Application of different phacoemulsification and chopping techniques in hard nuclear cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the efficacy of bevel-up phaco chop versus bevel-down phaco drill in the treatment of hard nuclear cataract and the influence on corneal endothelium.<p>METHODS: Between August 2018 and April 2020, 94 patients(104 eyes)with hard(grade Ⅳ-Ⅴ)nuclear cataract treated with phacoemulsification were enrolled in this retrospective study. Among them, 50 eyes treated by bevel-up phaco chop were included in the control group, while 54 eyes treated by phaco drill technique were included in the observation group. The time of using ultrasound, ultrasonic energy and accumulated energy complex parameter in the two groups were recorded. The best corrected visual acuity(BCVA)in 7d, corneal endothelial cell count in 2mo, the proportions of normal hexagonal cells and the degree of corneal edema in 7d were compared between the two groups.<p>RESULTS: The time of using ultrasound, ultrasonic energy and accumulated energy complex parameter of the observation group were shorter and lower than those of the control group(<i>P</i><0.05). The BCVA of both groups increased after operation, and the observation group had higher BCVA than the control group at the same time(<i>P</i><0.05). In 1 and 2mo, the corneal endothelial cell counts and the proportions of normal hexagonal cells in both groups were lower than those before operation. Meanwhile, the corneal endothelial cell count and the proportions of normal hexagonal cells in the observation group were higher than those in the control group(<i>P</i><0.05). Besides, corneal edema was milder in the observation group than in the control group at 24h and 7d after operation(<i>P</i><0.05).<p>CONCLUSION: Compared with bevel-up phaco chop, phaco drill can significantly shorten the time of using ultrasound, reduce ultrasound energy, promote visual recovery, and reduce corneal endothelial cell damage.

To Find Out if There is any Association between Dyslipidemia and Cataract in Tribal Population

Introduction: Cataract is a major cause of impaired vision andblindness. Study aimed to find out if there is any associationbetween dyslipidemia and cataract.Material and methods: This cross sectional hospital basedstudy was performed in a tertiary care center of Jharkhandbetween June 2017 to March 2018. Total 223 patients whowere diagnosed with senile cataract were included in the study.Detailed history, ophthalmologic and systemic examinationwas done. Dyslipidemia is defined as:Hypercholesterolemia(total cholesterol > 220 mg/dl), or Hypertriglyceridemia (totaltriglyceride > 150 mg/dl), or Low density lipoprotein > 130mg/dl.Results: Out of total 223 patients 134 were men and 89were women. 70% patients had dyslipidemia. Prevalenceof dyslipidemia was associated significantly (< 0.05) withnuclear and cortical cataract but not significant (> 0.05) forposterior sub capsular cataract.Conclusion: Dyslipidemia maybe considered having anassociation with nuclear and cortical cataract directly orindirectly.

Study on iTRAQ-based differential expression protein analysis in nuclear cataract lens with different axial length / 中华实验眼科杂志

Objective@#To identify and verify differentially expressed proteins in lens of nuclear cataract eyes with different axial lengths.@*Methods@#Forty-eight nuclear cataract patients with the hardness grade Ⅲ to Ⅳ were enrolled from January 2016 to December 2017 in the east area of Xining city.The lens nucleus was obtained during extracapsular cataract extraction (ECCE) surgery.The samples were divided into six groups according to age and axial length, with 8 samples in each group.Seven normal transparent human lens nuclei were obtained from donors during corneal transplantation surgery and served as normal control.Water-soluble, water-insoluble and water-insoluble-urea-soluble protein fractions were extracted separately and merged to analyze by using 8-plex isobaric tags for relative and absolute quantitation (iTRAQ) labeling combined with 2D-LC/MS/MS.The data were processed with ProteinPilot software.Two technical replicates of iTRAQ analyses were carried out.Up-regulated and down-regulated proteins were selected in two replicates as candidate biomarkers.Twenty lens nuclei from 20 nulear cataract patients were divided into long axis young age group, normal axis young age group, long axis old age group and normal axis old age group.Western blot was used to confirm the most different proteins.This study protocol was approved by the Ethics Committee of TangDu Hospital of Air Force Medical University (TDLL2015046). Written consent was obtained from each participant.@*Results@#Eighty proteins were identified.Six proteins were selected as differentially-expressed proteins.Sorbitol dehydrogenase (SDH) was elevated whereas beta-crystallin B2 (CRYBB2) was decreased in the long axis groups.The relative expression of SDH protein in the long axis low age group was 1.204±0.142, which was significantly higher than 0.711±0.072 in the normal axis low age group, the relative expression level of SDH in the long axis old age group was 1.092±0.334, which was significantly higher than 0.617±0.089 in the normal axis old age group, the difference was statistically significant (all at P<0.05).@*Conclusions@#The expression levels of SDH in the nuclear cataract were elevated with long axial length.SDH may be involved in the pathogenesis of axial myopia-associated nuclear cataract.

Application of femtosecond laser assisted cataract surgery in patients with hard nuclear cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the application effects of femtosecond laser assisted cataract surgery(FLACS)in patients with hard nuclear cataract.<p>METHODS: The clinical data of each 42 cases(eyes)in patients with hard nuclear cataract who underwent FLACS(observation group)and traditional phacoemulsification(control group)were retrospectively analyzed. The operation conditions and postoperative recovery were recorded in the two groups.<p>RESULTS: The mean ultrasound power, actual phacoemulsification time and effective phacoemulsification time and corneal edema degree at 3d after operation in observation group were lower than those in control group(<i>P</i><0.05). The changes of postoperative corrected distance visual acuity(CDVA), uncorrected distance visual acuity(UCDVA)and corneal endothelial cell loss rate showed 3d after operation>1wk after operation>1mo after operation, and the changes in observation group were greater than those in control group(<i>P</i><0.05). The corneal endothelial cell density in observation group at each time point after operation was higher than that in control group(<i>P</i><0.05).<p>CONCLUSION: FLACS has significant effects on hard nuclear cataract.

Identification of a GJA3 mutation in a Chinese family with congenital nuclear cataract using exome sequencing.

Congenital cataract, a clinically and genetically heterogeneous lens disorder is defined as any opacity of the lens presented from birth and is responsible for approximately 10% of worldwide childhood poor vision or blindness. To identify the genetic defect responsible for congenital nuclear cataract in a four-generation Chinese Han family, exome and direct Sanger sequencings were conducted and a missense variant c.139G>A (p.D47N) in the gap junction protein-alpha 3 gene (GJA3) was identified. The variant co-segregated with patients of the family and was not observed in unaffected family members or normal controls. The above findings indicated that the variant was a pathogenic mutation. The mutation p.D47N was found in the first extracellular loop (E1) domain of GJA3 protein. Our data suggest that exome sequencing is a powerful tool to discover mutation(s) in cataract, a disorder with high genetic heterogeneity. Our findings may also provide new insights into the cause and diagnosis of congenital nuclear cataract and have implications for genetic counseling.

One-Year Outcome of Microcoaxial Cataract Surgery Using 1.8 mm and 2.2 mm Incisions Versus that of Conventional Cataract Surgery

PURPOSE: To compare the 1-year outcome of 1.8 mm and 2.2 mm microcoaxial cataract surgery (MCCS) versus 2.75 mm conventional cataract surgery (CCS). METHODS: The present study evaluated 120 eyes (40 eyes in each group). The mean ultrasound power, ultrasound time (UST), and cumulative dissipated energy (CDE) were measured preoperatively and at 1 day, 1, 2, 6 months, and 1 year postoperative. Visual acuity, number of corneal endothelial cells, and surgically induced astigmatism (SIA) were compared. RESULTS: In LOCS III NO4, 1.8 mm MCCS showed a statistically higher ultrasound time (p-value = 0.031) and CDE (p-value = 0.029), and the day 1 corneal thickness increase was relatively higher in 1.8 mm MCCS (p-value = 0.043) than other two groups. There were no differences in postoperative 1 year visual acuity or number of corneal endothelial cells among the groups. SIA was significantly lower in 1.8 mm and 2.2 mm MCCS compared to that of the conventional treatment (p-value = 0.046). CONCLUSIONS: There were no differences in postoperative 1 year mean endothelial cell density or corrected visual acuity between 1.8 and 2.2 mm MCCS and CCS at all cataract densities. The 1.8 mm and 2.2 mm MCCS techniques were as safe and effective as CCS, and SIA in 1.8 mm and 2.2 mm MCCS was significantly lower than that of CCS.

Effect of High Vacuum Phaco Chop Technique for Hard Nucleolus Cataract / 中国康复理论与实践

@#ObjectiveTo observe the effect of high vacuum phaco chop technique for hard nucleolus cataract.Methods51 cases (65 eyes) of hard nucleolus cataract were performed by high vacuum phaco chop.ResultsThe best corrected visual acuity (BCVA) ≥ 0.3 was in 56 eyes (86%) one day after operation. The best corrected visual acuity (BCVA) ≥ 0.3 was in 61 eyes (94%) one month after operation. 3 eyes had posterior capsule rupture in operation.ConclusionHigh vacuum phaco chop technique is safe and effective for hard nucleolus cataract.

Biochemical Analysis of Inter-Connection between Types of Nuclear Opacity, Oxidative Stress and Glycation in Cataractous Lens

PURPOSE: To elucidate the inter-connection between lens nuclear opacity and its proposed two main factors, which are oxidative stress and glycation reaction initiated with sugars and proteins. METHODS: We have collected clinical samples after cataract surgery from 57 patients during 3 month period. We also classified these samples into three groups as initial, intermediate and advanced stages, and performed the biochemical assays for measurements of glutathione(GSH) and advanced glycation end products(AGEs). RESULTS: It showed that the concentrations of GSH in lens soluble proteins were 0.022+/-0.019, 0.017+/-0.011, and 0.011+/-0.010 nmoles/mg lens protein in initial stage, intermediate stage and advanced stage, respectively. Fluorophore formation(Ex370/Em440), which has been reported to represent general AGEs formation, was positively correlated with nuclear opacity showing that 108.8+/-48.3, 174.7+/-116.9, and 188.2+/-130.6 Fluorescence Unit(F.U.) in initial stage, intermediate stage and advanced stage, respectively. Likewise, a marker for AGEs, pentosidine-related fluorophore(Ex335/Em385) was increased with nuclear opacity(67.0+/-30.8, 75.5+/-36.4, and 80.4+/-41.7 F.U. in initial stage, intermediate stage and advanced stage, respectively), although significant differences existed between groups. CONCLUSION: Our results showed that there are clear inter-connection between lens nuclear opacity, oxidative stress and the formation of general AGEs compared with pentosidine, and suggested that therapy using antioxidants, chelating agents, or glycation inhibitors could be beneficial in delaying nuclear cataractogenesis.