ABSTRACT
@#AIM:To analyze the effects of corneoscleral limbus incision phacoemulsification and corneal incision phacoemulsification on postoperative rehabilitation of elderly cataract patients.<p>METHODS: Totally 98 elderly cataract patients(132 eyes)who underwent phacoemulsification in our hospital during the period from January 2015 to January 2017 were enrolled. According to surgical incision sites, they were divided into corneoscleral limbus incision group(group A, <i>n</i>=52 cases, 74 eyes)and corneal incision group(group B, <i>n</i>=46 cases, 58 eyes). The changes of uncorrected visual acuity, best corrected visual acuity(BCVA)and corneal astigmatism in both groups were measured at different time points before and after operation. The epithelial repair time and incision repair time in both groups were statistically analyzed. The changes of tear break-up time(BUT), tear secretion and corneal staining score were recorded at different time points before and after treatment. The incidence of postoperative complications was statistically analyzed.<p>RESULTS: There were significant differences in uncorrected visual acuity, corneal astigmatism, surgery induced corneal astigmatism, BCVA, BUT, tear secretion and corneal staining scores between the two groups and within the same group at different time points(<i>P</i><0.05). The uncorrected visual acuity and BCVA in group A were superior than those in group B at different time points after operation. The corneal astigmatism and surgery induced corneal astigmatism were lower than those in group B. BUT was longer than that of group B. And tear secretion was higher than that in group, and corneal staining score was lower than that in group B(<i>P</i><0.05).The epithelial repair time and incision repair time in group A were shorter than those in group B after operation(<i>P</i><0.05).There was no significant difference in the incidence of postoperative complications between the two groups(<i>P</i>>0.05).<p>CONCLUSION:The phacoemulsification under corneoscleral limbus incision can improve postoperative visual acuity of elderly cataract patients, reduce the corneal astigmatism, reduce the influence on the tear film function, and promote postoperative rehabilitation.
ABSTRACT
Aims: To report the technique and outcomes of sutureless manual cataract extraction via a subconjunctival limbus oblique incision for mature cataracts. Materials and Methods: This retrospective study comprised of 112 eyes of 83 patients with mature cataract who all had manual cataract extraction via a subconjunctival limbus oblique incision. A transconjunctival tunnel is fashioned with a 3.0 mm keratome, 0.5 mm behind the limbal vascular arcades. A limbal tunnel, with a transverse extent of 9 mm in the cornea and 7.0 mm in the limbus, is created beneath the conjunctival/Tenon’s tissue using an angled bevel‑up crescent blade. Outcome measures included visual acuity, intraoperative complications, surgically induced astigmatism, endothelial cell loss rate and surgery time. Results: Self‑sealing wound was achieved in 112 eyes (98.2%). The nucleus was delivered in whole in 108 eyes (96.4%). Intraoperative complications included hyphema in 3 eyes (2.7%), iridodialysis in 2 eyes 1.8%), posterior capsular rupture and zonular dialysis in 2 eyes (1.8%). At the 3‑month follow‑up, 91% patients achieved a best-corrected visual acuity of 20/20 or better, the mean of surgically induced astigmatism was ‑0.62 ± 0.41 Diopters and endothelial cell loss was 4.2%. Average surgical time was 3.75 min per case. Conclusion: This subconjunctival limbus oblique incision has the potential to serve as safe and effective technique for mature cataracts.