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      Secondary cataract: an epidemiologic and clinical survey at the Yaounde Gynaeco-obstetric and Paediatric Hospital

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          Abstract

          Objective:

          To determine the incidence and risk factors of secondary cataract.

          Materials and methods:

          A retrospective study involving a review of medical records in the ophthalmology unit of the Yaoundé Gynaeco-obstetric and Paediatric Hospital in Yaoundé, Cameroon, was carried out. All patients who had cataract surgery between January 2006 and September 2010 were included. Variables included age, sex, past medical history, morphology of primary cataract, type of surgery, intraocular lens implantation, site of implantation, intra- and postoperative complications, and the time lapse for the presentation of secondary cataract. Both univariate and bivariate analyses were carried out. The χ 2 test was used to compare proportions, and P-values <0.05 were considered statistically significant.

          Results:

          A total of 864 eyes of 718 patients had cataract surgery. Ninety-two eyes developed posterior capsule opacification, giving an incidence of 10.65%. The mean age of patients who developed secondary cataract was 52.3 ± 23.05 years, with a range of 4 years to 84 years. Secondary cataract was more frequent in the age group of 0–20 years. The time lapse for presentation of secondary cataract was 64.7 ± 9.53 days, with a range of 1 to 504 days. Risk factors for the development of secondary cataract were age ( P = 0.000), sex ( P = 0.011), cortical cataract ( P = 0.000), and postoperative inflammation ( P = 0.000).

          Conclusion:

          The incidence of secondary cataract, though high in this study, is lower than that reported in other studies.

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          Most cited references95

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          Posterior capsule opacification.

          A complication of extracapsular cataract extraction with or without posterior chamber intraocular lens (PC-IOL) implantation is posterior capsule opacification. This condition is usually secondary to a proliferation and migration of residual lens epithelial cells. Opacification may be reduced by atraumatic surgery and thorough cortical clean-up. Clinical, pathological and experimental studies have shown that use of hydrodissection, the continuous curvilinear capsulorhexis and specific IOL designs may help reduce the incidence of this complication. Capsular-fixated, one-piece all-polymethylmethacrylate PC-IOLs with a C-shaped loop configuration and a posterior convexity of the optic are effective. Polymethylmethacrylate loops that retain "memory" create a symmetric, radial stretch on the posterior capsule after in-the-bag placement, leading to a more complete contact between the posterior surface of the IOL optic and the taut capsule. This may help form a barrier against central migration of epithelial cells into the visual axis. Various pharmacological and immunological methods are being investigated but conclusive data on these modalities are not yet available.
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            A systematic overview of the incidence of posterior capsule opacification.

            Reported rates of posterior capsule opacification (PCO) vary widely and are based on various definitions of PCO, varying lengths and intervals of follow-up, and the use of different surgical techniques, intraocular lens (i.o.l.) designs, and methods of IOL implantation. This study was designed to obtain a more precise overall estimate of the incidence of PCO and to explore factors that might influence the rate of PCO development. A meta-analysis. Published articles were selected for study based on a computerized MEDLINE search of the literature and a manual search of the bibliographies of relevant articles. Articles meeting selected inclusion criteria were reviewed systematically, and the reported data were abstracted and synthesized using the statistical techniques of meta-analysis. Pooled estimates of the proportion of eyes developing PCO at three postoperative timepoints--1 year, 3 years, and 5 years--were measured. There is significant heterogeneity among published rates of PCO. The overall pooled estimates (95% confidence limits) of the incidence of PCO were 11.8% (9.3%-14.3%) at 1 year, 20.7% (16.6%-24.9%) at 3 years, and 28.4% (18.4%-38.4%) at 5 years after surgery. There is no evidence of a significant decline in PCO incidence during the study period. Visually significant PCO develops in more than 25% of patients undergoing standard extracapsular cataract extraction or phacoemulsification with posterior chamber intraocular lens implantation over the first 5 years after surgery. Patient characteristics, surgical techniques, and differences in research design and reporting may account for some of the variability in reported rates. However, no specific factors were identified in the authors' analysis. More precise estimates of incidence and identification of risk factors for PCO will depend on the development of a standardized measurement of PCO and wider adoption of more rigorous study methodology.
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              Role of cytokines in the pathogenesis of posterior capsule opacification.

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                Author and article information

                Journal
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2011
                2011
                22 June 2011
                : 5
                : 847-851
                Affiliations
                [1 ]Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon;
                [2 ]Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon;
                [3 ]Yaoundé Gynaeco-obstetric and Paediatric Hospital, Yaoundé, Cameroon
                Author notes
                Correspondence: André Omgbwa Eballé, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, PO Box 2701 Douala, Cameroon, Tel +237 99 65 44 68, Fax +237 33 40 64 75, Email andyeballe@ 123456gmail.com
                Article
                opth-5-847
                10.2147/OPTH.S19929
                3130924
                21750620
                ec50387c-fa85-4213-bd9a-4b9f015bc00f
                © 2011 Eballé et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                : 21 June 2011
                Categories
                Original Research

                Ophthalmology & Optometry
                incidence,secondary cataract,cameroon,cataract
                Ophthalmology & Optometry
                incidence, secondary cataract, cameroon, cataract

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