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Objective To select the risk factors and focus on the pathogenesis of anterior ischemic optic neuropathy (AION) after cataract surgery.Methods A retrospective review of all patients with phacoemulsification surgery referred to the Ophthalmology Divisions,the First Affiliated Hospital,Zhengzhou University,from September 1,2010 to September 1,2016 was performed.Eligible patients were 11 206 cases(13 320 eyes),30 cases (30 eyes) were complicated with AION after cataract surgery (AION group),and 90 cases (90 eyes) were selected as control group according to the ratio of 1 ∶ 3 by random sequence.Factors of small cup disc ratios,previous surgery history,cardiac disease,diabetes,hypertension,hyperlipemia,smoking,carotid disease and intraocular pressure (IOP) were collected,x2 test,Logistic regression and t test were performed to analyze risk factors for AION.Results Small cup-disc ratios,diabetes,hypertension,hyperlipemia,carotid disease were influencing factors of AION after cataract surgery.Hyperlipemia and carotid disease were risk factors of AION after cataract surgery.There was no significant difference in preoperative intraocular pressure between two groups(all P ＞ 0.05).The intraocular pressure at postoperative 1 day and 7 days in AION group were higher than those in control group (all P ＜ 0.05).Conclusion Hyperlipemia and carotid artery disease are risk factors for AION after cataract surgery,and high intraocular pressure may be the inductive factor of AION.
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Objective To analyze the operative methods,intraocular lens (IOL) implantation and postoperative complications in children with congenital cataract,and give the references for treating of congenital cataract.Methods From January 2008 to January 2016,children under the age of 13 years with congenital cataract were enrolled.Preoperative and posterior slit lamp microscope,fundus,intraocular pressure were examined.Children under 2 years old were treated with phacoemulsification (PHACO),posterior continuous curvilinear capsulorrhexis (PCCC),anterior-vitrectomy (AV),and ＞ 2-4 years old with PHACO + PCCC + AV + IOL implantation,＞ 4-7 years old children with PHACO + PCCC + IOL implantation,children ＞ 7 years with PHACO + IOL implantation.Results A total of 476 patients (740 eyes) were enrolled in the study,the average age were (33.59 ± 37.14) months,of which 0 ～ 6 months were 166 cases (282 eyes,38.11％).260 eyes were implanted with IOL,aged (5.59 ±2.43) years,480eyes were implanted in the second surgery,aged (4.06 ± 2.12) years.Refaction diopter (equivalent spherical) after IOL implantation in children aged ＞ 2-4 years old was (3.53 ± 0.56) D,＞ 4-6 years old was (2.36 ± 0.32) D,＞ 6-8 years old was (1.65 ±0.52)D,＞8-13 years old was (-0.25 ±0.32) D.The postoperative complications occurred in 326 eyes,of which 115 eyes (35.28％) with iridotic adhesions,97 eyes (29.75％) with posterior cataract on the visual axis,and 54 eyes (16.56％) with glaucoma.At the last follow-up,the best corrected visual acuity were (0.56 ± 0.41) LogMAR for monocular cataract surgery and (0.42 ± 0.27) LogMAR for binocular cataract surgery,the difference was statistically significant (P =0.04).Conclusion One-third of children with congenital cataract are treated with surgical treatment under 6 months old,about half of the children undergo IOL implantation at 2 ～ 3 years of age.The postoperative visual acuity in children with binocular cataract is better than children with monocular cataract.The complications in children are more complicated than adults,which should be paid more attention.
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Background It has been reported that murine Müller cells conditional medium can promote the survival of retinal ganglion cells (RGCs) and the regeneration of axons,and the survival rate of RGCs improve in the optic nerve axotomy eyes with cataractogenic lens injury in vitro.However,the interaction of Müller cells with pricking of lens in protecting RGCs is unclear.Objective The aim of this study was to investigate the role of Müller cells on survival of RGCs in the optic nerve axotomy with cataractogenic lens injury.Methods Forty-eight clean adult Wistar rats were randomized into sham operation group,optic nerve axotomy group and lens injury combined with optic nerve axotomy group.The optic nerve was exposed only in the rats of the sham operation group,optic nerve was completely transected at 3 mm behind the eyeball in the rats of the optic nerve axotomy group,and lens puncture and optic nerve axotomy were performed in the eyes of lens injury combined with optic nerve axotomy group.The rats were sacrificed at day 7 and day 14 after operation to prepare the retinal specimens.The RGCs were examined and counted by hematoxylin-eosin staining.Müller cells labeled by glial fibrillary acidic protein (GFAP) were counted using immunohistochemisty.Results The number of RGCs was (52.98 ± 1.90) /field and (51.81 ±3.09) /field on the 7th and 14th day in the sham operation group,without significant difference between them (t =0.910,P =0.378).The number of RGCs was significantly lower on the 14th day ([22.67±1.94] /field) than that of the 7th day ([36.61±1.69] /field) in the optic nerve axotomy group (t=15.312,P=0.000).Also,the number of RGCs was (50.76±2.77) /field and (35.69±1.80) /field on the 7th and 14th day in the lens injury combined with optic nerve axotomy group,showing a significant difference between the two timepoints (t =12.920,P =0.000).In addition,the RGCs number in the lens injury combined with optic nerve axotomy group was significantly higher than that in the optic nerve axotomy group both on 7 days and 14 days after operation (7 days:t =102.840,P =0.000; 14 days:t =164.020,P =0.000),and the number of RGCs was lower in the lens injury combined with optic nerve axotomy group than that of the sham operation group on day 14 (t =187.040,P =0.034).None of GFAP-labeled Müller cell was seen in sham operation group at both on 7 days and 14 days after operation,but a significant difference was found in the optic nerve axotomy group between the two timepoints ([29.38 ± 2.04]/field vs.[19.07 ± 2.14]/field ; t =-9.868,P=0.000).No significant difference in the number of the GFAP-labeled Müller cells was found in the lens injury combined with optic nerve axotomy group between 7 days and 14 days after operation([48.96±2.80] /field vs.[46.73±1.50]/field,t=1.987,P=0.067).In postoperative 7 days and 14 days after operation,the number of GFAP-labeled Müller cells increased in the lens injury combined with optic nerve axotomy group compared with the optic nerve axotomy group (7 days:t =-15.997,P=0.000; 14 days:t=-29.938,P=0.000).Conclusions In optic nerve axotomy with cataractogenic lens injury eye,the punctural injury of lens induce the activity of Müller cells and further promote the survival of RGCs in the cataratogenic lens injury combined with optic nerve axotomy rat eyes.