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AimTo determine the association between pseudoexfoliation (PEX) and peripheral vascular disease (PVD) among age-related cataract.SettingIladevi Cataract and IOL Research Center, Ahmedabad, India.Material and methodsAn observational age-matched case-control study of 160 patients over 60 years of age with age-related cataract. A total of 40 subjects with PEX (cases) were compared with 120 subjects with cataract but without PEX (controls). A detailed medical history, including hypertension, diabetes mellitus, cerebrovascular stroke and ischaemic heart disease, was recorded. Ankle brachial index (ABI) was used to determine the risk of PVD among age-related cataract patients. Color Doppler imaging was performed on the brachial and dorsalis pedis artery to measure ABI and detect PVD. Least mean ABI was the main outcome measure, as low ABI indicates higher risk for PVD. The lowest mean ABI was measured for each subject. An ABI ratio of <0.90 was considered abnormal. The Mann-Whitney U-test and logistic regression were used for analysis.ResultsThe lowest mean ABI in the controls was 0.98±0.03 (SD; a range of 0.86-1.08) as compared with 0.88±0.02 (SD) among the cases (a range of 0.79-0.92; P<0.001). When compared with controls, cases had a lower ABI (P<0.001) irrespective of the presence or absence of systemic illness. On multiple regression analysis adjusting for systemic illness, the presence of PEX increased the odds of a low ABI group 150 times (P<0.001).ConclusionSubjects with cataract and PEX had a significantly lower ABI as compared with controls (cataracts without PEX). PEX is associated with and may be a risk factor for PVD. [ABSTRACT FROM AUTHOR]

PurposeThe aim of this study was to identify risk factors for the development of cataract in young patients.SettingsThe study was undertaken at Iladevi Cataract and IOL Research Centre, Ahmedabad, Gujarat, India.MethodsIn a clinic-based observational study, 340 consecutive patients in the age group of 30–45 years presenting with nuclear, cortical, posterior subcapsular (PSC), mixed, and posterior polar cataract were prospectively studied. A detailed history regarding sunlight exposure, atopy, diabetes, steroid intake, myopia, glaucoma, and uveitis was elicited.ResultsThe mean age of the patients was 40.2±4.6 years; there were 202 men. The major risk factors were atopy (25.6%), idiopathic (19.1%), high myopia (12.4%), atopy with steroid intake (10.9%), steroid usage (7.4%), sunlight exposure (3.8%), and diabetes mellitus (3.2%). PSC was observed in 53.5% eyes. Multinomial logistic regression revealed that atopy (P=0.016), steroid usage (P=0.100), and diabetes mellitus (P=0.076) documented higher odds for PSC. High myopia (P<0.001) and sunlight exposure (P=0.003) documented higher odds for nuclear cataract.ConclusionAtopy was found to be the most common risk factor associated with the development of cataract in young individuals. PSC was the predominant type of cataract prevalent in young patients. [ABSTRACT FROM AUTHOR]

AimsTo evaluate the effect of anterior capsule polishing on the development of anterior capsule opacification (ACO) in patients undergoing cataract surgery.MethodsThis prospective randomized observational double-masked clinical trial comprised 120 eyes of 60 consecutive patients with bilateral age-related cataract who underwent phacoemulsification. The patients were randomly assigned to one of the two groups: One eye received a 360 degree anterior capsule polishing (group 1 (cases)) and the fellow eye was without anterior capsule polishing (group 2 (controls)) The primary observation was to observe the development of ACO between the 2 groups, whereas the secondary observation was to measure uveal inflammation. ACO was evaluated at 1 week, 1 month, and 6 months.ResultsAt the 1-week follow-up, there was no significant difference in the development of ACO between the two groups. At 1 month, 54 (90%) eyes developed ACO in controls and 26 (43.3%) eyes in cases (P<0.001). However, at 6 months, there was no significant difference in the development of ACO between controls and cases (P=0.500). The odds of having cells and flare were significantly more in cases compared with controls at first postoperative day (cells: OR, 39.27; 95% CI, 13.49–114.26 and flare: OR, 48.0; 95% CI, 15.57–147.97).ConclusionsACO was significantly lower at 1 month in cases compared with controls. However, the difference in ACO between the two groups was insignificant at 6 months. A significant difference in anterior segment inflammation was documented in cases on the first postoperative day. There was no detectable benefit of performing scraping on the anterior capsule to avoid opacification after phacoemulsification.Eye (2009) 23, 1702–1706; doi:10.1038/eye.2008.355; published online 12 December 2008 [ABSTRACT FROM AUTHOR]

PurposeTo report relationship of age group and axial length (AL) category to lens thickness values in eyes with a clear lens or different types of isolated cataract (nuclear, cortical, and posterior subcapsular (PSC)). Further, we evaluated lens thickness values on anterior chamber depth (ACD) in these eyes.DesignObservational clinic-based study.MethodsAn observational study of 1442 eyes of 1442 individuals (816 eyes with isolated cataract and 626 eyes with clear lens) of those above 25 years of age was evaluated. AL and lens thickness were performed with an A-scan ultrasound after dilatation of the pupil, and manual optical pachymetry was used to measure ACD after dilatation of the pupil.Main outcome measures: Lens thickness.ResultsMultiple regression analysis revealed that with each decade of advancement in age, the lens thickness increased by 0.155 mm (P<0.001). The difference in lens thickness after adjusting for age group and AL category was less in cortical cataract by −0.25 mm (P<0.001) and PSC by −0.29 mm (P<0.001); With advancement in AL category, lens thickness decreased by 0.004 mm (P<0.001). After adjusting for all the parameters/variables, regression analysis revealed that as lens thickness increased, there was a significant decrease in ACD (mean −0.44 mm; P<0.001).ConclusionsLens thickness was significantly greater in clear lenses when compared with isolated cataracts—greatest with nuclear cataract and least with PSC. Age group and AL category had a significant impact on the lens thickness of both cataract and clear lens. A significant decrease in ACD was found with the increase in lens thickness.Eye (2009) 23, 1542–1548; doi:10.1038/eye.2008.315; published online 24 October 2008 [ABSTRACT FROM AUTHOR]

PurposeTo evaluate the short-term protective effects of oestradiol against damages because of oxidative stress in human lens epithelial cells (LECs).MethodsThe central zone of human lens epithelium was obtained from the cataract surgery and cultured in MEM culture medium. These cultured LECs were treated with 17β-oestradiol for varying time intervals from 1 to 5 min followed by treatment with H2O2 (5 × 10−6 M) in the culture medium. Catalase activity was measured to access the oxidative stress levels.ResultsLECs exposed to H2O2 (5 × 10−6 M) showed a fourfold increase in catalase activity (407.03±89.11 U/μg protein) after 6 h when compared to cultured unexposed LECs (97.124±9.4 U/μg protein). When the cultured LECs were treated with oestradiol (5 × 10−8 M) before H2O2 treatment, the increase in catalase activity was inhibited, whereas simultaneous and post-treatments showed no effect. The catalase activity of LECs pretreated with oestradiol for 1, 2, 3, and 5 min was 259.92±18.37, 200.24±14.39, 140.50±19.83, and 110.01±14.66, respectively (P<0.0001).ConclusionAntioxidative enzymes are synthesized in response to the oxidative stress signal. Upon treatment with oestrogen catalase is not synthesized. The pretreatment time of oestrogen required for its antioxidative effect can be seen within 5 min indicating non-genomic mode of action of oestrogen.Eye (2009) 23, 1456–1463; doi:10.1038/eye.2008.284; published online 19 September 2008 [ABSTRACT FROM AUTHOR]

PurposeTo compare the effects of cooled and room temperature BSS Plus solution on the central corneal thickness (CCT), anterior segment inflammation, and corneal endothelium in patients undergoing phacoemulsification.MethodsIn this prospective, randomized study, 70 consecutive patients undergoing phacoemulsification were assigned to one of two groups: Group 1 (controls) (n=35) received BSS Plus at a room temperature of 23°C and Group 2 (cases; n=35) received BSS Plus cooled at 10°C. In both the groups, the percentage of difference for CCT, absolute change in endothelial cell density, and coefficient of variation (CV) from preoperative to postoperative periods was analysed. The presence of anterior chamber flare and cells were compared postoperatively between the two groups.ResultsThere was no significant difference in percentage change for CCT from preoperative to postoperative days 1, 7, and 30 between the two groups (P=0.30, P=0.56, and P=0.52). There was no statistically significant difference in the ECD loss (P=0.19) and CV (P=0.88) at 1 month between the two groups. The influence of the solutions on anterior chamber flare and cells was not statistically significant between the two groups on the first postoperative day (P=0.17, P=0.11).ConclusionsThe temperature of the BSS Plus solution did not affect any parameter of the study. The use of moderately cooled BSS had no detectable effect and benefit on the outcome of the surgery.Eye (2009) 23, 1158–1163; doi:10.1038/eye.2008.187; published online 27 June 2008 [ABSTRACT FROM AUTHOR]

AimsTo detect the presence of lens epithelial cells in the anterior chamber of the eye at the end of phacoemulsification.MethodsA prospective observational study was carried out on 50 patients undergoing phacoemulsification. Fluid from the anterior chamber was collected from these patients at the end of phacoemulsification. Thirty samples were processed for detection of viability using calcein AM–propidium iodide. Remaining samples were processed for immunofluorescence detection of αA-crystallin and vimentin. The nonparametric Mann–Whitney U test was applied.ResultsThe presence of lens epithelial cells was confirmed in 27 of the first 30 samples. The total number of cells observed in these 27 samples were 64.70 ± 58.49. Within these 27 samples, 35.5% were live cells and 64.5% were dead. The cells were present as single cell or in groups. Twenty three percentage samples were also positive for nucleated lens fibres. In the remaining 20 samples, 89% cells were confirmed to be lens epithelial cells.ConclusionsWe show for the first time, the presence of cells in the fluid of the anterior chamber at the end of phacoemulsification. The cells were positive for αA-crystallin and vimentin, thereby suggesting that they were lens epithelial cells.Eye (2009) 23, 1170–1175; doi:10.1038/eye.2008.182; published online 27 June 2008 [ABSTRACT FROM AUTHOR]

Purpose: To compare the performance of single-piece acrylic vs poly (methylmethacrylate) intraocular lenses (IOL) on the development of posterior capsule opacification (PCO) after conventional extra capsular cataract extraction (ECCE). Materials and Methods: One hundred and eighty-two eyes of 91 patients with bilateral senile cataract undergoing ECCE were prospectively randomized to receive a single-piece Alcon AcrySof® SA60AT IOL or a single-piece EPOCH® polymethylmethacrylate IOL in the first eye to have surgery. At 1, 6 and 12 months post-operative follow-up, digital retro illumination images of the posterior capsule were taken for PCO assessment semi-objectively using PCO (POCO automated analysis software) system. Relationship of anterior capsule contact (total off and partial cover) on optic for PCO was analyzed. Results: The AcrySof® IOL was associated with less PCO than EPOCH® lens at 6 months (10.01±8.75% vs32.26±27.44%; P<0.001) and 1-year (11.65±10.55% vs38.38±29.62%; P<0.001) follow-up. The EPOCH® IOL showed a remarkably significant difference on development of PCO with anterior capsule overlap on IOL optic (total off and part on) 1 year (P<0.039), whereas no such difference was observed with the AcrySof® IOL (P=0.197). Conclusion: The AcrySof® IOL led to significantly less PCO than the EPOCH® IOL post-operatively after extracapsular cataract extraction. Eye (2008) 22, 889–894; doi:10.1038/sj.eye.6702747; published online 23 February 2007 [ABSTRACT FROM AUTHOR]