ABSTRACT
Objective:To explore the effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus.Methods:A prospective case-control study was conducted to collect cataract patients with type 2 diabetes who were admitted to the First Hospital of Hebei Medical University from January 2018 to June 2019. All patients were treated with phacoemulsification. They were randomly divided into three groups: 40 cases (68 eyes) of corneoscleral incision, 40 cases (66 eyes) of upper transparent corneal incision and 40 cases (70 eyes) of temporal transparent corneal incision. The dry eye symptom scale score, corneal fluorescein staining (FL) score, tear rupture time (BUT) and Schirmer I test (SIt) were compared in three groups; The levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in aqueous humor were compared among the three groups before and 7 days after operation.Results:⑴ The levels of IL-6 and IL-8 in aqueous humor of the three groups were significantly lower than those before operation, especially in group A ( P<0.05), but there was no significant difference in the levels of IL-6 and IL-8 in aqueous humor of group B and C ( P>0.05); ⑵ The scores of dry eye symptoms in group B were significantly higher than those in group A at 1 and 7 days after operation ( P<0.05); The scores of dry eye symptoms in group C were significantly higher than those in group A and B at 1, 7 and 30 days after operation ( P<0.05); The dry eye symptom score in group A and B decreased to the preoperative level 30 days after operation ( P>0.05), and that in group C decreased to the preoperative level 90 days after operation ( P>0.05); ⑶ The postoperative 1, 7 and 30 d BUT in group A and C were significantly higher than those in group B ( P<0.05), and the level of SIt was significantly lower than that in group B ( P<0.05); At 1 and 7 days after operation, SIt in group A was significantly lower than that in group C ( P<0.05); the FLS score in group A and C was significantly lower than that in group B at 1 and 7 days after operation ( P<0.05). Conclusions:The incision of corneoscleral margin has little effect on tear film stability and ocular surface function of cataract patients with type 2 diabetes mellitus treated by phacoemulsification, which is worthy of clinical recommendation.
ABSTRACT
Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS) with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3%) was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of >0.50D was in 82.5% subjects of group A and 52.8% subjects of group B at 1st week. At 6th week postoperative astigmatism of less than 1D was in 79.95% subjects of Group A and 83.34% subjects of Group B. About 20% subjects in Group A and only 3.3% in Group B showed astigmatism of more than 1D and these differences on both the occasions were statistically significant. Conclusion: The post operative visual outcome was better in SICS with scleral incision (group B) than in SICS with clear corneal incision (Group-A). Keywords: SICS; clear corneal incision; scleral incision; astigmatism.
ABSTRACT
PURPOSE: To evaluate the onset of retinal detachment (RD) in eyes with phacoemulsification and post chamber lens (PE & PCL) implantation. METHODS: We retrospectively analyzed 3023 eyes that had undergone clear cornea incision and PE and PCL implantation and 116 eyes that had undergone scleral incision and PE and PCL implantation. They had been operated from January 1995 to December 2000 by one surgeon and followed up for 4 years or more. RESULTS: Eighteen eyes (0.57%) of the 3139 eyes developed pseudophakic RD within a mean period of 663 days. In the scleral incision group, there were 4 cases of pseudophakic RD (3.4%) of 116 eyes developed in a mean period of 185.2 days. In the clear cornea group, there were 14 pseudophakic RD eyes (0.46%) of the 3023 eyes and the mean period was 799 days. Of these, 3 eyes made up the intraoperative complication group with a mean period 205.6 days. But in the group of cases with no intraoperative complications, the mean period was 962 days. CONCLUSIONS: In high myopic eyes, retinal detachment developed in the earlier postoperative period and at a higher rate than those of non-high myopic eyes after PE and PCL implantation.
Subject(s)
Cornea , Intraoperative Complications , Phacoemulsification , Postoperative Period , Retinal Detachment , Retinaldehyde , Retrospective StudiesABSTRACT
Astigmatic change in planned extracapsular cataract extraction (P-ECCE) using temporal scleral incision (n=25 eyes) was compared for 2 months with that using superior scleral incision(n=19 eyes), retrospectively. The astigmatic change was analyzed using Naeser`s polar value. Surgically induced astigmatism induced by temporal scleral incision was 0.96+/-1.38D of with the rule(WTR), 2.35+/-1.36D (WTR), and 2.45+/-1.24(WTR) at 3 days, 2 weeks, and 2 months, respectively. In contrast, that induced by superior scleral incision was 2.29+/-2.30D(WTR), 0.76+/-2.39(WTR)and -0.95+/-1.88D of against the rule(ATR) at 3 days, 2 weeks, and 2 months, respectively. In another words, temporal scleral incision in P-ECCE induced WTR astigmatism as early as postoperative 3 days that incerased by 2 weeks and stabilized after 2 weeks, whereas superior scleral incision in P-ECCE induced a prominent WTR astigmatism as early as postoperative 3 days, that was converted to ATR astigmatism from 1 month and increased the change by 2 months. With this result, it was found that most cataract patients existing ATR astigmatism would be candidates for temporal incision in P-ECCE.