UNASSIGNED: Shear wave elastography (SWE) is a novel imaging technique that provides quantitative assessments of tissue stiffness. This non-invasive method offers real-time, quantitative measurements and has been widely applied to various tissues, providing valuable diagnostic insights.
UNASSIGNED: This study aimed to investigate the feasibility of using SWE to evaluate the stiffness of the lens in patients with age-related cataracts.
UNASSIGNED: A comparative analysis involving 92 patients diagnosed with age-related cataracts and 39 healthy controls was conducted. Lens stiffness was quantified using SWE measurements. The lens nucleus of all participants was graded based on the Lens Opacities Classification System II (LOCS II). Correlations between the stiffness of the lens and age were also analyzed.
UNASSIGNED: The study indicates that both the stiffness of the lens and the lens nucleus were significantly higher in patients with age-related cataracts compared to healthy controls (P < 0.001). In patients with age-related cataracts, although lens nucleus stiffness variations across different grades of cataract severity were not statistically significant, all grades displayed increased stiffness relative to healthy controls. Additionally, a significant positive correlation between lens stiffness and age was observed in all participants (P < 0.001).
UNASSIGNED: SWE appears to be a promising imaging technique for quantitatively assessing the mechanical characteristics of the lens in patients with age-related cataracts.

The influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy and hydrodynamic parameters of phacoemulsification remains insufficiently studied.
OBJECTIVE: This study evaluates the influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy, hydrodynamic parameters of phacoemulsification, and the degree of corneal endothelial cell loss.
METHODS: Hybrid phacoemulsification was performed in 336 patients (336 eyes) with grade IV immature cataract according to the Buratto classification in three age-matched groups. Group 1 included 103 patients (103 eyes) who underwent hybrid phacoemulsification with preliminary femtosecond laser-assisted fragmentation of the nucleus with a «pizza» pattern (division of the nucleus with 10 radial cuts). Group 2 included 112 patients (112 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «cylinders» pattern (division of the nucleus with 8 radial cuts in combination with 5 circular cuts). Group 3 included 121 patients (121 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «grid» pattern (division of the nucleus with 8 radial cuts in combination with multiple mutually perpendicular cuts in the central zone in the form of a grid with a 0.5 mm cell). Effective ultrasound time and the volume of irrigation solution for emulsification of the lens nucleus fragments were determined during the operation. The loss of corneal endothelial cells was assessed 3 months after surgery.
RESULTS: The minimum effective ultrasound time was noted after using the \"grid\" pattern - 4.05 (2.88; 4.74) s, which was significantly less than with the \"cylinders\" pattern - 4.97 (3.78; 5.88) s and the \"pizza\" pattern - 6.15 (4.52; 7.75) s (p<0.05). The effective ultrasound time when using the \"cylinders\" pattern was significantly less than with the \"pizza\" pattern (p<0.05). The volume of irrigation solution used for emulsification of the lens nucleus fragments was significantly less in the \"grid\" pattern - 41.5 (33.5; 49.5) ml compared to the \"cylinders\" patterns 58.5 (51.0; 66.0), p<0.05 and \"pizza\" pattern 75.0 (66.0; 83.5), p<0.01. The volume of irrigation solution when using the \"cylinders\" pattern was significantly less than when using the \"pizza\" pattern (p<0.05). The loss of corneal endothelial cells after using the \"grid\" pattern was 8.82 (7.59; 9.87)%, which was significantly less than after the \"cylinders\" patterns - 9.97 (8.81; 10.83)%, p<0.05 and \"pizza\" - 11.70 (10.62; 12.97)%, p<0.05. At the same time, the loss of endothelial cells after using the \"cylinders\" pattern was significantly less than after the \"pizza\" pattern (p<0.05).
CONCLUSIONS: The choice of the optimal pattern of preliminary femtosecond laser-assisted fragmentation of the lens nucleus provides a significant decrease in the energy and hydrodynamic parameters of phacoemulsification and, accordingly, the loss of corneal endothelial cells.
Влияние различных паттернов предварительной фемтолазерной фрагментации ядра хрусталика на энергетические и гидродинамические параметры факоэмульсификации остается в настоящее время недостаточно изученным.
UNASSIGNED: Оценить влияние различных паттернов предварительной фрагментации ядра хрусталика фемтосекундным лазером на энергетические, гидродинамические параметры факоэмульсификации и степень потери клеток эндотелия роговицы.
UNASSIGNED: Гибридная факоэмульсификация выполнена 336 пациентам (336 глаз) с незрелой катарактой IV степени плотности по классификации Буратто в трех сравнимых по возрасту группах. В 1-ю группу вошло 103 пациента (103 глаза), которым произведена гибридная факоэмульсификация с предварительной фемтолазерной фрагментацией ядра с паттерном «пицца» (разделение ядра с 10 радиальными разрезами), во 2-ю группу вошло 112 пациентов (112 глаз), которым выполнена фемтолазерная фрагментация ядра с паттерном «цилиндры» — разделение ядра с 8 радиальными разрезами в сочетании с 5 циркулярными разрезами), в 3-ю группу включен 121 человек (121 глаз), которым выполнена фемтолазерная фрагментация ядра с паттерном «сетка» (разделение ядра с 8 радиальными разрезами в комбинации с множественными взаимно перпендикулярными разрезами в центральной зоне в виде сетки с ячейкой 0,5 мм). В ходе операции определяли эффективное время действия ультразвука, объем ирригационного раствора для эмульсификации фрагментов ядра хрусталика. Через 3 мес после хирургического вмешательства оценивали потерю клеток эндотелия роговицы.
UNASSIGNED: Минимальное эффективное время ультразвука отмечено после применения паттерна «сетка» — 4,05 (2,88; 4,74) с, что существенно меньше по сравнению с паттерном «цилиндры» — 4,97 (3,78; 5,88) с и паттерном «пицца» — 6,15 (4,52; 7,75) с (p<0,05). Эффективное время ультразвука при использовании паттерна «цилиндры» было значительно меньше, чем при применении паттерна «пицца» (p<0,05). Объем ирригационного раствора, затраченный на эмульсификацию фрагментов ядра хрусталика, был существенно меньше после использования паттерна «сетка» — 41,5 (33,5; 49,5) мл по сравнению с паттернами «цилиндры» 58,5 (51,0; 66,0), p<0,05 и «пицца» 75,0 (66,0; 83,5), p<0,01. Объем ирригационного раствора при применении паттерна «цилиндры» был значительно меньше по сравнению с паттерном «пицца» (p<0,05). Потеря клеток эндотелия роговицы после применения паттерна «сетка» составила 8,82 (7,59; 9,87)%, что существенно меньше по сравнению с паттернами «цилиндры» — 9,97 (8,81; 10,83)%, p<0,05 и «пицца» — 11,70 (10,62; 12,97)%, p<0,05. При этом потеря клеток эндотелия после использования паттерна «цилиндры» была значительно меньше, чем после применения паттерна «пицца» (p<0,05).
UNASSIGNED: Выбор оптимального паттерна предварительной фемтолазерной фрагментации ядра хрусталика обеспечивает существенное уменьшение энергетических и гидродинамических параметров факоэмульсификации и, соответственно этому, потери клеток эндотелия роговицы.

BACKGROUND: Although relation between Lens Opacities Classification System III (LOCS III) and nuclear density is established, no data are available about nuclear size at different LOCS III grades.
OBJECTIVE: The aim of this study is to evaluate the relation between LOCS III grading of nuclear opacity obtained preoperatively and the size of the nucleus obtained during cataract surgery.
METHODS: This was a prospective observational study carried out in a hospital attached to medical college.
METHODS: Patients who underwent manual small-incision cataract surgery or extra-large temporal tunnel cataract extraction and gave consent were included in this study. Institutional Ethics Committee clearance was taken for the study. Preoperative LOCS III grading was obtained at slit-lamp biomicroscope. Ocular dimensions were obtained by preoperative immersion biometry. The thickness and diameter of the nucleus obtained by extraction were measured up to 10 μ accuracy. Data were analyzed for the change in nuclear thickness, nuclear diameter, age, lens thickness, and anterior chamber depth in relation to the LOCS III grade of the nucleus.
METHODS: Statistical analysis used in this study was one-way ANOVA, mean, and range.
RESULTS: There was a significant increase (P < 0.05) in nuclear thickness, nuclear diameter, and age with increasing LOCS III grade of the nucleus. The change in nuclear size was linear between Grades 1 and 4. The nuclear size did not increase between Grades 4 and 5. It increased steeply from Grade 5 to Grade 6.9.
CONCLUSIONS: LOCS III grading of the nucleus can be utilized for determining the nuclear thickness and diameter preoperatively. These data can be helpful in adjusting machine parameters during phacoemulsification.

We herein report a case of hemichorea-hemiballism in an 85-year-old man diagnosed with diabetes at 76 years of age. After a one-year interruption in treatment, he was treated with a low-calorie diet, linagliptin, and nateglinide. Over 51 days, his HbA1c level decreased from 15.8% to 7.7%. After a prompt improvement in his hyperglycemia, he began experiencing involuntary movements in the right upper and lower extremities. T1-weighted magnetic resonance imaging showed a high signal intensity in the left lens nucleus. The patient was diagnosed with diabetic hemichorea-hemiballism and received haloperidol (1 mg/day) as treatment.

438 eyes of 365 patients undergoing Extra-Capsular Catarct Extraction were included in this study. Preoperatively the age of the patients, colour of the nucleus and grading on the Wilmer System were recorded. Postoperatively the diameter, width and hardness of the nucleus were recorded. Statistical analysis revealed a strong correlation between the age, depth of colour and grading on the Wilmer system and the size and hardness of the nucleus. The size and hardness of the nucleus can be predicted preoperatively by proper assessment of the age, colour, and grading on the Wilmer System. This would help the Surgeon in evolving a proper surgical plan for each patient and thus bringing down the complication rate and difficulties faced during the surgery especially during Phacoemulsification surgeries.

The most unique biochemical characteristic of the eye lens fiber cell plasma membrane is its extremely high cholesterol content, the need for which is still unclear. It is evident, however, that the disturbance of Chol homeostasis may result in damages associated with cataracts. Electron paramagnetic resonance methods allow discrimination of two types of lipid domains in model membranes overloaded with Chol, namely, phospholipid-cholesterol domains and pure Chol bilayer domains. These domains are also detected in human lens lipid membranes prepared from the total lipids extracted from lens cortices and nuclei of donors from different age groups. Independent of the age-related changes in phospholipid composition, the physical properties of phospholipid-Chol domains remain the same for all age groups and are practically identical for cortical and nuclear membranes. The presence of Chol bilayer domains in these membranes provides a buffering capacity for cholesterol concentration in the surrounding phospholipid-Chol domains, keeping it at a constant saturating level and thus keeping the physical properties of the membrane consistent with and independent of changes in phospholipid composition. It seems that the presence of Chol bilayer domains plays an integral role in the regulation of cholesterol-dependent processes in fiber cell plasm membranes and in the maintenance of fiber cell membrane homeostasis.

OBJECTIVE: To evaluate the effects of chronic tobacco smoking on lens nucleus by Pentacam HR lens densitometry (LD) in young adults.
METHODS: Prospective cross-sectional case series.
METHODS: Thirty subjects (23 M, 7 F) who were chronic cigarette smokers (≥10 cigarettes/day for at least 2 years) (group 1) and another 30 subjects (23 M, 7 F) who did not smoke (group 2), were included in this study. The patients were matched for age and sex between the groups. The exclusion criteria were any history of ocular surgery, any systemic disorders and any ocular diseases except for mild refractive disorders. Lens densitometry measurements were done with the Pentacam HR (Oculus, Wetzlar, Germany). The Schirmer test and pachymetry measurements were also performed.
RESULTS: Mean age of the patients for both groups was 28.90 ± 8.20 years (range: 18-40 years). Mean lens densitometry (LD) measurements of Group 1 (chronic cigarette smoking group) were higher than those of Group 2 (control group) in all LD techniques; however only mean \"peak\" LD measurements showed a statistically significant difference between these two groups (Group 1: 8.67 ± 0.61, Group 2: 8.44 ± 0.70, p = 0.04). The mean Schirmer test value was 12.43 ± 5.60 mm in Group 1 and 13.00 ± 4.26 mm in Group 2 (p = 0.55). The mean central corneal thickness (CCT) value was 564.23 ± 34.61 µm in Group 1 and 550.47 ± 32.94 µm in Group 2 (p = 0.03).
CONCLUSIONS: The Pentacam HR LD seems to be an important option for the evaluation of lens nucleus in young adults, because it gives objective and quantitative data.
CONCLUSIONS: Although chronic smoking increases lens nucleus density in young adults, the effect is not statistically significant when compared with the control group.

OBJECTIVE: To investigate the frequency of idiopathic phacodonesis (IP) in senile cataract subjects and the short-term clinical outcomes following cataract surgery.
METHODS: This institutional case-control study included 1301 consecutive low-income cataract subjects from June to November 2009. Anterior segment were carefully evaluated with dilated pupil under slit-lamp. IP were screened and graded by a criteria set by the authors. Risk factors, surgical outcomes, and operative complications were analyzed.
RESULTS: A total of 42 subjects (3.2%) with IP were diagnosed and classified as grade 1 (36 subjects), grade 2 (5 subjects) and grade 3 (1 subject). Harder lenses and intumescent cataracts were observed in the IP group than the control group (P<0.05). Logistics regression test also indicated the main risk factor was the hardness of the lens. The incidence of zonular dialysis during surgery was 23.8% (10 eyes), which was significantly higher than the controls (0.7%, P<0.001). Visual outcomes of the two groups were not statistically or clinically significant.
CONCLUSIONS: Hard nucleus and intumescent cataract are related to IP in senile cataract subjects in Qinghai, China. With more care being taken, grade 1 and some of the grade 2 IP subjects achieved similar surgical outcomes as compared to controls.