ABSTRACT
Objective:To compare and study the clinical efficacy of three different phacoemulsification incisions for cataract patients with type 2 diabetes mellitus.Methods:A retrospective analysis was performed in 120 patients (198 eyes) with type 2 diabetes cataract who underwent cataract extraction and intraocular lens implantation from January 2018 to June 2019 in the First hospital of Hebei Medical University. According to the surgical incision, the patients were divided into three groups: A group (the cornea scleral marginal incision, 40 cases, 72 eyes), B group (the clear corneal incision at the top , 40 cases, 66 eyes), C group (underwent temporal clear corneal incision, 40 cases, 60 eyes). The corneal perception, dry eye symptoms, basic tear secretion test (SIt), tear film rupture time (BUT), corneal fluorescein staining (FL) and complications were compared among the three groups before and after treatment.Results:The corneal perception of B group and C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05); The scores of dry eye symptoms in C group were higher than those in A group and B group on 1 d, 7 d and 30 d after operation ( P<0.05), and the scores of dry eye symptoms in B group were higher than those in A group on 1 d and 7 d after operation ( P<0.05); The SIt value of C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05), and that of B group was lower than that of A group and group C on 1 d, 7 d and 30 d after operation ( P<0.05); The BUT value of C group was lower than that of A group at 1 d and 7 d after operation ( P<0.05), and the BUT value of B group was lower than that of A group and C group at 1 d, 7 d and 30 d after operation ( P<0.05); The FL value between A group and C group at 1 d, 7 d, 30 d and 90 d after treatment was not significant ( P>0.05). The FL value of B group returned to the level before treatment at 30 d after operation, and the FL value of B group was higher than that of A group and C group at 1 d and 7 d after operation ( P<0.05); There was little difference in the incidence of complications among the three groups ( P>0.05). Conclusions:The cornea scleral marginal incision can reduce the tear secretion, maintain the stability of tear film, and is more suitable for cataract patients with type 2 diabetes mellitus. It is worthy of further promotion in clinic.
ABSTRACT
Objective:To explore the effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus.Methods:A prospective case-control study was conducted to collect cataract patients with type 2 diabetes who were admitted to the First Hospital of Hebei Medical University from January 2018 to June 2019. All patients were treated with phacoemulsification. They were randomly divided into three groups: 40 cases (68 eyes) of corneoscleral incision, 40 cases (66 eyes) of upper transparent corneal incision and 40 cases (70 eyes) of temporal transparent corneal incision. The dry eye symptom scale score, corneal fluorescein staining (FL) score, tear rupture time (BUT) and Schirmer I test (SIt) were compared in three groups; The levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in aqueous humor were compared among the three groups before and 7 days after operation.Results:⑴ The levels of IL-6 and IL-8 in aqueous humor of the three groups were significantly lower than those before operation, especially in group A ( P<0.05), but there was no significant difference in the levels of IL-6 and IL-8 in aqueous humor of group B and C ( P>0.05); ⑵ The scores of dry eye symptoms in group B were significantly higher than those in group A at 1 and 7 days after operation ( P<0.05); The scores of dry eye symptoms in group C were significantly higher than those in group A and B at 1, 7 and 30 days after operation ( P<0.05); The dry eye symptom score in group A and B decreased to the preoperative level 30 days after operation ( P>0.05), and that in group C decreased to the preoperative level 90 days after operation ( P>0.05); ⑶ The postoperative 1, 7 and 30 d BUT in group A and C were significantly higher than those in group B ( P<0.05), and the level of SIt was significantly lower than that in group B ( P<0.05); At 1 and 7 days after operation, SIt in group A was significantly lower than that in group C ( P<0.05); the FLS score in group A and C was significantly lower than that in group B at 1 and 7 days after operation ( P<0.05). Conclusions:The incision of corneoscleral margin has little effect on tear film stability and ocular surface function of cataract patients with type 2 diabetes mellitus treated by phacoemulsification, which is worthy of clinical recommendation.
ABSTRACT
BACKGROUND: Spherical Toric intraocular lens can effectively correct the preoperative astigmatism of cataract patients, but it is unclear whether the aspheric Toric lens is better than the spherical Toric lens to improve the quality of vision. OBJECTIVE: To evaluate the optical quality after implantation of aspheric toric intraocular lens in cataract surgery. METHODS: Seventy-three cataract patients with corneal astigmatism (80 eyes) were enrol ed, including 37 males and 36 females, aged 47-83 years. Among them, 36 cases were implanted with aspheric Toric intraocular lens (test group), and the other 37 cases were implanted with spherical Toric intraocular lens (control group). Postoperative examinations were performed at 3 months, including axial intraocular lens, uncorrected visual acuity, corrected visual acuity, residual astigmatism, contrast sensitivity, and wavefront aberration. RESULTS AND CONCLUSION: Three months after implantation, the axial view, uncorrected visual acuity, corrected visual acuity and residual astigmatism showed no differences between the two groups; no shape deviation and lens decentration occurred; there was no case required to remove the lens or subjected to secondary adjustment. In the test group, the moderate and high spatial frequency contrast sensitivity at the scotopic or scotopic glare state was significantly higher than that in the control group (P < 0.05), the total higher order aberrations and spherical aberrations at a pupil diameter of 5.0 mm and spherical aberration at a pupil diameter of 3.0 mm were significantly less than those in the control group (P < 0.05). Additional y, there were no differences in scattering index, cut-off frequency of the modulation transfer function, Strehl ratio and visual acuity at 9%, 20% and 100% contrast between the two groups. These findings indicate that the aspheric and spherical toric intraocular lenses have similar effects in improving the astigmatism and raising the uncorrected visual acuity, but the former one is superior to the latter one in improving scotopic vision, and total higher order aberrations and spherical aberrations.