Comparison of postoperative visual acuity between two TECNIS multifocal intraocular lenses with different collocations / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of different lens combinations on visual acuity, visual quality and patient satisfaction by comparing mixed implantation of Tecnis Symfony ZXR00(ZXR00)and Tecnis ZMB00(ZMB00)lenses, bilateral implantation of ZMB00 lenses, and bilateral implantation of ZXR00 lenses.METHODS:This retrospective case-control study included 117 patients with cataracts(234 eyes)who underwent phacoemulsification combined with intraocular lens(IOLs)implantation from August 2020 to December 2021. The 3 groups included 36 patients(72 eyes)who underwent bilateral implantation of ZXR00(RR group), 37 patients(74 eyes)who underwent bilateral implantation of ZMB00(MM group), and 44 patients(88 eyes)who underwent implantation with a combination of ZXR00 and ZMB00(MR group). The uncorrected distance visual acuity(UDVA, 5 m), uncorrected intermediate visual acuity(UIVA, 80 cm), uncorrected near visual acuity(UNVA, 40 cm), corrected distance visual acuity(CDVA), defocus curve, stereopsis and VF-14 and QoV visual quality scale of the patients in the three groups were assessed at 3-month follow-up.RESULTS:Bilateral UNVA in the MM and MR group were significantly better than that in the RR group(P<0.05). Bilateral UIVA was the best in the RR group. There were no significant differences in bilateral UDVA, CDVA and stereopsis among the groups(P>0.05). Values for near-stereoscopic acuity at 40 cm were 107.27±80.53, 105.67±83.79, and 108.69±97.66(20-400)arcsec in the MR, MM, and RR groups, respectively(P>0.05). Satisfaction rates exceeded 90% in all groups.CONCLUSION:All groups achieved good distance, intermediate, and near visual acuity and near-stereoscopic vision postoperatively. Mixed implantation with ZXR00 and ZMB00 lenses achieved excellent full-range vision and resulted in high satisfaction. These results may aid in developing individualized clinical treatment plans.

Research progress on the relationship between miRNA and pathogenesis of cataract / 国际眼科杂志(Guoji Yanke Zazhi)

The microRNA(miRNA)is a widely present small non-coding RNA(ncRNA), with a length of 20-25 nucleotides. The miRNA in eye tissue plays crucial roles in normal eyes by participating in processes such as cell growth, proliferation, differentiation, and apoptosis. Cataracts are the main cause of blindness worldwide. Research has shown that miRNA is related to the occurrence and development of cataracts, and it has new application prospects as a potential target for the treatment and prevention of cataracts. This article reviews the relationship between miRNA and the occurrence and development of cataracts through several different pathogenesis mechanisms, including oxidative damage, apoptosis, autophagy, and epithelial mesenchymal transition(EMT).

Characteristics of retinal microcirculation after phacoemulsification and factors affecting visual acuity / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the changes of retinal microcirculation after phacoemulsification and the influencing factors of visual acuity.METHODS: Retrospective analysis. A total of 264 cataract patients(264 eyes)who underwent phacoemulsification in our hospital from January 2022 to December 2022 were selected as the study objects. Patients were divided into < 0.3 group(66 eyes)and ≥0.3 group(198 eyes)according to the recovery of best corrected visual acuity(BCVA)at 3 mo after surgery. The changes of retinal microcirculation indexes were compared before and after treatment. Logistic regression and LASSO regression models were used to screen the influencing factors of postoperative BCVA. A nomogram prediction model of postoperative BCVA was constructed and verified. A restricted cubic spline Logistic regression model was established to analyze the dose-response relationship between end-diastolic velocity(EDV), peak systolic velocity(PSV)and the risk of BCVA recovery.RESULTS: At 3 mo postoperatively, EDV and PSV were significantly improved compared with those before treatment, and resistance index(RI)levels were significantly lower than those before treatment(all P<0.05). Preoperative EDV, PSV, aqueous humor cell grade, fundus lesion grade, advanced age and Emery grade were influencing factors for poor BCVA recovery after phacoemulsification in cataract patients(P<0.05). The AUC before and after validation of the nomogram model by Bootstrap method were 0.869(95%CI: 0.815-0.903)and 0.866(95%CI: 0.802-0.895), respectively. The sensitivity was 88.36% and 88.27%, and the specificity was 91.82% and 91.78%, respectively. Restricted cubic spline model analysis showed no nonlinear dose-response relationship between EDV and PSV levels and the risk of poor BCVA recovery in either male or female(P>0.05).CONCLUSION: After phacoemulsification, retinal microcirculation in cataract patients improved significantly. EDV, PSV, aqueous humor cell grade, fundus lesion grade, advanced age and Emery grade are all factors influencing poor BCVA recovery after cataract surgery.

Clinical diagnosis and treatment guidelines for long-term systemic complications in kidney transplant recipients in China / 器官移植

In order to further standardize the diagnosis and treatment of long-term systemic complications in kidney transplant recipients, Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of “Clinical Diagnosis and Treatment Guidelines for Long-term Systemic Complications in Kidney Transplant Recipients in China”. Experts on organ transplantation were organized to summarize and integrate the latest progress in this field based on existing clinical guidelines, systematic evaluations, case studies, expert consensus. The guideline was formed after multiple rounds of discussion and reaching a consensus which included complications of hematological system, central nervous system，cardiovascular system, ocular, cutaneous and osteoporosis disorders. The full text focuses on 27 clinical problems and forms 40 recommendations, mainly involving the risk factors, classification, diagnosis, treatment and prevention of various complications. This guideline graded the quality of evidence and the strength of recommendation for each clinical issue using 2009 Oxford Centre for Evidence-Based Medicine (OCEBM) Grading and Strength of Recommendation criteria, so as to provide reference for the diagnosis and treatment of late complications, comprehensively improve the management capacity of clinicians to benefit kidney transplant recipients.

Changes of visual quality and influencing factors after primary angle-closure glaucoma complicated with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

In recent years, the combined surgery of phacoemulsification, intraocular lens implantation, and goniosychialysis has gradually emerged as a primary and effective approach in treating primary angle-closure glaucoma with cataracts. However, with the continuous progress of medical technology, postoperative intraocular pressure control is no longer the sole pursuit. Patients increasingly aspire to achieve higher postoperative visual quality. In order to ensure that patients attain a better refractive status and higher visual quality postoperatively, it is essential to minimize the negative impact caused by primary angle-closure glaucoma. This involves personalized selection of different intraocular lenses or calculation formulas,etc. Evaluation metrics for visual quality encompass visual acuity, contrast sensitivity, higher-order aberrations, subjective perception, etc. Therefore, this paper provides a comprehensive review of postoperative refractive shift, higher-order aberrations, contrast sensitivity and their influencing factors, and the selection of intraocular lenses for patients undergoing combined surgery for primary angle-closure glaucoma with cataracts.

Body mass index influences age-related cataracts: an updated meta-analysis and systemic review / O índice de massa corporal é o fator de influência da catarata relacionada à idade: uma meta-análise atualizada e revisão sistêmica

ABSTRACT Purpose: Visual impairment and blindness caused by cataracts are major public health problems. Several factors are associated with an increased risk of age-related cataracts, such as age, smoking, alcohol consumption, and ultraviolet radiation. This meta-analysis aimed to assess the association between body mass index and age-related cataracts. Methods: Studies on weight and age-related cataracts published from January 2011 to July 2020 were reviewed by searching PubMed, Medline, and Web of Science databases. The random-effects and fixed-effects models were used for the meta-analysis, and the results were reported as odd ratios. Results: A total of nine studies were included in the meta-analysis. No correlation was found between underweight and nuclear cataracts (OR=1.31, 95% CI [-0.50 to 3.12], p=0.156). The results of the random-effects model showed that overweight was significantly associated with age-related cataracts and reduced the risk of age-related cataracts (OR=0.91, 95% CI [0.80-1.02], p<0.0001; I2=62.3%, p<0.0001). Significant correlations were found between overweight and cortical, nuclear, and posterior subcapsular cataracts (OR=0.95, 95% CI [0.66-1.24], p<0.0001; OR=0.92, 95% CI (0.76-1.08), p<0.0001; OR=0.87, 95% CI [0.38-1.02], p<0.0001). Significant correlations were found between obesity and cortical, nuclear, and posterior subcapsular cataracts (OR=1.00, 95% CI [0.82-1.17], p<0.0001; OR=1.07, 95% CI [0.92-1.22], p<0.0001; OR=1.14, 95% CI [0.91-1.37], p<0.0001). Conclusion: This finding suggested a significant correlation between body mass index and age-related cataracts, with overweight and obesity reducing or increasing the risk of age-related cataracts, respectively.

RESUMO Objetivo: A deficiência visual e a cegueira causadas pela catarata são um grande problema de saúde pública. Há vários fatores associados a um risco maior de catarata relacionada à idade na população mundial, tais como idade, tabagismo, consumo de álcool e radiação ultravioleta. Esta meta-análise foi realizada para avaliar a associação entre o índice de massa corporal e a catarata relacionada à idade. Métodos: Foi revisada a literatura sobre catarata relacionada a peso e idade publicada de janeiro de 2011 a julho de 2020, através de buscas nos bancos de dados PubMed, Medline e Web of Science. Na meta-análise, foram utilizados modelos de efeito aleatórios e de efeitos fixos e os resultados foram apresentados como razões de chances (OR). Resultados: Um total de 9 estudos foi incluído na meta-análise. Não houve correlação entre ausência de sobrepeso e cataratas nucleares (OR=1,31, IC 95%: -0,50-3,12, p=0,156). Os resultados do modelo de efeitos aleatórios mostraram que o excesso de peso estava significativamente associado a uma redução do risco de catarata relacionada à idade (OR=0,91, IC 95%: 0,80-1,02, p<0,0001, I2=62,3%, p<0,0001). Houve correlações significativas entre o excesso de peso e cataratas corticais (OR=0,95, IC 95%: 0,66-1,24, p<0,0001), nucleares (OR=0,92, IC 95%: 0,76-1,08, p<0,0001) e subcapsulares posteriores (OR=0,87, IC 95%: 0,38-1,02, p<0,0001) relacionadas à idade. Houve correlações significativas entre obesidade e cataratas corticais (OR=1,00, IC 95%: 0,82-1,17, p<0,0001), nucleares (OR=1,07, IC 95%: 0,92-1,22, p<0,0001) e subcapsulares posteriores (OR=1,14, IC 95%: 0,91-1,37, p<0,0001) relacionadas à idade. Conclusão: Estes achados sugeriram uma correlação significativa entre o índice de massa corporal e a catarata relacionada à idade, com o excesso de peso e a obesidade reduzindo e aumentando o risco de catarata relacionada à idade, respectivamente.

Prevalence of pseudoexfoliation in diabetic patients with senile cataract: A hospital-based study in Kashmir, India

Purpose: To study the prevalence of pseudoexfoliation syndrome (PEX) in diabetics with senile cataracts and compare it to the prevalence in nondiabetic control group. Methods: Two hundred and fifty diabetics and 250 nondiabetics (age and sex matched) were evaluated for PEX deposition. Results: Chi?squared test was employed, and a P value < 0.05 was considered significant. In the PEX group, most patients belonged to the age group of 60–70 years (55.17%). Out of 18 patients with PEX, 11 (61.1%) showed bilaterality. There was a higher frequency of raised intraocular pressure (IOP; >20 mmHg) in PEX eyes (10.3%) than in the non?PEX eyes (5.9%). The PEX group had a higher number of eyes with cup?to?disc ratio (CDR) >0.6 (11.12%) than the non?PEX group (4.32%). Nuclear cataracts were more frequent in PEX eyes than non?PEX eyes, whereas PSC and mature cataracts were more prevalent in the non?PEX group. Most eyes had PEX deposition on the anterior lens capsule and pupillary margin. Of the 500 study eyes corresponding to the diabetic group, 418 had cataracts (rest pseudophakic), of which 28 had pseudoexfoliation, accounting for 6.7% of the total. In the nondiabetic control group comprising 500 eyes, 430 had senile cataracts (rest pseudophakic), of which 105 had PEX deposition, accounting for 24.4% of the total. Conclusion: According to our findings, diabetics have a lower prevalence of PEX than nondiabetics. Few such studies have been conducted so far, and none have been conducted in the Indian population.

Age-related cataract - Prevalence, epidemiological pattern and emerging risk factors in a cross-sectional study from Central India

Purpose: To study the epidemiological pattern, prevalence, types, and correlates of age?related cataracts in a tertiary care center in central India. Methods: This hospital?based single?center cross?sectional study was conducted on 2,621 patients diagnosed with cataracts for 3 years. Data pertaining to demography, socio?economic profile, cataract grading, cataract types, and associated risk factors were evaluated. Statistical analysis using unadjusted odds ratio (OR) and multivariate logistic regression was performed, with P-value <0.05 considered significant with the power of the study being 95%. Results: The commonest age group affected was 60–79 years, closely followed by the 40–59 years age group. The prevalence of nuclear sclerosis (NS), cortical (CC), and posterior subcapsular cataract (PSC) was found to be 65.2% (3,418), 24.6% (1,289), and 43.4% (2,276), respectively. Among mixed cataracts, (NS + PSC) had the highest prevalence of 39.8%. Smokers were found to have 1.17 times higher odds of developing NS than non?smokers. Diabetics had 1.12 times higher odds of developing NS cataracts and 1.04 times higher odds of developing CC. Patients with hypertension showed 1.27 times higher odds of developing NS and 1.32 times higher odds of developing CC. Conclusion: The prevalence of cataracts in the pre?senile age group (<60 years) was found to have increased significantly (35.7%). A higher prevalence of PSC (43.4%) was found in studied subjects, as compared to the data of previous studies. Smoking, diabetes, and hypertension were found to have a positive association with a higher prevalence of cataracts.

Effect of miR200a and SIRT1 expression on epithelial cell apoptosis in age-related cataract lens epithelial cells / 国际生物医学工程杂志

Objective:To investigate the effects of miR200a and SIRT1 expression on epithelial cell apoptosis in age-related cataract lens epithelial cells.Methods:30 anterior capsule samples of age-related cataract patients were enrolled from the ophthalmology outpatient department of Beichen Hospital affiliated with Nankai University from January to August 2022 as the cataract group and another 30 normal anterior capsule samples of corneal transplantation were enrolled during the same period as the control group. Real -time fluorescence quantitative PCR (RT-qPCR) was used to detect the expression levels of miR200a and SIRT1 genes in the cataract group and control group. The oxidative stress level divided human lens epithelial cells SRA01/04 into a negative control group, miR200a overexpression group, and miR200a inhibition group. The negative control group, miR200a overexpression plasmid, and miR200a inhibitor group were transfected, respectively. Cell apoptosis rate and oxidative stress level were detected by flow cytometry, and Western Blot was used to detect the expression of SIRT1 protein and Caspase-3, Bcl-2, and Bcl-2 related X (Bax) proteins containing cysteine in each group of cells. The targeting relationship between miR200a and SIRT1 was validated using dual luciferase reporter gene detection. Results:Compared with the control group, the expression level of miR200a in the cataract group was significantly increased ( P < 0.01), while the expression level of SIRT1 was significantly reduced ( P < 0.01). Compared with the control group, the levels of SOD, GSH, and GSH-Px in the cataract group were significantly reduced (all P < 0.01), and the MDA level was significantly higher than those in the control group ( P < 0.01). The apoptosis rate of the miR200a overexpression group was significantly higher than that of the negative control group ( P < 0.05), and the apoptosis rate of the miR200a inhibition group was significantly lower than that of the negative control group, the differences were statistically significant ( P < 0.05). The level of SIRT1 protein in the miR200a overexpression group was significantly lower than that in the negative control group ( P < 0.05), and the level of SIRT1 protein in cells of the miR200a inhibition group was significantly higher than that of the negative control group ( P < 0.05). Compared with the negative control group, the miR200a overexpression group showed a significant increase in Caspase-3 activity and Bax protein (all P < 0.05), while the Bcl-2 protein level was significantly reduced ( P < 0.05). The miR200a inhibition group showed a significant decrease in Caspase-3 activity and Bax protein (all P < 0.05), while the Bcl-2 protein level was significantly increased ( P < 0.05). The dual luciferase experiment showed that the overexpression group of miR-200a can significantly inhibit the luciferase activity of the wild-type SIRT1 plasmid, which is the target gene of miR-200a. Conclusions:miR220a is highly expressed in the capsule of lens of patients with age-related cataracts, and its mechanism may be that miR220a promotes apoptosis of lens epithelial cells by targeting the expression of SIRT1.

Tunnel-floor entry continuous curvilinear capsulorhexis technique: Rhexis in a controlled and stable anterior chamber always

Continuous circular capsulorhexis (CCC) was demonstrated independently by Thomas Neuhann, Kimiya Shimizu, and Howard Gimbel in the 1980s and it finds mention in the landmark paper by Gimbel and Neuhann. The authors describe a technique of achieving the rhexis in a stable, viscoelastic-filled anterior chamber using the tunnel floor as the entry. This gets covered by the roof of the tunnel postoperatively and, therefore, does not leak. There is no oar-locking or striae even when cystitome goes beyond the edge of the tunnel. As there is no escape of the viscoelastic substance, there is no change in the pressure or shallowing of the anterior chamber. It is a useful technique for beginners. It is of great help in difficult cases like intumescent cataracts, shallow anterior chambers, hyperopes, nanophthalmos, pseudoexfoliation, small non-dilating pupils, intraoperative floppy iris syndrome (IFIS), and phacomorphic glaucoma.

Reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic

Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID?19 pandemic. Methods: This was a prospective, cross?sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID?19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed. Results: One thousand four hundred seventy two patients were recruited with advanced cataracts. Absence of ophthalmic care nearby (44.2%), lack of awareness regarding elective surgeries (42.6%), lack of public transportation (37%), fear of contracting COVID?19 (23.4%), and waiting for outreach camps (20.4%) were found to be the reasons behind the delay in cataract surgery. 53.7% of the patients had worsening of defective vision and 55.3% of them had difficulty in carrying out activities of family living. 30.8% of the patients faced difficulty in commuting and 8.4% of the patients suffered a fall during this pandemic due to worsening of the visual acuity. Conclusion: The lockdown imposed during the pandemic has created a significant backlog of patients who are progressing to advanced cataracts due to lack of ophthalmic care nearby, lack of awareness regarding elective surgeries, lack of public transportation, and no outreach camps. Proactive measures to deal with this backlog are of utmost need to prevent blindness due to cataract

Prevalence and risk factors for cataracts in the Lao People’s Democratic Republic: The Vientiane Eye Study

Purpose: To determine the prevalence and risk factors for cataracts in the Vientiane Province. Methods: We conducted a population?based study of 1264 participants aged ?40 years of age from urban and rural areas of Vientiane Province. Data collection included demographic information, smoking history, body mass index, blood pressure, history of trauma and dilated lens examination using the World Health Organization WHO Simplified Cataract Grading System. Aphakic and pseudophakic eyes were included as operated cataracts for statistical analysis. Results: The mean age of the 1264 participants was 57.6 years. The prevalence of any cataract including operated eyes was 46.8% (95% CI: 44.1 – 49.6%): 36.9% nuclear, 21.7% cortical and 10.1% posterior subcapsular cataracts. Conclusion: The prevalence of cataract in the Vientiane Eye Study is similar compared to the prevalence reported in other studies from Asian regions; however, the median age in this study was low, reflecting the age group of the population and the rapid urbanisation occurring in the Lao People’s Democratic Republic. A significant association for any cataract was found with elevated blood pressure >148mmHg (OR2.48, 95%CI:1.55 ? 3.97, P < 0.01), increasing age (OR1.19, 95%CI:1.17 ? 1.22, P < 0.001) and rural inhabitants for cortical cataract (OR1.99, 95%CI:1.37 ? 2.90, P < 0.001). An inverse relationship between rural inhabitants with any cataract and nuclear cataract was found (OR 0.63, 95%CI: 0.45 – 0.89, P < 0.01 and OR 0.42, 95%CI: 0.31 ? 0.59, P < 0.001) respectively.Nevertheless, cataract remains a high prevalence disease in this population

Vitrector-assisted anterior capsulorhexis in adult intumescent cataract

Performing capsulorhexis in white intumescent cataracts during phacoemulsification surgery is challenging for cataract surgeons because of high intralenticular pressure and reduced red reflex. Capsulorhexis extension to the periphery of the lens is a common occurrence due to lens intumescence. We used a vitrectomy cutter to create an initial tear in the anterior capsule and simultaneously remove a part of milky fluid coming out of the intumescent lens. Once the lens was decompressed, capsulorhexis was completed using capsulorhexis forceps. This technique helped in controlling capsulorhexis in eyes with intumescent cataracts by reducing the intralenticular pressure and thereby preventing unexpected radial capsular tear

Ocular biometry in dense cataracts: Comparison of partial-coherence interferometry, swept-source optical coherence tomography and immersion ultrasound

Purpose: To assess the axial length (AL) measurement failure rate using partial?coherence interferometry (PCI) and swept?source optical coherence tomography (SS?OCT) in dense cataracts. As a secondary outcome, the SS?OCT biometry was compared to immersion ultrasound. Methods: This is a prospective cross?sectional and comparative study. Seventy eyes from 70 patients with dense cataracts were enrolled in this study. Dense cataract was defined according to the Lens Opacities Classification System III (LOCS III) scores equal to or more than NO4, NC4, C4, and P3. The failure rate of AL measurement was evaluated using PCI and SS?OCT. Anterior chamber depth (ACD), lens thickness (LT), and AL measurements obtained by SS?OCT were compared with IUS. Results: AL measurement failure rate with PCI was 68.57% and 21.43% with SS?OCT (P = 0.007). AL measurement was achieved in 69.23% of NO4, 66.6% of P3, and 15.3% of mixed cataracts using PCI, while SS?OCT was achieved in 100% of NO4, NO5, P3, and P5 and 76.9% of mixed cataracts. Cortical cataracts alone did not influence AL measurement. Biometric data of ACD, LT, and AL were statistically different comparing US and SS?OCT with a good correlation of AL. Conclusion: SS?OCT significantly improves the rate of successful AL measurements when compared to PCI in dense cataracts. The LOCS III clinical cut?off for the use of SS?OCT ocular biometry may well be up to P4 and NO5

Comparison of phacoemulsification combined with goniosynechialysis and trabeculectomy in the treatment of APACG / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate and compare the quality of life of patients submitted to phacoemulsification combined with goniosynechialysis(PPI+GSL)and trabeculectomy, and analyze the potentially involved variables.<p>METHODS: A perspective, randomized case-control study was conducted. Patients with acute primary angle-closure glaucoma(ACG)and early cataracts underwent PPI+GSL implantation(group A, <i>n</i>=29)and trabeculectomy(group B, <i>n</i>=30). The quality of life was assessed using the National Eye Institute 25-Item Visual Function Questionnaire(NEI-VFQ-25)before and 6mo after surgery. Intraocular pressure(IOP), best corrected visual acuity(BCVA), review frequency and the basic characteristics were recorded simultaneously.<p>RESULTS: Compared with preoperative status, the IOP in both groups was significantly decreased(all <i>P</i><005), and the BCVA was significantly increased in group A(<i>P</i><0.05), while did not differ significantly in group B(<i>P</i>>0.05). Besides, group B presented higher review frequency than group A(<i>P</i><0.05). Moreover, significant increases in postoperative scores were founded in the two groups respectively(all <i>P</i><0.05). Compared with group B, group A had better postoperative performance in items of general vision, ocular pain, long-distance activities, social functioning and role limitations(all <i>P</i><0.05). Besides, group A presented significantly higher net increases in postoperative total scores than group B(<i>P</i><0.05), which was positively associated with the degree of the BCVA recovery and negatively associated with review frequency(<i>R</i>²=0.48, <i>F</i>=5.00, <i>P</i><0.05).<p>CONCLUSION: APACG patients with early cataracts, PPI+GSL determines better improvement in quality of life compared to trabeculectomy.

Lesiones oculares y radiación ionizante / Eye injuries and ionising radiation

El número y la complejidad de los procedimientos de diagnóstico e intervencionismo cardiovascular han incrementado de manera significativa, hecho que genera mayor exposición a dosis bajas de radiación ionizante debido a la radiación dispersa por el paciente. El cristalino es una de las estructuras más sensibles a la radiación y las cataratas son la enfermedad ocular más estudiada y frecuente en el personal de la salud ocupacionalmente expuesto a dosis bajas de radiación. La formación de cataratas es un proceso multifactorial y la exposición a la radiación ionizante se ha asociado a opacidades subcapsulares posteriores, que es la forma más común de lesión, seguida por las cataratas corticales. Existen varios estudios que han evaluado los efectos de la exposición ocupacional por radiación ionizante en el cristalino en cardiólogos intervencionistas, comparándolos con controles no expuestos. Concluyen que hay mayor prevalencia de opacidades subcapsulares posteriores en el personal expuesto a radiación ionizante, especialmente en los cardiólogos intervencionistas (por trabajar muy cerca del generador de rayos X), las cuales están relacionadas con la duración de la práctica del intervencionismo cardíaco y disminuyen con el uso regular de los lentes plomados. Lo llamativo de muchos estudios es el bajo uso por parte de los cardiólogos intervencionistas de los elementos de protección radiológica, especialmente gafas y mampara plomada, las cuales han demostrado efectividad en la reducción de la radiación ionizante recibida por el personal de la sala de cateterismo cardiaco.

As the number and complexity of diagnostic and cardiovascular intervention procedures has increased significantly, this has led to a greater exposure to low doses of ionising radiation due to the radiation dispersal by the patient. The crystalline lens is one of the structures most sensitive to radiation, and cataracts are the most studied eye disease, and are common in health staff occupationally exposed to low radiation doses. The formation of cataracts is a process involving many factors, and exposure to ionising radiation has been associated with posterior sub-capsular opacities, the most common form of the injury, followed by cortical cataracts. There are several studies that have evaluated the effects of occupational exposure due to ionising radiation in the crystalline lens in interventionist cardiologists, and comparing them with non-exposed controls. They conclude that there is a higher prevalence of posterior sub-capsular opacities in personnel exposed to ionising radiation, especially in interventionist cardiologists (due to working very near the X-ray generator). These are associated with the duration of the practice of cardiac interventions, and decrease with the regular use of leaded glasses. The low use of radiation protection wear by interventionist cardiologists is highlighted in many studies, especially glasses and a leaded screen, which have shown to be effective in the reduction in the ionising radiation by the staff in the cardiac catheterisation room.

Prediction of Olsen formula in postoperative refractive power of patients with high myopia complicated with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the predictability of Olsen formula for postoperative refractive power in patients with high myopia complicated with cataract.<p>METHODS: This retrospective study reviewed 65 patients(101 eyes)with high myopia and who had phacoemulsification combined with intraocular lens implantation from October 10th 2016 to August 20th 2019 in our hospital. They were divided into three groups according to the axis length: group A(26mm <AL≤28mm)17 cases(29 eyes), group B(28mm<AL≤30mm)26 cases(41 eyes), group C(AL>30mm)22 cases(31 eyes). The postoperative theoretical diopter(that is, the preoperative predictive diopter of each formula corresponding to the degree of IOL implanted)of intraocular lens was calculated by SRK/T, Haigis and Olsen formulas of IOL-master. The actual postoperative 3mo diopter was recorded and the absolute refractive error(MAE)was calculated.<p>RESULTS: The postoperative 3mo MAE in the three groups calculated with Olsen formula was 0.15(0.04, 0.22), 0.19(0.14, 0.27), 0.26(0.115, 0.455)D respectively(<i>P</i>>0.05). For patients with the same axial length, the postoperative 3mo MAE of Olsen formula was the smallest. The Bland-Altman method was used to analyze the consistency between the postoperative theoretical diopter and the postoperative 3mo actual diopter. The results showed that the postoperative 3mo actual diopter was the closest to the postoperative theoretical diopter of the Olsen formula, while the postoperative theoretical diopter of the SRK/T formula was the worst.<p>CONCLUSION: For patients with high myopia and cataract, the accuracy and stability of Olsen formula is better than that of SRK/T and Haigis formula, and Olsen formula is least affected by eye axis length.

Analysis of visual acuity and visual quality after regional refracted multifocal IOL implantation and aspherical unifocal IOL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To contrast the visual acuity and visual quality after implantation of regional refraction multifocal IOL and aspheric unifocal IOL.<p>METHODS: The study enrolled 82 cases(96 eyes)of age-related cataract patients, underwent phacoemulsification surgery in our hospital. According to the intraoperative intraocular lens implantation type, they were divided into two groups: the observation group(46 cases, 53 eyes, implanted with Oculentis MF30 regional refractive multifocal IOL)and the control group(36 cases, 43 eyes, implanted with ADAPT AO aspherical unifocal IOL). The total visual acuity and visual quality 3mo after operation were compared between the two groups. <p>RESULTS: Three months after surgery, compared with the control group, the observation group had significantly improved near and middle vision, significantly increased contrast sensitivity, significantly increased modulation transfer function cutoff frequency, Strehl ratio, objective scatter index and OQAS values, significantly decreased VF-12-CN score(38.16±4.05 <i>vs</i> 45.72±4.69), and significantly increased desorption rate score(11.38±1.04 <i>vs</i> 9.23±0.87)and surgical satisfaction score(3.57±0.36 <i>vs</i> 3.32±0.31)(<i>P</i><0.05). Age >65 years old, illiteracy, uncorrected distant visual acuity of good eye ≥0.1(LogMAR), implantation of aspheric unifocal IOL are the influencing factors of the quality of life of cataract patients. <p>CONCLUSION: Compared with aspheric unifocal IOL, Oculentis regional refraction multifocal IOL can provide good overall vision in the short term after operation, and the contrast sensitivity, visual quality, quality of life, glasses removal rate and satisfaction are significantly improved.

Effect of GSH and niacin combination on protein oxidation, ER stress, glycation and aggregation in HLE cells under high glucose condition / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effects of reduced glutathione(GSH)and niacin combination on protein oxidative stress, endoplasmic reticulum(ER)stress, glycation, and aggregation of the αβ crystalline in human lens epithelial(HLE)cells treated with high glucose levels. <p>METHODS:HLE cells were cultured and exposed to 25 mmol/L glucose to promote high glucose conditions. Groups of cells were co-treated with three different combinations of dosages: 10 μmol/L GSH+2 μmol/L niacin, 30 μmol/L GSH+25 μmol/L niacin, and 100 μmol/L GSH+25 μmol/L niacin. After 72h incubation, protein carbonyl content(PCC)and glucose reactive protein(GRP78)content were assessed using ELISA examinations. After two-week incubation, advanced glycation end products(AGEs)were also assessed and the expression of αβ crystalline was measured using Western Blot examination. The SPSS 18.0 statistical package was used for all data analyses.<p>RESULTS:PCC and GRP78 levels in the co-treated groups were not significantly reduced compared to control(<i>P</i>>0.05). In contrast, there was a significant decrease of the AGEs levels in all groups co-treated with GSH and niacin when compared with the control group(<i>P</i><0.05). In addition, the αβ crystalline expression increased after high dose glucose administration, but decreased in all groups co-treated with GSH and combinations of GSH and niacin.<p>CONCLUSION:The results suggest that combinations of GSH and niacin inhibit the aggregation of proteins and prevent glycation in hyperglycemic human lens epithelial cells. This study shows that this combination may play an active role in preventing diabetic cataract mainly from the AGEs pathway.

Análisis de costos en la cirugía de catarata por facoemulsificación bilateral simultánea versus facoemulsificación bilateral secuencial / Cost analysis of simultaneous bilateral phacoemulsification cataract surgery versus sequential bilateral phacoemulsification

RESUMEN Objetivo: Evaluar el costo en la cirugía de catarata por facoemulsificación bilateral simultánea vs. facoemulsificación bilateral secuencial, con implante de lente intraocular. Métodos: Se realizó un estudio analítico de evaluación económica en 762 pacientes mayores de 50 años, intervenidos de catarata con la cirugía de facoemulsificación bilateral simultánea (grupo I), y 762 pacientes operados de catarata con la cirugía de facoemulsificación bilateral secuencial (grupo II), en el Instituto Cubano de Oftalmología Ramón Pando Ferrer, del año 2014 al 2019. Se evaluaron los costos en recursos humanos, materiales e indirectos, así como los costos totales de ambos grupos después de la intervención quirúrgica, partiendo de la demostración científica de que ambos procedimientos son igualmente eficaces. Resultados: Predominó la edad de 61 a 80 años y el sexo femenino (75 por ciento) en ambos grupos. Los costos unitarios relacionados con los recursos humanos disminuyeron en 1,69 pesos para el grupo I, mientras que los costos totales y unitarios en relación con los recursos materiales fueron similares en ambos grupos. Los costos unitarios indirectos disminuyeron en 3,63 pesos en el grupo I. Finalmente, el costo unitario total para el grupo de cirugía bilateral simultánea resultó 6,19 pesos menor que el de cirugía bilateral secuencial. Conclusiones: La cirugía de catarata por facoemulsificación bilateral simultánea tiene menores costos que la facoemulsificación bilateral secuencial(AU)

ABSTRACT Objective: Evaluate the cost of simultaneous bilateral phacoemulsification cataract surgery vs. sequential bilateral phacoemulsification with intraocular lens implantation. Methods: An analytic economic evaluation was conducted of 762 patients aged over 50 years undergoing simultaneous bilateral phacoemulsification cataract surgery and 762 patients undergoing sequential bilateral phacoemulsification cataract surgery at Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period 2014-2019. Evaluation was performed of costs incurred on human resources and materials, indirect costs, and total costs for the two groups after surgery, starting from the scientific certainty that both procedures are equally effective. Results: The 61-80 years age group and female sex (75 percent) prevailed in both groups. Human resources unit costs decreased 1.69 CUP in group I, whereas material resources total and unit costs were similar in both groups. Indirect unit costs decreased 3.63 CUP in group I. Total unit cost was 6.19 CUP lower in the simultaneous bilateral surgery group than in the sequential bilateral surgery group. Conclusions: Simultaneous bilateral phacoemulsification cataract surgery is more cost-effective than sequential bilateral phacoemulsification(AU)