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@#In recent years, with the extensive development of phacoemulsification and the gradual application of femtosecond laser technology in the field of cataract surgery, femtosecond laser-assisted cataract surgery(FLACS)has become popular year by year, and has been recognized and promoted by more and more doctors. Femtosecond laser technology has high accuracy, automation and repeatability, so it is quite suitable for cataract surgery characterized by precision operation, it can be used in cataract surgery for corneal incision and limbal incision, anterior capsule incision, lens fragmentation and other key operations. FLACS has broad application prospects and can greatly improve the predictability and safety of surgery. The emergence of FLACS is one of the most important developments in modern cataract surgery. With the continuous development of FLACS, cataract surgery will usher in new technological innovations. However, FLACS are relatively new, and longer term, more comprehensive data are still needed to better demonstrate their effectiveness in the future. We review the current research progress of FLACS.
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?AIM: To compare the clinical effect of 23G and 25G+vitrectomy for retinal detachment.?METHODS:Forty seven patients with retinal detachment were treated with 23G vitrectomy (27 eyes in 27 cases as group A) and 25G+ vitrectomy (20 eyes in 20 cases as group B ) . The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure ( IOP ) and complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo. The relevant records were statistically analyzed and compared.?RESULTS: The operation time of 23G group and 25G+group were 50. 21+4. 52min, 49. 15+5. 14min,respectively and there was no significant difference between the two groups (P>0. 05). The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+group, and the difference was statistically significant ( P0. 05). The number of eyes with hypotonia in 23G and 25G+group were 3 and 1 eyes respectively, the difference was statistically significant ( P 0. 05). At the last follow-up, the results showed that 26 eyes ( 96%) with retinal reposition in 23G group, 19 eyes (95%) in 25G+ group, the difference was not statistically significant (P>0. 05).?CONCLUSION: The clinical effect of 23G and 25G+vitrectomy for retinal detachment is similar, but 25G+vitrectomy can reduce incidence of complications and early postoperative low IOP.
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Background The different incisions in phacoemulsification,including the length,location and shape etc.,can cause surgery-induced astigmatism ( SIA ).But the SIA caused by 2.2 mm,3.0 mm corneal limbal incision after phacoemulsification,especially the change of posterior corneal surface astigmatism is still rarely reported. Objective This study was to investigate the anterior,posterior and total corneal SIA and compare their differences between phacoemulsification and foldable intraocular lens (IOL) implantation with 2.2 mm and 3.0 mm corneal limbal incisions. Methods Seventy-one eyes of 47 cases were randomly divided into two groups with matched age,visual acuity and astigmatism degree.Phacoemulsification and IOL implantation with 2.2 mm incision at the steepest corneal meridian was performed on the patients of 2.2 mm incision group,and the same surgery was adopted with 3.0 mm incision as 3.0 mm incision group.Corneal curvature radius and central corneal thickness were measured by Pentacam at 1 day before surgery and 1 week,1 month and 3 months after surgery respectively.The anterior and posterior corneal surface SIAs were calculated according to the flat axis and steep axis of corneal curvature and the air and the cornea refractive index.Based on the anterior and posterior surface SIAs,the total corneal SIA was then calculated using the vector analysis method.Jaffe/Clayman vector method was used to calculate the anterior and posterior and total corneal SIAs in the different time points,and the differences were compared between the two groups.Oral informed consent was obtained from each subject prior to the trial. Results The mean anterior and posterior surface corneal SIAs appeared to be lower in 2.2 mm incision group compared with 3.0 mm incision group at postoperative 1 day,1 week,1 month and 3 months but were not significantly different among groups at various time points ( anterior SIA:P =0.290 ; posterior SIA:P =0.740 ; total SIA:0.434 ).The mean anterior corneal surface SIAs were significantly lower at the postoperative 3 months than those at postoperative 1 day,1 week in both groups(2.2 mm incision group:P=0.020,0.036;3.0 mm incision group:P=0.006,0.023 ).The posterior corneal surface SIAs were (0.70±0.43 ) D and (0.75 ±0.54 ) D at 1 day in 2.2 mm incision group and 3.0 mm inscision group,respectively,and significantly decreased posterior corneal surface SIAs were found in postoperative 1 week,1 month and 3 months compared with 1 day in both groups ( 2.2 mm incision group:all P =0.001 ; 3.0 mm incision group:P=0.028,0.044,0.032).The total corneal surface SIA showed significant differences between 1 day and 1 week,1 month,3 months after surgery ( 2.2 mm incision group:P =0.015,0.002,0.002 ; 3.0 mm incision group:P =0.049,0.007,0.016 ). Conclusions There are no significant differences in the anterior,posterior and total corneal surface SIAs between 2.2 mm and 3.0 mm incisions after phacoemulsification with IOL implantation.The SIA is gradually reduced with the prolongation of postoperative time.