Ocular comorbidity and self-assessed visual function after cataract surgery

Inflammation originating from infection of the vitreous cavity is called endophthalmitis. Attention has been focused on the epidemiologic, microbiologic reports, and treatment options; unfortunately, the role of the host immune reaction in the visual function damage is still not well understood. Endophthalmitis occurs most frequently after cataract surgery. In this paper we review the published literature regarding inflammatory mediators and apoptosis during the course of endophthalmitis. Toll-like receptors, cytokines, high-mobility group box 1 proteins, aB-crystallin and apoptosis have been studied during clinical and experimental cases of endophthalmitis. Further understanding of the host-immune reaction to vitreous infection is essential for the development of new therapies. The use of intravitreal antibiotics and corticosteroids, vitrectomy and systemic antibiotics for the preservation of visual function is still discouraging.

Download Full-text

Seeing Invisible Light: 2-photon Microperimetry to Measure Visual Function

10.20944/preprints202011.0329.v1 ◽

2020 ◽

Author(s):

Urmi Mehta ◽

Grazyna Palczewska ◽

Ken Lin ◽

Andrew Browne

Keyword(s):

Visible Light ◽

Cataract Surgery ◽

Visual Function ◽

Visual Stimulation ◽

Contrast Threshold ◽

Retinal Sensitivity ◽

Novel Device ◽

Function Tests ◽

Before And After ◽

Media Opacities

Purpose: The accuracy of conventional visual function tests, which emit visible light, decreases in patients with corneal scars, cataracts, and vitreous hemorrhages. In contrast, infrared (IR) light exhibits greater tissue penetrance than visible light and is less susceptible to optical opacities. We therefore compared visual function results obtained using conventional visual function tests and infrared 2-photon microperimetry (2PM-IR) in a subject with a brunescent nuclear sclerotic and posterior subcapsular cataract before and after cataract surgery. Methods: Visual function testing using the cone contrast threshold (CCT) test, conventional microperimetry (cMP), visible light microperimetry from a novel device (2PM-Vis), and 2PM-IR were performed before and after cataract surgery. Results: Cone contrast threshold testing improved for the S-cone, M-cone, and L-cone by 111, 14, and 30. Retinal sensitivity assessed using cMP, 2PM-Vis, and 2PM-IR improved by 18 dB, 17.4 dB, and 3.4 dB, respectively. Conclusions and Importance: 2PM-IR, unlike conventional visual function tests, showed minimal variability in retinal sensitivity before and after surgery. Thus, IR visual stimulation introduces a paradigm shift for measuring visual function in the retina and posterior visual pathways by circumventing optical media opacities.

Download Full-text

Frequency of cataract surgery and its impact on visual function—results from the German Gutenberg Health Study

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-04770-0 ◽

2020 ◽

Vol 258 (10) ◽

pp. 2223-2231

Author(s):

Alexander K. Schuster ◽

S. Nickels ◽

N. Pfeiffer ◽

I. Schmidtmann ◽

P. S. Wild ◽

...

Keyword(s):

Cataract Surgery ◽

Visual Function ◽

Adult Population ◽

Population Based ◽

Health Study ◽

Multivariable Logistic Regression Analysis ◽

Ophthalmological Examination ◽

Association Analyses ◽

Bilateral Cataract ◽

Gutenberg Health Study

Abstract Purpose To determine the frequency of cataract surgery in Germany and to evaluate its impact on visual function in an adult population. Methods The population-based Gutenberg Health Study was conducted in Germany with its baseline examination between 2007 and 2012 and a 5-year follow-up examiantion. An ophthalmological examination including slit-lamp examination, ocular biometry, and Scheimpflug imaging was carried out. Overall and age-specific frequencies of unilateral and bilateral cataract surgery within 5 years were computed including the 95% confidential intervals [95%-CI]. Association analyses were conducted to determine social and ocular associated factors using multivariable logistic regression analysis. Vision-related quality of life was assessed using NEI VFQ-25. Results A total of 10,544 people aged 35 to 74 years were bilateral phakic at baseline and had information on lens status at the 5-year examination. Of these, 168 had unilateral cataract surgery (1.6% [1.4–1.9%]), and 448 had bilateral cataract surgery (4.2% [3.9–4.7%]) in the following 5 years. The frequency of cataract surgery increased with age: 45–54-year-old subjects had twice as often cataract surgery (in at least on eye: OR = 2.32) than at age 35–44 years. The frequency further strongly increases with age (55–64 years: OR = 10.5; 65–74 years: OR = 43.8, p < 0.001). Subjects with glaucoma were more likely to have cataract surgery (OR = 2.52, p < 0.001). Visual function increased when undergoing bilateral cataract surgery. Conclusions The frequency of cataract surgery is low at younger ages and increases up to 26% at age 70–74 years. Persons with glaucoma are more likely to undergo cataract surgery at population-based level in Germany.

Download Full-text