statistical analysis. Results: The age was (70±9) years in the diabetic group and (71±8) years in the non-diabetic group. There was no significant difference in age and gender distribution between the two groups (both P>0.05). Western blotting analysis showed that the expression levels of NLRP3, caspase-1 and GSDMD protein in the LECs of anterior capsule were 1.11±0.06, 0.95±0.04 and 0.39±0.03 in the diabetic group, significantly higher than those of the non-diabetic group (0.81±0.04, 0.33±0.11 and 0.16±0.04; t=4.38, 5.36, 4.63; all P<0.05). Real-time quantitative PCR showed that the levels of NLRP3, caspase-1 and GSDMD mRNA in the LECs of anterior capsule were 1.98±0.07, 54.36±4.88 and 6.98±1.18 in the diabetic group, significantly higher than those of the non-diabetic group (1.38±0.16, 15.31±1.51 and 2.41±0.95; t=3.49, 7.64, 3.00, all P<0.05). Immunohistochemical staining showed that the average gray values of NLRP3, caspase-1 and GSDMD in the diabetic group were higher than those of the non-diabetic group (all P˂0.01). ELISA showed that the levels of IL-1ß and IL-18 in the aqueous humor were (4.178±0.028) fg/L and (20.983±0.018) fg/L in the diabetic group, significantly higher than those of the non-diabetic group [(4.063±0.017) fg/L and (20.509±0.073) fg/L; t=20.63, 37.21; both P˂0.01]. Conclusion: Caspase-1-mediated pyroptosis of LECs and the release of inflammatory mediators induced by pyroptosis may be involved in the occurrence and development of diabetic cataract.


Assuntos
Catarata , Diabetes Mellitus , Idoso , Caspase 1/metabolismo , Caspases , Células Epiteliais/metabolismo , Humanos , Interleucina-18/metabolismo , Interleucina-1beta/metabolismo , Pessoa de Meia-Idade , Proteína 3 que Contém Domínio de Pirina da Família NLR , Piroptose
18.
Zhonghua Yan Ke Za Zhi ; 58(5): 385-389, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511667

RESUMO

Cataract is the leading cause of visual impairment and blindness on a global scale. The pathogenesis of cataract is not completely understood. Circular RNAs (circRNAs) are a special kind of non-coding RNAs with high stability and conservation. They are widely involved in a variety of biological processes and diseases. Abnormal expression of circRNAs can participate in the development of cataract, affecting the function of lens epithelial cells through interacting with proteins and sponging microRNAs. They are possible targets for cataract prevention and treatment. This article reviews the research progress on the role of circRNAs in the occurrence and development of cataract.


Assuntos
Catarata , MicroRNAs , Catarata/genética , Catarata/patologia , Células Epiteliais/metabolismo , Humanos , MicroRNAs/genética , RNA Circular
19.
Sci Rep ; 12(1): 7357, 2022 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513494

RESUMO

To compare the predictive refractive accuracy of intraoperative aberrometry (ORA) to the preoperative Barrett True-K formula in the calculation of intraocular lens (IOL) power in eyes with prior refractive surgery undergoing cataract surgery at the Loma Linda University Eye Institute, Loma Linda, California, USA. We conducted a retrospective chart review of patients with a history of post-myopic or hyperopic LASIK/PRK who underwent uncomplicated cataract surgery between October 2016 and March 2020. Pre-operative measurements were performed utilizing the Barrett True-K formula. Intraoperative aberrometry (ORA) was used for aphakic refraction and IOL power calculation during surgery. Predictive refractive accuracy of the two methods was compared based on the difference between achieved and intended target spherical equivalent. A total of 97 eyes (69 patients) were included in the study. Of these, 81 eyes (83.5%) had previous myopic LASIK/PRK and 16 eyes (16.5%) had previous hyperopic LASIK/PRK. Median (MedAE)/mean (MAE) absolute prediction errors for preoperative as compared to intraoperative methods were 0.49 D/0.58 D compared to 0.42 D/0.51 D, respectively (P = 0.001/0.002). Over all, ORA led to a statistically significant lower median and mean absolute error compared to the Barrett True-K formula in post-refractive eyes. Percentage of eyes within ± 1.00 D of intended target refraction as predicted by the preoperative versus the intraoperative method was 82.3% and 89.6%, respectively (P = 0.04). Although ORA led to a statistically significant lower median absolute error compared to the Barrett True-K formula, the two methods are clinically comparable in predictive refractive accuracy in patients with prior refractive surgery.


Assuntos
Catarata , Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Lentes Intraoculares , Miopia , Facoemulsificação , Aberrometria/métodos , Biometria/métodos , Humanos , Hiperopia/cirurgia , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
20.
Einstein (Sao Paulo) ; 20: eAO6687, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35544893

RESUMO

OBJECTIVE: To evaluate the standards of practice of Brazilian cataract surgeons in relation to the protective measures adopted to mitigate the risks of transmission of COVID-19 during cataract surgery, in asymptomatic patients. METHODS: A descriptive, cross-sectional, quantitative paradigm study, developed from a self-administered electronic questionnaire sent to ophthalmologists and residents/specialists in ophthalmology in Brazil, who performed cataract surgeries in 2019 and 2020, connected through social media and mail listing from local societies. RESULTS: Of the 303 participating surgeons, 159 (n=52.2%) performed elective cataract surgeries between March 20th, 2020 to June 1st, 2020. Among the measures adopted by ophthalmologists with the purpose of preventing viral transmission, the patient's temperature was measured by 84.3% (n=134), and the verification of respiratory symptoms and contact/exposure to cases of COVID-19 by 87.4% (n=139). Most did not submit their patients to laboratory tests to detect COVID-19 (145; 91.2%). In surgery, 44.7% (n=71) used an N95 mask, and 69.2% (n=110) kept their patients with a mask. No stage of phacoemulsification was modified in 144 (90.6%) participants, 13 (8.2%) added methylcellulose under the main incision, and two (1.3%), modified another surgical stage. CONCLUSION: The COVID-19 pandemic significantly interrupted part of cataract surgeries in Brazil from March to June 2020 and measures to prevent viral spread are being heterogeneously adopted by surgeons. Understanding these measures could be the first step to improve strategies to return to pre-pandemic levels.


Assuntos
COVID-19 , Catarata , Catarata/epidemiologia , Estudos Transversais , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
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