Time to eat your veggies to prevent cataracts! In the 1991 LOCS study, risk factors were determined for the development of nuclear, cortical, posterior subcapsular, and mixed cataracts using 1380 patients with known cataracts. There were 435 controls alongside 72 posterior subcapsular, 137 nuclear, 290 cortical, and 446 mixed cataracts.
Overall, the LOCS study is a landmark study because it determined the various personal, nutritional, medical, and other exposures that lead to cataract formation, which are now part of numerous clinical discussions around the development of cataracts.
Older, wiser, and a little blurrier – must be those cataracts! Cataracts are an incredibly common cause of decreased vision across the world, especially among older individuals. Researchers in Beaver Dam Eye Study set out to gather longitudinal data to better investigate characteristics associated with cataract development in order to shed light on areas of greater social and health care needs. This prospective epidemiologic study utilized census data of 2764 participants living in a rural town in the midwestern United States in order to determine the incidence of age-related cataracts and cataract surgery over a 10-year period. Lenses of participants were photographed and graded according to standardized protocol at baseline, 5 years, and 10 years.
The Beaver Dam Eye Study is a critical piece of literature in the epidemiology of cataract development as it provided long-term data to better appreciate the role of age and gender in cataract progression. Its contributions to the early understanding of the incidence and prevalence of different lens opacities make it landmark study in ophthalmology.
Is more always better? Or, more money, more problems? In this study from 2000, preoperative medical testing was compared to no preoperative medical testing prior to age-related cataract surgery in 19,250 total cataract surgeries. They randomized patients to a no testing and a routine testing group, and assessed for medical adverse events during and within 7 days of the surgery.
Overall, the study is a landmark study because it showed that preoperative medical testing before age-related cataract surgery does not provide any significant benefit or improve postoperative outcomes. Further studies and reviews have instead showed that it primarily increases medical costs for patients with age-related cataracts.
If an apple-a-day keeps the doctor away, what keeps away endophthalmitis? While endophthalmitis is rare, invasion of the globe during cataract surgery is a risk factor and must be taken into consideration before, during, and after the procedure. In an effort to better understand ways to prevent such a postoperative complication, the ESCRS (European Society of Cataract and Refractive Surgeons) endophthalmitis study coordinated 24 ophthalmology clinics/units across Europe to gather data. Researchers in this partially masked, placebo-controlled, randomized clinical trial enrolled 13,698 participants to evaluate the prophylactic effect of intracameral cefuroxime injection and/or perioperative levofloxacin eyedrops on the incidence of endophthalmitis after cataract surgery.
The ESCRS endophthalmitis study earns its landmark status as it was among the trailblazers of endophthalmitis prophylaxis as it relates to cataract surgery. The results of the study influenced surgical technique in the following years and widened the discussion on how to best prevent endophthalmitis after cataract surgery.