2021–2022 BCSC Basic and Clinical Science CourseTM,Section 11: Lens and Cataract

Many areas of lens physiology and biochemistry are still subjects of active research. Lens regeneration has been studied since the 18th century. This regeneration, from epithelial cells from the lens, cornea, or iris, has succeeded repeatedly in several vertebrate species, especially newts and rabbits. In 2016, an experimental trial in children with congenital cataracts was able to regenerate working lenses from intact lens epithelial stem cells within six to eight months. However, no medical treatment can yet prevent the formation or progression of cataract in the lens of the otherwise healthy adult eye, and theories about cataract formation and innovative forms of management continue to be controversial. Although various risk factors for cataract development have been identi-fied (discussed in Chapter 1), data to develop guidelines for reducing the risk of cataract remain inconclusive.The prevalence of lens disorders and continuing developments in their management make the basic and clinical science of this structure a vital component of ophthalmology training. The goal of Section 11 is to provide a curriculum for the study of the structure and function of the normal lens, the features of diseases involving the lens, and the surgi-cal management of cataract. Contents Objectives Introduction Epidemiology of Cataract Anatomy Biochemistry and Physiology Embryology and Developmental Defects Pathology Evaluation and Management of Cataracts Preoperative Considerations for Cataract Surgery Phacoemulsification for Cataract Extraction Optimizing Refractive Outcomes of Cataract Surgery Intraoperative Challenges in Cataract Surgery Postoperative Surgical Course and Complications Preparing for Cataract Surgery in Special Situations Historical Development of Cataract Surgery and Non-Phacoemulsification Cataract Surgery Techniques Index