ABSTRACT
AIM: To investigate the effect of phacoemulsification with steep meridian transparent corneal incision on visual function, corneal astigmatism and tear film changes.METHODS: A total of 106 cataract patients(106 eyes)who underwent phacoemulsification in our hospital from January 2019 to December 2020 were selected as research objects, and they were divided into observation group and control group according to the operation mode: with 51 patients in the observation group who were treated with steep meridian transparent corneal incision, and 55 patients in the control group who were treated with transnasal transparent corneal incision. The changes of visual function, corneal astigmatism and tear film between the two groups were compared before operation and at 1wk, 1 and 3mo after operation.RESULTS: There was no statistical difference between the operation of two groups(all P>0.05). The visual acuity was significantly improved at 1wk, 1 and 3mo after operation, and it was better in the observation group than that in the control group. Mean defect(MD)of visual field was significantly lower, and it was significantly lower in the control group(all P<0.05); The corneal astigmatism AKP(+0)of the two groups was significantly lower at 3mo after operation, and the observation group was significantly lower than the control group(P<0.05). There was no statistical difference in corneal astigmatism AKP(+45)(P>0.05); Schirmer Ⅰ test(SⅠt)value increased first and then decreased, and the valley value was at 1wk after operation; Tear film break-up time(BUT)decreased first and then increased, and the valley value was at 1wk after operation. SⅠt in the observation group was lower than that in the control group at each time point(all P<0.05), while BUT in the observation group was higher than that in the control group at each time point(all P<0.05).CONCLUSION: Steep meridian transparent corneal incision phacoemulsification surgery is beneficial to improve the postoperative visual function of patients, reduce postoperative corneal astigmatism, reduce the damage to the patient's tear film function, and promote its recovery.
ABSTRACT
@#AIM: To investigate the changes and clinical significance of corneal parameters and tear film stability after cataract combined with pterygium surgery. <p>METHODS: The clinical data of 80 patients with cataract and pterygium admitted to our hospital from January to December 2020 were retrospectively studied. All patients underwent pterygium excision + phacoemulsification + intraocular lens implantation + limbal stem cell transplantation. The changes of visual acuity, corneal Pentacam parameters, corneal astigmatism, corneal curvature and tear film stability before and after operation were compared, and the degree deviation of intraocular lens(IOL)was calculated.<p>RESULTS: At 3mo after operation, the average corneal refractive index and average corneal refractive index of the patients in this group were significantly higher than those before operation. The index of surface variance(ISV)of corneal surface and astigmatism of anterior corneal surface were significantly lower than those before operation, and the indexes of tear film stability were significantly improved compared with those before operation(all <i>P</i><0.01). At 6mo after operation, the visual acuity of the patients in this group was significantly improved compared with that before operation, and the corneal astigmatism was significantly decreased compared with that before operation, but the corneal curvature was significantly higher than that before operation(all <i>P</i><0.001). The IOL degree deviation of the patients in this group was -5.5 - +3.5D.<p>CONCLUSION: Cataract combined with pterygium surgery can effectively improve the visual acuity of patients and improve the stability of tear film, but there may be corneal astigmatism. Therefore, the contralateral corneal refractive power should be used to calculate the IOL degree after pterygium excision. When the corneal refractive state is stable, cataract phacoemulsification is performed to ensure its prognosis.
ABSTRACT
@#AIM: To investigate the therapeutic effect of conbercept injection combined with Ahmed valve implantation and phacoemulsification in the treatment of neovascular glaucoma(NVG).<p>METHODS: Retrospective analysis. Totally 18 patients(18 eyes)with NVG complicated combined with cataract in our hospital from June 2018 to January 2020. All patients received intraocular injection of conbercept at 3-7d before surgery, Ahmed valve implantation and phacoemulsification were performed after meeting the surgical indications. Best corrected visual acuity(BCVA), intraocular pressure(IOP), resolution of iris neovascularization and postoperative complications were followed up after the surgery, and all the cases were followed up 12mo. <p>RESULTS: Compared with preoperation(51.44±8.18 mmHg), IOP was significant decreased at 1, 7d, 1, 3, 6mo, 1a after surgery(25.94±11.82, 15.39±4.97, 15.94±2.69, 15.33±4.54, 18.89±7.95, 16.27±5.22 mmHg)(<i>P</i><0.05). Last follow up after surgery, BCVA was improved in 12 eyes(67%), unchanged in 5 eyes(28%)and decreased in one eye. At 1a after operation, the complete success rate was 83%(15 eyes), conditional success rate was 11%(2 eyes), one eye of losing control of IOP was failed. <p>CONCLUSION: Conbercept intraocular injection combined with Ahmed valve implantation and phacoemulsification can not only effectively control postoperative IOP, but also improve the visual acuity of the patients as much as possible. It is an effective method for the treatment of NVG with cataract.
ABSTRACT
@#AIM:To analyze curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on subjective sylptols of dry eye questionnaire scores(SDES)and break-up time(BUT).<p>METHODS: During the period from June 2015 to January 2019, 117 cataract patients(139 eyes)who underwent cataract surgery in the hospital were divided into group A(<i>n</i>=65, 72 eyes)and group B(<i>n</i>=52, 67 eyes)by random number table method. Groups A and B underwent phacoemulsification through 2.2mm and 3.0mm micro-incision, respectively. The general surgical status, SDES, BUT and curative effect indexes \〖best corrected visual acuity(BCVA), spherical equivalent(SE), endothelial cell density(ECD)\〗 were compared between the two groups.<p>RESULTS: There was no significant difference in ultrasound time, cumulative released energy, operation time or postoperative complications between two groups(<i>P</i>>0.05). After surgery, SDES scores in both groups were significantly increased, BUT was decreased compared with that at 1d before surgery. At 3mo after surgery, SDES and BUT recovered to preoperative levels. At 1d and 1wk after surgery, SDES score in group A was significantly lower than that in group B, while BUT was significantly higher than that in group B(<i>P</i><0.05). After surgery, BCVA LogMAR and ECD in both groups were significantly decreased, while SE and corneal diopter were significantly increased, without significant difference between the two groups(<i>P</i>>0.05). <p>CONCLUSION:The curative effect of phacoemulsification through clear corneal tunnel incision is reliable on cataract. The tear film function is better through 2.2mm micro-incision.
ABSTRACT
@#AIM: To investigate the effect of application of corneal protective agent(2% hydroxyl propyl methyl cellulose, 2% HPMC)on the stability of ocular surface tear film after phacoemulsification in age-related cataract(ARC)patients with type 2 diabetes.<p>METHODS: Prospective parallel controlled trial. Totally 107 cases(107 eyes)of the patients with ARC and type 2 diabetes who underwent phacoemulsification in our hospital from March 2017 to May 2018 were included in this study. According to the random number table, the patients were divided into HPMC group and BSS group. All 57 eyes were enrolled in HPMC group and 2% HPMC was evenly covered on the corneal surface during operation; 50 eyes were enrolled in BSS group and BSS was continuously dripped on the cornea during operation. Break up time(BUT), Schimer Ⅰ test(SⅠt)and corneal fluorescein staining(CFS)were performed 1d before operation and 7d, 30d, 60d and 90d after operation, and observed their changes.<p>RESULTS: At 7d, 30d and 60d after cataract surgery, compared with BSS group, BUT was significantly prolonged and CFS staining spots were significantly reduced in HPMC group; At 7d after surgery, SⅠt in HPMC group was significantly lower than that in BSS group; At 30d and 60d after surgery, SⅠt in HPMC group was significantly higher than that in BSS group(<i>P</i><0.05). At 60d after operation, there was no difference in BUT, SⅠt and CFS between HPMC group and preoperative group(<i>P</i>>0.05), while there was difference in BUT, SⅠt and CFS between BSS group and preoperative group(<i>P</i><0.05).<p>CONCLUSION:2% HPMC in phacoemulsification can protect the stability of tear film on the ocular surface of ARC patients with type 2 diabetes. The tear film stability indexes can be restored to the preoperative level 60d after operation.
ABSTRACT
@#AIM: To investigate the causes and effective diagnosis and treatment of Descemet's membrane detachment in the patients received phacoemulsification combined with intraocular lens implantation and extracapsular cataract extraction combined with intraocular lens implantation. <p>METHODS: A retrospective analysis was applied for 2 069 eyes in 2006 patients which had received one of above-mentioned surgeries from January 2015 to December 2017. The treatment and prognosis of 26 patients(26 eyes)who had the complication of Descemet's membrane detachment during or after the surgery were observed. <p>RESULTS:After the appropriate treatment, no corneal endothelial decompensation happened in the 26 patients, and the visual acuity was improved to different extent. UBM confirmed that the Descemet's membrane was reset. <p>CONCLUSION: Early detection and appropriate treatment of Descemet's membrane detachment is important for the visual acuity recovery.
ABSTRACT
@#AIM: To observe the clinical surgical effect of brown hard nuclear cataract, and discuss the surgical skills. <p>METHODS: Totally 80 eyes of 80 patients with level V cataract were randomly stratified, divided into two groups. We operated with sclera tunnel incision phacoemulsification in Group A(40 eyes), combined with manual cataract extraction. Sutureless large-incision-manual cataract extraction(SLIMCE)was used in Group B(40 eyes). All cases were implanted posterior chamber folding intraocular lens. We compared the best corrected visual acuity, corneal astigmatism, operation time, intraoperative complications, corneal edema, intraocular pressure and corneal endothelial cells in two groups of different postoperative time. <p>RESULTS: The postoperative best corrected visual acuity at 3 and 7d of Group A were better than those of Group B(<i>P</i><0.05), and there was no difference in the 1d and 1mo after surgery(<i>P</i>>0.05). The corneal astigmatism of 1mo after surgery was much smaller in Group A, and there was a significant statistical difference between two groups(<i>P</i><0.05). Less intraopretative complications happened in Group A, but there was not statistical difference between two groups(by Fisher's exact test, <i>P</i>=0.36). There was a significant statistical difference in corneal edema of these two groups at 1d after surgery(<i>χ</i><sup>2</sup>=5.70, <i>P</i><0.05). There were no significant differences in operation time, postoperative corneal edema, intraocular pressure and corneal endothelial cells in two groups at 7d(<i>P</i>>0.05). <p>CONCLUSION: Sclera tunnel incision phacoemulsification combined with manual nuclear extraction would be a preferred surgical technique for level V cataract.
ABSTRACT
AlM:To observe and compare the influence of different incision cataract phacoemulsification on comprehensive state in patients. METHODS: Sixty patients with cataract who were treated with phacoemulsification in our hospital from November 2012 to May 2014 were selected as research object, and they were divided into group A ( corneal incision group) 30 cases and group B ( corneoscleral rim incision group) 30 cases according to the disease state. Epithelial and incision repair time, tear break-up time, tear secretion, corneal staining score and tear related indexes before and after the treatment of two groups were respectively analyzed and compared. RESULTS: The epithelial and incision repair time constitution of group B were better than those of group A, the incision repair time, tear break - up time, tear secretion, corneal staining score and tear related indexes at 1,7, 14 and 28d after the treatment were all significantly better than those of group A too, there were all significant differences (all P<0. 05).CONCLUSlON: The application value of corneoscleral rim incision in the patients with cataract phacoemulsification is relatively higher,and bad influence of this method for the patients is smaller, the postoperative recovery of comprehensive state are faster.
ABSTRACT
AIM:To compare the operation effect of 2. 2mm micro incision and 3. 0mm incision coaxial phacoemulsification. METHODS: Patients with age - related cataract ( 90 cases, 90 eyes) were enrolled in the study from January 2012 to June 2013 in our hospital, and they were randomly divided into 2 groups:2. 2mm incision group (45 eyes of 45 cases), 3.0mm incision group (45 eyes of 45 cases). Corneal tunnel incision coaxial phacoemulsification was performed. At 1d, 1wk, 1, 3mo after operation, the visual acuity, corneal endothelial cell count, central corneal thickness, operation astigmatism were recorded. RESULTS:One day after operation, the visual acuity of 2. 2mm incision group were significantly improved, the difference was statistically significant ( P0. 05). Operation source astigmatism had statistically significant difference at 1d, 1wk, 1, 3mo after operation ( PCONCLUSION: The 2. 2mm small incision coaxial phacoemulsification with postoperative visual acuity improved more significantly, can significantly reduce the operation astigmatism.