Age-related Cataract
Conditions
Keywords
Ocular surface, Cataract, Conjunctival impression cytology, Aqueous humor, Metabolomic, Lipidomic
Brief summary
Cataract is the world's leading cause of blindness, the treatment of which, exclusively surgical, offers excellent results in terms of visual recovery. It represents the most frequently performed surgery in France with more than 800,000 procedures each year. However, some patients develop postoperative ocular surface disease that can affect final visual acuity and quality of life. For example, dry eye disease, very common in the elderly, can be worsened by cataract surgery. The identification of ocular surface biomarkers predictive of the postoperative risk of ocular surface disease carries the promise of better personalized perioperative care. Conjunctival impression cytology represents a rapid, minimally invasive method of collecting conjunctival cells, which has proven its usefulness in the evaluation of diseases of the ocular surface. The aqueous humor is directly accessible at the beginning of the surgery. An approach combining ultra-high performance liquid chromatography coupled with high-resolution mass spectrometry on the cells of the ocular surface and on the aqueous humor could improve our understanding of the physiopathology of ocular surface disease following cataract surgery. This study will aim to 1) search for prognostic biomarkers of ocular surface disease after cataract surgery using a metabo-lipidomic approach 2) improve our understanding of the pathophysiological mechanisms involved.
Interventions
Questionnaire on ocular surface disorders
OTHERInterferometry
Non-contact examination measuring NIBUT (non-invasive break-up time), meibography and tear meniscus measurement
OTHEROxford score
Investigation and quantification of superficial corneal punctate keratitis using the Oxford score
OTHERConjunctival collection
Two conjunctival prints: one for metabolomic and one for lipidomic
Collection of 0.1 mL of aqueous humor immediately after making the accessory corneal incision at the beginning of the cataract surgery.
OTHERQuantification of Tyndall and flare
Quantification of Tyndall and flare (from 1 to 4 crosses) in anterior chamber
Sponsors
University Hospital, Tours
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient with cortico-nuclear and/or subcapsular cataract * Age \> or = 50 years * Patient affiliated to a social security system * Patient agreeing to participate in the study who provided his/her free and informed written consent
Exclusion criteria
* History of ocular surgery or trauma (≤ 3 months) * Other types of cataract excepted age-related or diabetic cataract * Any eye drops or treatments that may interfere with the ocular surface * Lens wearer * Any general pathology with a known impact on the ocular surface (auto-immune disease, allergy) * Proven allergy to povidone-iodine or to a component of the postoperative treatment * Patient under legal protection (safeguard of justice, curatorship and guardianship), or in a situation of deprivation of freedom * Patient unable to understand the nature and objectives of the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative ocular surface disease | 1 months after cataract surgery | Metabo-lipidomic analysis of intracellular content of the ocular surface preoperatively and aqueous humor intraoperatively to predict occurrence of ocular surface disease 1 month following cataract surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in number and semi-quantitative concentrations of ocular surface metabolites | From baseline to 1 month after cataract surgery | Comparison of ocular surface metabolome using conjunctival impression cytology pre and postoperatively 1 month after cataract surgery |
| Change in number and semi-quantitative concentrations of ocular surface lipids | From baseline to 1 month after cataract surgery | Comparison of ocular surface lipidome using conjunctival impression cytology pre and postoperatively 1 month after cataract surgery |
Countries
France
Outcome results
None listed