Prevalence and risk factors on age-related cataract and surgery in adults over 50 years old in Binhu District, Wuxi, China

AIM:To investigate the prevalence and risk factors of age-related cataract(ARC),ARC surgery procedures,and postoperative vision results among adults over 50 years old in the Binhu District of Wuxi City,China.METHODS:Thirty basic sampling units were analyzed via a cluster random sampling method.Detailed medical histories were collected and eye examinations were performed.Cataract prevalence and surgical procedures were quantified.RESULTS:Among the 6150 participants,1421 cataract cases were diagnosed and prevalence was 23.1%.The prevalence of cortical,nuclear,and posterior subcapsular cataracts increased with age(P<0.001).Cataract prevalence was significantly higher among elderly,female,or illiterate individuals and people with hypertension,diabetes,and a history of smoking and drinking(all P<0.05).As participant age increased and education level decreased,the frequency of cataract blindness surgeries gradually decreased,but without statistical significance within groups(P>0.05).The odds ratio of cataract patients who had or did not have cataract surgery was 3.15(87/28)and the frequency of cataract blindness surgery was 75.7%(87/115).Poor visual outcomes was in 107 eyes(40.7%)after cataract surgery.Poor vision was mostly caused by uncorrected reflective errors(30.9%)and ocular comorbidities(41.1%).The prevalence of cataract surgery complications was 5.7%(15/263).Surgical complications and posterior capsular opacification were avoidable factors facilitating poor vision.CONCLUSION:ARC,especially in females and illiterateindividuals,presents a public health problem in this district.Poor visual outcomes after cataract surgery are frequent.High-quality cataract surgeries and treatment of ocular comorbidities are vital.

Cigarette smoking,body mass index associated with the risks of age-related cataract in male patients in northeast China

AIM: To determine the association between cigarettes smoking, body mass index (BMI) and the risk of age-related cataract (ARC) in middle-aged and elderly men in Northeast China. METHODS: A hospital-based case control study was conducted. Cases (n =362) were men who had surgically treated ARC, 45-85 years old; controls frequency-matched (n=362) were men who had been admitted to the same hospital as cases for other diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits (tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously BMI was calculated. The odds ratios (OR) and 95% confidence intervals (CI) of ARC were estimated using multiple logistic regression models. RESULTS: After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoking or moderate cigarette smoking (1-29 cigarettes per day) had no relation with the risk of ARC (P>0.05), although patients smoking >= 30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers (OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC (OR=1.55, 95% CI:1.02-1.98, P=0.015 and OR=1.71, 95% CI:1.32-2.39, P=0.013 respectively) compared to normal BMI. Then participants were grouped into quartiles of BMI (Q1 to Q4), compared to controls in the lowest quartile, the ORfor cases in the highest quartile of BMI was 1.54 (OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI (P >0.05). Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC (OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile (OR =1.46, 95% CI: 1.06-5.29, P<0.001). Followed multivariate models revealed that the association had never changed. CONCLUSION: Current cigarette smoking is positively related to ARC only among those who smoking 30 or more cigarettes per day. For men who are both overweight and obesity, cigarette smoking is associated with a significantly increased risk for ARC.

Relationship between dietary macronutrient intake and the risk of age-related cataract in middle-aged and elderly patients in northeast China

AIM:To examine the association between dietary macronutrient intake and the risk of age-related cataract(ARC)in middle-aged and elderly men.METHODS:A hospital-based case-control study was conducted from December 2009 to November 2011.Cases(n=360)were patients with cataract aged 45-85years old,and controls(n=360)were patients who had been admitted to the same hospital for diseases not related with cataract.All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics,lifestyle habits and detailed medical history,simultaneously,the dietary intakes of nutrients were collected via a valid semi-quantitative food frequency questionnaire(FFQ).The odds ratios(OR)and corresponding 95%confidence intervals(CI)of three types of ARC were estimated using multiple logistic regression models.RESULTS:After adjusting for multiple potential confounders,total dietary intake of carbohydrate was positively associated with cortical cataract,compared to controls in the lowest quartile,and the OR for cases in the highest quartile of intake was 2.471(95%CI:1.348-6.043,P=0.027).Higher dietary intakes of protein were protective for posterior subcapsular cataract(PSC)(OR=0.528,95%CI:0.148-0.869,P=0.023).Dietary fat intake was not associated with any type of cataract,however,participants in the highest quartile of polyunsaturated fatty acids intake had 2.7 times the risk of nuclear cataract as did those in the lowest quartile(OR=2.742,95%CI:1.790-4.200,P=0.033).CONCLUSION:A high intake of carbohydrate and polyunsaturated fatty acid may increase the odds of cortical and nuclear cataract,respectively,whereas high intake of protein,especially animal protein,may protect against PSC cataract.It is possible that dietary changes of target population may reduce the risk of ARC.

miR-211 regulates the antioxidant function of lens epithelial cells affected by age-related cataracts

AIM： To investigate the effects and mechanism of miR-211 in mediating the antioxidant function of lens epithelial cells affected by age-related cataracts. METHODS： Real-time quantitative polymerase chain reaction （RT-qPCR） was used to detect miR-211 expression in the anterior lens capsules of healthy people, the anterior lens capsules of patients with age-related cataracts, and human epithelial cell line （SRA01/04） cells exposed to oxidative stress. A 2＇, 7＇-dichloro-fluorescein diacetate （DCFH-DA） probe was used to measure the levels of endogenous reactive oxygen species （ROS） in human lens epithelial cells （hLECs） exposed to 400 pmol/L H2O2 for lh. SRA01/04 cells were transfected with either miR-211 mimics, mimic controls, miR-211 inhibitors or inhibitor controls. After 72h, these cells were exposed to 400 IJmollL H2O2 for lh, then p53 and Bax mRNA expression were measured using RT-qPCR. p53 and Bax protein expression were also measured by Western blotting analysis. Finally, cell viability was assessed using an MTS assay. RESULTS： Compared to the control group, expression of miR-211 in the anterior lens capsules of age-related cataract patients and in SRA01/04 cells exposed to oxidative stress was significantly increased （P〈0.001）. Levels of endogenous ROS were significantly elevated in hLECs exposed to oxidative stress （P〈0.001）. Compared to the mimic control group, the hLECs in the miR-211 mimic group expressed significantly higher levels of p53 and Bax mRNA and protein while cell viability was significantly reduced （P〈0.001）. Conversely, p53 and Bax mRNA and protein expression were significantly reduced in the miR-211 inhibitor group as compared to the control group, while the cells in this group had much higher levels of call viability （P〈0.001）. CONCLUSION： miR-211 is upregulatsd in the anterior lens capsules of age-related cataract patients, miR-211 decreased the antioxidative stress capacity of lens epithelial cells by upregulating p53 and Bax, while inhibiting cell proliferation and repair. This finding suggests that miR-211 may play a key role in the development of age-related cataracts.

Screening of methylation genes in age-related cataract

AIM： To analyze and screen the methylation status of whole-genome in age-related cataract samples. METHODS： Anterior lens capsule samples were collected from age-related cortical cataract patients over 50 years of age with LOCS III score of nuclear color ≥4 along with control subjects. DNAs were extracted and subjected to methylation microarray for the identification of methylated genes employing the high-throughput sequencing approach. RESULTS： Compared with the control group, 843 sites were found methylated, including 802 hypermethylation sites with 542 corresponding genes, 41 demethylation sites with 29 corresponding sites. COL4 A1, GJA3, SIPA1 L3 were confirmed by mass spectrometry, the results were consistent with high-throughput sequencing. CONCLUSION： DNA methylation microarrays is an efficient way for screening the aberrantly methylated genes. In this study, we are able to screen a few age-related cataract genes such as COL4 A1, GJA3, and SIPA1 L3 for their aberrant methylation patterns in cataract patients however further work is warranted to understand the significance of these findings.

The impact of GJA3 SNPs on susceptibility to age-related cataract

AIM: To determine the association of gap junction protein alpha 3(GJA3) gene tag single-nucleotide polymorphisms(SNPs) with susceptibility to age-related cataract(ARC).METHODS: In total, 486 ARC patients were matched with 500 healthy controls. All the participants underwent complete ophthalmic examinations. Haplotype-tagging SNPs of GJA3 gene were selected from the HapMap Beijing Han Chinese population. Genomic DNA was extracted from the peripheral blood leukocytes of all the subjects.Under three different genetic models: dominant, recessive,and additive, the association between SNPs and ARC was examined. After adjusting for age and sex, the genetic effects of the GJA3 SNPs were evaluated with logistic regression analysis.RESULTS: Four tag GJA3 SNPs(rs6490519, rs9506430,rs9509053, and rs9552089) were included in the present study. None of the SNPs showed a significant relationship with an altered risk of total ARC under the dominant,recessive, or additive models. In the subgroup analysis,rs9506430 had a significant effect on the formation of a posterior subcapsular cataract(P=0.002, OR: 0.227, 95%CI:0.088-0.590) under the recessive model.CONCLUSION: Our study indicates that GJA3 variants may influence the development of posterior subcapsular cataracts. Further studies need to be designed to confirm this possibility.

Association of IGF1R polymorphisms(rs1546713) with susceptibility to age-related cataract in a Han Chinese population

AIM:To explore the susceptible association between the insulin-like growth factor-1 receptor(IGF1 R)single nucleotide polymorphism(SNP)and age-related cataract(ARC),and investigate the underlying mechanisms in human lens epithelium(HLE)cells.METHODS:Totally 1190 unrelated participants,comprising 690 ARC patients and 500 healthy individuals in Han Chinese population were recruited and genotyped for target SNP.Theχ2-test was used to detect genotypic distribution between the patient and control groups and the logistic regression was performed to adjust the age and gender.Meanwhile,different biological experimental methods,such as cell counting kit 8(CCK-8)assay,flow cytometry,quantitative real time polymerase chain reaction(Q-PCR)and Western blot,were used to detect cell viability,cell cycle progression and apoptosis in HLE cells or IGF1 R knockdown HLE cells.RESULTS:The rs1546713 in IGF1 R gene was identified(P=0.046,OR:1.606,95%CI:1.245-2.071),which shown a significant relevance with ARC risk under the dominant model.The results demonstrated that IGF1 R knockdown inhibited cell proliferation by inducing cell cycle arrested at S phase and promoting apoptosis.Mechanistically,the cell cycle blocked at S phase was linked with the alterations of cyclin A,cyclin B,cyclin E and P21.The pro-apoptosis function of IGF1 R may related with stimulating the activation of Caspase-3 and altering the expression levels of apoptotic proteins,including Bcl-2,Bax and Caspase-3.CONCLUSION:This study first report that IGF1 R polymorphisms may affect susceptibility to ARCs in Han Chinese population and provide new clues to understand the pathogenic mechanism of ARCs.Notably,IGF1 R is likely a potential target for ARC prevention and treatment.

A pilot exome-wide association study of age-related cataract in Koreans

Age-related cataract （ARC） is the most common cause of visual impairment and blindness worldwide. A previous study reported that genetic factors could explain approximately 50% of the heritability of cataract. However, a genetic predisposition to ARC and the contributing factors have not yet been elucidated in the Korean population. In this study, we assessed the influence of genetic polymorphisms on the risk of ARC in Koreans, including 156 cataract cases and 138 healthy adults. We conducted an exome-wide association study using Illumina Human Exome-12v1.2 platform to screen 244,770 single nucleotide polymorphisms （SNPs）. No SNPs reached exome-wide significance level of association （P 〈 l x 10 6）. B3GNT4 rs7136356 showed the most significant association with ARC （P = 6.54x 10 5）. Two loci （MUC16 and P2RY2） among the top 20 ARC-associated SNPs were recognized as probably linked to cata- ractogenesis. Functions of these genes were potentially related to regulating dehydration or homeostasis of the eyes, and showed a potential association with dry eye disease. This finding suggests that mucin- and dry eye disease-related genes may play a significant role in cataractogenesis. Our study provides insight into the genetic predisposition of ARC in Koreans. Additional studies with larger sample sizes are required to confirm the results of this study.

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

AIM： To figure out the contributed factors of the hospitalization expenses of senile cataract patients（HECP） and build up an area-specified senile cataract diagnosis related group（DRG） of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS： The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector（E-CHAID） model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS： The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION： The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.

Expression of lens-related microRNAs in transparent infant lenses and congenital cataract

AIM：To identify the expression of lens-related micro RNAs（miRNAs）in the central epithelium of transparent infant lenses and congenital cataract. METHODS：Lens-related mi RNAs were retrieved from Pub Med database. The expression levels of these mi RNAs in transparent infant lenses and congenital cataract were determined by stem-loop reverse transcription-polymerase chain reaction（RT-PCR）. mi Randa algorithm was used to predict the target genes of these differentially expressed mi RNAs. The target m RNA was validated.RESULTS：Six lens-related mi RNAs were retrieved from screening Pub Med database. The most abundant mi RNA in transparent infant lenses according to stem-loop RT-PCR was mi R-184. miR-182 was up-regulated in congenital cataract. Contrarily,miR-204 and miR-124 was down-regulated.mi R-204 exhibited a more significant decrease in expression than mi R-124. In addition,Meis2 was predicted to be the target of mi R-204 using mi Randa algorithm. mi R-204mimic/antagomir transfection experiments suggested the negative correlation between the expression of mi R-204 and Meis2.CONCLUSION：The expression levels of miR-182,miR-204 and mi R-124 differ between the central epithelium of transparent infant lens and congenital cataract,suggesting their involvement in the pathogenesis of congenital cataract. miR-204 may act via silencing Meis2 to regulate lens development and congenital cataract formation.

Correlation between contrast sensitivity and the lens opacities classification system III in age-related nuclear and cortical cataracts

Background Contrast sensitivity （CS） testing can detect differences in functional vision and is highly correlated with visual performance. This study was designed to investigate the association between CS and the grading score using the lens opacities classification system （LOCS） III as well as the association between CS and visual acuity （VA） in nuclear or cortical age-related cataract （ARC） patients. Methods A total of 270 eyes with ARC and 30 control eyes were divided into nuclear opacity （NO）, nuclear color （NC）, cortical cataract （C） based on LOCS II1. The CS values measured at all spatial frequencies under photopic and glare conditions that resulted in contrast sensitivity function （CSF） were evaluated, and LogMAR VA was tested with the Early Treatment Diabetic Retinopathy Study （ETDRS） chart. The correlation between CSF and LOCS III grading scores, and between CSF and LogMAR VA were analyzed. Results Compared to the controls, CSF of the nuclear or cortical ARC significantly declined. There are significant correlation between CSF and LogMAR VA, and between CSF and LOCS III grading scores. Compared to the VA, a stronger correlation existed between CSF and LOCS III grading score than that of LogMAR VA and LOCS III grading score. CS at some spatial frequencies is significantly influenced with LOCS III grading score. Conclusions CSF significantly declined with the increasing ARC grading scores. Comparing to VA, CSF reflected the severity of cataract more comprehensively. CS at low spatial frequency is significantly influenced by ARC. Therefore, CS is more precise than VA in assessing the visual function of ARC patients.

Expressions of TGF-β2, bFGF and ICAM-1 in lens epithelial cells of complicated cataract with silicone oil tamponade

AIM： To investigate the expression differences of transforming growth factor-β2（TGF-β2）, basic fibroblast growth factor（b FGF） and intercellular cell-adhesion molecule-1（ICAM-1） in lens epithelial cells（LECs） of complicated cataract with silicone oil tamponade and agerelated cataract. METHODS： Totally 150 eyes of 150 patients（aged 35 to 77y） were investigated, including 75 patients with complicated cataract after silicone oil tamponade and 75 patients with age-related cataract. The central piece of anterior capsules was collected during cataract surgery. TGF-β2, b FGF and ICAM-1 were detected in the 60 specimens of the two groups by immunohistochemistry. The expression levels of the three kinds of messenger ribonucleic acid（m RNA） were determined by real-time quantitative reverse transcriptionpolymerase chain reaction in the 90 specimens of the two groups.RESULTS： TGF-β2 was detected in the cytomembrane and cytoplasm of the LECs and b FGF was detected in the nucleus. ICAM-1 was positive in the cytomembrane of the LECs and the distribution of positive cells was uneven. The m RNA genes expression of the TGF-β2, b FGF and ICAM-1 was significant differences between the two groups and markedly increased in complicated cataract group（P〈0.05）.CONCLUSION： The up-regulated TGF-β2, b FGF and ICAM-1 maybe associate with the occurrence and development of complicated cataract with silicone oil tamponade.

Evaluation of antioxidants and argpyrimidine in normal and cataractous lenses in north Indian population

AIM： To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population.METHODS： Human cataractous lenses were collected from the patients who underwent extracapsular cataract extraction surgery; clear lenses were collected from the freshly donated eye bank eyes. Antioxidant molecules such as glutathione and thioltransferase enzyme activity were measured; simultaneously in these lenses a blue fluorophore argpyrimidine, an advanced glycation end（AGE） product level was assessed using high performance liquid chromatography（HPLC）.RESULTS： The protein concentration was found to be present at higher levels in the control lenses compared to cataract lenses. A significant decrease in the glutathione level was observed in the nuclear cataractous lenses compared to cortical cataractous（P=0.004） and clear lenses（P≤0.005）, but no significant change in the level of antioxidant enzyme thioltransferase was observed. Further, argpyrimidine a blue fluorophore（AGE） was found to be significantly higher in the nuclear cataract（P=0.013） compared to cortical cataract lenses.CONCLUSION： Antioxidants such as glutathione significantly decrease in age-related nuclear and cortical cataract and an AGE, argpyrimidine are present at significantly higher levels in nuclear cataract.

金合欢素调节Sirt1/AMPK/Nrf2信号通路对糖尿病白内障大鼠氧化应激损伤的影响

目的探讨金合欢素对糖尿病白内障(DC)大鼠氧化应激损伤的影响及其对沉默调节蛋白1(Sirt1)/腺苷酸活化蛋白激酶(AMPK)/核因子E2相关因子2(Nrf2)信号通路的调控作用。方法60只SD大鼠随机分为对照组、模型组、金合欢素低剂量组、金合欢素高剂量组、金合欢素+Sirt1抑制剂(EX527)组,除对照组以外均构建DC大鼠模型,其中,金合欢素低剂量组、金合欢素高剂量组大鼠分别经颈部皮下注射10 mg·kg^(-1)、20 mg·kg^(-1)的金合欢素,金合欢素+EX527组大鼠经颈部皮下注射20 mg·kg^(-1)金合欢素,均为每天2次,同时金合欢素+EX527组大鼠经皮下埋入渗透微型泵每天泵入3.5 mg·kg^(-1)EX527,其余组别均泵入等量生理盐水,给药持续4周。给药结束后,测量血压和空腹血糖(FBG),裂隙灯照射法观察大鼠晶状体混浊状况,HE染色观察晶状体组织病理学变化,ELISA测定血清丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、白细胞介素(IL)-6、IL-1β的含量,Western blot检测Sirt1、p-AMPK、AMPK、Nrf2蛋白表达水平。结果与对照组相比,模型组大鼠晶状体上皮细胞呈片状、条索状,发生迁移性聚集,收缩压、FBG、晶状体混浊评分、MDA、IL-6、IL-1β水平均升高,SOD、GSH-Px含量及Sirt1、p-AMPK/AMPK、Nrf2蛋白表达水平均降低(均为P<0.05);与模型组比较,金合欢素低、高剂量组大鼠晶状体上皮细胞迁移性聚集现象改善,收缩压、FBG、晶状体混浊评分、MDA、IL-6、IL-1β水平均降低,SOD、GSH-Px含量及Sirt1、p-AMPK/AMPK、Nrf2蛋白表达水平均升高(均为P<0.05);与金合欢素高剂量组比较,金合欢素+EX527组晶状体上皮细胞形态改变和聚集现象加重,收缩压、FBG、晶状体混浊评分、MDA、IL-6、IL-1β水平均升高,SOD、GSH-Px含量及Sirt1、p-AMPK/AMPK、Nrf2蛋白表达水平均降低(均为P<0.05)。结论金合欢素可能通过激活Sirt1/AMPK/Nrf2通路保护DC大鼠免受氧化应激损伤。

飞秒激光辅助下超声乳化术、普通白内障超声乳化术对年龄相关性白内障患者眼内压及最佳矫正视力、视盘区血流密度的影响

目的比较飞秒激光辅助下超声乳化术(FLACS)、普通白内障超声乳化术(CPCS)在年龄相关性白内障(ARC)患者中的效果。方法选取2021年7月至2023年7月南昌爱尔眼科医院收治的70例ARC患者作为研究对象,按随机数字表法分为对照组(35例)、观察组(35例)。对照组行CPCS,观察组行FLACS,两组术后均随访3个月。比较两组的手术相关指标、眼内压、黄斑中心凹厚度(CMT)、最佳矫正视力(BCVA)、视盘区血流密度、并发症等。结果观察组的超声乳化时间为(14.57±2.30)min,短于对照组的(22.49±3.58)min,观察组的超声乳化能量为(5.39±1.20)ml,低于对照组的(11.33±2.15)ml,观察组的并发症总发生率为5.71%(2/35),低于对照组的22.86%(8/35),差异有统计学意义(P<0.05)。重复测量方差分析结果显示,两组患者术前,术后1 d,术后1周,术后1、3个月BCVA的时间、组间比较,差异有统计学意义(P<0.05),交互作用比较,差异无统计学意义(P>0.05);两组患者术后1 d,术后1周,术后1、3个月的BCVA均高于本组术前,差异有统计学意义(P<0.05)。两组患者手术前后各时间点眼内压、CMT、视盘旁血流密度、视盘内血流密度的时间、组间、交互作用比较,差异无统计学意义(P>0.05)。结论FLACS具有更短的超声乳化时间,更少的乳化能量,其可提升视力,且不会加重对眼压、视盘区血流密度与CMT的影响,并发症较少。

老年性白内障患者血糖与术后视力恢复的关联

目的分析年龄相关性白内障患者血糖水平及血糖变异性与人工晶体植入术后康复质量的关联。方法选取2020年1月~2023年1月收治的172例糖尿病合并年龄相关性白内障患者纳入观察组,并选取同期35例未合并糖尿病的年龄相关性白内障患者纳入对照组。对比观察组、对照组的血糖水平和血糖变异性,并按照观察组患者血糖变异性,将其分别纳入低、中、高变异性组,比较3组患者术后并发症及术后康复质量,包括最佳矫正视力、角膜散光度、视觉质量。结果观察组FPG、2 hPG、HbA1c以及GluMAGE、GluSD、GluAve、GluCV、GluGLI均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率高于对照组,其术后1周、术后3个月BCVA、视觉质量均低于对照组,同时期角膜散光度均高于对照组,差异有统计学意义(P<0.05)。高血糖变异性患者术后并发症发生率高于低、中血糖变异性患者,其术后1周、术后3个月BCVA、视觉质量均低于低、中血糖变异性患者,同时期角膜散光度均高于低、中血糖变异性患者,差异有统计学意义(P<0.05)。结论合并糖尿病的年龄相关性白内障患者血糖水平及血糖变异性均更高,其术后并发症发生率高于未合并糖尿病者,且术后康复质量明显受限,而随着患者血糖变异性的上升,患者术后并发症发生率上升并伴康复质量显著下降。

基于扫频OCT测量的术前晶状体界面位置对于白内障术后人工晶状体真实位置的预测价值

目的 探讨基于扫频OCT(SS-OCT)技术的光学生物测量仪IOLMaster 700获得的晶状体界面位置(IIP)对白内障术后人工晶状体(IOL)的真实位置(ALP)的预测价值。方法 回顾性描述性研究。选取2021年7月至2022年7月于苏州大学附属第一医院眼科接受白内障手术的年龄相关性白内障患者208例208眼为研究对象。根据植入的IOL不同分为2组:IQ组(80眼)术中植入IQ IOL;ZCB组(128眼)术中植入ZCB IOL。使用基于SS-OCT的生物测量仪IOLMaster 700在术前和术后3个月对患眼进行生物学参数的测量,获取ALP、术后前房深度(ACD)、IOL厚度等参数,并计算IOL位置误差。结果 白内障术后,208眼的绝对屈光度预测误差(ARPE)为(0.43±0.35) D,134眼(64.4%)的ARPE<0.50 D。与IQ组相比,ZCB组患眼的ALP和ALP2值更大(均为P<0.001)。与IQ组相比,ZCB组ARPE≥0.50 D患眼的IIP显著降低(P=0.028);在ZCB组患者中,与ARPE<0.50 D相比,ARPE≥0.50 D患眼的IIP显著降低(P=0.041)。两组患者的ALP与IIP均具有较好的相关性(IQ组:r=0.815,P<0.001;ZCB组:r=0.757,P<0.001);ALP2与IIP也均具有较好的相关性(IQ组:r=0.797,P<0.001;ZCB组:r=0.743,P<0.001)。通过IIP和术前参数可以获得线性表达式来预测ALP(IQ组、ZCB组的R^(2)分别为0.70、0.68)。结论 基于SS-OCT技术的IOL Master 700测量的IIP位置与白内障术后的ALP相关,可用于优化IOL度数计算。

重视先天性白内障术后高眼压和青光眼的防治

先天性白内障是严重影响婴幼儿视功能的疾病。随着白内障手术和人工晶体植入手术技术的发展,先天性白内障患者术后多可获得高质量的视觉康复。然而,如何更好防治手术相关的不良事件和并发症、先天性白内障伴随的其他眼部发育不良疾病的治疗以及形觉剥夺性弱视的治疗,仍然是先天性白内障手术后需要重视的临床问题。文章对先天性白内障摘除及人工晶体植入术后高眼压和继发性青光眼的发生、相关危险因素、治疗和预防的手段进行总结,以期进一步提高对先天性白内障术后高眼压和青光眼防治的认识,减少术后并发症对视功能造成的进一步损害。

中医药治疗年龄相关性白内障术后干眼的研究进展

年龄相关性白内障是后天性白内障中最常见的一种类型,指晶状体随着年龄的增长逐渐老化,表现为视力进行性下降,手术是其主要的治疗手段。但患者术后常出现干涩、异物感等与干眼相关的眼部不适症状,影响视觉质量。本文回顾了近年的相关文献,对年龄相关性白内障术后干眼的发病机制及中医药的治疗进行梳理和总结,发现中医药可有效地控制其病程发展,且中医药的多种治疗方法可相互联合,共同发挥优势,缓解患者术后眼部不适症状。本文可为临床医师治疗年龄相关性白内障术后干眼提供参考。

东方田鼠自发性年龄相关性白内障的鉴定

目的:年龄相关性白内障是成人白内障中最常见的类型,也是主要的致盲眼科疾病。目前关于年龄相关性白内障动物模型的建立报道较少。本课题组在东方田鼠实验动物化培育过程中首次发现12~15月龄东方田鼠能自然发生白内障。本研究通过对东方田鼠自发性白内障进行鉴定分析,探讨其发展成为年龄相关性白内障动物模型的可能性。方法:分别选用12月龄健康东方田鼠为对照组和12月龄白内障东方田鼠为实验组。通过裂隙灯生物显微镜观察晶状体透明度;苏木精-伊红染色观察东方田鼠的晶状体病理变化;生物化学方法测定2组东方田鼠的血常规、血糖水平及血清中超氧化物歧化酶(superoxide dismutase,SOD)和谷胱甘肽过氧化物酶(glutathione peroxidase,GSHPx)活性。最后通过实时反转录聚合酶链反应(real-time reverse transcription PCR,real-time RT-PCR)检测2组东方田鼠晶状体中白内障发病相关基因的转录水平。结果:与对照组比较,实验组东方田鼠的晶状体呈现不同程度的浑浊,晶状体结构被严重破坏,晶状体上皮细胞出现明显肿胀、大量空泡、变性/坏死、钙化、增生和纤维液化等病理变化,纤维结构紊乱,分布不规则,变性的晶状体纤维中有马氏小体聚集。与对照组比较,实验组东方田鼠的血糖水平差异无统计学意义(P>0.05),白细胞数量(P<0.05)、淋巴细胞数量(P<0.01)、淋巴细胞比率(P<0.05)均显著降低,而中性粒细胞百分比(P<0.05)和单核细胞比率(P<0.01)均显著增加,血清中SOD和GSH-Px活性均降低(均P<0.05);实验组东方田鼠晶状体中白内障发病相关基因CRYAA、CRYBA1、CRYBB3、Bsfp1、GJA3、CRYBA2、MIP、HspB1、DNase2B和GJA8的mRNA水平均显著降低(均P<0.05)。结论:白内障东方田鼠与健康东方田鼠相比,晶状体病理变化、过氧化物酶水平和白内障相关基因表达均有显著差异。东方田鼠自发性白内障具有年龄相关性,白内障东方田鼠有望发展成为年龄相关性白内障研究的理想动物模型。