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@#AIM:To observe the clinical effects of the small incision non phacoemusification cataract surgery in 462 Sudanese cataract cases(536 eyes). <p>METHODS:From September 2013 to August 2015, we analyzed the 462 Sudanese cataract cases(536 eyes)performed cataract surgery by the way of the small incision non phacoemusification with intraocular lens(IOL)implantation and summarized the intraoperative and postoperative complications, the eyesight and intraocular pressure(IOP)of the eyes in 1d, 1wk and 1mo after operation. <p>RESULTS: Intraoperative complications: posterior capsular ruptured and vitreous prolapsed in 18 eyes(3.4%), iris prolapsed in 10 eyes(1.9%), suspensory ligament of the lens ruptured in 7 eyes(1.3%), not implanted IOL in 5 eyes(0.9%), descent's membrane detachment in 3 eyes(0.6%), iridodialysis in 1 eye(0.2%). Postoperative complications: corneal edema in 47 eyes(8.8%), anterior chamber inflammatory reaction in 32 eyes(6.0%), pupil oval or slightly upward in 12 eyes(2.2%), the upper iris incarcerated in the tunnel incision in 3 eyes(0.6%),hyphema in 2 eyes(0.4%), infective endophthalmitis in 1 eye(0.2%). Visual acuity: uncorrected visual acuity were ≤0.1 in 52 eyes(9.7%), >0.1-<0.3 in 97 eyes(18.1%), 0.3-<0.5 in 129 eyes(24.1%), and ≥0.5 in 258 eyes(48.1%)in 1d after operation. Uncorrected visual acuity was ≤0.1 in 28 eyes(5.2%), >0.1-<0.3 in 66 eyes(12.3%), 0.3-<0.5 in 150 eyes(28.0%), and ≥0.5 in 292 eyes(54.5%)in 1wk after operation. At 1mo after operation, some patients did not follow-up on time, uncorrected visual acuity of reviewer above 0.5 in 321 eyes. IOP: in 1d after operation, IOP above 20 mmHg in 26 eyes(4.9%). In 1wk after operation, IOP above 20 mmHg in 2 eyes(0.4%). In 1mo after operation, 1 eye was still poor control with traumatic cataract surgery, and IOP returned to normal after the reoperation of trabeculectomy. <p>CONCLUSION:The small incision non phacoemusification cataract surgery with IOL implantation has the advantages of small incision, short operation time, relatively safe, easy to mastered, no-suture, quick visual function recovery and low cost. And, the operation equipments are simple and do not need many expensive medical equipments, supplies and professional staffs. So, the small incision non phacoemusification cataract surgery with IOL implantation is suitable for the anti-blind work of cataract in the foreign aid and remote areas.
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PURPOSE: To evaluate long-term change in intraocular pressure (IOP) in the fellow eyes after laser iridotomy and early phacoemusification with laser iridotomy in patients with acute angle-closure glaucoma. METHODS: We performed a retrospective, comparative chart review of 62 patients with acute angle-closure glaucoma; 35 patients (Group A) who underwent only prophylactic laser iridotomy on fellow eyes and 27 patients (Group B) who underwent prophylactic laser iridotomy and early phacoemusification on fellow eyes. Patients were followed up at 1 day, 1 week and 1, 3, 6 and 12 months. IOP change was analyzed after laser iridotomy 1 hour and at every follow-up. In addition, visual acuity and complications of laser iridotomy and phacoemusification were determined. RESULTS: In Group A, the mean IOP increase in fellow eyes occurred within 1 month after laser iridotomy (initial, 15.9 ± 5.0 mm Hg; final, 15.9 ± 2.6 mm Hg), However, in Group B, the mean IOP of fellow eyes was maintained up to 12 months without an increase in IOP (initial, 17.0 ± 3.3 mm Hg; final, 13.3 ± 2.8 mm Hg) Among the fellow eyes, 13 patients in Group A (37.14%) and 4 patients in Group B (14.81%, p = 0.032) underwent further medical therapy. The initial visual acuity of fellow eyes in Group A was 0.78 ± 0.21 and 0.71 ± 0.22 in Group B, and at the final visit, 0.73 ± 0.31 in Group A and 0.93 ± 0.27 in Group B (p = 0.003). CONCLUSIONS: We found that most fellow eyes treated with laser iridotomy and phacoemulsification maintained satisfactory IOP and good vision. These results support that laser iridotomy and phacoemulsification in the fellow eye with acute angle-closure glaucoma is a reasonable prophylactic treatment.
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Humans , Follow-Up Studies , Glaucoma, Angle-Closure , Intraocular Pressure , Phacoemulsification , Retrospective Studies , Visual AcuityABSTRACT
Objective To analyze the operation methodes and effects of cataract complicated with acute angle-closure glaucoma . Methods Phacoemusification combined with intraocular lens implantation and phacoemusification ,intraocular lens implantation combined with trabeculectomy were choosed to be performed on 40 eyes(38 patients) which were diagnosed with cataract compli-cated combined with acute angle-closure glaucoma ,according to the intraocular pressure and the opening level of the angle of anteri-or chamber of patients .All cases were been followed-up from 6-24 months after the operation .Results For postoperative correc-ted vision ,20 eyes were greater than 0 .6 ,17 eyes were between 0 .3-0 .6 and 3 eyes were less than 0 .3;For postoerative intraocu-lar pressure ,38 eyes were in normal range ,2 eyes were in normal range with drug control .Conclusion Phacoemusification combined with intraocular lens implantation prefer to be choosed for cataract complicated with acute angle-closure glaucoma with opening lev-el of the angle of anterior chamber greater than the half .Phacoemusification ,intraocular lens implantation combined with trabeculec-tomy prefer to be choosed for cataract complicated with acute angle-closure glaucoma with opening level of the angle of anterior chamber less than the half .Choosing proper operation methodes for the patients who were diagnosed with cataract complicated with acute angle-closure glaucoma ,according to patients′situation ,benefit to improve patients′vision and control intraocular pressure .
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ObjectiveTo compare the effects of two treatmnent methods in the treatment of proliferative diabetic retinopathy (PDR) patients with cataract.Methods79 PDR patients with cataract,according to the different surgical methods were divided into:phacoemulsification with lensectomy of 41 cases(52 eyes) in Group A and crystal resection with lensectomy of 38 cases(48 eyes) in Group B.The changes of eye pressure,iris neovascularization (INV),fundus fluorescein angiography were observed.ResultsThe visual acuity increased in 42cases (80.0％)postoperative in group A,which was significantly higher than that of group B [ 30 cases(62.5％ ) ] (x2 =4.26,P ＜ 0.05) ;The incidence of INN was 3.8 ％ in Group A,which was significantly lower than that of Group B (12.5％ )( x2=4.02,P ＜ 0.05 ) ;The macular edema and postoperative fundus fluorescein angiography showed no significant difference in two groups ( x2 =2.02,2.58,all P ＞ 0.05 ).ConclusionThe effect of phacoemulsification with vitrectomy for the treatment of PDR with cataract was superior to the posterior lens removal of vitrectomy surgery.
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Las opciones de tratamiento en el cierre angular incluyen medicamentos hipotensores oculares, cirugía láser (iridotomía, gonioplastia) y la cirugía incisional (filtrante, remoción del cristalino), en dependencia de la forma clínica de presentación. Dentro de estas, la medicación sistémica, gonioplastia láser, indentación corneal y paracentesis de la cámara anterior han sido efectivas en el control urgente de la presión intraocular. El tratamiento definitivo es la iridotomía periférica, que previene la crisis aguda, pero no la progresión al glaucoma. Posterior al ataque agudo, la cirugía filtrante se relaciona con una mayor probabilidad de complicaciones quirúrgicas y fallo posoperatorio en el control de la presión intraocular. Por otra parte, la facoemulsificación ha mostrado resultados favorables al aumentar la amplitud angular, eliminar el bloqueo pupilar y disminuir la presión intraocular
The therapeutic options for the angle closure glaucoma cover medical treatment with ocular hypotensors, laser surgery (iridotomy, gonioplasty) and incisional surgery (trabeculectomy and lens extraction) depending on the clinical form of the presentation. Medical treatment, laser gonioplasty, corneal indentation and immediate anterior chamber paracentesis are good effective options to immediately stabilize intraocular pressure in acute primary angle closure. The definitive treatment is the laser iridotomy that avoids the acute attack, although progression to glaucoma may occur. After the acute attack, the filtering surgery fails to reduce intraocular pressure and is associated with more surgical complications. Phacoemulsification has shown good results by increasing the angle depth, eliminating the papillary block and reducing the intraocular pressure
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Objective To explore the nursing care of patients with Marfan syndrome accompanied with lens subluxation, and the clinical efficacy of phacoemusification combined with the implantation of modified capsular tension ring and foldable posterior chamber intraocular lens. Methods 11 patients (11 eyes) were performed the surgery. Uncorrected visual acuity preoperatively was (0.13±0.09). Best corrected visual acuity preoperatively was (0.20±0.17). Preoperative preparation, intraoperative observation and postoperative guidance were executed. The prognosis of these patients were observed. Results The operations were performed successfully. No intraoperative complications were founded. Mean uncorrected visual acuity at 2 year postoperatively was (0.60±0.28), and mean best corrected visual acuity was (0.70±0.28). Conclusions Careful preparation before surgery, close cooperation during surgery and the correct management after surgery were the important measures for the success of surgery.