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·AIM: To investigate the visual acuity after cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole (IMH) at different stages. ·METHODS: In this study, 75 IMH patients ( 75 eyes ) treated in our hospital from August 2014 to August 2016 were enrolled and underwent cataract extraction, vitrectomy and C3F8gas tamponade. Patients were divided into stage Ⅱ Group ( 18 cases ), stage Ⅲ ( 36 cases) and stageⅣ(21 cases) according to Gass stages, and macular hole closure at 2 and 4wk postoperatively were compared. The routine visual acuity examination before and after surgery were performed, and the visual acuity in each group were compared. The optical coherence tomography ( OCT) was used to measure the macular thickness before and after surgery. ·RESULTS: The closure rate of macular hole in stage Ⅱwas significantly higher than that of stage Ⅲ and IV at the 1mo after operation, that at the stage Ⅲ was significantly higher than that of stageⅣgroup, and the difference was statistically significant (P<0. 05). There was no significant difference in the rate of closure of macular hole between stage Ⅱ and stage Ⅲ at 3mo after operation (P>0. 05). The proportion of eyes with visual acuity of finger counting, 0. 02-0. 08, 0. 10-0. 20, 0. 25-0. 40 and ≥0. 50 was statistically significant different before and after surgery(P<0. 05). The improvement rate of visual acuity was 94% in stage Ⅱ, which was significantly higher than that in stage Ⅲ (83%) and stage Ⅳ (67%). The macular thickness of the stage Ⅱ and Ⅲ was significantly lower after the surgery, but there was no significant difference in the stage Ⅳ before and after surgery (P>0. 05), the decreasing range of the stage Ⅱ and Ⅲ was not statistically significantly different (P>0. 05), which were significantly higher than that of the stage Ⅳ, the difference was statistically significant (P<0. 05). ·CONCLUSION: Cataract extraction, vitrectomy and C3F8 gas tamponade surgery is conducive to the vision recovery after idiopathic macular hole, but the effects with different Gass staging are different, surgery should be performed as early as possible to improve macular hole closure and eyesight recovery.
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AIM: To investigate the clinical efficacy of intravitreal injection of Conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma (NVG). METHODS: The clinical data of 90 patients with NVG treated in our hospital from June 2014 to June 2016 were analyzed retrospectively. There were 42 patients treated with trabeculectomy and panretinal photocoagulation enrolled as the control group. On the basis of this, 48 patients who received intravitreal injection of conbercept 5-7d preoperatively were enrolled as observation group. The best corrected visual acuity (standard logarithmic visual acuity), intraocular pressure and the regression of neovascularization were observed and compared before treatment,and 1wk,1,3,and 6mo post treatment. Then the clinical efficacy and postoperative complications were observed and recorded. RESULTS: The difference of visual acuity of the two groups was significant before and after treatment,and the best corrected visual acuity of observation group was significantly higher than that of the control group at 1mo after the operation (P<0.05), no difference was found at 1wk,3 and 6mo post treatment (P>0.05). The pre- and postoperative intraocular pressure of the two groups showed significant difference, and the intraocular pressure of the observation group was significantly lower than the control group at 1wk, 1, 3 and 6mo post treatment (P<0. 05). The cure rate in the observation group was significantly higher than that in the control group (77% vs 64%), with statistical significance (P<0 05). The incidence of anterior chamber hemorrhage and shallow anterior chamber in the observation group was significantly lower than that of the control group (P<0.05), with no difference in the incidence of macular degeneration(P>0.05). Moreover, the recurrence rate of neovascularization in the observation group was significantly lower than that of the control group at 6mo after operation (P<0.05). CONCLUSION: The intravitreal injection of conbercept 5-7d before panretinal photocoagulation can significantly reduce intraocular pressure,improve the visual acuity for the treatment of NVG, which also has a higher comprehensive cure rate.
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·AIM: To investigate the effect of phacoemulsification intraocular lens implantation combined with trabeculectomy on ocular surface in the treatment of glaucoma and cataract. ·METHODS: Totally 45 cases of patients with glaucoma and cataract in our hospital from February 2016 to February 2017 were enrolled. All the patients had unilateral disease,and the medical records of the patients were analyzed retrospectively. The sicked eyes were set as the observation group and contralateral eyes were set as the control group. The dry eye score, break-up time (BUT), corneal fluorescein staining score (FL), tear secretion test (S I t) and conjunctival epithelium goblet cell density(CIC) was compared between two groups before operation and at 1wk,1 and 3mo after operation. · RESULTS: The preoperative dry eye score of the observation group had no significant difference with that of the control group (P > 0. 05). At 1wk, 1mo after operation,data of the observation group was significantly higher than that of the control group and before operation, with statistical significance (P < 0. 05), no significant difference was shown at postoperative 3mo (P>0.05). Preoperative BUT of the observation group had no significant difference with that of the control group(P>0.05); at 1 wk,1 and 3mo after operation, data of the observation group was significantly lower than that of the control group and before operation, with statistical significance (P<0.05). The preoperative FL score of the observation group was significantly higher than that of the control group, while the postoperative FL score of the observation group at 1wk,1 and 3mo had sharp difference with that before operation(P<0.05),all were significantly higher than that of the control group,there was statistical significance(P<0.05). There was no significant difference in S I t score between the observation group and the control group preoperatively ( P > 0. 05), and the postoperative S I t scores of the observation group at 1wk,1 and 3mo postoperatively was evidently lower than that of the control group and before operation (P<0.05). There was no significant difference in CIC density between the two groups preoperatively. While the postoperative data of the observation group at 1wk, 1 and 3mo postoperatively was significantly lower than that of the control group and before operation,with statistical points (P<0.05). · CONCLUSION: Phacoemulsification intraocular lens implantation combined with trabeculectomy for treatment of glaucoma and cataract can aggravate dry eye symptoms, as well as reduce tear film stability and tear secretion,impair conjunctival epithelium goblet cell.
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Objective To compare the sensitivity of regional refraction multifocal intraocular lens implantation with other methods. Methods A total of 78 patients with simple cataract treated by visual acuity in our hospital from February 2016 to June 2017 were selected as subjects.The patients were divided into SBL-3 group (26 cases),SN6AD1 group (26 cases) and ZMB00 group (26 cases) according to the different intraocular lens.The contrast sensitivity value of patients in 3 groups under clear light(85 cd/m2),dark light(3 cd/m2),clear and glare light(45 Lux),dark and glare light(28 Lux) with different spatial frequencies (3,6,12,18 c/d) by the United States CSV-1000E contrast sensitivity tester after surgery.Results In terms of sensitivity index as clear light,dark light,clear and glare light,and dark and glare,the SBL-3 group were better than those of ZMB00 group and SN6AD1 group,the difference was significant(P<0.05);there were no significant differences between ZMB00 group and SN6AD1 group of each index sensitivity(P>0.05).Conclusion The postoperative sensi-tivity of refractive multifocal intraocular lens implantation of SBL-3 is significantly better than the apodized diffractive multifocal intraocular lens implantation of SN6AD1 and alll optical diffractive multifocal intraocular lens implantation of ZMB00,which is worthy of widely use for simple cataract.
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AIM:To investigate the effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity.METHODS: Totally 145 eyes in 120 patients underwent phacoemulsification from July 2013 to July 2015 were randomly divided into observation group 60 cases (73 eyes) and control group 60 cases (72 eyes).The observation group 60 cases were given 1.8mm coaxial micro incision cataract phacoemulsification operation,while the control group were given traditional 3.2mm coaxial micro incision cataract surgery.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),corneal thickness of incision area,incision width,incision length,macular retinal thickness,surgically induced astigmatism,corneal endothelial cell counts and complications of the two groups were compared.RESULTS: The UCVA and BCVA on 1wk after surgery of the observation group were significantly higher than the control group (t=3.604,7.109;P0.05).CONCLUSION: The 1.8mm micro incision phacoemulsification is helpful to improve the visual acuity of patients with cataract phacoemulsification,which may be related to the reduction of corneal cell injury,enhancement of corneal closure and decrease post-operation corneal original astigmatism.