-
Gene Jun 2024Congenital cataract is one of the leading causes of vision loss in children, and a large proportion of cases are related to genetics. In a Chinese family, we reported a...
Congenital cataract is one of the leading causes of vision loss in children, and a large proportion of cases are related to genetics. In a Chinese family, we reported a new missense mutation in CRYBA2 (c.223T>C: p.Tyr75His), which can cause autosomal dominant congenital bilateral cataract. We collected blood samples from family members (mother and two sons) and extracted DNA. Through whole-exome sequencing, we discovered a novel unreported mutation. According to relevant ACMG guidelines, this mutation was determined to be a variant of unknown clinical significance. This article further expands the site information on the CRYBA2 mutations.
PubMed: 38909969
DOI: 10.1016/j.gene.2024.148726 -
Archivos de La Sociedad Espanola de... Jun 2024A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe,...
INTRODUCTION
A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe, including a disparity between the sexes and a variation in the experience on cataract surgery (CC) between them. This study is about the Spanish sub-cohort of the survey, and its objective is to present and analyse the peculiarities of ophthalmology training in Spain within the European context, as well as discussing ways to harmonise and improve that training throughout the EU.
METHODS
We analyse data of the Spanish participants in the EBO exams, defining subgroups by the Autonomous Communities existing in Spain.
RESULTS
93 of 135 requested participants (68.9%) responded. A 60.2% passed the EBO exam between 2021-2022, being mostly women (65.59%) aged 31 years old on average. The 91.4% were right-handed, coming from 13 of the 17 Spanish autonomous communities, although mostly from the Community of Valencia, Madrid and Catalonia. Respectively, 16.1%, 3.2% and 8.7% of the respondents said they have completed 10 or more training sessions on animal eyes, synthetic eyes and through the virtual reality simulator. This training was correlated with greater self-confidence in the management of a posterior capsular tear during surgery (p .025). All respondents manifested to have already performed stages of the CC. The average number of operations reported was 181.6 with regional disparities. A significant difference is observed between the sexes against women (-28.3%, p 0.03).
DISCUSSION
Ophthalmologists in Spain, much more than other European countries, have greater opportunities for surgical training, with surgical procedures during the residency, that nearly triples those made by the others. Spanish women refer, like their European colleagues, to be in disadvantage in learning opportunities about cataract surgery. The Simulation Based Medical Education (SBME) allows to respond to the training deficit and complements the training on the patient. Although we demonstrate a significant correlation between the number of procedures carried out and self-confidence to operate simple cases, the SBME would be a complementary tool in self-confidence in front of a complication like capsular rupture.
CONCLUSION
Spain massively adopts the model named by us "surgery for all", despite the underrepresentation of women in this area, emphasising a need for cultural change that the SBME could facilitate.
PubMed: 38909893
DOI: 10.1016/j.oftale.2024.06.009 -
International Ophthalmology Jun 2024To analyze the hotspots and trends in artificial intelligence (AI) research in the field of cataracts.
PURPOSE
To analyze the hotspots and trends in artificial intelligence (AI) research in the field of cataracts.
METHODS
The Science Citation Index Expanded of the Web of Science Core Collection was used to collect the research literature related to AI in the field of cataracts, which was analyzed for valuable information such as years, countries/regions, journals, institutions, citations, and keywords. Visualized co-occurrence network graphs were generated through the library online analysis platform, VOSviewer, and CiteSpace tools.
RESULTS
A total of 222 relevant research articles from 41 countries were selected. Since 2019, the number of related articles has increased significantly every year. China (n = 82, 24.92%), the United States (n = 55, 16.72%) and India (n = 26, 7.90%) were the three countries with the most publications, accounting for 49.54% of the total. The Journal of Cataract and Refractive Surgery (n = 13, 5.86%) and Translational Vision Science & Technology (n = 10, 4.50%) had the most publications. Sun Yat-sen University (n = 25, 11.26%), the Chinese Academy of Sciences (n = 17, 7.66%), and Capital Medical University (n = 16, 7.21%) are the three institutions with the highest number of publications. We discovered through keyword analysis that cataract, diagnosis, imaging, classification, intraocular lens, and formula are the main topics of current study.
CONCLUSIONS
This study revealed the hot spots and potential trends of AI in terms of cataract diagnosis and intraocular lens power calculation. AI will become more prevalent in the field of ophthalmology in the future.
Topics: Humans; Bibliometrics; Artificial Intelligence; Cataract; Cataract Extraction; Ophthalmology; Biomedical Research
PubMed: 38909343
DOI: 10.1007/s10792-024-03207-5 -
The National Medical Journal of India 2023Anterior ischaemic optic neuropathies (AIONs) are a common cause of permanent visual loss in the elderly population. The non-arteritic subtype has been intensively...
Anterior ischaemic optic neuropathies (AIONs) are a common cause of permanent visual loss in the elderly population. The non-arteritic subtype has been intensively studied. While systemic associations such as hypertension and diabetes mellitus are commonly recognized and treated, others such as obstructive sleep apnoea (OSA) are largely overlooked in daily practice. A 60-year-old man who gave no history of any systemic illness presented to us 1 week following an uneventful cataract surgery with posterior chamber intraocular lens implantation in his right eye. The surgery was performed elsewhere by an eye-healthcare professional where the patient presented primarily with a history of progressively worsening diminution of vision in the same eye for 5 days and was diagnosed with a senile cataract. The postoperative visual gain was unsatisfactory; hence he sought another opinion. A diagnosis of non-arteritic AION (NAION) was established. Systemic evaluation revealed elevated diastolic blood pressure, dyslipidaemia and severe OSA. Prompt treatment with systemic steroids and simultaneous management of the accompanying systemic morbid conditions saved some useful vision in the affected eye. This also prevented involvement of the fellow unaffected eye. A comprehensive ocular examination with emphasis on systemic evaluation of the patient for coexisting illness is imperative before proceeding with any medical or surgical intervention. OSA is a definitive risk factor for the development of NAION, though it remains underdiagnosed and untreated. Cataract surgery has been shown to worsen underlying NAION. Systemic stabilization averts potentially blinding sequel in the unaffected eye of these patients.
Topics: Humans; Optic Neuropathy, Ischemic; Sleep Apnea, Obstructive; Male; Middle Aged; Cataract Extraction; Risk Factors
PubMed: 38909295
DOI: 10.25259/NMJI_982_20 -
International Ophthalmology Jun 2024To explore ocular characteristics of patients with cataracts after renal transplantation and analyze the results of phacoemulsification combined with intraocular lens...
PURPOSE
To explore ocular characteristics of patients with cataracts after renal transplantation and analyze the results of phacoemulsification combined with intraocular lens (IOL) implantation.
METHODS
Patients with cataracts after renal transplantation and control patients who underwent phacoemulsification combined with IOL implantation were enrolled. All patients underwent phacoemulsification combined with IOL implantation. Visual acuity, intraocular pressure, type of lens opacity, corneal endothelial cell density, and ocular biological parameters were evaluated before surgery. Visual prognosis, dry eye, and postoperative complications were monitored for 6 months after phacoemulsification.
RESULTS
We analyzed 25 eyes of 16 patients after renal transplantation and 30 eyes of 21 control patients. The most common type of cataract of renal transplantation group was posterior subcapsular, while the most common type of cataract of control group was cortical. Significant differences in corneal astigmatism, white-to-white ratio, and keratometry values were observed between the groups. The postoperative visual acuity of both groups significantly improved following surgery. Postoperative complications, such as the degree of anterior and posterior capsule opacification and the incidence of a requirement of neodymium-doped yttrium aluminum garnet laser capsulotomy, were significantly lower in the renal transplantation group. Moreover, secondary glaucoma occurred in two eyes in the renal transplantation group.
CONCLUSION
This study showed that cataracts after renal transplantation were mostly posterior subcapsular. Postoperative visual acuity recovered well in most patients, with reduced incidence of postoperative complications. This study suggested that phacoemulsification combined with IOL implantation was safe and effective, providing a reference for multi-focal IOL implantation in kidney transplant recipients.
Topics: Humans; Phacoemulsification; Male; Female; Cataract; Visual Acuity; Kidney Transplantation; Middle Aged; Postoperative Complications; Adult; Intraocular Pressure; Lens Implantation, Intraocular; Retrospective Studies; Treatment Outcome; Follow-Up Studies; Aged
PubMed: 38909160
DOI: 10.1007/s10792-024-03161-2 -
International Ophthalmology Jun 2024To determine the incidence, risk factors and clinical outcomes in patients with nucleus drop (ND) following phacoemulsification surgery at a tertiary care ophthalmic...
PURPOSE
To determine the incidence, risk factors and clinical outcomes in patients with nucleus drop (ND) following phacoemulsification surgery at a tertiary care ophthalmic institute.
METHODS
Medical records of patients with ND during phacoemulsification between January'2019 and December'2022 were reviewed retrospectively. Incidence of ND was calculated overall, and according to surgical expertise levels and surgical steps. Associated pre- and intra-operative risk factors were assessed. Clinical outcome parameters [best-corrected visual acuity (BCVA) and intraocular pressure (IOP)] were compared with respect to timing of PPV (immediate vs early vs delayed), location (sulcus vs scleral fixated-IOL) and timing of IOL placement (primary vs secondary).
RESULTS
Among 93,760 phacoemulsifications, ND was noted in 130 patients (0.1%). Significant direct and associated pre-operative risk factors were advanced cataract, glaucoma, posterior polar cataract, and diabetes mellitus. Junior medical consultants had 40 ND (mostly in non-complex cases), whereas senior medical consultants had 90 ND (mostly in complex cases). ND most frequently occurred during emulsification of nuclear fragments. Sulcus placement of IOL during primary surgery yielded significantly better visual outcome compared to secondary procedures, although timing of PPV had insignificant effect. 77.1% had BCVA of 6/12 or better at final follow-up. Timing of IOL implantation, PPV, and type of IOL did not have any significant effect on IOP.
CONCLUSIONS
Though the incidence of ND is low, it is a dreaded complication. Accurate pre-operative evaluation, risk stratification, distribution of cases among surgeons based on their surgical expertise, and immediate or early management of ND yields better anatomical and functional outcomes.
Topics: Humans; Phacoemulsification; Male; Incidence; Female; Retrospective Studies; Risk Factors; Aged; Visual Acuity; Postoperative Complications; Intraocular Pressure; Middle Aged; Follow-Up Studies; Aged, 80 and over; Lens Implantation, Intraocular
PubMed: 38907180
DOI: 10.1007/s10792-024-03180-z -
International Ophthalmology Jun 2024To assess the refractive outcomes of secondary intraocular lenses (IOL) in patients with traumatic aphakic eyes with corneal penetrating injury and compare different... (Comparative Study)
Comparative Study
BACKGROUND/AIM
To assess the refractive outcomes of secondary intraocular lenses (IOL) in patients with traumatic aphakic eyes with corneal penetrating injury and compare different corneal curvature measurement methods.
METHODS
Patients with unilateral penetrating eye injuries underwent corneal wound repair and cataract extraction, followed by secondary IOL implantation. Corneal curvature measurements were taken on the contralateral healthy eye (Group A), from the affected eye before removing corneal sutures (Group B), or after suture removal (Group C). The refractive outcomes were compared among the three groups.
RESULTS
The study included 261 eyes. The Mean Absolute Error (MAE) in Group C (0.99 ± 0.85 D) was significantly smaller than that in Group A (1.87 ± 1.71 D) and Group B (1.37 ± 1.20 D) (both P < 0.001). Moreover, the percentage of eyes with IOL prediction errors within ± 0.50 D in Group C (40%) was higher than that in group A (21.7%) (OR = 2.364, 95%CI: 1.272-4.392, P = 0.006) and group B (28.0%) (OR = 1.714, 95%CI: 0.948-3.099, P = 0.073), and the percentage of eyes with IOL prediction errors within ± 1.0 D in Group C (90.9%) was higher than that in group A (67.9%) (OR = 4.758, 95%CI: 2.131-10.626, P < 0.001) and group B (75.0%) (OR = 3.370, 95%CI: 1.483-7.660, P = 0.003) as well.
CONCLUSIONS
In traumatic aphakic eyes with corneal sutures, IOL power calculation based on the corneal curvature of the injured eye after removing the corneal sutures yields the best refractive outcomes.
Topics: Humans; Female; Male; Lens Implantation, Intraocular; Adult; Middle Aged; Corneal Injuries; Visual Acuity; Refraction, Ocular; Cornea; Retrospective Studies; Young Adult; Adolescent; Lenses, Intraocular; Eye Injuries, Penetrating; Aphakia, Postcataract; Aged; Aphakia; Cataract Extraction; Corneal Topography; Child
PubMed: 38907133
DOI: 10.1007/s10792-024-03172-z -
Ophthalmology and Therapy Jun 2024This study evaluated 10-year results of implanting one iStent trabecular micro-bypass stent during cataract surgery in eyes with open-angle glaucoma (OAG) or ocular...
INTRODUCTION
This study evaluated 10-year results of implanting one iStent trabecular micro-bypass stent during cataract surgery in eyes with open-angle glaucoma (OAG) or ocular hypertension.
METHODS
This retrospective, non-randomized study examined 10-year outcomes of iStent trabecular micro-bypass stent implantation with cataract surgery by one surgeon in eyes with OAG [including primary OAG (POAG) and pseudoexfoliative glaucoma (PXG)] or ocular hypertension at a multi-specialty German ophthalmology center. Study visits were conducted preoperatively and at 2.5, 3, 5, and 10 years postoperatively; examinations included intraocular pressure (IOP), medications, corrected-distance visual acuity (CDVA), and adverse events.
RESULTS
A total of 63 eyes of 45 patients with OAG (n = 60 eyes) or ocular hypertension (n = 3 eyes) and data through 10 years were analyzed. Mean preoperative IOP was 18.6 ± 4.4 mmHg on 1.83 ± 1.03 mean medications. At study visits through 10 years postoperative, mean IOP reduced by 12.9-19.0% (p < 0.005 at all points), and mean medication burden reduced by 37.8-51.4% (p ≤ 0.006 at all points). At 10 years postoperatively, 77.8% of eyes had IOP ≤ 18 mmHg and 47.6% had IOP ≤ 15 mmHg (vs. 50.8% and 25.4% preoperatively, respectively; p = 0.016). One-third (33.3%) of eyes were medication-free vs. 3.2% preoperatively (p < 0.001); 17.5% were on 2-5 medications (vs. 55.6% preoperatively, p = 0.005); and 93.7% of eyes were on the same or fewer medications vs. preoperative. Post-phacoemulsification CDVA improvement was maintained; no filtering surgeries were completed over 10-year follow-up.
CONCLUSIONS
Significant and safe IOP and medication reductions were observed through 10 years after iStent implantation with cataract surgery in patients with OAG or ocular hypertension.
PubMed: 38907091
DOI: 10.1007/s40123-024-00984-1 -
Eye (London, England) Jun 2024To investigate the postoperative clinical outcomes and axial length (AL) growth of infants with congenital cataracts and microphthalmos following first-stage cataract...
PURPOSE
To investigate the postoperative clinical outcomes and axial length (AL) growth of infants with congenital cataracts and microphthalmos following first-stage cataract surgery.
DESIGN
Retrospective case-control study.
METHODS
Setting: Single centre. Infants with congenital cataract that met the inclusion criteria were classified into two groups: the microphthalmos and comparison groups. All infants underwent a thorough ophthalmologic examination before surgery, and one week, 1 month, 3 months, and every 3 months after surgery.
RESULTS
This study enrolled 21 infants (42 eyes) in the microphthalmos group and 29 infants (58 eyes) in the comparison group. More glaucoma-related adverse events were observed in the microphthalmos group (7 eyes, 16.7%) than in the comparison group (0 eyes, 0%) (p < 0.001). At each subsequent follow-up, the comparison group had a greater AL than the microphthalmos group (all p < 0.001), and AL growth was significantly higher in the comparison group than in the microphthalmos group (all p = 0.035). Visual acuity improvement in the microphthalmos group was similar to that of the comparison group.
CONCLUSION
Early surgical intervention improves visual function in infants with congenital cataracts and microphthalmos although with a higher incidence of glaucoma-related adverse events. After cataract removal, the AL growth of microphthalmic eyes is slower than that of normally developed eyes.
PubMed: 38907015
DOI: 10.1038/s41433-024-03176-0 -
Indian Journal of Ophthalmology Jul 2024
Topics: Humans; Cataract Extraction; Cataract; Microscopy; Ophthalmology; Equipment Design
PubMed: 38905468
DOI: 10.4103/IJO.IJO_3158_23