ABSTRACT
Objective To assess the outcomes of OASIS iris expander in phacoemulsification surgery of cataract with small pupil.Methods A prospective case-control study was conducted in 22 microcoria cataract patients (22 eyes).And they were randomly divided into group A and B,in which the pupils of group A were dilated by tearing instruments in 13 eyes,and the pupils of group B were dilated using OASIS iris expander in 9 eyes.All patient underwent phacoemulsification with 3.2 mm clear corneal incision and were followed up at postoperative 1 week,1 month,3 months and 6 months.Finally,the best corrected visual acuity (BCVA),intraocular pressure (IOP),corneal endothelial cell counts,pupil size before and after surgery were recorded and analyzed by an independent sample t test.Results All procedures were completed successfully by the same skilled doctor.Intraocular lenses were implanted in capsule completely,and no complications occurred.At 6 months after operation,patients'BCVA in group A (0.41 ± 0.30) and group B (0.77 ± 0.23) was significantly higher than that in group A (0.17 ±0.14) and group B (0.16 ±0.14) before operation,but there was no statistical difference between the two groups (all P ＞0.05);whereas there was no significant change in the IOP of group A and B at 6 months after operation (1 kPa =7.5 mmHg) and before operation [(14.22 ±6.00) mmHg vs.(15.70 ± 5.70) mmHg)] (all P ＞ 0.05).Moreover,corneal endothelial cell counts in group A [(1486 ±718) cells · mm-2] and B [(1246 ±516)cells · mm-2] were significantly smaller than those before operation [(2498 ±564)cells · mm-2 vs.[(2424 ± 640) cells · mm-2],with no significant difference (P=0.091).The postoperative diameter of the pupil in group A [(4.00 ±0.88) mm] and group B [(4.70 ± 1.57) mm] after operation was larger than that in group A [(2.30 ±0.35)mm] and group B [(1.94 ±0.50)mm] before operation,and there was no statistical difference between the two groups (all P ＞0.05).Conclusions OASIS iris expander can help to dilate and hold pupils and does not affect the postoperative visual acuity and intraocular pressure in mlcrocoria cataract phacoemulsification.The postoperative pupils become larger,and it is necessary to pay attention to protect corneal endothelial cell during usage of OASIS iris expander.
ABSTRACT
@#AIM: To observe the effect of built-in type OASIS iris expander in phacoemulsification surgery for cataract with small pupil. <p>METHODS: Totally 44 cataract patients with small pupil were treated in our hospital from January 2016 to October 2017 were randomly divided into the control group(22 cases, 31 eyes)and the observation group(22 cases, 30 eyes). The patients in control group was treated by conventional phacoemulsification surgery, within surgery the small pupils were dilated by cleavage and lens position hook; the patients in observation group use OASIS iris expander within surgery. The best corrected visual acuity(BCVA), corneal endothelial cell counts, pupil size, intraocular pressure(IOP)of two groups before and after surgery were compared and analyzed, and the application effect of built-in type OASIS iris expander was evaluated. <p>RESULTS: At 1mo after operation, the BCVA of the two groups were significantly improved, and the BCVA of the observation group(0.09±0.04)was significantly better than that of the control group(0.20±0.03), the difference was statistically significant(<i>P</i><0.05). At 1mo after operation, the corneal endothelial cell counts of the two groups were significantly decreased, but the corneal endothelial cell counts of the observation group(2455.77±52.98/mm<sup>2</sup>)were significantly higher than those of the control group(2298.94±49.12/mm<sup>2</sup>), the difference was statistically significant(<i>P</i><0.05). At 1mo after operation, the pupil diameter of the two groups was enlarged(<i>P</i><0.05), and the pupil diameter of the observation group(3.52±1.14mm)was larger than that of the control group(3.15±1.02mm, <i>P</i>>0.05). At 6mo after operation, the pupil diameter of the two groups was significantly enlarged(<i>P</i><0.05), but there was no significant difference in the pupil diameter between the two groups(<i>P</i>>0.05). At 1mo after operation, intraocular pressure in both groups was lower than that before operation(<i>P</i><0.05), and the intraocular pressure in observation group(13.40±1.73mmHg)was lower than that in control group(13.93±1.98mmHg, <i>P</i>>0.05). At 6mo after operation, intraocular pressure in both groups was lower than that before operation and 1mo after operation(<i>P</i><0.05), but there was no significant difference in intraocular pressure between the two groups at 6mo after operation(<i>P</i>>0.05). <p>CONCLUSION: The OASIS built-in iris dilator can improve the best corrected visual acuity, reduce intraocular pressure and expand pupil diameter in small pupil phacoemulsification.