UNASSIGNED: Residual astigmatism is common after cataract surgery involving implantation of an intraocular lens, yet the tolerance of presbyopia-correcting intraocular lens to astigmatism of different magnitudes and axes is poorly understood. Here we compared visual acuity and quality in the presence of induced astigmatism after implantation of a trifocal or extended-depth-of-focus (EDOF) intraocular lens, the two widely used presbyopia-correcting intraocular lenses.
UNASSIGNED: At least 3 months after implantation of a TFNT00 or ZXR00 intraocular lens, patients were analyzed by slit-lamp examination, non-contact tonometry, subjective refraction, iTrace aberrometry, and corneal topography. After correction of residual astigmatism, astigmatism of different magnitudes on different axes was induced using cylindrical lenses, and overall visual acuity was measured, while objective visual quality was measured using the Optical Quality Analysis System II. Subjects were also asked about subjective visual quality using the Visual Function-14 questionnaire.
UNASSIGNED: Comparison of 18 individuals who received a trifocal lens and 19 who received an EDOF lens showed that objective visual quality was better in the EDOF group regardless of the magnitude or axis of the induced astigmatism. In both groups, astigmatism of at least -1.00 DC influenced distant vision more severely when the axis was 45° than 0° or 90°, meanwhile astigmatism of at least -1.50 DC influenced near and intermediate vision more severely when the axis was 45° than 0° or 90°.
UNASSIGNED: Trifocal or EDOF intraocular lenses are less tolerant of oblique astigmatism than astigmatism with or against the rule. EDOF lenses may provide better objective visual quality than trifocal lenses in the presence of astigmatism, regardless of its magnitude or axis.

UNASSIGNED: Retinitis pigmentosa (RP) is an inherited retinal dystrophy characterized by progressive vision loss due to photoreceptor degeneration. Complicated cataract formation, particularly posterior subcapsular cataract (PSC), frequently occurs in RP and exacerbates the visual impairment. Cataract surgery may improve vision; however, the distinctive challenges of RP require specific considerations. This mini-review aims to provide a comprehensive overview of the RP-related cataract.
UNASSIGNED: A comprehensive literature review was conducted via PubMed/MEDLINE, spanning the period from January 1976 to June 2024, using the keywords \"cataract,\" \"cataract surgery,\" \"cystoid macular edema,\" \"hereditary retinal dystrophy,\" \"retinitis pigmentosa,\" \"posterior subcapsular cataract,\" \"posterior capsular opacification,\" \"zonular weakness,\" and \"artificial intelligence.\" We aimed to evaluate cataract surgery in patients with RP, focusing on cataract formation, its surgical management, postoperative complications, patient follow-up, and visual outcomes. Relevant review articles, clinical trials, and case reports with related reference lists of these articles were included.
UNASSIGNED: A total of 53 articles were examined in detail, including those identified through focused keyword searches and the reference lists of these articles. Cataract surgery in patients with RP generally results in substantial visual improvement. However, surgery can be complicated, particularly by zonular weakness and subluxation of the crystalline lens. These risks can be reduced by using capsular tension rings and employing meticulous surgical technique. Furthermore, postoperative complications, such as cystoid macular edema and posterior capsular opacification, are common. Despite these challenges, regular postoperative follow-up and appropriate management can help mitigate complications. Integrity of the ellipsoid zone and external limiting membrane on preoperative optical coherence tomographic examination are the main predictors of visual outcomes following cataract surgery; however, outcomes can vary. Though many patients experience significant visual improvement, some may experience limited benefits due to pre-existing advanced retinal degeneration.
UNASSIGNED: Cataract surgery may offer meaningful visual benefits in patients with RP; however, careful preoperative evaluation and meticulous surgical technique are required to address the possible challenges. Attentive postoperative care and follow-up are essential to optimize visual outcomes. Early surgical intervention can significantly improve the quality of life in selected candidates, and tailored approaches are necessary in patients with RP requiring cataract surgery. Further studies on the potential application of artificial intelligence to monitor postoperative recovery and detect complications may improve surgical outcomes and enhance patient care.

UNASSIGNED: To compare the structural anatomy of the anterior segment in pediatric Trisomy 21 (T21) subjects with and without cataracts to age-matched controls.
UNASSIGNED: Prospective case-control study.
UNASSIGNED: 40 subjects (57 eyes) age 0-25 years old (9.1 ± 10.6 years).
UNASSIGNED: This prospective case-control study evaluated anterior segment measurements from ultrasound biomicroscopy (UBM) imaging on 342 images.
UNASSIGNED: Among persons with T21 cataract, the iris was significantly thinner than T21 individuals without cataract (0.28 vs 0.32 mm, p = 0.0181). T21/cataract subjects also had significantly thinner lenses than subjects without cataract, regardless of whether they have T21 or are controls (3.1 mm vs 3.5 mm, p = 0.0074).Thinner lens (<3.5 mm) was insignificantly associated with increased odds of cataract (OR = 9.5 [0.872,104], p = 0.065). Thinner iris (<0.32 mm) was associated with increased odds of cataract (OR = 8.4 [1.188, 59.273], p = 0.033).
UNASSIGNED: These findings support the hypothesis that subtle quantitative anatomic variants are present in the anterior eye of individuals with T21. Specific anatomic variants are unique to the presence of cataract among subjects with T21.

This study assesses the quality of retinal images captured using a non-mydriatic fundus camera within a teleophthalmologic platform in Taiwan. The objective was to evaluate the effectiveness of non-mydriatic fundus cameras for remote retinal screening and identify factors impacting image quality. From June 2020 to August 2022, 629 patients from five rural infirmaries underwent ophthalmic examinations, with fundus images captured without pupil dilation. These images were reviewed by senior ophthalmologists and graded based on quality. The results indicated that approximately 70% of images were of satisfactory diagnostic quality. Risk factors for poor image quality included older age, the presence of cataracts, pseudophakia, and diabetes mellitus. This study demonstrates the feasibility of using non-mydriatic fundus cameras for teleophthalmology, highlighting the importance of identifying and addressing factors that affect image quality to enhance diagnostic accuracy in remote settings.

UNASSIGNED: To compare objective and subjective outcomes of the multifocal intraocular lenses ReSTOR SN6AD1 and Tecnis ZKB00, extended depth of focus IOL Symfony ZXR00, and trifocal IOL PanOptix TFNT00.
UNASSIGNED: This study included 262 patients (524 eyes) who had phacoemulsification with IOL implantation, 128 eyes with SN6AD1, 124 eyes with ZKB00, 136 eyes with ZXR00, and 136 eyes with TFNT00. Objective outcomes included one-month postoperative uncorrected (U) and corrected (C) distance (D) and near (N) visual acuities (VA). Subjective outcomes included photic phenomena, spectacle use, and spectacle-independent visual function.
UNASSIGNED: Spectacle use (%) in the SN6AD1, ZKB00 ZXR00, and TFNT00 groups was 39, 64, 87, and 37 respectively (P < 0.0001). Presence of photic phenomena (%) for SN6AD1, ZKB00, ZXR00, and TFNT00 was 66, 61, and 67, and 73, respectively (P = 0.57). Spectacle-independent mean VF-14 score (%) for SN6AD1, ZKB00, ZXR00, and TFNT00 was 89.5, 87.2, 80.9, and 83.6, respectively (P < 0.01).
UNASSIGNED: All four IOLs provided excellent postoperative visual acuity and equally high rates of photic phenomena. SN6AD1 and TFNT00 provided the least spectacle use while ZXR00 had the highest spectacle use.

OBJECTIVE: To compare the associations of race/ethnicity and socioeconomic status (SES) with visual impairment (VI) prior to surgical removal of cataracts across two large health systems in the U.S. Mid-Atlantic region.
METHODS: Multi-institutional cross-sectional data study.
METHODS: Patients aged 65 and older who underwent cataract surgery at Johns Hopkins Hospital (JHH) and Kaiser Permanente (KP) between January 1, 2017 and December 31, 2019.
METHODS: Covariates included patient age, sex, smoking status, surgery laterality, Charlson Comorbidity Index (CCI), and ocular comorbidities. Multivariable generalized estimating equation models were used to examine the association of race/ethnicity and area deprivation index (ADI) with visual acuity.
METHODS: Visual acuity prior to cataract surgery was assessed using Log of Minimum Angle of Resolution (logMAR). Race/ethnicity and ADI were the main exposures of interest.
RESULTS: At JHH, 11,509 patients (17,731 eyes) were included, while KP had 7,143 patients (10,542 eyes). After adjusting for covariates, Black (β, 0.49), Asian (β, 0.83), and Hispanic patients (β, 0.95) were more likely to have worse visual acuity secondary to cataracts at JHH (P < 0.001 for all) compared to White patients. Similarly, at KP, Black (β, 0.56), Asian (β, 0.70), and Hispanic patients (β, 0.89) were more likely to have worse visual acuity (P < 0.001 for all) compared to White patients. Compared to those living in the least disadvantaged neighborhoods (Quartile [Q]1 ADI) at JHH, higher ADI quartiles (more deprived) were more likely to have worse visual acuity (β, 0.27; P = 0.001 for Q2, β, 0.40; P = 0.001 for Q3, β, 0.95; P < 0.001 for Q4). There was no significant association found between ADI and VI secondary to cataracts at KP.
CONCLUSIONS: Among older adults, non-White race/ethnicity was independently associated with VI secondary to cataracts in two large health systems in the U.S. Mid-Atlantic region, after adjustment for ADI. Area deprivation was also associated with VI but only in the JHH system. Our study suggests that non-White patients and those with lower SES are at greater risk of VI secondary to cataracts possibly due to social, structural and institutional barriers.

Our purpose is to develop and validate a new iPad-based contrast sensitivity (CS) test for measuring the contrast sensitivity function at near vision (Optopad-CSF). A total of 200 eyes of 100 healthy subjects (ages 17-63) were evaluated in a comparative study between the Optopad-CSF test (near vision) and the CSV-1000E test (distance vision). The agreement between tests was assessed with the index of contrast sensitivity (ICS) and the area under the curve (AUC). CS for all the spatial frequencies in both eyes showed a negative significant correlation with age, and corrected distance, and near visual acuities (r ≤ -0.512, p ≤ 0.013). A significantly lower CS was found with the Optopad-CSF test in the over-40-year-old subgroup for all the spatial frequencies evaluated compared to the below-40 subgroup (p ≤ 0.008). The mean AUC of the Optopad-CSF test (5.84) was twice that of the CSV-1000E test (2.76). The mean ICS of the Optopad-CSF (-0.019) and CSV-1000E (-0.075) tests showed similar values, both close to 0 (p = 0.3). There was a weak but significant correlation between the Optopad-CSF and CSV-1000E ICS tests (r = 0.246, p < 0.02). A range of normality for the values obtained with the Optopad-CSF test was calculated. The mean CS values in 16 bilateral cataract patients were out of the normal range for all the spatial frequencies evaluated (p < 0.001). Optopad-CSF is a valid portable system for measuring CS at near vision for five spatial frequencies, allowing the detection of age-related changes in CSF with age and CSF loss in cataracts, with no ceiling effect.

Cataracts and glaucoma account for a high percentage of vision loss and blindness worldwide. Small extracellular vesicles (sEVs) are released into different body fluids, including the eye\'s aqueous humor. Information about their proteome content and characterization in ocular pathologies is not yet well established. In this study, aqueous humor sEVs from healthy individuals, cataracts, and glaucoma patients were studied, and their specific protein profiles were characterized. Moreover, the potential of identified proteins as diagnostic glaucoma biomarkers was evaluated. The protein content of sEVs from patients\' aqueous humor with cataracts and glaucoma compared to healthy individuals was analyzed by quantitative proteomics. Validation was performed by western blot (WB) and ELISA. A total of 828 peptides and 192 proteins were identified and quantified. After data analysis with the R program, 8 significantly dysregulated proteins from aqueous humor sEVs in cataracts and 16 in glaucoma showed an expression ratio ≥ 1.5. By WB and ELISA using directly aqueous humor samples, the dysregulation of 9 proteins was mostly confirmed. Importantly, GAS6 and SPP1 showed high diagnostic ability of glaucoma, which in combination allowed for discriminating glaucoma patients from control individuals with an area under the curve of 76.1% and a sensitivity of 65.6% and a specificity of 87.7%.

UNASSIGNED: Glare is a known side effect of intraocular lens (IOL) implantation, affected principally by IOL material and optics, although it is reported subjectively to decrease in impact with time. However, little objective data have been published on changes over time, how these relate to subjective reports, and whether those who will report greater glare symptoms can be predicted prior to IOL implantation.
UNASSIGNED: A total of 32 patients (aged 72.4 ± 8.0 years) with healthy eyes were implanted bilaterally with hydrophilic 600s (Rayner, Worthing, UK) or hydrophobic Acrysof (Alcon, Texas, USA) acrylic IOLs (n = 16 each, randomly assigned). Each patient reported their dysphotopsia symptoms subjectively using the validated forced choice photographic questionnaire for photic phenomena, and halo size resulting from a bright light in a dark environment was quantified objectively in eight orientations using the Aston Halometer. Assessment was performed binocularly pre-operatively and at 1, 2, 3, and 4 weeks after IOL implantation.
UNASSIGNED: The study was carried out at the National Health Service Ophthalmology Department, Queen Elizabeth Hospital, Birmingham, UK.
UNASSIGNED: Visual acuity (average 0.37 ± 0.26 logMAR) did not correlate with subjective glare (r = 0.184, p = 0.494) or objective glare (r = 0.294, p = 0.270) pre-surgery. Objective halo size (F = 112.781, p < 0.001) decreased with cataract removal and IOL implantation and continued to decreased over the month after surgery. Subjective dysphotopsia complaints (p < 0.001) were also greater pre-surgery, but did not change thereafter (p = 0.228). In neither case was there a difference with IOL material (p > 0.05). It was not possible to predict post-surgery dysphotopsia from symptoms or a ratio of symptoms to halo size pre-surgery (p > 0.05).
UNASSIGNED: Subjective dysphotopsia and objective halos caused by cataracts are greatly reduced by implantation of IOL after cataract removal causing few perceivable symptoms. However, objective measures are able to quantify a further reduction in light scatter over the first month post-IOL implantation, suggesting that any subjective effects over this period are due to the healing process and not due to neuroadaptation.

UNASSIGNED: Protein post-translational modifications (PTMs) have been associated with aging and age-related diseases. PTMs are particularly impactful in long-lived proteins, such as those found in the ocular lens, because they accumulate with age. Two PTMs that lead to protein-protein crosslinks in aged and cataractous lenses are dehydroalanine (DHA) and dehydrobutyrine (DHB); formed from cysteine/serine and threonine residues, respectively. The purpose of this study was to quantitate DHA and DHB in human lens proteins as a function of age and cataract status.
UNASSIGNED: Human lenses of various ages were divided into five donor groups: transparent lenses (18-22-year-old, 48-64-year-old, and 70-93-year-old) and cataractous human lenses of two age groups (48-64-year-old lenses, and 70-93-year-old lenses) and were subjected to proteomic analysis. Relative DHA and DHB peptide levels were quantified and compared to their non-modified peptide counterparts.
UNASSIGNED: For most lens proteins containing DHA or DHB, higher amounts of DHA- and DHB-modified peptides were detected in aged and cataractous lenses. DHA-containing peptides were classified into three groups based on abundance changes with age and cataract: those that (1) increased only in age-related nuclear cataract (ARNC), (2) increased in aged and cataractous lenses, and (3) decreased in aged lenses and ARNC. There was no indication that DHA or DHB levels were dependent on lens region. In most donor groups, proteins with DHA and DHB were more likely to be found among urea-insoluble proteins rather than among water- or urea-soluble proteins.
UNASSIGNED: DHA and DHB formation may induce structural effects that make proteins less soluble in water that leads to age-related protein insolubility and possibly aggregation and light scattering.