• Title/Summary/Keyword: cataract

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Surgical Management of Coexisting Glaucoma and Cataract (녹내장과 백내장이 동반된 환자의 수술적 치료)

  • Cha, Soon-Cheol
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.12-22
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    • 2004
  • The management of coincident glaucoma and cataract is not only a common clinical challenge but also an important research topic in the ophthalmic surgical field. The purpose of this article is to compare the different surgical options on the basis of their achievable postoperative intraocular pressure (IOP) control, success rates, and complication rates reported in the related literature, and to give advice on how to manage typical situations of patients with both glaucoma and cataract. Main topics were focused on indications and rationale of 3 surgical options (only cataract surgery first and later trabeculectomy, only trabeculectomy first and later cataract surgery, or simultaneous combined surgery). Modern clear corneal cataract extraction techniques resulted in a modest intermediate-term reduction of IOP and has considerably improved the success rates of combined glaucoma and cataract surgery. It also enabled future trabeculectomy to be successfully performed at a later date if necessary. Trabeculectomy alone achieved better IOP regulation than phacotrabeculectomy (combined surgery), but subsequent cataract surgery may compromise preexisting filtering bleb. Combined surgery augmented with mitomycin C achieved a lower IOP than combined surgery alone but had a higher complication rate. In conclusion, the choice of the preferred surgical method should be determined according to the target pressure, the amount of glaucomatous damage, and the grade of visual disturbance caused by the cataract. Phacotrabeculectomy with adjunctive mitomycin C offers visual improvement and achieves the best IOP lowering of all types of combined glaucoma and cataract surgery currently used but is associated with potentially sight-threatening complications.

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TGF-$\alpha$, -$\beta$$_1$, and bFGF mRNA Expression of Lens Epithelial Cells in Senile and Diabetic Cataract

  • Hwang, Bum-Noon;Her, Jun
    • Biomedical Science Letters
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    • v.8 no.3
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    • pp.127-135
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    • 2002
  • Anterior subcapsular cataract was developed by opacification with transdifferentiation and abnormal proliferation of lens epithelial cells (LECs) and pathological accumulation of extracellular matrix (ECM). After-cataract also be caused by a similar transdifferentiation of LECs remaining after surgery and the accompanying increase of ECM deposits. It is blown that prostaglandin E2 and cytokine, such as TGF-$\beta$, bFGF, and IL-1, were associated with abnormal proliferation and transdifferentiation of LECs. The aim of this study was to detect the expression of transforming growth factor-$\alpha$ (TGF-$\alpha$), transforming growth factor-$\beta_1$(TGF-$\beta_1$) and basic fibroblast growth factor (bFGF) in LECs of senile and diabetic cataract. The expressions of these growth factors in lens epithelial cells were determined. The sample for growth factor determination were collected in senile cataract patients without metabolic disorder, especially diabetes mellitus and diabetic cataract patients. The mRNA expression of growth factors was detected by semi-quantitative reverse transcription - polymerase chain reaction (RT-PCR) followed by Southern blot analysis. Statistics were analysed using Wilcoxon rank sum test. Semi-quantitative RT-PCR/southern analysis of RNA obtained from thirty surgical specimens demonstrated that the level of mRNA expression of TGF-$\alpha$, -$\beta_1$ and bFGF was increased in diabetic cataract lens tissues compared with senile cataract specimens but non-significant, bFGF and TGF-$\beta_1$ mRNA expression were detected in most patients, expression level of TGF-$\beta_1$ was most high on the basis of normal ocular concentration. Detection rate of TGF-$\alpha$ in diabetic cataract was 1.5 fold higher than in senile cataract (P=0.098). TGF-$\alpha$, TGF-$\beta_1$, and bFGF mRNA expression of LECs were detected in senile and diabetic cataract. In both patient groups, expression level of TGF-$\beta_1$, mRNA was high, so We suggest TGF-$\beta_1$ strong influence in development of senile cataract and of diabetic cataract also. TGF-$\alpha$ expression level was similar but more frequently detected in diabetic cataract than in senile cataract. In conclusion, TGF-$\alpha$ may be associated with early development of diabetic cataract.

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Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study

  • Jeong, Ihn Sook;Lee, Eun Joo;Kim, Myo Sung;Yu, Jung Ok;Yun, Hae Sun;Jeong, Jeong Hee;Hwang, Youn Sun
    • Journal of Korean Academy of Nursing
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    • v.52 no.1
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    • pp.24-35
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    • 2022
  • Purpose: This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES). Methods: Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001-2002) to fifth follow-up visit (2011-2012) were examined. The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model. Results: The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05-1.13) and HbA1c (HR=1.21, 95% CI=1.07-1.37) or the duration of DM (HR=1.05, 95% CI=1.00-1.09) were found to be independently associated with cataract development. Conclusion: Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

Refractive Error Shift in Nuclear, Cortical, and Subcapsular Cataract (핵, 피질 그리고 낭 백내장의 굴절이상 전환)

  • Park, Sang-Chul;Lee, Soek-Ju;Sung, A-Young
    • Journal of Korean Ophthalmic Optics Society
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    • v.8 no.1
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    • pp.41-45
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    • 2003
  • The researchers have studied on the effect of three main morphological types(nuclear, cortical, and subcapsular cataract) of age related cataract on refractive error. We also identified that spherical and cylinderical shift in each type of morphological cataract accoding to their locations and effect of intraocular pressure before and after cataract surgery. Nuclear cataract showed myopic shift while cortical cataract showed hyperopic shift, and subcapsular cataract showed not significant changes on both direction. Age related cataract subjects(120 eyes) only were recruited from sun-cheon area. We use optic section of slit lamp biomicroscope to identify the anatomical location of cataract, and optimal refractive correction determined by objective(retinoscope) and subjective refraction then spherical changes were calculated from the spherical eqivalent value. Intra-ocular pressure were measured by auto-tonometer before and 7 days after cataract has been replaced by IOL. The change in cylindrical power, usually A-P diameter decreased according to increases of age, A-P diameter increased because intra-ocular pressure rises by progression of cataract and this convertion with the rule astigmatism to against the rule astigmatism and this increases more by intra-ocular pressure.

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Effect of diabetes, hypertension, and obesity management on visual acuity in geriatric cataract surgery patients

  • Cho, Seonahr
    • International Journal of Advanced Culture Technology
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    • v.9 no.3
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    • pp.212-220
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    • 2021
  • Method : Using annual statistics of major surgeries provided by the National Health Insurance Corporation, it figured out what changes come in visual acuity by the number of cataract surgeries nationwide plus age, gender, and geriatric disease every 3 years from 2013 to 2019 through joint point regression for statistics. Objective : This study is intended to identify the relationship between geriatric diseases (diabetes, hypertension, obesity) and visual acuity in geriatric cataract surgery patients. Result : First, geriatric diseases of cataract surgery patients were closely related to diabetes, hypertension, obesity, smoking, and drinking. In particular, diabetes, hypertension, and smoking had a high prevalence rate. There was no difference in gender and age. Second, 72% of all geriatric cataract surgeries were performed at the clinic level, and intraocular lens that was used after geriatric cataract surgery accounted for the majority of monofocal intraocular lens as 96.6%. Third, the visual acuity in geriatric cataract surgery patients improved from an average of 0.40 before surgery to 0.06 after surgery, and visual acuity improvement was found in 95% of them. These results suggest that geriatric cataract patients can expect visual acuity stabilization and positive visual acuity improvement through early surgery.

A Study on the Improvement of Visual Acuity and Refractive Power According to General Characteristics of Cataract Surgery Patients

  • Cho, Seon Ahr;Lee, Seong Jae
    • International Journal of Advanced Culture Technology
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    • v.6 no.4
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    • pp.71-79
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    • 2018
  • For 299 patients who had undergone cataract surgeries we investigated the difference in visual acuity and refractive power before and after cataract surgery and the clinical change of the visual acuity and the refractive power according to age, gender, hospital visit time and specific medical history. We found the factors affecting preoperative and postoperative outcomes of the cataract patients in metropolitan hospitals by input, process, and outcome and analyzed medical characteristics and patient characteristics as the input variables. T-test and ANOVA have been performed for statistical analysis of functional status, and general status and the technical characteristic as the process variable and the outcome variable of diagnosis. Visual acuity improved significantly in patients who had undergone cataract surgery. However, the change in refractive power did not show a statistically significant difference but only a slight difference. The improvement of male patients was greater than that of female patients. The difference in age was more effective in patients under 50 years old and the effect of cataract surgery was relatively high in patients without the presence of specific medical history. Cataract surgery did not seem to help all of the patients, but it is more effective in improving visual acuity and refractive power. We conclude that simultaneous cataract surgery in both eyes is reasonable in order to have at least the better effect.

Relationship between Metabolic Syndrome and Cataract in a Middle-Aged Men over the Age of 40's -Based on the 5th Korean National Health and Nutrition Examination Survey- (40세 이상 중장년의 대사증후군과 백내장과의 관련성 -제5기 국민건강영양조사 자료중심으로-)

  • Hwang, Hye-Kyung;Park, Chun Man
    • The Journal of Korean Society for School & Community Health Education
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    • v.16 no.2
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    • pp.17-31
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    • 2015
  • Objectives: This study aimed to analyze the relationship between metabolic syndrome and cataract in a middle-aged men over the age of 40's by using the data from the 5th Korean National Health and Nutrition Examination Survey(2010~2012). Methods: The subjects for the analysis were comprised of 5,808 patients who were at least 40 years or more with metabolic syndrome and cataract. The comparison between the metabolic syndrome and ophthalmic diseases according to the health demographic characteristics, health behavior and health conditions was analyzed with ${\chi}^2-test$. The complex samples logistic regression analysis was used to calculate the odds ratio of cataract according to the health demographic characteristics, health behavior and health conditions and the combination of the comprising factors of the metabolic syndrome. Results: After controlling the confounding factors, the odds ratio of cataract in the metabolic syndrome group was OR 1.30, which was significantly high (p<0.01). Furthermore, the odds ratio of cataract was significantly high in the case of males, as the age increased, educational level decreased, with exercising habits of less than 3 days a week, sun exposure of at least 5 hours, with hypertension and diabetes (p<0.01). The results of analyzing the odds ratio for the occurrence of cataract with the components of metabolic syndrome were OR 1.36 (concurrent high fasting blood glucose, high triglycerides, low HDL cholesterol), OR 1.63 (concurrent high fasting blood glucose, high triglycerides, high waist circumference) and OR 1.33 (high triglycerides, low HDL cholesterol, high waist circumference), which showed significantly high odds ratio for cataract occurrence (p<0.05). Conclusions: We come to know that the relation between metabolic syndrome and components are associate with cataract. Therefore the thorough management of metabolic syndrome and components is needed to prevent cataract.

The association between dietary sodium intake and the risk of cataract: data from Korean National Health and Nutrition Examination Survey 2012

  • Choi, Jeong-Hwa;Heo, Young-Ran
    • Journal of Nutrition and Health
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    • v.52 no.3
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    • pp.277-284
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    • 2019
  • Purpose: Sodium intake is known to be a critical dietary factor in several diseases including cataract. Earlier studies have reported that excess intake of sodium may elevate the risk of cataract. However, little is known about this in Koreans. Thus, the purpose of this study was to examine whether dietary intake of sodium and potassium might modify the risk of cataract. Methods: A total of 1,319 males (219 cases) and 1,966 females (369 cases) from Korean National Health and Nutrition Examination Survey 2012 were analyzed. Energy adjusted dietary intakes of sodium and potassium and their ratios were evaluated to ascertain their associations with the risk of cataract. Dietary intake levels were stratified into quartiles and their risk modifying effects were estimated with logistic regression models with or without subjects' socio-economic characteristics and life styles for each sex. Results: Findings suggested that various descriptive factors were associated with the risk of cataract either in males or females. Males' intake levels of sodium and potassium and their ratios did not differ between phenotypes. Higher intakes or higher ratio was not associated with the risk of cataract. In contrast, female controls had higher intakes of sodium and potassium. Higher intake of potassium reduced the risk of cataract in females. However, such association was not retained when subjects' socioeconomic status and life styles were factored into the analysis. Conclusion: Dietary sodium and potassium intakes minimally affected the risk of cataract in Korean males and females. More studies are needed to ascertain the true pathological effect of sodium intake on cataract aetiology.

Phacoemulsification for Cataract Extraction in Dogs: 85 eyes (1999-2001) (개의 백내장 적출을 위한 수정체유화흡인술:85 안 (1999-2001))

  • 김완희;권오경
    • Journal of Veterinary Clinics
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    • v.19 no.4
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    • pp.411-414
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    • 2002
  • Eighty five canine eyes performed phacoemulsification for cataract extraction between January 1999 and December 2001 were reviewed. Mean age was 7.26 years old and main breed was poodle (37 dogs). Mature cataract was 51.76%, immature cataract 27.05% and hypermature 21.18%. Improvement of vision was detected in 75 (88.24%) of 85 eyes at 4 weeks after surgery. Postoperative complications were posterior capsular opacification(6), partial posterior synechia(5), glaucoma(3) and uveitis(2). Reasons for failure of visual improvement among the patients performed phacoemulsification were mainly related to development of postoperative anterior uveitis, secondary glaucoma and progressive retinal degeneration.

Investigation of Prevalence and Awareness of Cataract (백내장의 유병율과 인지도에 관한 조사)

  • Han, Sun-Hee;Kim, Bong-Hwan;Kim, Byung-Gun;Kyeon, Ki-Young;Lee, Sang-Gyeong;Choi, Jin-Hun;Park, Jun-Sung
    • Journal of Korean Clinical Health Science
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    • v.5 no.2
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    • pp.834-849
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    • 2017
  • Purpose: The aim of this study is to examine the trends of cataract surgery and the recognition of cataract. Methods: ; It enrolled a total of 150 respondents, comprising 72 men and 78 women, who reside in Busan Metropolitan City, Ulsan Metropolitan City and Kyeong-nam Province. By the age groups, they include 44 people in their 20s, 24 in their 30s, 24 in their 40s, 26 in their 50s and 32 aged 60 years or older. In addition, the current study was conducted by dividing the respondents into two groups: people with cataract or not. Moreover, it was also conducted mainly for younger people. Results: 1. As for age of cataract operation, this study say that 1 patient was in their 20s, 3 patients in their 30s, 3 patients in their 40s, 6 patients in their 50s, and 7 patients in their over 60s. 2. In the question about whether they know about cataract, 100 respondents answered 'I know', 50 answered 'I do not know', 67% answered 'I know', 33% answered 'I do not know'. 3. As for pathways to know about cataract, of the total 120 respondents, 49 (41%) were in the media, 20 (17%) were Internet users, 26 (22%) were acquaintances, and 10 (7%) were specialty books, and 15 (13%) were 'others'. 4. As for cataract causes, 20 respondents (13%) answered 'exposure to sunlight', 12 (8%) answered 'electronic devices', 7 answered 'hereditary' 89 (60%) answered, and 22 (14%) answered 'eye disease'. 5. Twenty (13%) answered 'extremely yes', 40 (27%) answered 'yes', and 31 (21%) answered 'normal' when asked whether the use of smartphone was affected by cataracts. 48 (32%) answered 'little', and 11 (7%) answered 'not at all'. Our results showed that many people aged 50 years or older developed cataract and received surgery. It was also shown, however, that people in their 20s to 40s also developed cataract and received surgery. Conclusions: Our eyes are exposed to many places. Many people are unaware of cataracts, despite the fact that cataracts are gradually getting younger, due to the development of electronic devices and the use of electrical appliances. We should have interest in many information and contents about cataracts, knowing the importance to eyes, and gradually reducing the use of many electronic devices in young people.