Influence of cataract surgery on progression of lens opacities in the fellow eye.

OBJECTIVE: To evaluate whether, in the Italian-American natural history study, cataract surgery in one eye influences the incidence/progression rate of lens opacities in the fellow eye. DESIGN: Follow-up study of age-related cataract. PARTICIPANTS: A total of 1399 participants with age-related cataracts were regularly followed for 5 years and cataract status evaluated by the Lens Opacities Classification System II on slit-lamp and retroillumination lens photographs. A total of 228 participants had cataract surgery in 1 eye during the study period, and 192 had sufficient follow-up visits to be included in the analysis. MAIN OUTCOME MEASURE: The incidence/progression of cataract was defined as two or more consecutive visits with a severity grade greater than the baseline grade. RESULTS: When entered into a Cox model, incidence/progression of specific cataract types was not associated with cataract surgery on the fellow eye and was not significantly different from that observed in participants who had no cataract surgery. CONCLUSIONS: Cataract extraction does not influence incidence/progression rate of specific lens opacities in the fellow eye.

Self-assessment of the quality of vision: association of questionnaire score with objective clinical tests.

PURPOSE: To investigate the association of a quality of life-visual function questionnaire with an objective clinical test of visual function. METHODS: We have developed a questionnaire to assess self-reported visual satisfaction in ophthalmic patients suffering from chronic eye conditions causing visual impairment. The questionnaire was administered to 120 patients suffering from age-related cataract, chronic open angle glaucoma, age-related macular degeneration, branch retinal vein occlusion, and presbyopia or minor refractive defects. All the participants also underwent determination of visual acuity, contrast sensitivity, glare, and visual field. RESULTS: The questionnaire has a good reproducibility, a high internal consistency, and is able to discriminate between the different groups of patients. The total questionnaire score is significantly associated with the results of all visual function tests with the exception of glare. When entered into a multiple linear regression model, near visual acuity and contrast sensitivity are still considerably associated with the total questionnaire score. The psychological attitude of the patient towards his/her health problem is also associated with the total average score. CONCLUSIONS: Overall, the model explains 49% of the variance in the average questionnaire score.

Distribution of cataract types in the Italian-American case-control study and at surgery in the Parma area.

PURPOSE: To compare the distribution of cataract types at surgery with the distribution detected in an ophthalmology clinic-based case-control study in the same geographic area (Parma, Italy). METHODS: The distribution of cataract type assessed according to the Lens Opacities Classification System I in 284 consecutive patients 45 years of age or older, who were admitted for cataract surgery to the Institute of Ophthalmology in Parma during 1994, was compared with the distribution assessed in 1008 participants in the Italian-American case-control study of age-related cataract in the Parma metropolitan area from 1987 to 1989. RESULTS: Analysis of cataract distribution indicates in the surgical group, compared with the case-control population, a significant increase of nuclear (N) and posterior subcapsular (PSC) opacities (any), a reduction of pure forms of cortical and N cataracts, and a marked increase of mixed types of opacities with a simultaneous N and PSC component. CONCLUSION: Although cortical opacities are probably the most prevalent type of age-related lens change in the general population of Parma metropolitan area, the type of cataract most frequently responsible for the decision of patients to undergo cataract surgery is a mixed type of opacity with an N-PSC component.

Enzyme activities in human lens epithelium of age-related cataract.

PURPOSE: To investigate associations between enzyme activity of glutathione reductase (GR) with and without added flavin adenine dinucleotide (FAD), glutathione peroxidase (GPX), and 6-phosphogluconic dehydrogenase (6PGDH) in the lens epithelium collected at surgery, and some nutritional and biochemical variables determined in the same individuals during the Italian-American Case-Control Study of age-related cataract. METHODS: One hundred eighty-three epithelium capsule samples were collected from 174 patients undergoing surgery. Data on enzyme activity were obtained from 52 samples for 6-PGDH and from 53 samples for GR and for GPX. The Lens Opacity Classification System II was used to classify and grade cataracts. RESULTS: No correlation was found between enzyme activity in lens epithelium and the same enzymatic activity in erythrocytes (with the exception of a negative correlation between lens and erythrocyte 6PGDH activity), or the type and severity of cataract. No correlation was found between lens GPX activity and plasma selenium and between lens GR activation coefficient (GRAC) and riboflavin intake. Lens GR with added FAD and lens GRAC were significantly correlated to plasma vitamin E level. Lens GRAC was positively correlated to a nutritional vitamin index. CONCLUSIONS: Present data stress the difficulty in verifying the assumption that biochemical indices collected on plasma and on erythrocyte actually reflect the status of these factors in the lens itself.

Sugar alcohols in the lens epithelium of age-related cataract.

We have measured the levels of glucose and sugar alcohols in the lens epithelium of 24 non-diabetic and 21 diabetic patients undergoing extracapsular cataract extraction for age-related cataract. Lens status was assessed preoperatively according to the Lens Opacities Classification System II. In comparison to non-diabetics, the lens epithelia of diabetic patients have increased levels of glucose and sorbitol, and lower content of myo-inositol. Both myo-inositol decrease and sorbitol accumulation are strictly related to the fasting blood sugar level. No correlation or trend was detected in diabetic subjects between myo-inositol or sorbitol level and cataract type. In non-diabetic patients nuclear opacification was associated with a significant increase of myo-inositol level in lens epithelium.

[Corneal transplantation in Parma: a critical review of activities from 1983 to 1989]. / Il trapianto di cornea a Parma: revisione critica dell'attività svolta dal 1983 al 1989.

At the Institute of Ophthalmology of Parma 66 corneal transplants were performed from 1983 to 1989. In this period the number of grafts per year remarkably increased. Two therapeutic choices characterized corneal transplantation in Parma: a) a fresh donor cornea was used without any storage medium; b) the post-operative ambulatory follow-up of patients was particularly frequent in the first 12 months after surgery. The follow-up period ranged from 3 to 75 months (mean 25 months). The life table calculated using the Kaplan-Meier method shows a graft survival of 86% after 4 years. Graft failures were 8. The authors report all postoperative complications that appeared. In comparison with what reported in Literature, a higher percentage of graft survival and a better final visual acuity were observed in the patients who underwent corneal transplantation in the Eye Clinic of Parma.

Oxidative cross-linking of fodrin parallels a membrane conductance increase in the mammalian lens.

An oxidative cross-linking of the lens spectrin-like protein fodrin was induced by incubating WKY-rat lenses in the presence of the SH-reagent diamide. The oxidation of fodrin was paralleled by an increase in lens membrane conductance. The time relationship between these two events as well as the reversibility of both, achieved by incubating the lens in the presence of dithiothreitol, indicate that normal permeability characteristics of the lens membranes require the integrity of the membrane attached cytoskeleton.