Time trends and gender disparities of Chinese cataract burden and their predictions

AIM:To evaluate the trends and changes in the number and rates of disability-adjusted life years(DALYs)and prevalence of cataract in China between 1990 and 2019,and to predict the trends of cataract burden from 2020 to 2030.METHODS:The Global Burden of Diseases(GBD)database was employed to collect the data on DALYs and the prevalence of cataract in China,which was distinguished by age and sex during the past three decades from 1990 to 2019,and then changes in the number and rates of cataract from 2020 to 2030 were predicted.All data were analyzed by the R program(version 4.2.2)and GraphPad Prism 9.0 statistics software.RESULTS:The number of DALYs of cataract increased from 449322.84 in 1990 to 1087987.61 in 2019,number of cataract cases increased from 5607600.94 in 1990 to 18142568.96 in 2019.The age-standardized DALY rates(ASDR)generally increased slightly[estimated annual percentage change(EAPC=0.1;95%CI:-0.24 to 0.45)],age-standardized prevalence rates(ASPR)also increased(EAPC=0.88;95%CI:0.6 to 1.15).Cataract burden increased with age and female gender.Among the causes of cataract,air pollution was the most important,followed by smoking,high fasting plasma glucose,and high body mass index(BMI).The burden of cataract is predicted to grow persistently from 2020 to 2030,the number of DALYs and prevalence for cataract will rise to 2336431 and 43698620 respectively by 2030,the ASDR is predicted to be 85/100000 and ASPR will be 1586/100000 in 2030,females will still be at greater risk of suffering from cataract than males.CONCLUSION:The burden of cataract in China kept rising from 1990 to 2019.Increasing age and female gender are risk factors for cataract.Air pollution,smoking,high fasting plasma glucose,and high BMI are associated with cataract.The burden of cataract in China will gradually increase from 2020 to 2030,the elderly women in particular need attention.Our results may be of help for providing reference strategies to reduce cataract burden in the near future.

Efficacy and safety of ultrasound cycloplasty for the treatment of glaucoma: a Meta-analysis

AIM:To evaluate the efficacy and safety of ultrasound cycloplasty(UCP)for glaucoma.METHODS:A comprehensive search of PubMed,Embase,Web of Science,and Google Scholar databases was used to select studies met the inclusion criteria.Metaanalysis was performed by Review Manager and StataCorp LLC.RESULTS:A total of 19 articles met the inclusion criteria.Overall,UCP is effective and safe in the glaucoma treatment,the risk ratio(RR)of the success rate was 2.28(95%CI,1.82-2.84).After UCP,patients had a significant reduction in intraocular pressure(IOP;mm Hg),the weighted mean difference(WMD)was 11.39(95%CI,9.88-12.90).In addition,UCP brings fewer postoperative complications with RR of 0.30(95%CI,0.19-0.49).Most of the complications were short-term and mild.Postoperatively,patients’use of IOP-lowering medications reduced,the standardized mean difference(SMD)was 0.78(95%CI,0.40-1.17).However,best corrected visual acuity(BCVA;logMAR)did not have obvious improvement after UCP,the WMD was 0.01(95%CI,-0.06-0.09).This procedure does provide painfulness relief,with RR of 3.06(95%CI,1.95-4.81).CONCLUSION:UCP is effective and safe for suitable glaucoma.It can effectively decrease IOP in glaucoma patients,reduce the patients’dependence on IOP-lowering medications after surgery,relief the painfulness and has fewer long-term or severe postoperative complications,but the BCVA did not improve much.

Influence of lens position as detected by an anterior segment analysis system on postoperative refraction in cataract surgery

AIM:To predict postoperative intraocular lens(IOL)position using the Sirius anterior segment analysis system and investigate the effect of lens position and IOL type on postoperative refraction.METHODS:A total of 97 patients(102 eyes)were enrolled in the final analysis.An anterior segment biometry measurement was performed preoperatively with Sirius and Lenstar.The results of predicted lens position(PLP)and IOL power were automatically calculated by the software used by the instruments.Effective lens position(ELP)was measured manually using Sirius 3 mo postoperatively.Pearson's correlation analysis and linear regression analysis were used to determine the correlation of lens position to other parameters.RESULTS:PLP and ELP were positively correlated to axial length(AL;r=0.42,P<0.0001 and r=0.49,P<0.0001,respectively).There was a weak correlation between the peLP(ELP-PLP)and the prediction error of spherical refraction(peSR;r=0.34,P<0.0001).The peLP of Softec HD IOL differed statistically from those of both the TECNIS ZCB00 and Sensor AR40E IOLs.Multiple linear regression was used to obtain the prediction formula:ELP=0.66+0.63×[aqueous depth(AQD)+0.6 LT](r=0.61,P<0.0001),and a new variable(AQD+0.6 LT)was found to have the strongest correlation with ELP.CONCLUSION:The Sirius anterior segment analysis system is helpful to predict ELP,which reduces postoperative refraction error.