Clinical efficacy of femtosecond laser-assisted phacoemulsification in diabetic cataract patients

BACKGROUND Diabetic patients with cataracts encounter specific difficulties during cataract surgery due to alterations in microcirculation,blood supply,metabolism,and the microenvironment.Traditional phacoemulsification may not fully tackle these issues,especially in instances with substantial preoperative astigmatism.The utilization of femtosecond laser-assisted phacoemulsification,in conjunction with Toric intraocular lens(IOL)implantation,offers a potentially more efficient strategy.This research seeks to evaluate the efficacy and possible complications of this approach in diabetic cataract patients.AIM To investigate the clinical efficacy and complications of femtosecond laser-assisted phacoemulsification combined with Toric IOL implantation in diabetic cataract patients,comparing it with traditional phacoemulsification methods.METHODS This retrospective study enrolled 120 patients with diabetes cataract from May 2019 to May 2021.The patients were divided into two groups:the control group underwent traditional phacoemulsification and Toric IOL implantation,while the treatment group received Len Sx femtosecond laser-assisted treatment.Outcome measures included naked eye vision,astigmatism,high-level ocular phase difference detection,clinical efficacy,and complication.RESULTS There were no significant preoperative differences in astigmatism or naked eyesight between the two groups.However,postoperative improvements were observed in both groups,with the treatment group showing greater enhancements in naked eye vision and astigmatism six months after the procedure.High-level corneal phase difference tests also indicated significant differences in favor of the treatment group.CONCLUSION This study suggests that femtosecond laser-assisted phacoemulsification combined with Toric IOL implantation appears to be more effective in enhancing postoperative vision in diabetic cataract patients compared to traditional methods offering valuable insights for clinical practice.

Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery

BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.

Advances in the Pathogenesis and Pharmacologic Treatment of Diabetic Cataracts

Diabetic cataract(DC)is a common complication prior to diabetes mellitus,which is a metabolic disease with pathogenesis including abnormal metabolism of polyphenol pathway(PP)and non-enzymatic glycosylation(NEG)of proteins,etc.The therapeutic drugs are mainly aldose reductase inhibitors(ARIs)and glycosylation inhibitors.The therapeutic regimens for DC are becoming more and more diversified due to the development of biological testing and clinical research technology,thus improving its clinical efficacy.With the development of biological testing and clinical research technology,the treatment options for DC have become increasingly diversified and the treatment specificity has been improved,improving its clinical efficacy.In order to comprehensively analyze the pathogenesis and pharmacological treatment of this disease,the following review is made.

Comparison of three fundus inspection methods during phacoemulsification in diabetic white cataract

AIM:To investigate whether Wild Field Imaging System(WFIS SW-8000),25G endoilluminator,and intraoperative optical coherence tomography(iOCT)can perform realtime screening and diagnosing in patients with suspicious diabetic retinopathy(DR)during phacoemulsification,especially in cases of white cataract.METHODS:A cross-sectional study was carried out.A total of 204 dense diabetic cataractous eyes of 204 patients with suspected DR treated from April 2020 to March 2021 were included.Phacoemulsification combined with intraocular lens implantation was performed.Following the removal of the lens opacity,the 25G endoilluminator,fundus photography,and iOCT were performed successively.Optical coherence tomography(OCT)and/or fundus fluorescein angiography(FFA)were used to verify the fundus findings postoperatively.Intraoperative and postoperative results were compared to verify the accuracy of intraoperative diagnosis in each group.RESULTS:Intraoperative and postoperative examinations revealed 58 and 62 eyes with DR,respectively(positive rate,28.43%and 30.39%,respectively).During the phacoemulsification,WFIS SW-8000 detected 44 eyes with DR(the detection rate,70.97%);25G endo-illuminator found 56 eyes with DR(the detection rate,90.32%);iOCT found 46 eyes with DR(the detection rate,74.19%);and 58 eyes with DR were found by combining the three methods(the detection rate,93.55%).There were statistically significant differences in the diagnostic sensitivity for DR among the methods(χ^(2)=16.36,P=0.001).CONCLUSION:WFIS SW-8000,25G endo-illuminator,iOCT,and especially their combination can be used to inspect the fundus and detect DR intraoperatively;they are helpful for the timely diagnosis and treatment of DR in patients with dense cataract.

Astragalin attenuates diabetic cataracts via inhibiting aldose reductase activity in rats

AIM:To investigate the aldose reductase(AR)inhibition capacity of astragalin(AST)against streptozoticin-induced diabetic cataracts(DCs)in rats.METHODS:Ex vivo investigations were conducted by treating the lens of a goat placed for 72h in artificial aqueous humor(AAH)of pH 7.8 at room temperature with cataract-causing substance(55 mmol/L of galactose)and in vivo studies were performed on rats via induction with streptozotocin.AST was administered at different dose levels and scrutinize for DC activity.RESULTS:In diabetic rats,AST improved the body weight,blood insulin,and glucose as well as the levels of galactitol in a dose-dependent way,other biochemical parameters i.e.inflammatory mediators and cytokines,and also suppress AR activity.The level of the antioxidant parameters such as superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH)activity were also altered on a diabetic lens after the administration of the AST.CONCLUSION:AST protects against lens opacification to avoid cataracts and polyols formation,indicating that it could be used as a potential therapeutic agent for diabetes.

Analysis of N6-methyladenosine-modified mRNAs in diabetic cataract

BACKGROUND Cataracts remain a prime reason for visual disturbance and blindness all over the world,despite the capacity for successful surgical replacement with artificial lenses.Diabetic cataract(DC),a metabolic complication,usually occurs at an earlier age and progresses faster than age-related cataracts.Evidence has linked N6-methyladenosine(m6A)to DC progression.However,there exists a lack of understanding regarding RNA m6A modifications and the role of m6A in DC pathogenesis.AIM To elucidate the role played by altered m6A and differentially expressed mRNAs(DEmRNAs)in DC.METHODS Anterior lens capsules were collected from the control subjects and patients with DC.M6A epitranscriptomic microarray was performed to investigate the altered m6A modifications and determine the DEmRNAs.Through Gene Ontology and pathway enrichment(Kyoto Encyclopedia of Genes and Genomes)analyses,the potential role played by dysregulated m6A modification was predicted.Real-time polymerase chain reaction was further carried out to identify the dysregulated expression of RNA methyltransferases,demethylases,and readers.RESULTS Increased m6A abundance levels were found in the total mRNA of DC samples.Bioinformatics analysis predicted that ferroptosis pathways could be associated with m6A-modified mRNAs.The levels of five methylation-related genes-RBM15,WTAP,ALKBH5,FTO,and YTHDF1-were upregulated in DC samples.Upregulation of RBM15 expression was verified in SRA01/04 cells with high-glucose medium and in samples from DC patients.CONCLUSION M6a mRNA modifications may be involved in DC progression via the ferroptosis pathway,rendering novel insights into therapeutic strategies for DC.

The Prevention and Treatment of Polysaccharide from the Rhizomorph of Armillaria mellea on Diabetic Cataract in Rat

[Objective] To investigate the prevention and control effect of polysaccharide from the rhizomorph of Armillaria mellea by distilled water elution （AMP-1） on diabetic cataract in rats.[Methods] Streptozotocin （STZ）,combined with freund＇s adjuvant （CFA）,was used to induce diabetic cataract in rat,to observe the onset of lenticular turbidity by slit lamp and compare the turbid degree of eyes lens among different groups.The super oxide dismutase （SOD）,glutathione peroxidase （GSH-px） and malondialdehyde （MDA） in serum and eyes lens were measured by colorimetric method.[Results] The slit lamp examination results showed that AMP-1 obviously delayed the onset of diabetic cataract and reduced turbid degree of eyes lens.Compared with model group,AMP-1 at various doses should significantly reduce the level of MDA ascended in serum of rats.Medium-and high-dose groups could increase the levels of SOD and GSH-Px in serum,and the dose of AMP-1 was closely related to the effect.[Conclusion] AMP-1 played a prominent role in prevention and treatment of diabetic cataract in rats.

Protective effect of resveratrol on lens epithelial cell apoptosis in diabetic cataract rat

Objective:To study the protective effect of resveratrol on lens epithelial cell apoptosis in diabetic cataract rat.Methods:A total of 84 Wistar rats were divided into 4 groups:12 in Group A(control group).24 in Group B(diabetic cataract group),24 in Group C(therapeutic-dose of resveratrol group) and 24 in Group D(low-dose of resveratrol group).Rats in Group B-D were given with60 mg/kg streptozotocin through intraperitoneal injection.Rats in Group C were given with 100mg/kg resveratrol and rats in Group D were given with 20 mg/kg resveratrol.The caspase-3expression levels and apoptosis ratios of LEC among each group were observed:the degrees of lens opacity in Group B-D after 12 weeks were compared.Results:There were significant differences in caspase-3 expression levels,apoptosis ratios of T.F.C among groups at 4 w,8 w and12 w(P<0.05).After 12 weeks,in Group B the degree of lens opacity was as follow:0(0.00%) in grade Ⅰ,3(37.50%) in grade Ⅱ,2(25.00%)in grade Ⅲ,2(25.00%)grade Ⅳ,and 1(12.50%) in gradeⅤ:in Group C:2(25.00%)in grade Ⅰ,4(50.00%) in grade Ⅱ.2(25.00%)in grade Ⅲ,0(0.00%)gradeⅣ,and 0(0.00%) in grade Ⅴ;in Group D:1(12.50%)in grade Ⅰ,4(50.00%) in grade Ⅱ,2(25.00%)in grade Ⅲ,1(12.50%) grade Ⅳ,and 0(0.00%) in grade Ⅴ.The.difference among Group B-D was statistically significant(P<0.05).Conclusions:Resveratrol has protective effect on lens epithelial cell apoptosis in diabetic cataract rat,and the effect is relative to its dose.

Macular edema after cataract surgery in diabetic eyes evaluated by optical coherence tomography

AIM：To assess quantitative changes of the macula in diabetic eyes after cataract surgery using optical coherence tomography（OCT）and to estimate the incidence of development or worsening of macular edema（ME）in diabetic eyes with or without pre-existing ME.·METHODS：In this prospective,observational study,92eyes of 60 diabetic patients who underwent cataract surgery were evaluated before surgery and 1,3mo after surgery using OCT.Macular thickness was measured with OCT at nine macular subfields defined by the 9zones early treatment of diabetic retinopathy study（ETDRS）,as well as total macular volume obtained by OCT at 1,3mo after surgery were compared with baseline features obtained before surgery.In addition,the incidence of development or worsening of ME was analyzed in diabetic eyes with or without pre-existing ME.·R ESULTS：The central subfield mean thickness increased 21.0μm and 25.5μm at 1,3mo follow-up,respectively（〈0.01）.The average thickness of inner ring and outer ring increased 14.2μm and 9.5μm at 1mo,18.2μm and 12.9μm at 3mo.Central-involved ME developed in 12 eyes at 3mo,including 4 eyes with preexisting central-involved and 8 eyes with pre-existing non-central involved ME.Pre-existing diabetic macular edema（DME）was significantly associated with centralinvolved ME development（〈0.001）.·C ONCLUSION：A statistically significant increase could be detected in the central subfield as well as perifoveal and parafoveal sectors though the increase was mild.And eyes with pre-operative DME prior to cataract surgery are at higher risk for developing central-involved ME.

Risk factors for endophthalmitis after cataract surgery in diabetic patients: a case control study

AIM: To identify risk factors associated with post-cataract surgery endophthalmitis(PCE) in type 2 diabetic patients.METHODS: A hospital-based retrospective case-control study was conducted on 194 type 2 diabetic patients undergoing cataract surgery in Rajavithi Hospital from January 2007 to December 2015. Fifteen patients with PCE were included as the case group and 179 patients without PCE were included as the control group. Potential factors associated with PCE among both groups including demographics, pre-operative characteristics, surgical settings and complications, were statistically analyzed using Chi-square testing and a logistic regression model.RESULTS: Within the case group, 53% were females and the median age was 68 y. Univariate analysis of pre-operative characteristics, surgical settings and complications revealed that recent pre-operative fasting plasma glucose, insulin therapy, presence of diabetic retinopathy, and severe non-proliferative or proliferative diabetic retinopathy were significantly associated with PCE. In a multivariate analysis adjusting for blood glucose level, insulin treatment was the only significant factor associated with an increased risk of PCE(OR 3.9, 95%CI 1.0-15.0, P=0.04) compared to patients without insulin treatment. The most common causative organisms were gram-positive bacteria(89%). Staphylococcus species represented the most common group(67%). Median best corrected visual acuity at 1-month and 3-month follow-up was equal at 0.7 logMAR(20/100).CONCLUSION: The authors identify insulin treatment as the only risk factor associated with endophthalmitis after cataract surgery in type 2 diabetic patients. Further studies with serum levels of pre-operative glycated hemoglobin(HbA_(1c)) and post-operative fasting plasma glucose level are essential to truly demonstrate the role of peri-operative glycemic markers as a risk factor for PCE.

Expression and regulation of microRNA-29a and microRNA-29c in early diabetic rat cataract formation

AIM： To determine the role of microRNA （miRNA）-29a and miRNA-29c in the regulation of apoptosis in early rat diabetic cataract formation.METHODS： Streptozotocin （STZ）-induced diabetic Sprague-Dawley （SD） rats were used in the study. The expression level of miRNA-29a, miRNA-29c, and BCL2-modifying factor （BMF） in lens epithelial cells （LECs） samples were measured using quantitative real-time polymerase chain reaction. Prediction algorithms of miRanda, TargetScan 6.2, and mirRDB to perform a miRNA gene network analysis were used for the potential miRNA-29a and miRNA-29c targets. RESULTS： The miRNA-29a and miRNA-29c expression levels were all significantly lower in the control group compared to the 2 and 4wk diabetic samples （P〈0.01）. The network analysis indicated that one miRNA-29a and miRNA-29c targets was BMF. There was significantly higher expression of BMF mRNA compared to the normal controls （P〈0.01）. CONCLUSION： Apoptosis occurs in rat LECs following high blood glucose exposure. It is likely that apoptosis during diabetic cataract formation involves the decreased expression of miRNA-29a and miRNA-29c and the increased expression of BMF.

Impact of topical nonsteroidal anti-inflammatory drugs in prevention of macular edema following cataract surgery in diabetic patients

AIM： To evaluate the efficacy of prophylactic administration of topical non-steroidal anti-inflammatory drugs（NSAIDs） on macular edema following cataract surgery in diabetic patients, and to compare between types of NSAIDs（ketorolac tromethamine 0.4% and nepafenac 0.1%）. METHODS： Group 1（control） received artificial tears substitute as a placebo group, group 2（nepafenac） received topical nepafenac 0.1%, and group 3（ketorolac） received topical ketorolac tromethamine 0.4%. Patients were examined postoperatively after completing one week, one month, two months and three months＇ intervals for evaluating cystoid macular edema（CME） development. The main study outcomes were achieving the best corrected visual acuity（BCVA） and change in the central macular thickness（CMT） measured with optical coherence topography（OCT）.RESULTS： Eighty eyes of 76 patients were included in this study. BCVA showed a statistically significant difference at the third month postoperative follow up between the control group and the NSAIDs groups（P=0.04）. There was an increase in the CMT in all cases starting from postoperative first week until third month. CMT showed a statistically significant difference between control group and NSAIDs groups from postoperative first month until third month（P=0.008, 0.027, 0.004）. There was no statistically significant difference between nepafenac and ketorolac groups in BCVA and OCT CMT. CONCLUSION： Prophylactic preoperative and postoperative NSAIDs may have a role in reducing the frequency and severity of CME in diabetic eyes following cataract surgery.

Exosomal miR-29b found in aqueous humour mediates calcium signaling in diabetic patients with cataract

AIM:To investigate the role of exosomal miR-29b and Ca^(2+)in regulating the function of human lens epithelial cells(HLECs).METHODS:Exosomes were isolated from human aqueous humour(AH)by ultracentrifugation,and visualized by nanopar ticle tracking and transmission electron microscopy.Exosomal miRNA sequencing was performed to identify differentially expressed miRNAs between diabetes with cataracts(DMC)group and age-related cataracts(ARC)group.TargetScan was used to predict potential target of certain miRNA.The expression of CACNA1C mRNA was determined by quantitative real-time polymerase chain reaction and CACNA1C protein was determined by Western blotting.Concentration of Ca^(2+)in human AH and the culture supernatant of cells were detected by the calcium assay kit.Cell counting kit-8 was used to determine cell viability.RESULTS:Exosomes were isolated from human AH,which had a typical cup-shaped phenotype and a particle size distribution in accordance with micro extracellular vesicles.Exosomal miRNA sequencing revealed that miR-29b was significantly downregulated in DMC group compared with ARC.Ca^(2+)concentration of human AH in DMC was higher than that in ARC.The culture supernatant of cells transfected with miR-29b inhibitors had a higher concentration of Ca^(2+)than that transfected with miR-29b mimics.miR-29b reduced the viability of HLECs by upregulating CACNA1C expression.CONCLUSION:Exosomes isolated from human AH contains abundant miRNAs.A significantly expressed miR NA,miR-29b,can affect the concentration of Ca^(2+)and regulate HLEC processes by upregulating CACNA1C.

Role of Mediterranean diet, tropical vegetables rich in antioxidants, and sunlight exposure in blindness, cataract and glaucoma among African type 2 diabetics

AIM: To assess whether regular Mediterranean diet and regular intake of vegetables may reduce the risk of blindness, cataract, and glaucoma in these type 2 diabetics. · METHODS: A cross-sectional design was carried out among known black diabetics admitted at the diabetic clinics of Kinshasa, between October 2008 and March 2009. The Mediterranean-style dietary score (MSDPS) was used to characterize a Mediterranean-style dietary pattern in the study population using the Harvard semi quantitative FFQ adapted for Africa. · RESULTS: Five hundred Type 2 diabetic patients were included in this study (48% of males; 40% aged ≥60 years). There was a significant association between blindness, cataract and aging; between blindness (P <0.05), cataract (P<0.05), glaucoma (P <0.05), and physical inactivity; between blindness (P<0.05), cataract (P <0.0001), glaucoma (P <0.01) and high SES, and a very significant association between blindness (P <0.0001), cataract (P <0.0001), glaucoma (P <0.0001) and exposure to sunlight. There was also a significant association between blindness, glaucoma, and male sex. Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, Musa acuminata reduced significantly the risk of blindness, cataract and glaucoma. · CONCLUSION: Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, and Musa acuminata may significantly reduce the risk of blindness or its major causes among type 2 diabetes mellitus in Africa.

Effects of Dendrobium candidum polysaccharides on microRNA-125b and mitogen-activated protein kinase signaling pathways in diabetic cataract rats

Background:Diabetic cataract is a common complication and a lens disorder in diabetes.Moreover,Dendrobium officinale polysaccharide(DOP)is found to alleviate diabetes complications.Consequently,microRNA-125b and mitogen-activated protein kinase signaling pathways play significant roles in diabetes.However,the mechanism and the effect of DOP on diabetic cataract remains unknown.Methods:Wistar male rats were randomly assigned to the control,model,and DOP groups.Diabetes was induced with streptozotocin.Furthermore,DOP was orally given for 12 weeks.The Lens Opacities Classification System III was used to evaluate lens opacity by slit-lamp microscope.The lens was then harvested for testing the mRNA expression of microRNA-125b,ERK1,ERK2,Raf and Ras using reverse transcription-polymerase chain reaction.The protein expression of ERK1,ERK2,Raf,and Ras was detected using the Western blot analysis.The targets of microRNA-125b were predicted in miRWalk 2.0.These targets were obtained from the Kyoto Encyclopedia of Genes and Genomes pathway.Results:The lens opacities of the rats in the control group were almost at C0N0.Moreover,the majority of the lens opacities in the model group were C3 to C4 and N1 to N2,and were mostly at C1 to C2 and N0 to N1 in the DOP group.The difference was statistically significant(P<0.05).Furthermore,the microRNA-125b expression in the model group is significantly higher compared with the control group.Conversely,the microRNA-125b expression in the DOP group is significantly decreased(all P<0.05).The mRNA expression of ERK1,ERK2,Raf,and Ras in the model groups were upregulated compared with those of the control group.However,the ERK1 and Raf mRNA expressions of the DOP group were lower compared with the model group(all P<0.05).The protein expression of ERK1,Raf,and Ras in the model group was significantly increased compared with those of the control group.The protein expression of ERK1,Raf,and Ras in the DOP group was significantly lower compared with the model group(all P<0.05).Moreover,3,378 genes of the microRNA-125b target were gained from the miRWalk.After Kyoto Encyclopedia of Genes and Genomes pathways analysis in Gene Set Enrichment Analysis,246 items were gained including Ras(rno04014)and mitogen-activated protein kinase(rno04010)signaling pathways.A positive correlation exists between microRNA-125b and mRNA expression of ERK1,ERK2,Raf and Ras(r=0.940,0.841,0.666,and 0.768;all P<0.05).Conclusion:DOP can alleviate the severity of the opacity of the lens in diabetic cataract rats via microRNA-125b and mitogen-activated protein kinase signaling pathways.Thus,microRNA-125b has something to do with the mitogen-activated protein kinase signaling pathway.

Effect of phacoemulsification with conjunctival Angle scleral margin tunnel incision on postoperative ocular surface in patients with diabetic cataract

Objective:To study the effect of the conjunctival flap with limbus tunnel incision on change in tear function after phacoemulsification cataract surgery in diabetic cataract.Methods:One hundred and twenty patients with type 2diabetes(120 eyes)were enrolled,The patients were randomly divided into two groups,A:3.0mm clear corneal incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation;sixty patients(60 eyes)in group,B:3.0mm conjunctival flap with limbus tunnel incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation;sixty patients(60 eyes)in group.The difference of demographic characteristics between two groups were insignificant.Theocular surface disease index(OSDI),corneal sensation,break up time(BUT)and corneal fluorescein staining(FL)were examined preoperatively and 1wk,1 and 3mo postoperatively.Results:the OSDI score of group A was significantly higher than those of group B and the differences were statistically significant(P<0.05).The corneal sensation in two groups decreased after operations and the corneal sensation of group A was significantly lower than those of group B after surgery 1 week and 1 month、3month,and the differences were statistically significant(all P<0.05).the BUT in two groups decreased after operations and the BUT of group B was significantly better than those of group A after surgery,and the differences were statistically significant(P<0.05).At 1wk,1 and 3mo postoperatively,the FL score in two groups increased and the FL score of group A was significantly higher than those of group B and the differences were statistically significant(P<0.05).Conclusions:With conjunctival flap limbal tunnel incision,and the tunnel incision into the anterior chamber,closed more general limbal incision closed better,not easy infection and without the stitches,affecting small ocular tear film,This is especially suitable for patients with type 2 diabetes and cataract.It is worthy of clinical application.

Effects of fuming tablet combined with operation on serum β2-mg, HbA1c, no and antioxidant capacity in patients with diabetic cataract

Objective: To observe the effect of oral fuming tablets on the levels of serum β2-microglobulin (β2-MG), Glycosylated hemoglobin (HbA1c), Nitric oxide (NO), Malondialdehyde (MDA) and superoxide dismutase (SOD) in patients with diabetic cataract (DC) after phacoemulsification combined with vitrectomy. Methods: A total of 90 patients with DC were randomly divided into control group (n=45) and observation group (n=45) according to the lottery method. Both groups were treated with conventional therapy. On this basis, the control group underwent phacoemulsification combined with vitrectomy. The observation group was treated with Fuming tablets on the basis of the control group. The levels of β2-MG, HbA1c, NO, MDA and SOD in peripheral blood were measured in all subjects. Result: Before treatment, there were no significant difference in serum levels of β2-MG, HbA1c, NO, MDA and SOD between the two groups. The levels of β2-MG, HbA1c, NO and MDA in the two groups after treatment were significantly lower than those before treatment. And the levels of β2-MG, HbA1c, NO and MDA of the observation group was notably lower than those of the control group. After treatment, the levels of SOD in the two groups were notably higher than those before treatment. And the levels of SOD of the observation group was notably higher than those of the control group after treatment. Conclusion: After phacoemulsification combined with vitrectomy, supplemented with Fuming tablet treatment can effectively reduce serum levels of β2-MG and HbA1c to improve the degree of fundus lesions in DC patients;reduce serum MDA and NO levels, increase the concentration of SOD, DC patients to restore the antioxidant energy. Fuming tablets are effective adjuvant drugs for clinical cataract surgery.

Analysis of Ultrasonic Emulsification Surgery and Small Incision Cataract Extracapsular Extraction Surgery for Cataract Clinical Treatment Level Improvement

Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected and randomly grouped into group A(ultrasonic emulsification)and group B(small-incision extracapsular cataract extraction),with 48 cases each.Results:At 1 week,1-month,and 3 months post-operation,the visual acuity of group A was higher and the astigmatism value was lower than that of group B(P<0.05);at 12h,24h,and 48h post-operation,the intraocular pressure of group A was higher than that of group B(P<0.05);the thickness of macular area of group A was lower than that of group B at 1 week and 1-month post-operation(P<0.05).Conclusion:Ultrasonic emulsification in cataract patients was slightly better than small incision cataract extracapsular extraction in correcting astigmatism,improving visual acuity,and regulating macular thickness.However,due to the high energy of ultrasonic emulsification,the risk of complications such as high postoperative intraocular pressure was higher.Small-incision extracapsular cataract extraction has better application value in economically disadvantaged areas.

Multicolor pattern scan laser for diabetic retinopathy with cataract

· AIM: To evaluate the ability of various laser wavelengths in delivering sufficient burns to the retina in eyes with cataract using a new multicolor pattern scan laser with green(532 nm), yellow(577 nm), and red(647 nm)lasers.·METHODS: The relationship between the Emery-Little(EL) degree of cataract severity and the laser wavelength required to deliver adequate burns was investigated in102 diabetic eyes. Treatment time, total number of laser shots, and intra-operative pain were assessed as well.·RESULTS: All EL-1 grade eyes and 50% of EL-2 eyes were successfully treated with the green laser, while 50%of EL-2 eyes, 96% of EL-3 eyes, and 50% of EL-4 eyes required the yellow laser. The red laser was effective in the remaining 4% of EL-3 and 50% of EL-4 eyes.·CONCLUSION: Longer wavelength lasers are more effective in delivering laser burns through cataract when we use a multicolor pattern scan laser system.

Effectiveness and safety of early lens extraction during par plana vitrectomy for proliferative diabetes retinopathy with mild cataract:a randomized clinical trial

●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.