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Meduri A, De Luca L, Oliverio GW, Mancini M, Minutoli L, Silvagno F, Bergandi L, Aragona P. DEXAMETHASONE INTRAVITREAL INJECTION IN DIABETIC PATIENTS UNDERGOING CATARACT SURGERY: An Updated Literature Review. Retina 2025; 45:1030-1042. [PMID: 39787414 DOI: 10.1097/iae.0000000000004381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2025]
Abstract
PURPOSE This literature review synthetizes current evidence on the timing and efficacy of dexamethasone intravitreal injections for diabetic macular edema in patients undergoing cataract surgery, particularly phacoemulsification, to determine the optimal timing for improved outcome. METHODS A systematic review of the literature was conducted across key databases to identify peer-reviewed studies, clinical trials, and meta-analyses addressing dexamethasone injections administered pre-, intra-, and postoperatively for diabetic macular edema in the context of cataract surgery. Studies were selected based on relevance to timing, visual outcomes, and inflammation control, with a focus on comparative efficacy. RESULTS The findings suggest that timely dexamethasone injections can substantially reduce inflammation and enhance visual recovery for patients with diabetic macular edema undergoing cataract surgery. Studies indicate that preoperative injections may effectively dampen the inflammatory response triggered by surgical trauma, potentially preserving retinal integrity, whereas intraoperative and postoperative administrations contribute to sustained anti-inflammatory effects during the recovery phase. Comparative studies also highlight dexamethasone's advantages over other anti-inflammatory treatments, such as NSAIDs, particularly in preventing cystoid macular edema. Notably, there was considerable variation in dosage and timing across studies, underscoring the need for standardized treatment protocols. CONCLUSION Dexamethasone intravitreal injections offer a valuable intervention for managing diabetic macular edema in diabetic patients undergoing cataract surgery, with optimal timing playing a crucial role in maximizing therapeutic benefits. Preoperative injections appear to be particularly beneficial in reducing the risk of postoperative inflammatory complications. Further research should focus on developing comprehensive guidelines for timing and dosage to standardize treatment and improve patient outcomes in this high-risk population.
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Affiliation(s)
- Alessandro Meduri
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, Messina, Italy
| | - Laura De Luca
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, Messina, Italy
| | | | - Maura Mancini
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, Messina, Italy
| | - Letteria Minutoli
- Department of Clinical and Experimental Medicine and Pharmacology, Section of Pharmacology, University of Messina, Messina, Italy; and
| | | | | | - Pasquale Aragona
- Ophthalmology Clinic, Department of Biomedical Sciences, University of Messina, Messina, Italy
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Hussain ZS, Shakarchi AF, Chauhan MZ, Jester DA, Soliman MK, Sallam AB. Is There a Safe Glycemic Threshold for Cataract Surgery? Am J Ophthalmol 2025:S0002-9394(25)00221-1. [PMID: 40324554 DOI: 10.1016/j.ajo.2025.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2025] [Revised: 04/22/2025] [Accepted: 04/27/2025] [Indexed: 05/07/2025]
Abstract
OBJECTIVE To assess the relationship between cataract surgery and the 30-day incidence of post-operative endophthalmitis (POE) (analysis 1) and serious systemic adverse events (analysis 2) in diabetic patients with varying preoperative hemoglobin A1c (HbA1c) levels. DESIGN Retrospective, longitudinal cohort study; multicenter study using a global federated database of electronic health records. SUBJECTS AND CONTROLS Adults (≥18 years) with type 1 or type 2 diabetes mellitus who underwent phacoemulsification cataract surgery. Control groups in analysis 1 were patients without diabetes who underwent cataract surgery. Control groups in analysis 2 were diabetic patients with similar HbA1c who had a routine eye examination without cataract surgery. INTERVENTION Cataract surgery. MAIN OUTCOMES MEASURES The primary outcomes were 30-day incidence of: (1) POE, defined by ICD-10 codes; and (2) serious systemic adverse events, including mortality, stroke/transient ischemic attack, major cardiovascular events, and a composite outcome of these events. Hazard ratios (HRs) and 95% CIs were calculated using Cox proportional hazards models. RESULTS In analysis 1, the risk of POE within 30 days post-cataract surgery did not differ significantly across HbA1c levels compared to non-diabetic controls. The HRs were 0.62 (95% CI, 0.30-1.27) for good HbA1c level (<7%), 1.08 (95% CI, 0.44-2.66) for moderate (7%-8.4%), 1.36 (95% CI, 0.43-4.28) for poor (8.5%-11.3%), and 2.85 (95% CI, 0.29-27.44) for very poor HbA1c (>11.3%). In analysis 2, the HRs for the 30-day composite outcome of any systemic events were not significantly different across HbA1c levels compared to controls. The 90-day analyses showed similar results for systemic events. CONCLUSIONS Cataract surgery does not appear to increase the risk of POE or serious systemic adverse events in diabetic patients across all HbA1c levels. These findings suggest that HbA1c alone should not be a reason to defer cataract surgery and highlight the need for individualized risk assessments to determine surgical fitness.
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Affiliation(s)
- Zain S Hussain
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ahmed F Shakarchi
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Muhammad Z Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Dane A Jester
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mohamed K Soliman
- University Hospitals Eye Institute, Case Western Reserve University, Cleveland, OH, USA; Department of Ophthalmology, Assiut University Hospitals, Assiut, Egypt
| | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt.
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Nagino K, Inomata T, Ohta T, Sung J, Midorikawa-Inomata A, Eguchi A, Ishida G, Inagaki K, Yamaguchi M, Nakatani S, Fujio K, Kobayashi H, Nakao S. Postoperative complications of intrascleral intraocular lens fixation: A systematic review and meta-analysis. Surv Ophthalmol 2025; 70:489-498. [PMID: 39672475 DOI: 10.1016/j.survophthal.2024.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 12/03/2024] [Accepted: 12/09/2024] [Indexed: 12/15/2024]
Abstract
Our systematic review and meta-analysis elucidates the postoperative complication rates associated with 3 major surgical approaches, including the scleral tunnel, glued, and flanged techniques, for sutureless intrascleral intraocular lens (IOL) fixation. An online search was performed for articles published in PubMed and EMBASE between January 1, 1975, and January 7, 2023. Original studies reporting postoperative complications of sutureless intrascleral IOL fixation were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The initial search yielded 1854 articles, from which 1797 were excluded; 57 and 51 were included in the qualitative synthesis and meta-analysis, respectively. Based on the meta-analysis, the postoperative complication rates of cystoid macular edema (5.7 %), retinal detachment (3.5 %), vitreous hemorrhage (8.8 %), and hypotony (5.5 %) were highest with the scleral tunnel technique. The glued technique had the highest complication rate for corneal edema (14.2 %). The rates of temporarily elevated intraocular pressure (9.9 %), iris capture (5.4 %), haptic exposure (6.5 %), and IOL decentration (7.3 %) were the highest with the flanged technique. The flanged technique had a significantly shorter operative time (median, 17.1 min) compared with the scleral tunnel (42.7 min) and glued (56.5 min) techniques. Postoperative best-corrected visual acuity with the flanged technique was significantly better than that with the other techniques (P = 0.017). This meta-analysis identified high postoperative complication rates related to the impact of surgical manipulations with the scleral tunnel technique and IOL placement stability with the flanged technique. These findings enable surgeons to minimize postoperative complications in high-risk patients.
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Affiliation(s)
- Ken Nagino
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo 113-0033, Japan; Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan; Juntendo University Graduate School of Medicine, Department of Telemedicine and Mobile Health, Tokyo 113-0033, Japan
| | - Takenori Inomata
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo 113-0033, Japan; Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan; Juntendo University Graduate School of Medicine, Department of Telemedicine and Mobile Health, Tokyo 113-0033, Japan; Juntendo University Graduate School of Medicine, Data Science, Tokyo, Japan.
| | - Toshihiko Ohta
- Juntendo University Shizuoka Hospital, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Jaemyoung Sung
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Akie Midorikawa-Inomata
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo 113-0033, Japan; Juntendo University Graduate School of Medicine, Data Science, Tokyo, Japan
| | - Atsuko Eguchi
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo 113-0033, Japan
| | - Gaku Ishida
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Keiji Inagaki
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Masahiro Yamaguchi
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Satoru Nakatani
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Kenta Fujio
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
| | - Hiroyuki Kobayashi
- Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo 113-0033, Japan
| | - Shintaro Nakao
- Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan
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Güven YZ, Işık MU, Ilgüy S, Yozgat Z. Phacoemulsification surgery in patients with diabetic macular edema: should intravitreal anti-VEGF therapy be performed before or simultaneously with surgery? Int J Ophthalmol 2025; 18:637-641. [PMID: 40256016 PMCID: PMC11947536 DOI: 10.18240/ijo.2025.04.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 12/24/2024] [Indexed: 04/22/2025] Open
Abstract
AIM To investigate the optimal anti-vascular endothelial growth factor (VEGF) treatment time in patients with diabetic macular edema (DME) scheduled for cataract surgery. METHODS The study was designed to include 4 groups. Twenty-six eyes of 26 patients with diabetes but no retinopathy (DR; group 1), 17 eyes of 17 patients with DR but no DME (group 2), and 19 eyes of 19 patients with DME who received anti-VEGF therapy concurrently with cataract surgery (group 3), and 21 eyes of 21 patients who received anti-VEGF therapy for DME 1wk before cataract surgery (group 4). The patients' best corrected visual acuity, intraocular pressure, central and mean macular thickness (CMT and MMT) values were noted on the day of surgery, postoperative day 1, week 1, and month 1. RESULTS There was a significant increase of CMT after cataract surgery in groups 1, 2, and 3 (P<0.001, P=0.044, and P=0.034, respectively) but not in group 4 (P=0.948). The change in MMT was the same as CMT (P=0.009, P=0.006, P=0.011, and P=0.172, respectively). There was a higher increase in CMT and MMT in group 2 compared to group 1 at the 1st month after surgery (P=0.002 and P=0.001, respectively). CONCLUSION In eyes with DME undergoing cataract surgery, preoperative anti-VEGF treatment may be more effective than simultaneous intravitreal anti-VEGF with surgery.
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Affiliation(s)
- Yusuf Ziya Güven
- Department of Ophthalmology, Izmir Katip Çelebi University Atatürk Educating and Research Hospital, Izmir 35200, Türkiye
| | - Mehmed Uğur Işık
- Kastamonu University Kastamonu Training and Research Hospital, Kastamonu 37200, Türkiye
| | - Serdar Ilgüy
- Kastamonu University Kastamonu Training and Research Hospital, Kastamonu 37200, Türkiye
| | - Zübeyir Yozgat
- Kastamonu University Kastamonu Training and Research Hospital, Kastamonu 37200, Türkiye
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Shumye AF, Tegegn MT, Bekele MM. Prevalence of cataract and its associated factors among adult diabetic patients attending at diabetic care clinics in Northwest Ethiopia, 2023. BMC Public Health 2025; 25:134. [PMID: 39806335 PMCID: PMC11726909 DOI: 10.1186/s12889-025-21343-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Accepted: 01/06/2025] [Indexed: 01/16/2025] Open
Abstract
BAGROUND Cataract is a major public health concern and the leading cause of blindness and low vision in Ethiopia. However, no studies have been conducted to assess the prevalence of cataract and associated factors among adult diabetic patients in the study area. Therefore, this study aimed to assess the prevalence of cataract and associated factors among adult diabetic patients in Northwest Ethiopia. METHODS A multicenter cross-sectional study was conducted in Northwest Ethiopia from May 8 to June 8, 2023. A systematic random sampling technique was used to select study subjects. Data were collected through an in-person interview and physical examination. The data were imported to Kobo Toolbox version 2022 4.4 and exported to Stata version 14. A binary logistic regression was carried out to identify factors associated with cataract, and the strength of association was determined by adjusted odds ratio. A variable with a P-value of < 0.05 at a 95% confidence interval was considered a significant factor for cataract. RESULTS The study included 1100 study subjects with a median age of 52 years. The prevalence of cataract was 42.2% (95%CI: 39.1-45.1%). Older age (AOR = 9.73, 95% CI: 5.53-17.13), ≥ 10 years duration of diabetic mellitus (AOR = 2.77, 95% CI: 1.96-3.90), poor glycemic control (AOR = 1.96, 95% CI: 1.40-2.74), and proliferative diabetic retinopathy (AOR = 4.14, 95% CI: 2.04-8.40), were factors significantly associated with cataract. CONCLUSIONS This study revealed a high prevalence of cataract among adult diabetic patients. Older age, longer duration of diabetes mellitus, poor glycemic control, diabetic retinopathy, and proliferative diabetic retinopathy had statistically significant associations with cataract. Therefore better controlling blood sugar levels will reduce the development of cataract. Regular screening of their eye will be also recommended to reduce visual impairment and blindness due cataract.
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Affiliation(s)
- Abebech Fikade Shumye
- Department of Optometry, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
| | - Melkamu Temeselew Tegegn
- Department of Optometry, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Matiyas Mamo Bekele
- Department of Optometry, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Alipour F, Abdi P, Asadigandomani H, Rezakhani M, Moosaie F, Jafari F, Yaseri M, Motamed-Gorji N, Khalili F, Tavakoli R, Tahkor A, Mohseni M, Salimpour S, Aref SMJM, Mirzaei M, Soleimani M, Shahraki K, Alizade Y, Shoja MR, Khataminia GR, Behrouz MJ, Hashemi H. Prevalence of cataracts in Iran based on the Persian eye cohort study. Sci Rep 2024; 14:31812. [PMID: 39738422 PMCID: PMC11685764 DOI: 10.1038/s41598-024-83080-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 12/11/2024] [Indexed: 01/02/2025] Open
Abstract
The PERSIAN eye cohort study is a population-based study that evaluates the overall prevalence of cataracts and their subtypes (nuclear sclerosis, cortical, and PSC) in Iran. In this study, from January 2015 to September 2021, 16,016 participants over 35 years of age from four provinces who were selected by random cluster sampling were examined. Demographic information, education, socioeconomic status, and place of residence were collected through interviews. The cataract status of the study participants was examined by two experienced ophthalmologists using slit lamp photography. The average age of the study participants was 49.52 ± 9.31 and 8891 (55.5%) were female. The overall prevalence of each type of cataract, nuclear sclerosis, cortical, and PSC was 18.90%, 12.65%, 9.20%, and 3.08%, respectively. The results indicated that the prevalence of any type of cataract (adjusted OR = 0.85, 95% CI: 0.78-0.92, p < 0.001) and NS cataract (adjusted OR = 0.80, 95% CI: 0.73-0.88, p < 0.001) is lower in women. The risk of developing cataracts increased exponentially with aging. The prevalence of any type of cataract and cortical subtype was higher in rural than urban populations. Also, the risk of developing cataracts decreased with an increase in education level and socioeconomic status and some Iranian races such as Arabs, Azari, and Guilak were also at a higher risk of cataracts. The results of this study indicate the importance of a comprehensive regard of cataract as one of the causes of avoidable blindness in Iran due to its higher prevalence than the global average.
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Affiliation(s)
- Fateme Alipour
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Parisa Abdi
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran.
| | - Hassan Asadigandomani
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Mehran Rezakhani
- Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moosaie
- International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fateme Jafari
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Khalili
- Liver and Gastrointestinal Diseases Research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Tavakoli
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Masoome Mohseni
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Guilan, Iran
| | - Samira Salimpour
- Geriatric Ophthalmology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mohammad Mirzaei
- Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Kourosh Shahraki
- Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Yousef Alizade
- Department of Ophthalmology, Amiralmomenin Hospital, Gillan University of Medical Sciences, Rasht, Iran
| | - Mohammad Reza Shoja
- Department of Ophthalmology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mahmoud Jabbarvand Behrouz
- Translational Ophthalmology Research Center, Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, 1336616351, Iran
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Zarei-Ghanavati S, Hadi Y, Habibi A, Ashraf Khorasani M, Yoo SH. Cataract and diabetes: review of the literature. J Cataract Refract Surg 2024; 50:1275-1283. [PMID: 39254426 PMCID: PMC11556822 DOI: 10.1097/j.jcrs.0000000000001547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/11/2024]
Abstract
Cataracts can cause visual impairment in diabetic patients. Diabetes mellitus affects different parts of the eye and causes many complications and problems before, during, and after intraocular surgeries. In this review, we will discuss the effects of diabetes on different aspects of cataract surgery and review the current management of diabetic cataracts. Careful preoperative examination of the patient's ocular surface, cornea, iris, and posterior segment, as well as the use of advanced phacoemulsification techniques, new intraocular lenses and the appropriate use of auxiliary medications such as nonsteroidal anti-inflammatory drugs and anti-vascular endothelial growth factors have improved the outcomes of cataract surgery in diabetic patients.
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Affiliation(s)
- Siamak Zarei-Ghanavati
- From the Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (Zarei-Ghanavati); Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (Hadi, Habibi, Ashraf Khorasani); Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Yoo)
| | - Yasaman Hadi
- From the Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (Zarei-Ghanavati); Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (Hadi, Habibi, Ashraf Khorasani); Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Yoo)
| | - Abbas Habibi
- From the Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (Zarei-Ghanavati); Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (Hadi, Habibi, Ashraf Khorasani); Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Yoo)
| | - Maryam Ashraf Khorasani
- From the Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (Zarei-Ghanavati); Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (Hadi, Habibi, Ashraf Khorasani); Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Yoo)
| | - Sonia H. Yoo
- From the Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (Zarei-Ghanavati); Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (Hadi, Habibi, Ashraf Khorasani); Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (Yoo)
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Ivanescu A, Popescu S, Gaita L, Albai O, Braha A, Timar R. Risk Factors for Cataracts in Patients with Diabetes Mellitus. J Clin Med 2024; 13:7005. [PMID: 39685467 DOI: 10.3390/jcm13237005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 11/16/2024] [Accepted: 11/19/2024] [Indexed: 12/18/2024] Open
Abstract
Background: Diabetes mellitus (DM) is one of the most impactful health problems worldwide. It affects ocular health in multiple ways and is one of the leading causes of vision loss. Our study aimed to evaluate the most important systemic risk factors related to the occurrence of cataracts in patients with DM. Method: This study evaluated a final number of 319 participants who were previously diagnosed with DM. For all patients, we retrieved data regarding DM status, metabolic control, demographic and anthropometric indices, and generally associated comorbidities from their medical charts. A comprehensive eye examination was performed on all patients. Results: The main studied risk factors were hypertension, cardiovascular disease (CVD), chronic kidney disease (CKD), diabetic polyneuropathy (DPN), dyslipidemia, and hepatic steatosis, which were present among the entire population. Hypertension (67.6%), DPN (53.3%), and dyslipidemia (46.6%) were highly prevalent in the cataract subgroup, and CKD (p < 0.001) and DPN (p = 0.019) were found to be predictive factors for the probability of cataract occurrence. Ophthalmologic evaluation was used to assess the presence of ocular complications, such as diabetic retinopathy (DR) and diabetic maculopathy. DR reached statistically significant values in the occurence of cataracts. Patients' age and DM-related factors, such as disease duration (p < 0.001) and HbA1c values (p = 0.029), significantly increased the risk of cataracts. Smoking was self-reported by 24.8% of the patients, with a significant impact on the occurrence of cataracts (p = 0.04). Conclusions: Patients with DM who exhibit a longer disease duration and poor glycemic control in conjunction with systemic comorbidities present a higher risk of developing cataracts; consequently, a strict therapeutic approach regarding these risk factors is needed.
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Affiliation(s)
- Adriana Ivanescu
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Opticlass Ophtalmology Clinic, 300012 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Simona Popescu
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, "Pius Brînzeu" Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Laura Gaita
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, "Pius Brînzeu" Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Oana Albai
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, "Pius Brînzeu" Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Adina Braha
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, "Pius Brînzeu" Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Romulus Timar
- Department of Second Internal Medicine Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Diabetes, Nutrition, and Metabolic Diseases Clinic, "Pius Brînzeu" Emergency Clinical County University Hospital, 300723 Timisoara, Romania
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Li B, Hou X, Ning B, Li X, Zhang M, Wang J, Liu M, Shi Y, Kang Z. Predictive role of the peripheral blood inflammation indices neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immunoinflammatory index (SII) for age-related cataract risk. PLoS One 2024; 19:e0313503. [PMID: 39556543 PMCID: PMC11573120 DOI: 10.1371/journal.pone.0313503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 10/24/2024] [Indexed: 11/20/2024] Open
Abstract
The novel inflammatory markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immunoinflammatory index (SII) have not yet been used in the study of age-related cataracts. The aim of this study was to investigate the possible relationships between the NLR, PLR, and SII and age-related cataracts. In the 2005-2008 National Health and Nutrition Examination Survey (NHANES) cross-sectional surveys, we collected complete information on blood counts, whether cataract surgery had been performed, and baseline information for adults. We investigated the independent interactions between the inflammatory markers NLR, PLR, and SII and age-related cataracts via weighted multivariate regression analyses and subgroup analyses. Smoothed curve fitting was performed to identify nonlinear associations and saturation effects between inflammation indices and cataract risk. Finally, receiver operating characteristic (ROC) curves were plotted for factors significantly associated with the development of cataracts to identify the optimal diagnostic inflammation index. This study included 8887 participants without cataracts and 935 participants with cataracts. Multivariate logistic regression analyses after adjusting for covariates revealed that a high SII (OR = 1.000, 95% CI = 1.000-1.000; P = 0.017) and high NLR (OR = 1.065, 95% CI = 1.000-1.134; P = 0.048) were independent risk factors for cataracts. Subgroup analyses did not reveal interactions between the SII, NLR, or cataract and covariates. Smoothed curve fits of the relationships between the SII or NLR and cataracts did not show positive significant saturating effect values for any of the variables. The ROC curve revealed some diagnostic value for cataracts for both the SII (AUC = 0.549, P < 0.001) and the NLR (AUC = 0.603, P < 0.001), but both had weak diagnostic value. Our study suggests that the SII and NLR are independent risk factors for cataracts in U.S. adults, but no such associations was identified between the PLR and cataracts.
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Affiliation(s)
- Baohua Li
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Xinyue Hou
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Bobiao Ning
- Department of Dermatology, China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, China
| | - Xiao Li
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - MingMing Zhang
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Jianquan Wang
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Mengyu Liu
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Yipeng Shi
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
| | - Zefeng Kang
- China Academy of Chinese Medical Sciences, Eye Hospital, Beijing, China
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10
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Xie P, He J, Ou Y. RBM15 Promotes High Glucose-Induced Lens Epithelial Cell Injury by Inducing PRNP N6-Methyladenine Modification During Diabetic Cataract. Curr Eye Res 2024; 49:1145-1153. [PMID: 39206850 DOI: 10.1080/02713683.2024.2362855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/15/2024] [Accepted: 05/28/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Diabetic cataract (DC) is a major cause of blindness worldwide. Prion protein (PRNP) was proved to be up-regulated and hypomethylated in DC samples. Here, we investigated whether PRNP was involved in DC progression in N6-methyladenosine (m6A)-dependent manner, and its potential mechanisms. METHODS Levels of genes and proteins were assayed using qRT-PCR and western blotting. Cell proliferation and apoptosis were determined using Cell Counting Kit-8 assay, 5-thynyl-2'-deoxyuridine (EdU) assay, and flow cytometry, respectively. Oxidative stress was analyzed by measuring the production of glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), and malondialdehyde (MDA). The m6A modification was determined by RNA immunoprecipitation (Me-RIP) assay. The interaction between RBM15 (RNA binding motif protein 15) and PRNP was probed using RIP assay. RESULTS PRNP was highly expressed in DC patients and HG-induced HLECs. Functionally, PRNP deficiency reversed HG-induced apoptosis and oxidative stress in HLECs. Mechanistically, RBM15 induced PRNP m6A modification and directly bound to PRNP. Knockdown of RBM15 abolished HG-induced apoptotic and oxidative injury in HLECs, while these effects were rescued after PRNP overexpression. CONCLUSION RBM15 silencing suppressed HG-induced lens epithelial cell injury by regulating PRNP in an m6A-mediated manner, hinting a novel therapeutic strategy for DC patients.
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Affiliation(s)
- Ping Xie
- Department of Ophthalmology, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, China
| | - Jing He
- Department of Ophthalmology, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, China
| | - Yangjun Ou
- Department of Ophthalmology, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, China
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11
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Dong S, Zhang J, Fu Y, Tang G, Chen J, Sun D, Qi Y, Zhou N. METTL3-mediated m6A modification of SIRT1 mRNA affects the progression of diabetic cataracts through cellular autophagy and senescence. J Transl Med 2024; 22:865. [PMID: 39334185 PMCID: PMC11429169 DOI: 10.1186/s12967-024-05691-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The increasing incidence of diabetes mellitus has established diabetic cataracts (DC) as a significant worldwide public health issue. The mechanisms underlying DC remain unknown, and effective prevention and treatment strategies are lacking. Accordingly, we aimed to explore the role and mechanism behind N6-methyladenosine (m6A) in DC progression. METHODS Methyltransferase-like 3 (METTL3), p21, Beclin1, LC3, and p62 expression levels were measured in human tissues. This study assessed total m6A levels and common m6A-regulated biomarkers in both in vitro and in vivo DC models. Autophagy flux was detected in vitro through Ad-mCherry-GFP-LC3B and Monodansylcadaverine (MDC) staining. Cellular senescence was assessed utilizing the senescence-associated β-galactosidase (SA-β-Gal) assay. Furthermore, the effect of METTL3 on SIRT1 mRNA modification was demonstrated, and its mechanism was elucidated using RT-qPCR, western blot, RNA stability assays, and RIP analysis. RESULTS METTL3, p21, and p62 expression levels were elevated in lens epithelial cells (LECs) from DC patients, while Beclin1 and LC3 levels were reduced. Silencing METTL3-mediated m6A modifications restored high-glucose-induced autophagy inhibition and prevented premature senescence in LECs. Notably, SIRT1720 and Metformin significantly enhanced autophagosome generation and delayed cellular senescence. The m6A-reading protein YTHDF2 bound to m6A modifications, and YTHDF2 silencing significantly reduced METTL3-mediated SIRT1 inactivation. CONCLUSIONS METTL3 induces senescence in DC by destabilizing SIRT1 mRNA in an m6A-YTHDF2-dependent manner. The METTL3-YTHDF2-SIRT1 axis is a key target and potential pathogenic mechanism in DC.
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Affiliation(s)
- Su Dong
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Jiajia Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Yushan Fu
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Gege Tang
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Jianfeng Chen
- Laboratory Animal Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Dawei Sun
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Yanhua Qi
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Nan Zhou
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
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12
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Chang Y, Yu Q. Correlation Study of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) on Diabetic Patients with Hypertension. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:1560-1568. [PMID: 39086405 PMCID: PMC11287599 DOI: 10.18502/ijph.v53i7.16050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/18/2023] [Indexed: 08/02/2024]
Abstract
Background We aimed to investigate the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on blood pressure, blood glucose and blood lipid in diabetic patients with hypertension. Methods A total of 300 diabetic patients and essential hypertension admitted to the Second Affiliated Hospital of Dalian Medical University, Dalian, China from January 2021 to December 2022 were selected. They were divided into an observation group and a control group using a random number table method. The control group was treated with conventional antihypertensive drugs, hypoglycemic drugs, and lipid-lowering drugs. The observation group was supplemented with liraglutide based on the control group. Blood pressure, blood glucose and blood lipid of the two groups were compared at the initial stage of medication and after 4 weeks and half a year, and the influencing factors of patients with persistent hypertension were further analyzed through Logistic regression. Results After 4 weeks and 6 months of medication, inter group comparisons showed that systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), as well as total cholesterol (TC), triacylglycerol (TG), and plasma arteriosclerosis index (AIP) in the observation group were significantly lower than those in the control group (P<0.05). Multivariate Logistic regression model analysis showed that age, smoking history, drinking history, taking conventional antihypertensive drugs, taking hypoglycemic drugs, taking lipid-lowering drugs, BMI, FBG, HbA1c and LDL-C were independent influencing factors for persistent hypertension (P<0.05). Conclusion GLP-1RAs could effectively improve the indexes including blood pressure, blood glucose and blood lipid in diabetic patients with hypertension.
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Affiliation(s)
- Yeting Chang
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Qin Yu
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, China
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13
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Li JL, Zhao J, Guo ZF, Xiao C, Liu X. Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery. World J Diabetes 2024; 15:1234-1241. [PMID: 38983819 PMCID: PMC11229957 DOI: 10.4239/wjd.v15.i6.1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/05/2024] [Accepted: 04/17/2024] [Indexed: 06/11/2024] Open
Abstract
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 thera-peutic 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 treatment, 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.
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Affiliation(s)
- Jun-Ling Li
- Department of Ophthalmology, Tianjin Beichen Hospital, The Affiliated Hospital of Nankai University, Tianjin 300400, China
| | - Jin Zhao
- Department of Ophthalmology, Xianyang First People’s Hospital, Xianyang 712000, Shaanxi Province, China
| | - Zhen-Feng Guo
- Department of Ophthalmology, Tianjin Beichen Hospital, The Affiliated Hospital of Nankai University, Tianjin 300400, China
| | - Chang Xiao
- Department of Ophthalmology, Tianjin Beichen Hospital, The Affiliated Hospital of Nankai University, Tianjin 300400, China
| | - Xuan Liu
- Department of Ophthalmology, Xianyang First People’s Hospital, Xianyang 712000, Shaanxi Province, China
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Morya AK, Nishant P, Ramesh PV, Sinha S, Heda A, Salodia S, Prasad R. Intraocular lens selection in diabetic patients: How to increase the odds for success. World J Diabetes 2024; 15:1199-1211. [PMID: 38983821 PMCID: PMC11229963 DOI: 10.4239/wjd.v15.i6.1199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/23/2024] [Accepted: 04/23/2024] [Indexed: 06/11/2024] Open
Abstract
The incidence of cataracts is significantly higher in diabetic individuals, particularly in younger age groups, with rates quadrupled in those under 65 and doubled in those over 65 compared to non-diabetics. Cataract surgery in diabetic patients poses many challenges: Poor epithelial healing, decreased corneal sensitivity, increased central corneal thickness, decreased endothelial cell count, variable topography, poor pupillary dilatation, anterior capsular phimosis, posterior capsular opacification (PCO), chances of progression of diabetic retinopathy (DR), zonular weakness, and vitreous prolapse and diabetic macular edema. Selection of an appropriate intraocular lens (IOL) is crucial for visual rehabilitation and monitoring DR. The choice of IOL in diabetic cataract patients is a challenging scenario. Square-edge IOLs are favored for their capacity to mitigate PCO, whereas hydrophilic counterparts may incur calcification in the setting of proliferative DR. The advisability of premium IOLs for achieving spectacle independence warrants judicious evaluation, particularly in the presence of advanced retinopathy. Optimal IOL placement within the capsular bag is advocated to minimize postoperative complications. Rigorous preoperative assessment and informed patient counseling regarding IOL options are indispensable for optimizing surgical outcomes. This review article covers various aspects regarding the choice of IOLs in different case scenarios and complications in the diabetic population.
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Affiliation(s)
- Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Prateek Nishant
- Department of Ophthalmology, ESIC Medical College, Patna 801113, Bihar, India
| | - Prasanna Venkatesh Ramesh
- Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Sony Sinha
- Department of Ophthalmology-Vitreo-Retina, Neuro-Ophthalmology and Oculoplasty, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Aarti Heda
- Department of Ophthalmology, National Institute of Ophthalmology, Pune 411000, Maharashtra, India
| | - Sarika Salodia
- Department of Safety, Global Medical Safety, Lundbeck, Singapore 307591, Singapore
| | - Ripunjay Prasad
- Department of Ophthalmology, RP Eye Institute, Delhi 110001, India
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Tang YF, Duan ZH. Clinical efficacy of femtosecond laser-assisted phacoemulsification in diabetic cataract patients. World J Clin Cases 2024; 12:1733-1741. [PMID: 38660074 PMCID: PMC11036478 DOI: 10.12998/wjcc.v12.i10.1733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/25/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024] Open
Abstract
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.
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Affiliation(s)
- Yi-Fei Tang
- Department of Glaucoma and Cataracts, Han Yang Eyegood Ophthalmic Hospital, Wuhan 430056, Hubei Province, China
| | - Zhi-Hui Duan
- Department of Glaucoma and Cataracts, Han Yang Eyegood Ophthalmic Hospital, Wuhan 430056, Hubei Province, China
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Elmi Sadr N, Mirsharif SS, Khadamy J, Lavvaf S, Hariri R. Assessing the Impact of Tropicamide on Anterior Segment Parameters in Diabetic Patients: A Randomized Clinical Trial. Cureus 2024; 16:e58223. [PMID: 38745798 PMCID: PMC11091937 DOI: 10.7759/cureus.58223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Evaluation of anterior segment parameters is crucial in ophthalmic procedures such as intraocular surgeries and contact lens fitting. However, the use of tropicamide in diabetic patients presents challenges due to its potential impact on biometric measurements. This study aims to investigate and compare the effects of 0.5% and 1% tropicamide on anterior segment parameters in diabetic patients. METHODS This double-masked randomized clinical trial enrolled 98 patients with diabetes mellitus. Participants were randomly assigned to receive either 0.5% or 1% tropicamide. Anterior segment parameters were measured using Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) before and 30 minutes after tropicamide administration. Parameters included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), keratometry, central corneal thickness (CCT), white-to-white distance (WTW), and pupillary diameter (PD). RESULTS Both concentrations of 0.5% and 1% tropicamide induced significant changes in anterior segment parameters. There was a notable increase in PD (2.99 ± 0.62, 3.11 ± 0.55, respectively, both P-values < 0.001), ACD (both 0.10 ± 0.05, both P-values < 0.001), ACV (16.69 ± 9.56, 17.51 ± 9.26, respectively, both P-values < 0.001), and WTW (0.06 ± 0.14, 0.03 ± 0.30, respectively, both P-values < 0.001), along with a decrease in ACA (-3.50 ± 10.65, -3.30 ± 6.87, P-value < 0.001 and P-value=0.001, respectively), and CCT (-6.10 ± 8.06, -6.39 ± 9.97, respectively, both P-values < 0.001) post-dilation. However, no significant changes were observed in keratometry (front Km (-0.03 ± 0.19, -0.04 ± 0.21, respectively), back Km (0.01 ± 0.05, 0.004 ± 0.05, respectively), P-values> 0.05). CONCLUSION Both concentrations of tropicamide exhibited comparable effects on anterior segment parameters in diabetic patients. These post-dilation changes should be considered for accurate intraocular lens power calculation and decision-making for cataract, phakic intraocular lens, and refractive surgeries.
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Affiliation(s)
- Navid Elmi Sadr
- Ophthalmology, Semnan University of Medical Sciences, Semnan, IRN
- Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, IRN
| | | | - Joobin Khadamy
- Ophthalmology, Skellefteå Eye Clinic, Skellefteå, SWE
- Ophthalmology, Norrlands Universitetssjukhus, Umeå, SWE
| | - Samaneh Lavvaf
- Epidemiology, Semnan University of Medical Sciences, Semnan, IRN
| | - Ramyar Hariri
- Ophthalmology, Semnan University of Medical Sciences, Semnan, IRN
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17
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Guo M, Su F, Chen Y, Su B. Methyltransferase METTL3-mediated maturation of miR-4654 facilitates high glucose-induced apoptosis and oxidative stress in lens epithelial cells via decreasing SOD2. Chem Biol Drug Des 2024; 103:e14491. [PMID: 38404215 DOI: 10.1111/cbdd.14491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/23/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
N6-methyladenosine (m6 A) modification has been reported to have roles in modulating the development of diabetic cataract (DC). Methyltransferase-like 3 (METTL3) is a critical m6 A methyltransferase involving in m6 A modification activation. Here, we aimed to explore the action and mechanism of METTL3-mediated maturation of miR-4654 in DC progression. Human lens epithelial cells (HLECs) were exposed to high glucose (HG) to imitate DC condition in vitro. Levels of genes and proteins were tested via qRT-PCR and western blotting assays. The proliferation and apoptosis of HLECs were evaluated by cell counting kit-8, 5-ethynyl-2'-deoxyuridine (EdU), and flow cytometry assays, respectively. Oxidative stress was analyzed by detecting the contents of reactive oxygen species (ROS), superoxide dismutase (SOD) and malondialdehyde (MDA). The binding of miR-4654 and SOD2 was confirmed by dual-luciferase reporter assay. The m6 A-RNA immunoprecipitation (MeRIP) assay detected the m6 A modification profile. Thereafter, we found that miR-4654 expression was elevated in DC samples and HG-induced HLECs. MiR-4654 knockdown reversed HG-mediated apoptosis and oxidative stress in HLECs. Mechanistically, miR-4654 directly targeted SOD2, silencing of SOD2 abolished the protective effects of miR-4654 knockdown on HLECs under HG condition. In addition, METTL3 induced miR-4654 maturation through promoting pri-miR-4654 m6 A modification, thereby increasing miR-4654 content in HLECs. METTL3 was highly expressed in DC samples and HG-induced HLECs, METTL3 deficiency protected HLECs against HG-mediated apoptotic and oxidative injury via down-regulating miR-4654. In all, METTL3 induced miR-4654 maturation in a m6 A-dependent manner, which was then reduced SOD2 expression, thus promoting apoptosis and oxidative stress in HLECs, suggesting a novel path for DC therapy.
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Affiliation(s)
- Ming Guo
- Department of Ophthalmology, Jingzhou Hospital, Yangtze University, (Jingzhou Central Hospital), Jingzhou, Hubei, China
| | - Fanfan Su
- Department of Ophthalmology, Jingzhou Hospital, Yangtze University, (Jingzhou Central Hospital), Jingzhou, Hubei, China
| | - Yao Chen
- Department of Ophthalmology, Jingzhou Hospital, Yangtze University, (Jingzhou Central Hospital), Jingzhou, Hubei, China
| | - Bo Su
- Department of Pathology, School of Medicine, Yangtze University, Jingzhou, Hubei, China
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Wotipka EK, Wright AJ, Fan JZ, Fuhriman D, Chuang AZ, Lindhorst GC, Feldman RM, Crowell EL. Postoperative Complications of True Dropless Cataract Surgery versus Standard Topical Drops. JOURNAL OF ACADEMIC OPHTHALMOLOGY (2017) 2023; 15:e144-e153. [PMID: 37564162 PMCID: PMC10411064 DOI: 10.1055/s-0043-1771043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 06/12/2023] [Indexed: 08/12/2023]
Abstract
Purpose Compare postoperative outcomes in cataract surgery between eyes with standard drop regimen versus dropless protocol by residents. Design Retrospective cohort study between April 1, 2018 and March 31, 2020. Methods The study was performed at Lyndon B. Johnson General Hospital in Houston, Harris County, Texas. A total of 547 eyes (234 dropless vs. 313 standard) with phacoemulsification cataract surgery and minimum of 1-month follow-up with best-corrected visual acuity (BCVA) were included. Dropless received 40 mg sub-Tenon's triamcinolone and intracameral moxifloxacin. Patients were followed at postoperative day 1 (POD1), week 1 (POW1), and month 1 (POM1). Postoperative rate of BCVA better than 20/40 (Good vision) and rate of complications were compared between groups. Results Good vision on POM1 in dropless (77.8%) was noninferior to standard (75.1%, p = 0.80). Complication rate in dropless (28.6%) was noninferior to standard (24.0%, p = 0.13). Intraocular pressure (IOP) elevation on POD1 ( p = 0.041) and anterior chamber (AC) cells on POW1 and POM1 ( p < 0.001) were more frequent in dropless. Mean spherical equivalent at POM1 was better in dropless (-0.37 D [±0.81 D]) compared with standard (-0.61D [±0.77 D], p = 0.001). Early posterior capsular opacification (early PCO) was more frequent in dropless ( p = 0.042). Conclusions Postoperative rate of BCVA better than 20/40 and rate of postoperative complications were noninferior, although dropless had higher rates of AC inflammation, IOP elevation, and early PCO.
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Affiliation(s)
- Evan K. Wotipka
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Alex J. Wright
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - James Z. Fan
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - David Fuhriman
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Alice Z. Chuang
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Grace C. Lindhorst
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Robert M. Feldman
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Eric L. Crowell
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
- Department of Ophthalmology, Dell Medical School, Austin, Texas
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Santilli CM, Johnson S, Thunstrom CR, Armbrust KR. Glycated Hemoglobin Improvement After Medical and Surgical Eye Care in American Veterans Involves Multidisciplinary Care. Clin Ophthalmol 2023; 17:1675-1682. [PMID: 37325065 PMCID: PMC10266375 DOI: 10.2147/opth.s412187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose The effects of diabetes mellitus (DM) on visual function have been extensively studied. Fewer studies evaluate the effect of visual function on DM, and previous small studies have shown mixed results concerning the relationship between glycated hemoglobin (HbA1c) and cataract surgery. We performed a retrospective, observational, single-site study at a Veterans hospital to evaluate this relationship and the relationship between HbA1c and non-surgical eye care. Patients and Methods We compared pre- and post-operative/examination HbA1c in 431 surgical and 431 matched, non-surgical subjects who underwent eye examination at the same institution. Subgroup analysis was performed by age, elevated (≥8) pre-operative/examination HbA1c, and change in diabetic management. We also assessed for a relationship between changes in best-corrected visual acuity (BCVA) and HbA1c. The Minneapolis Veterans Affairs Health Care System Research Administration determined this study to be Institutional Review Board exempt from the requirements of 38 CFR 16 under Category 4 (iii). Results Pairwise comparison of pre- versus post-operative HbA1c trended towards reduction at 3-6 months in all surgical subjects, with a statistically significant reduction in older subjects, and those with higher pre-operative HbA1c. Eye examination subjects experienced a significant HbA1c reduction 3-6 months after eye examination. Reduction in post-operative/examination HbA1c was associated with concurrent change in diabetic management. Conclusion We found an overall reduction in HbA1c in diabetic Veterans who interacted with an ophthalmologist, whether for cataract surgery or eye examination. HbA1c reduction was greatest when ophthalmic care was delivered as part of a multidisciplinary care team. Our findings add new evidence to further support the importance of ophthalmic care in patients with DM and suggest improved visual function may facilitate improved glycemic control.
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Affiliation(s)
- Christopher M Santilli
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA
| | - Shaun Johnson
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Coltt R Thunstrom
- Department of Statistics, University of Minnesota, Minneapolis, MN, USA
| | - Karen R Armbrust
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA
- Department of Ophthalmology, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
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Gill ZS, Caldwell AS, Patnaik JL, Marin AI, Mudie LI, Grove N, Ifantides C, Ertel MK, Puente MA, Seibold LK. Comparison of cataract surgery outcomes in English proficient and limited English proficiency patients. J Cataract Refract Surg 2023; 49:595-601. [PMID: 36779806 DOI: 10.1097/j.jcrs.0000000000001164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/31/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE To determine differences in cataract surgery outcomes between English proficient (EP) and limited English proficiency (LEP) patients. SETTING Sue Anschutz-Rodgers Eye Center, Aurora, Colorado. DESIGN Retrospective. METHODS Patients who underwent phacoemulsification at the Sue Anschutz-Rogers Eye Center between January 2014 and February 2020 were included. Patients who self-identified as needing or preferring an interpreter in medical encounters were defined as LEP. Differences in surgical characteristics and outcomes including cataract maturity, surgical complexity, and surgical complications were analyzed. RESULTS 868 eyes (6.4%) were identified from LEP patients. LEP patients were more likely to have mature cataracts (5.1% vs 2.3%, P < .0001). LEP patients' surgeries were more likely to be considered complex (27.8% vs 15.3%, P < .0001) and use higher cumulative dissipated energy (mean of 9.5 [SD = 9.5] vs 7.2 [SD = 7.1], P < .0001). Preoperative visual acuity was worse in LEP patients (logMAR 0.566 [SD = 0.64] vs 0.366 [SD = 0.51], P < .0001) but showed greater improvement after surgery (logMAR 0.366 [SD = 0.54] vs 0.254 [SD = 0.41], P < .0001). There were no significant differences in operative time, intraoperative or postoperative complications. More LEP patients were on steroids 4 weeks postoperatively when compared with EP patients (14.6% vs 10.1%, P < .0002). LEP patients were less likely to undergo subsequent YAG capsulotomy (7.3% vs 12.8%, P < .0001). CONCLUSIONS Disparities in cataract outcomes between EP and LEP patients was demonstrated. Further research into ophthalmic health disparities for LEP patients is needed to understand the root causes and how they can be addressed.
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Affiliation(s)
- Zafar S Gill
- From the Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Mrugacz M, Pony-Uram M, Bryl A, Zorena K. Current Approach to the Pathogenesis of Diabetic Cataracts. Int J Mol Sci 2023; 24:ijms24076317. [PMID: 37047290 PMCID: PMC10094546 DOI: 10.3390/ijms24076317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
Cataracts remain the first or second leading cause of blindness in all world regions. In the diabetic population, cataracts not only have a 3–5 times higher incidence than in the healthy population but also affect people at a younger age. In patients with type 1 diabetes, cataracts occur on average 20 years earlier than in the non-diabetic population. In addition, the risk of developing cataracts increases with the duration of diabetes and poor metabolic control. A better understanding of the mechanisms leading to the formation of diabetic cataracts enables more effective treatment and a holistic approach to the patient.
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Evaluation of the Corneal Endothelium Following Cataract Surgery in Diabetic and Non-Diabetic Patients. Diagnostics (Basel) 2023; 13:diagnostics13061115. [PMID: 36980422 PMCID: PMC10047116 DOI: 10.3390/diagnostics13061115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
The aim of this study was to evaluate the influence of phacoemulsification cataract surgery on the state of the corneal endothelium in diabetic versus non-diabetic patients. We compared the corneal cell morphology in 48 diabetics with good glycemic control and 72 non-diabetic patients before and after uneventful phacoemulsification. Corneal cell density, central corneal thickness, and hexagonality were measured preoperatively and post-surgery (at 1 and 4 weeks) by specular microscopy. The effect of age, gender, axial length, and anterior chamber depth on the parameters of the corneal endothelium were evaluated. We noticed a drop in the endothelial density in both groups postoperatively: a mean endothelial cell loss of 472.7 ± 369.1 in the diabetic group was recorded versus 165.7 ± 214.6 mean loss in the non-diabetic group after the first week. A significant increase in central corneal thickness was also noticed in both groups one week after phacoemulsification, but no statistical significance after 4 weeks in the diabetic group. In terms of cell hexagonality, statistically significant differences were noticed after 4 weeks in both groups. Overall, a significant difference between diabetic and non-diabetic population was noticed in terms of corneal endothelial cell loss after uneventful phacoemulsification cataract surgery. Routine specular microscopy and HbA1c evaluation is recommended before cataract surgery, while intraoperative precautions and high monitorisation in terms of pacho power intensity and ultrasound energy, along with a proper application of the dispersive viscoelastic substances are essential to reduce the risk of endothelial damage.
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Rachmilevich A, Yanculovich N, Hazan I, Tsumi E, Liberty IF. Glycemic control and macular edema in patients undergoing cataract surgery. Prim Care Diabetes 2023; 17:55-59. [PMID: 36599797 DOI: 10.1016/j.pcd.2022.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/12/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023]
Abstract
AIMS Cataract, the most common cause of blindness, has higher prevalence among patients with diabetes mellitus. About 20% of cataract surgeries are performed on patients with diabetes. One of the complications of cataract surgery is pseudophakic cystoid macular edema (CME). This study examined whether patients' glycemic control (as indicated by HbA1c level before cataract surgery) is associated with CME incidence within one year post-surgery. METHODS We conducted a retrospective cohort study of 1285 diabetes patients over age 18 who underwent cataract surgery between January 2015 and January 2020. Data were obtained from medical records reporting glycated hemoglobin (HbA1c) level prior to surgery and post-operative CME with intraocular anti-vascular endothelial growth factor injections. RESULTS The patients with CME complications were younger, with longer duration diabetes, and higher percentages of type 1 diabetes and diabetic retinopathy. The main variables influencing risk of post-operative CME were found to be diabetic retinopathy and HbA1c level. Multivariate analysis revealed that HbA1c is an independent risk for post-operative CME with a relative risk of 2.01 when HBa1c is above 7 c (95% CI, 1.10-3.67). CONCLUSION The study demonstrates that pre-cataract surgery diabetes control, measured by HbA1c level, is an independent risk factor for developing post-surgery CME.
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Affiliation(s)
- Amit Rachmilevich
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel.
| | - Noam Yanculovich
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel; Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel.
| | - Itai Hazan
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel; Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel.
| | - Erez Tsumi
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel; Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel.
| | - Idit F Liberty
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B 635, Beer-Sheva 8410501, Israel; Diabetes Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O.B. 635, Beer-Sheva 8410501, Israel.
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Application of the Active-Fluidics System in Phacoemulsification: A Review. J Clin Med 2023; 12:jcm12020611. [PMID: 36675540 PMCID: PMC9863491 DOI: 10.3390/jcm12020611] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
The fluidics system is an indispensable and primary component of phacoemulsification. Both the gravity-fluidics system and active-fluidics system are commonly used in practice. The irrigation pressure of the gravity-fluidics system is determined by the bottle height, which is relatively constant, while the active-fluidics system is paired with a cassette that contains pressure sensors to monitor intraocular pressure changes. The active-fluidics system allows surgeons to preset a target intraocular pressure value, and it replenishes the fluids proactively; thus, the intraocular pressure is consistently maintained near the target value. Under such circumstances, stable intraocular pressure and anterior chamber volume values could be acquired. Research on surgical safety, efficiency and results have reported several strengths of the active-fluidics system. It is also advantageous in some complicated cataract surgeries. However, the system is not widely used at present, mainly due to its low penetration rate and high equipment cost. Some of its updates such as the new Active Sentry handpiece showed potential superiority in laboratory studies recently, but there is still further research to be conducted. This article gives an overview of the mechanism and performance of the active-fluidics system, and it is expected to provide clues for future research.
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25
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Chan LKY, Lin SS, Chan F, Ng DSC. Optimizing treatment for diabetic macular edema during cataract surgery. Front Endocrinol (Lausanne) 2023; 14:1106706. [PMID: 36761187 PMCID: PMC9905225 DOI: 10.3389/fendo.2023.1106706] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/09/2023] [Indexed: 01/26/2023] Open
Abstract
Diabetic macular edema (DME) causes visual impairment in diabetic retinopathy (DR). Diabetes mellitus is a global epidemic and diabetic individuals are at risk of developing DR. Approximately 1 in 10 diabetic patients suffers from DME, which is the commonest cause of vision-threatening DR at primary-care screening. Furthermore, diabetes predisposes to a higher frequency and a younger onset of cataract, which further threatens vision in DME patients. Although cataract extraction is an effective cure, vision may still deteriorate following cataract surgery due to DME progression or recurrence, of which the risks are significantly higher than for patients without concurrent or previous history of DME at the time of operation. The management of pre-existing DME with visually significant cataract is a clinical conundrum. Deferring cataract surgery until DME is adequately treated is not ideal because of prolonged visual impairment and maturation of cataract jeopardizing surgical safety and monitoring of DR. On the other hand, the progression or recurrence of DME following prompt cataract surgery is a profound disappointment for patients and ophthalmic surgeons who had high expectations for postoperative visual improvement. Prescription of perioperative anti-inflammatory eye drops is effective in lowering the risk of new-onset DME after cataract surgery. However, management of concurrent DME at the time of cataract surgery is much more challenging because DME is unlikely to resolve spontaneously even with the aid of anti-inflammatory non-steroidal or steroid eye drops. A number of clinical trials using intravitreal injection of corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) as first-line therapy have demonstrated safety and efficacy to treat DME. These drugs have also been administered perioperatively for the prevention of DME worsening in patients undergoing cataract surgery. This article reviews the scientific evidence to guide ophthalmologists on the efficacy and safety of various therapies for managing patients with DME who are particularly vulnerable to cataract surgery-induced inflammation, which disintegrates the blood-retinal barrier and egression of fluid in macular edema.
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Affiliation(s)
- Leo Ka Yu Chan
- Hong Kong Eye Hospital, Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sui Sum Lin
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Counselling and Psychology, Faculty of Social Sciences, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Fiona Chan
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danny Siu-Chun Ng
- Hong Kong Eye Hospital, Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Danny Siu-Chun Ng,
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26
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Meng B, Li S, Wang K, Huang Y, Wang Y, Zhao L. Systematic review of the efficacy and safety of stage I or II IOL implantation in patients with diabetic retinopathy. Medicine (Baltimore) 2022; 101:e32406. [PMID: 36595831 PMCID: PMC9794241 DOI: 10.1097/md.0000000000032406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Intraocular lens (IOL) implantation is required after vitrectomy combined with cataract surgery in diabetic retinopathy patients. However, the question of whether an IOL should be implanted in stage I after vitrectomy or stage II during silicone oil filling has been controversial, and there has been no systematic review of this clinical issue. METHODS WanFang, SinoMed CNKI, VIP, PubMed, Embase, and Cochrane Library databases were systematically searched for relevant studies. The deadline was May 8, 2021. All studies of stage I or II IOL implantation in patients with diabetes who underwent vitrectomy were included. Revman 5.3 software was used for the meta-analysis. RESULTS Four studies, involving 253 eyes, were included. This study analyzed the literature with a common outcome index by meta-analysis and systematically evaluated the literature without a common outcome index. Four studies compared the efficacy and safety of the 2 sequential surgical methods in patients with diabetic retinopathy. The results of the meta-analysis showed that there was no significant difference in the efficacy and safety of stage II IOL implantation when compared with stage I IOL implantation (P > .05). One study showed that stage II cataract surgery with oil extraction resulted in better postoperative visual acuity and fewer complications than stage I cataract surgery with vitrectomy. One study showed that stage II IOL implantation during oil extraction had better postoperative visual acuity than stage I IOL implantation during vitrectomy without increasing surgical complications. CONCLUSION Vitrectomy combined with stage II IOL implantation is safer and more effective than stage I in patients with diabetic retinopathy; however, more clinical studies are needed to verify this.
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Affiliation(s)
- Bo Meng
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuang Li
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Kang Wang
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yingxiang Huang
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yanling Wang
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lu Zhao
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
- * Correspondence: Lu Zhao, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China (e-mail: )
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Analysis of cataract-regulated genes using chemical DNA damage induction in a rat ex vivo model. PLoS One 2022; 17:e0273456. [PMID: 36477544 PMCID: PMC9728860 DOI: 10.1371/journal.pone.0273456] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/08/2022] [Indexed: 12/12/2022] Open
Abstract
Although cataracts affect almost all people at advanced age and carry a risk of blindness, the mechanisms of cataract development remain incompletely understood. Oxidative stress, which is a causative factor in cataract, results in DNA breakage, which suggests that DNA damage could contribute to the formation of cataracts. We developed an ex vivo experimental system to study changes in gene expression during the formation of opacities in the lens by culturing explanted rat lenses with Methylmethanesulfonate (MMS) or Bleomycin, which induce DNA damage. Lenses cultured using this experimental system developed cortical opacity, which increased in a concentration- and time-dependent manner. In addition, we compared expression profiles at the whole gene level using microarray analysis of lenses subjected to MMS or Bleomycin stress. Microarray findings in MMS-induced opacity were validated and gene expression was measured from Days 1-4 using RT-qPCR. Altered genes were classified into four groups based on the days of peak gene expression: Group 1, in which expression peaked on Day 1; Group 2, in which expression peaked on Day 2; Group 3, in which expression progressively increased from Days 1-4 or were upregulated on Day 1 and sustained through Day 4; and Group 4, in which expression level oscillated from Days 1-4. Genes involved in lipid metabolism were restricted to Group 1. DNA repair- and cell cycle-related genes were restricted to Groups 1 and 2. Genes associated with oxidative stress and drug efflux were restricted to Group 2. These findings suggest that in temporal changes of MMS-induced opacity formation, the activated pathways could occur in the following order: lipid metabolism, DNA repair and cell cycle, and oxidative stress and drug efflux.
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28
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Xia Y. The management of cataract surgery in diabetic patients. J Perioper Pract 2022; 32:361-367. [PMID: 35445624 DOI: 10.1177/17504589221091063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A cataract in the eye is a major cause of vision loss in diabetic patients, which occurs earlier and develops faster than non-diabetic patients, and often requires surgery for treatment. However, diabetic patients undergoing cataract surgery have a higher risk of intraoperative and postoperative complications than non-diabetic patients. For diabetic patients undergoing any surgery, careful perioperative assessment and management are required to reduce postoperative complications and improve surgical outcomes. Better understanding of their needs may guide perioperative practitioners to manage their care appropriately. This article presents recent evidence and guidance associated with the preoperative, intraoperative and postoperative management of diabetic patients undergoing cataract surgery and to inform perioperative practitioners of the challenges and potential complications to provide the best care and improve sight.
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Affiliation(s)
- Yu Xia
- Beijing Aerospace General Hospital, Beijing, China
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29
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Bahl VJ, Malik KPS, Guliani BP. Evaluation of cautery in manual small-incision cataract surgery. Indian J Ophthalmol 2022; 70:3883-3887. [PMID: 36308120 PMCID: PMC9907235 DOI: 10.4103/ijo.ijo_1540_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Manual small-incision cataract surgery (MSICS) has a major role in tackling cataract blindness in our country. Cauterization of sclera is one of the important steps performed in MSICS to have bloodless field during surgery. Only few studies have addressed the effect of cautery on post-operative astigmatism. The present study is designed to evaluate the effect of cautery on surgically induced astigmatism in Indian patients. Methods The study was designed as a prospective randomized trial conducted in a tertiary health care institution over a period of 2 years. A total of 150 eyes were randomized into two groups. The study group (Group 1, n = 75) underwent MSICS with cauterization using wetfield bipolar cautery with 4 amperes power. In the control group (Group 2, n = 75), no cauterization was performed. Surgically induced astigmatism was calculated using Naesers polar value method and compared between these two groups up to 60 days post-operatively. Results Data from 150 eyes were available for evaluation. The net post-operative astigmatic value was 1.01 ± 0.21, 1.04 ± 0.19, and 1.03 ± 0.22 D on the 1st, 7th, and 30th post-operative days, respectively, showing a stable trend in patients undergoing cauterization. In Group 2, the net post-operative astigmatic values observed were 0.47 ± 0.11 D, 0.54 ± 0.10, and 0.54 ± 0.09 D on the 1st, 7th, and 30th post-operative days, respectively. The mean value of surgically induced astigmatism at 2 months post-operatively with and without cautery was 0.60 ± 0.20 D at 90° and 0.47 ± 0.10 D at 90°. The difference was not statistically significant (P = 0.08). Conclusion The results of this study show that the use of cautery in MSICS is not associated with a higher surgically induced post-operative astigmatism. The magnitude of surgically induced astigmatism decreases with time.
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Affiliation(s)
- Vishwa Jyoti Bahl
- Department of Ophthalmology, MM Medical College & Hospital, Solan, Himachal Pradesh, India,Correspondence to: Dr. Vishwa Jyoti Bahl, Department of Ophthalmology, MM Medical College and Hospital, Solan, Himachal Pradesh, India. E-mail:
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30
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Scutifero M, Lanza M, Petillo R, De Bernardo M, Passamano L, Rosa N, Politano L. Gender effect on onset, prevalence and surgical treatment of cataract in patients with Myotonic Dystrophy type 1. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2022; 41:105-110. [PMID: 36349183 PMCID: PMC9628803 DOI: 10.36185/2532-1900-n75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/21/2022]
Abstract
Myotonic Dystrophy type 1 (DM1) is the most common muscular dystrophy in adults, affecting 1:8000 individuals. It is a multi-systemic disorder involving muscle, heart, endocrine and respiratory apparatus and eye. The eye symptoms can include ptosis, external ophthalmoplegia, epiphora, and early onset cataracts. Cataracts occur at a much earlier age (usually between 30 and 40) than the general population, where females are usually affected more than men. We studied gender differences in cataract prevalence and treatment age in 243 DM1 patients (134 M; 109 F), aged 18 to 70 years, who were subsequently screened at routine follow-up. For each patient, information was collected on age, sex, CTG expansion, age of cataract onset, and age at cataract surgery, when available. Seventy-three patients, 30 females and 43 males, had cataracts, at a mean age of onset of 41.14 ± 12.64 in females, and 40.36 ± 10.03 in males. Sixty-nine of them underwent cataract surgery, males at an earlier age than females (42.8 ± 9.8 years versus 47.3 ± 12.6 years) and in 52.5% of cases before the age of 40, compared to 17.2% of females. The difference was statistically significant. The assumption that females in general and those with DM1 in particular develop cataracts more frequently and earlier than males is not confirmed, at least in this study. A possible explanation for these results could be related to non-advanced age, the protective role of estrogen and the lower prevalence of smoking in the study population.
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Affiliation(s)
- Marianna Scutifero
- Cardiomyology and Medical Genetics,
University Hospital of Campania “Luigi
Vanvitelli”, Naples, Italy
| | - Michele Lanza
- Eye Department, University of Campania
“Luigi Vanvitelli”, Naples,
Italy
| | - Roberta Petillo
- Cardiomyology and Medical Genetics,
University Hospital of Campania “Luigi
Vanvitelli”, Naples, Italy
| | | | - Luigia Passamano
- Cardiomyology and Medical Genetics,
University Hospital of Campania “Luigi
Vanvitelli”, Naples, Italy
| | - Nicola Rosa
- Department of Medicine and Surgery,
University of Salerno, Salerno,
Italy
| | - Luisa Politano
- Cardiomyology and Medical Genetics,
University Hospital of Campania “Luigi
Vanvitelli”, Naples, Italy,Correspondence Luisa Politano Cardiomyology and
Medical Genetics, University Hospital of Campania “Luigi
Vanvitelli”, piazza Miraglia 2, 80138 Naples, Italy. E-mail:
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Kalani M, Shinde P. Diabetic Retinopathy May Covariate With Stroke in Diabetes Mellitus. Cureus 2022; 14:e28227. [PMID: 36158371 PMCID: PMC9491626 DOI: 10.7759/cureus.28227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/21/2022] [Indexed: 12/01/2022] Open
Abstract
Diabetes mellitus is a chronic metabolic disorder with increasing prevalence per hour. Cataracts are one of the most common eye complications, and they affect all structures of the eye. The incidence of cataracts is increasing in patients with diabetes by several mechanisms. With the advancement of technology, cataract surgery is now a necessary procedure for diabetic patients. High-risk complications, like diabetic macular oedema, diabetic retinopathy (DR), phakic, postoperative cyst, and postoperative macular oedema, and macular oedema and endophthalmitis following surgery for a pseudocyst, could result in blindness. The importance of preoperative, intraoperative, and postoperative factors cannot be overestimated in managing complications and improving visual outcomes. DR can be a severe problem if it worsens and causes non-proliferative or proliferative DR or if fluid accumulation in the eye is diagnosed as macular oedema. A woman progressing to sight-threatening DR during childbearing age experiences distress and often requires ocular treatment. Diabetes that has been present for a more extended period, as well as more significant hyperglycaemia, hypertension, cardiovascular diseases, and elevated blood pressure, substantially predict the development of DR. Oxidative stress can be caused by hyperglycaemia, irregular metabolic processes, and people with DR developing neurodegeneration. Therefore, controlling postprandial hyperglycaemia is crucial for preventing DR. Femtosecond laser technology, multifocal intraocular lenses, and other surgical innovations are popularly referred to as surgical management; it will be engaged in the coming era to determine whether there will be a continued reduction in the complication of cataract surgery. This article aims to review the correlation of DR with stroke and its screening and to outline the critical management strategies.
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Bek T, Tilma K, Cour M. The risk for developing vision-threatening retinopathy after cataract surgery in diabetic patients depends on the postoperative follow-up time. Acta Ophthalmol 2022; 100:e719-e725. [PMID: 34339106 DOI: 10.1111/aos.14992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/04/2021] [Accepted: 07/16/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE To identify parameters that can predict the postoperative risk for progression of retinopathy to a vision-threatening stage after cataract surgery. This may optimize the timing of surgery and the postoperative follow-up strategy in diabetic patients. METHODS Multi-state survival analysis with death as competing risk was used to investigate how year of onset and age of onset of diabetes, gender, body mass index, HbA1c and blood pressure had affected the risk for developing diabetic macular oedema (DME) and proliferative diabetic retinopathy (PDR) among 2540 right eyes from 2797 diabetic patients operated for cataract on one or both eyes during 25 years until July 1. 2019. RESULTS Cataract surgery had been performed in 98.8% of patients reaching 90 years of age. The risk for developing both DME and PDR was increased by cataract surgery. The risk was highest during the first postoperative years and increased by pre-operative variability in HbA1c. The risk after more than 20 years postoperatively increased by increased cumulative HbA1c pre-operatively. The other studied risk factors contributed differently to the development of the two complications. CONCLUSIONS Decision models for the timing of cataract surgery in diabetic patients should consider that the risk for developing vision-threatening retinopathy depends on follow-up time. Differences in the risk profiles for developing DME and PDR after cataract surgery support that the two complications should be regarded as separate late complications.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology Aarhus University Hospital Aarhus N Denmark
| | - Kathrine Tilma
- Department of Ophthalmology Aarhus University Hospital Aarhus N Denmark
| | - Morten Cour
- Department of Ophthalmology Rigshospitalet/Glostrup Glostrup Denmark
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Bu Y, Shih KC, Tong L. The ocular surface and diabetes, the other 21st Century epidemic. Exp Eye Res 2022; 220:109099. [DOI: 10.1016/j.exer.2022.109099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
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Fu J, Hu X. Simvastatin alleviates epithelial‑mesenchymal transition and oxidative stress of high glucose‑induced lens epithelial cells in vitro by inhibiting RhoA/ROCK signaling. Exp Ther Med 2022; 23:420. [PMID: 35601076 PMCID: PMC9117960 DOI: 10.3892/etm.2022.11347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/18/2022] [Indexed: 11/06/2022] Open
Abstract
Diabetic cataracts (DC) is one of the main causes of blindness among patients with diabetes mellitus. The aim of the present study was to examine the effect of simvastatin on lens epithelial cells in DC and the underlying mechanism. The viability of SRA01/04 cells treated with different concentrations of simvastatin was detected using a Cell Counting Kit-8 assay before and after high glucose (HG) treatment. The expression levels of E-cadherin, N-cadherin, Vimentin and α-smooth muscle actin (α-SMA), proteins associated with epithelial-mesenchymal transition (EMT), in addition to RhoA, Rho-associated kinases (ROCK)1 and ROCK2, proteins related to RhoA/ROCK signaling, were also measured in SRA01/04 cells treated with HG and simvastatin, with or without U46619, using western blot analysis. DCFH-DA dyes, superoxide dismutase (SOD) and glutathione (GSH)/glutathione disulfide (GSSG) kits were used to measure the levels of oxidative stress parameters in SRA01/04 cells treated with HG and simvastatin with or without U46619. The cell viability of SRA01/04 cells treated with simvastatin was found to be significantly elevated after HG treatment. The protein expression levels of E-cadherin were increased but those of N-cadherin, Vimentin and α-SMA decreased after HG and simvastatin treatment, and this was reversed by U46619. The levels of SOD and GSH-GSSG were found to be increased whereas reactive oxygen species levels were decreased, effects that were reversed by U46619. Additionally, the protein expression levels of RhoA, ROCK1 and ROCK2 were markedly decreased. These findings provided evidence that simvastatin increased HG-induced SRA01/04 cell viability and exerted inhibitory effects on EMT and oxidative stress that occurs during DC.
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Affiliation(s)
- Jianming Fu
- Department of Ophthalmology, The Second People's Hospital of Yueqing, Wenzhou, Zhejiang 325608, P.R. China
| | - Xiaojie Hu
- Department of Ophthalmology, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, P.R. China
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Junejo MS, Rebecca, Shaikh FF, Siyal N. Visual outcome of cataract surgery in a tertiary care teaching hospital. Pak J Med Sci 2022; 38:900-903. [PMID: 35634638 PMCID: PMC9121925 DOI: 10.12669/pjms.38.4.5163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/02/2021] [Accepted: 12/30/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives To review the visual outcomes after cataract surgery in a tertiary care teaching hospital, Isra University Hyderabad. Methods This retrospective clinical study was carried out for six months at Isra University Hyderabad from December 2020-May 2021. Total patients included were 982. The data comprised of patients who underwent cataract surgery from Sept 2018 - Aug 2020. Individuals over 40 years were included and who returned for out-patient appointments. Visual acuity before and six weeks after cataract surgery were noted and categorized according to World Health Organization criteria (i-e Good, Moderate and Poor).. Data analysis was done with the help of SPSS version 22.0. Results Out of 982 patients who underwent Phacoemulsification at Isra University Hospital, the operated eyes were 483 right and 499 left respectively. Meanwhile, 966 had good visual acuity six weeks after the surgery, while 16 had moderate visual acuity noted after six weeks. Conclusion Clinical audit of cataract surgeries by measuring visual acuity postoperatively is an excellent approach in improving the outcomes and maintaining the good care facilities at a tertiary care hospital.
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Affiliation(s)
- Murtaza Sameen Junejo
- Dr. Murtaza Sameen Junejo, FCPS, Department of Ophthalmology, Isra University Hospital, Hyderabad, Pakistan
| | - Rebecca
- Dr. Rebecca, MBBS, Department of Ophthalmology, Isra University Hospital, Hyderabad, Pakistan
| | - Fahad Feroz Shaikh
- Dr. Fahad Feroz Shaikh, FCPS, FRCS (GLASGOW), FCPS(VR), Department of Ophthalmology, Isra University Hospital, Hyderabad, Pakistan
| | - Naimatullah Siyal
- Prof. Dr. Naimatullah Siyal, MCPS, MS, Department of Ophthalmology, Isra University Hospital, Hyderabad, Pakistan
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36
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Kovacova A, Shotliff K. Eye problems in people with diabetes: more than just diabetic retinopathy. PRACTICAL DIABETES 2022. [DOI: 10.1002/pdi.2378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Kevin Shotliff
- Consultant Endocrinologist, Chelsea and Westminster Hospital London UK
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Han X, Cai L, Shi Y, Hua Z, Lu Y, Li D, Yang J. Integrated Analysis of Long Non-Coding RNA -mRNA Profile and Validation in Diabetic Cataract. Curr Eye Res 2022; 47:382-390. [PMID: 35068271 DOI: 10.1080/02713683.2021.1984536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Xiaoyan Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Lei Cai
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yumeng Shi
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Zhixiang Hua
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Dan Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, China
| | - Jin Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Abstract
PURPOSE OF REVIEW Given the epidemiology and demographic trends of diabetes mellitus and cataracts, ophthalmologists are likely to encounter patients with both comorbidities at an increasing frequency. Patients with diabetes represent a higher risk population than healthy patients for cataract surgery. In this review, we discuss key risks and risk-mitigation practices when performing cataract surgery on these patients. RECENT FINDINGS Patients with diabetes continue to represent a high-risk surgical population: Nagar et al. suggest a dose-dependent relationship may exist between number of intravitreal injections and likelihood of posterior capsular rupture. However, novel treatments are improving outcomes for patients with diabetes. Several studies have reported intracameral phenylephrine/ketorolac may reduce the incidence of post-operative cystoid macular edema while others have discussed the efficacy of pre-treatment and post-treatment with intravitreal bevacizumab on improving cataract surgery outcomes in patients with diabetic retinopathy. Pre-operatively, ophthalmologists should perform an enhanced evaluation, consider timing and lens selection decisions, and complete any appropriate pre-operative treatment. Peri-operatively, surgeons should be aware of pupillary dilation adjustments, combination surgery options, and potential complications. Post-operatively, clinicians should address pseudophakic cystoid macular edema, diabetic macular edema, diabetic retinopathy, and posterior capsular opacification.
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Affiliation(s)
| | - Christina A Mamalis
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA
| | - Sumitra S Khandelwal
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA.
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Hamati JN, Das AV, Prashanthi GS, Behera UC, Narayanan R, Rani PK. Factors protecting against diabetic retinopathy in a geriatric Indian cohort. Indian J Ophthalmol 2021; 69:3167-3172. [PMID: 34708765 PMCID: PMC8725154 DOI: 10.4103/ijo.ijo_1495_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: Diabetic retinopathy (DR) is a potentially sight-threatening complication of diabetes mellitus. The majority of cases are in older adults. This study aims to evaluate modifiable and nonmodifiable protective factors against DR in a geriatric Indian population. Methods: This retrospective observational study uses data from a multitiered ophthalmology network to evaluate several demographic and clinical variables against diabetic retinopathy and visual acuity. Results: Our data show that high myopia, the female sex, and no cataract surgery are associated with lower prevalence of DR (OR = 0.21, 0.65, and 0.76, respectively; P < 0.001). We also found that among those with DR, people categorized as payers, retirees, and those living in urban or metropolitan areas have better visual acuity (OR = 0.65, 0.65, 0.83, and 0.73, respectively; P < 0.001). Among those with DR, females, presence of cataracts, and no cataract surgery had lower associations with sight-threatening DR (STDR) (OR = 0.68, 0.37, and 0.76, respectively; P < 0.001). Prevalence of DR decreased in older age groups while controlling for DM duration. Conclusion: It is probable that high myopia, the female sex, and better glycemic control are protective against DR and STDR in our study cohort of adults over 60 years of age. It is possible that occupations involving manual labor, delayed cataract surgery, and living past the age of 70 are also protective against DR.
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Affiliation(s)
- Jacquelyn N Hamati
- Department of Ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University; Department of Public Health, Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Anthony Vipin Das
- Department of EyeSmart EMR and AEye; Department of Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Gumpili Sai Prashanthi
- Department of EyeSmart EMR and AEye; Department of Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Umesh C Behera
- Department of Vitreoretinal Diseases, L. V. Prasad Eye Institute, Bhubaneshwar, Odisha, India
| | - Raja Narayanan
- Department of EyeSmart EMR and AEye; Department of Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Padmaja K Rani
- Smt. Kanuri Santhamma Center for Vitreo Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India, Indiaz
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Baristaite G, Gurwitz D. d-Galactose treatment increases ACE2, TMPRSS2, and FURIN and reduces SERPINA1 mRNA expression in A549 human lung epithelial cells. Drug Dev Res 2021; 83:622-627. [PMID: 34677831 DOI: 10.1002/ddr.21891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 11/09/2022]
Abstract
Several comorbidities including diabetes, immune deficiency, and chronic respiratory disorders increase the risk of severe Covid-19 and fatalities among SARS-CoV-2 infected individuals. Severe Covid-19 risk among diabetes patients may reflect reduced immune response to viral infections. SARS-CoV-2 initially infects respiratory tract epithelial cells by binding to the host cell membrane ACE2, followed by proteolytic priming for cell entry by the host cell membrane serine protease TMPRSS2. Additionally, the protease FURIN facilitates cell exit of mature SARS-CoV-2 virions. Alpha-1 antitrypsin (AAT), the major plasma serine protease inhibitor, encoded by SERPINA1, is known to promote immune response to viral infections. AAT inhibits neutrophil elastase, a key inflammatory serine protease implicated in alveolar cell damage during respiratory infections, and AAT deficiency is associated with susceptibility to lung infections. AAT is implicated in Covid-19 as it inhibits TMPRSS2, a protease essential for SARS-CoV-2 cell entry. Here we show that treatment of A549 human lung epithelial cells for 7 days with 25 mM d-galactose, an inducer of diabetic-like and oxidative stress cellular phenotypes, leads to increased mRNA levels of ACE2, TMPRSS2, and FURIN, along with reduced SERPINA1 mRNA. Together, the dysregulated transcription of these genes following d-galactose treatment suggests that chronic diabetic-like conditions may facilitate SARS-CoV-2 infection of lung epithelial cells. Our findings may in part explain the higher severe Covid-19 risk in diabetes, and highlight the need to develop special treatment protocols for diabetic patients.
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Affiliation(s)
- Gabriele Baristaite
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - David Gurwitz
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,Sagol School of Neuroscience, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
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Jaffery SMF, Khan MA, Ullah S, Atia‐tul‐Wahab, Choudhary MI, Basha FZ. Synthesis of New Valinol‐Derived Sultam Triazoles as
α
‐Glucosidase Inhibitors. ChemistrySelect 2021. [DOI: 10.1002/slct.202102119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Syeda Mehak Fatima Jaffery
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
| | - Maria Aqeel Khan
- Third World Center for Science and Technology (TWC) H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
| | - Saeed Ullah
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
| | - Atia‐tul‐Wahab
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD) International Center for Chemical and Biological Sciences University of Karachi-75270 Karachi Pakistan
| | - Muhammad Iqbal Choudhary
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD) International Center for Chemical and Biological Sciences University of Karachi-75270 Karachi Pakistan
| | - Fatima Zehra Basha
- H.E.J. Research Institute of Chemistry International Center for Chemical and Biological Sciences University of Karachi Karachi 75270 Pakistan
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42
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Yin L, Zhang M, He T. Design and development of novel thiazole-sulfonamide derivatives as a protective agent against diabetic cataract in Wistar rats via inhibition of aldose reductase. HETEROCYCL COMMUN 2021. [DOI: 10.1515/hc-2020-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
In recent years, ALR2 (aldose reductase) inhibitors have attracted attention for their effective ability to reduce the progression of diabetes-associated cataracts. Therefore, in the present article, we intended to develop novel thiazole-sulfonamide hybrids as a potent inhibitor of ALR2. These molecules significantly inhibited the ALR2 level in the rat lenses homogenate, where the most potent compound 7b showed activity comparable to sorbinil as standard. In Wistar rats, compound 7b improved the insulin level and body weight of the experimental animal together with a reduction in the glucose output. Compound 7b showed a significant reduction in the expression of ALR2 in rat lenses in western blot analysis.
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Affiliation(s)
- Liang Yin
- Department of Ophthalmology, General Hospital of the Tianjin Medical University, Tianjin Medical University, Heping District , Tianjin City , 300014 , China
| | - Mingxue Zhang
- Department of Ophthalmology, General Hospital of the Tianjin Medical University, Tianjin Medical University, Heping District , Tianjin City , 300014 , China
| | - Tiangeng He
- Department of Ophthalmology, General Hospital of the Tianjin Medical University, Tianjin Medical University, Heping District , Tianjin City , 300014 , China
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43
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Chai WF, Tang KS. Protective potential of cerium oxide nanoparticles in diabetes mellitus. J Trace Elem Med Biol 2021; 66:126742. [PMID: 33773280 DOI: 10.1016/j.jtemb.2021.126742] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/15/2021] [Accepted: 03/09/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is a non-communicable metabolic disease which is closely related to excessive oxidative stress after constant exposure to high plasma glucose. Although the current antidiabetic medications are effective in lowering blood glucose, these medications do not prevent or reverse the disease progression. Thus, there is a crucial need to explore new therapeutic interventions that could address this shortcoming. As cerium oxide nanoparticles (CONPs) possess antioxidant property, this agent may be used as a treatment option for the management of DM. PURPOSE This review aims to provide a critical evaluation of the pharmacological and antidiabetic effects of CONPs in cell and animal models. The roles of CONPs in attenuating DM complications are also presented in this report. METHODS We conducted a literature search in the PubMed database using the keywords "cerium oxide", "cerous oxide", "ceria", "nanoceria", and "diabetes" from inception to December 2020. The inclusion criteria were primary source articles that investigated the role of CONPs in DM and diabetic complications. RESULTS We identified 47 articles from the initial search. After the thorough screening, only 31 articles were included in this study. We found that CONPs can attenuate parameters that are related to DM and diabetic complications in various animals and cell culture models. CONCLUSION CONPs could potentially be used in the treatment of those with DM and complications caused by the disease.
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Affiliation(s)
- Wui Fang Chai
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Kim San Tang
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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Umm-E-Farwa, Ullah S, Khan MA, Zafar H, Atia-Tul-Wahab, Younus M, Choudhary MI, Basha FZ. Dibenzazepine-linked isoxazoles: New and potent class of α-glucosidase inhibitors. Bioorg Med Chem Lett 2021; 40:127979. [PMID: 33766763 DOI: 10.1016/j.bmcl.2021.127979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
α-Glucosidase inhibition is a valid approach for controlling hyperglycemia in diabetes. In the current study, new molecules as a hybrid of isoxazole and dibenzazepine scaffolds were designed, based on their literature as antidiabetic agents. For this, a series of dibenzazepine-linked isoxazoles (33-54) was prepared using Nitrile oxide-Alkyne cycloaddition (NOAC) reaction, and evaluated for their α-glucosidase inhibitory activities to explore new hits for treatment of diabetes. Most of the compounds showed potent inhibitory potency against α-glucosidase (EC 3.2.1.20) enzyme (IC50 = 35.62 ± 1.48 to 333.30 ± 1.67 µM) using acarbose as a reference drug (IC50 = 875.75 ± 2.08 µM). Structure-activity relationship, kinetics and molecular docking studies of active isoxazoles were also determined to study enzyme-inhibitor interactions. Compounds 33, 40, 41, 46, 48-50, and 54 showed binding interactions with critical amino acid residues of α-glucosidase enzyme, such as Lys156, Ser157, Asp242, and Gln353.
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Affiliation(s)
- Umm-E-Farwa
- Third World Center for Science and Technology (TWC), H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - Saeed Ullah
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - Maria Aqeel Khan
- Third World Center for Science and Technology (TWC), H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan.
| | - Humaira Zafar
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan.
| | - Atia-Tul-Wahab
- Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - Munisaa Younus
- Third World Center for Science and Technology (TWC), H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan
| | - M Iqbal Choudhary
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan; Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan; Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21412, Saudi Arabia; Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Komplek, Campus C, Surabaya 60115, Indonesia
| | - Fatima Z Basha
- H. E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, 75270 Karachi, Pakistan.
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Macular Vascular Density Changes following Cataract Surgery in Diabetic Patients: An Optical Coherence Tomography Angiography Study. J Ophthalmol 2021; 2021:6641944. [PMID: 33854796 PMCID: PMC8019390 DOI: 10.1155/2021/6641944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/21/2021] [Accepted: 03/13/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose Cataracts and diabetes very commonly coexist. The aim of the present study was to quantify the effect of uncomplicated phacoemulsification on retinal microvasculature in diabetic patients by using optical coherence tomography angiography (OCTA). Methods A prospective observational study of diabetic and nondiabetic patients at baseline and 1 day, 1 week, 1 month, and 3 months after cataract surgery was performed by using OCTA. We measured the macular thickness (MT), superficial capillary plexus (SCP), deep capillary plexuses (DCP), and foveal avascular zone (FAZ) in the 3 × 3 mm macular images. Results A total of 32 eyes of 32 type 2 diabetic patients and 40 eyes of 40 nondiabetic patients were assessed. There was a significant increase in MT at 1 month and 3 months after surgery in both groups (all P < 0.05), but there was no significant difference between the two groups (P=0.217). At 3 months postoperatively, the SCP level in the diabetic group was significantly higher than that at baseline (P < 0.05). The MT and SCP were negatively correlated with logMAR best-corrected visual acuity (BCVA), while the FAZ area and perimeter were positively correlated with logMAR BCVA in the diabetic group. Conclusions Our study demonstrated that phacoemulsification can increase macular thickness in both diabetic and nondiabetic patients and increase SCP in diabetic patients within 3 months after surgery. Whether these changes persist for a longer period still needs to be investigated.
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46
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Erdem S. Diseases associated with age-related cataract: a health-board-based retrospective study focusing on common physiopathological mechanisms. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Ragab IT, Abdelkader AME, Kishk HM, Elshal AA. Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy. Clin Ophthalmol 2020; 14:1495-1501. [PMID: 32581506 PMCID: PMC7276325 DOI: 10.2147/opth.s255626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/19/2020] [Indexed: 12/25/2022] Open
Abstract
Purpose Pseudophakic glaucoma is a secondary glaucoma in which intra-ocular pressure is elevated following cataract removal. The current study aimed to evaluate the role of ultrasound biomicroscopy (UBM) in assessing post-operative pseudophakic glaucoma. Patients and Methods This is a case series, prospective, observational and analytical study. It included 29 eyes of 29 patients with post-operative pseudophakic glaucoma. The patients were evaluated by medical history, detailed ophthalmologic examination and UBM. Results UBM examination has unmasked different causes of pseudophakic glaucoma. The detected causes were classified into 3 main groups, including intraocular lens (IOL)-related causes, lens remnants and intra-ocular inflammation. Haptic-related causes were present in 9 eyes, while 6 eyes had decentered or tilted IOLs. Soemmering's ring was the main cause in 3 eyes while in one eye the cause was lens particle in the anterior chamber (AC). Silicone oil in AC with seclusio pupillae was the main cause in one eye. Peripheral anterior synechiae were detected in 8 eyes while, posterior synechiae were evident in 7 eyes. Uveitis induced by anterior chamber IOL (ACIOL) was found in 3 eyes and one eye had peripheral anterior synechiae due to neovascular glaucoma. Conclusion UBM is a helpful diagnostic tool to evaluate causes of pseudophakic glaucoma through adequate visualization of different angle structures.
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Affiliation(s)
- Islam Taher Ragab
- Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Hanem Mohammad Kishk
- Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Jiang X, Meng W, Li L, Meng Z, Wang D. Adjuvant Therapy With Mushroom Polysaccharides for Diabetic Complications. Front Pharmacol 2020; 11:168. [PMID: 32180724 PMCID: PMC7059129 DOI: 10.3389/fphar.2020.00168] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 02/07/2020] [Indexed: 12/11/2022] Open
Abstract
Background Diabetic complications seriously endanger the health of most diabetic patients around the world. Most chemical hypoglycemic agents have adverse effects and are unable to improve the progression of diabetic complications. In recent years, a number of medicinal herbs have become increasingly popular for the treatment of diabetic complications due to their relative safety. Polysaccharides extracted from medicinal herbs with multiple pharmacological activities and low toxicity have been reported to be useful in the treatment of diabetic complications. Methods Primary studies with keywords including polysaccharide and diabetic complications were retrieved from the Web of Science and NCBI databases and were read and analyzed. Results Mushroom polysaccharides were proven to have positive effects on diabetic complications. Conclusions We studied the effects of mushroom polysaccharides on hyperglycemia and as adjuvant therapies for diabetic complications and summarized the applications and limitations of mushroom polysaccharides to better understand their application for the treatment of diabetic complications.
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Affiliation(s)
- Xue Jiang
- Department of Translational Medicine Research Institute, First Hospital, Jilin University, Changchun, China.,School of Life Sciences, Jilin University, Changchun, China
| | - Weiqi Meng
- School of Life Sciences, Jilin University, Changchun, China
| | - Lanzhou Li
- School of Life Sciences, Jilin University, Changchun, China
| | - Zhaoli Meng
- Department of Translational Medicine Research Institute, First Hospital, Jilin University, Changchun, China
| | - Di Wang
- School of Life Sciences, Jilin University, Changchun, China
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Diabetes and Phacoemulsification Cataract Surgery: Difficulties, Risks and Potential Complications. J Clin Med 2019; 8:jcm8050716. [PMID: 31137510 PMCID: PMC6572121 DOI: 10.3390/jcm8050716] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 02/07/2023] Open
Abstract
Diabetes mellitus is one of the most prevalent chronic diseases worldwide. Diabetic patients are at risk of developing cataract and present for surgery at an earlier age than non-diabetics. The aim of this study was to review the problems associated with cataract surgery in a diabetic patient. Corneal complications in diabetic patients include delayed wound healing, risk of developing epithelial defects or recurrent erosions due to the impairment of epithelial basement membranes and epithelial-stromal interactions. Diabetic patients present lower endothelial cell density and their endothelium is more susceptible to trauma associated with cataract surgery. A small pupil is common in diabetic patients making cataract surgery technically challenging. Finally diabetic patients have an increased risk for developing postoperative pseudophakic cystoid macular edema, posterior capsule opacification or endophthalmitis. In patients with pre-proliferative or proliferative diabetic retinopathy, diabetic macular edema or iris neovascularization adjunctive therapy such as an intravitreal anti-vascular endothelial growth factor injection, can inhibit exacerbation related to cataract surgery.
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