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Purpose: To primarily compare surgically induced astigmatism (SIA), total and posterior corneal curvature, pachymetry, and their stabilization after 2.2 and 2.8 mm clear corneal incision in phacoemulsification. Methods: A randomized, prospective interventional study of 130 patients (130 eyes) of either sex having senile cataract (>40 years) divided randomly into two groups. The patients underwent uncomplicated phacoemulsification surgery with foldable intraocular lens implantation using 2.2 mm (group 1) and 2.8 mm incisions (group 2). The patients were evaluated preoperatively and followed?up at first, third, and sixth weeks. Results: Mean SIA was less in group 1 at all the follow?up visits which was not statistically significant (P value – 0.507 (at week 1), 0.626 (at week 3), and 0.312 (at week 6). Mean SIA decreased from week 1 to week 6 in both the groups. Both the groups showed an increase in SIA with the increase in the hardness of cataract. Posterior keratometry (k1 and k2) showed statistically significant steepening in the first postoperative week, followed by gradual flattening which continued till the sixth week postoperatively. Posterior astigmatism increased in both the groups at week 1 (not statistically significant). Thereafter, it decreases and does not change significantly after 3 weeks. Pachymetry increased significantly (P value < 0.001 in both the groups) in the first week in both the groups and thereafter stabilizing at 3 weeks. Conclusion: Reducing the incision size does not result in any significant reduction in SIA. We observed that the posterior corneal curvature majorly stabilized by 3 weeks, but some stabilization continued till 6 weeks.
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Background- The primary goal of cataract extraction surgery is immediate visual recovery and the best uncorrected visual acuity (UCVA) post operatively. Aim: To compare the surgically induced astigmatism (SIA) after phacoemulsification surgery with superior clear corneal incision (SCCI) and temporal clear corneal incision (TCCI). Materials & method: 11 articles were reviewed on PubMed related to SIA & a review was made on the factors that are responsible to reduce the post-operative astigmatism. The outcome measures were SIA and UCVA at 2 and 6 weeks, post?operatively. Results - In this study we expect to have better visual outcome and reduce incidence of SIA in TCCI than SCCI. Conclusion: TCCI appears to have better visual outcome and reduced incidence of SIA.
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@#AIM: To investigate the influencing factors of clear corneal incision(CCI)after phacoemulsification by Logistic regression analysis. <p>METHODS: A retrospective cases-control study was performed. 126 patients(138 eyes)who received phacoemulsification combined with implantation of foldable intraocular lens(IOL)were included in Erdos Central Hospital. Postoperative 1d, all of the CCIs were scanned by anterior segment optical coherence tomography(AS-OCT). According to whether there were presence of inner opening CCIs, the patients were divided into two groups. Group 1: inner opening CCIs(84 eyes)were absent. They were stable. Group 2: inner opening CCIs(54 eyes)were present. The factors affecting the stability of CCI were analyzed.<p>RESULT: The incidence of internal opening incisions was 39.1%(54/138). It decreased to 8.7%(12/138)at 1wk. One month postoperative, the internal mouths of the incisions were completely closed. The stability of the incisions was good. But AS-OCT scan found 3 cases with poor healing internal incisions. Binary Logistic regression analysis showed that age, incision length, incision angle, location of the internal incision, incision method and descemet's membrane detachment had statistically significant difference(<i>OR</i>=1.102, 0.994, 27.895, 0.127, 30.269, 6.750, all <i>P</i><0.05).<p>CONCLUSION:Age, incision length, incision angle, location of the internal incision, incision method and descemet's membrane detachment are the influencing factors of CCI stability after phacoemulsification.
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@#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.
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@#AIM: To explore the effect of 3.2mm clear corneal incision cataract phacoemulsification combined with intraocular lens(IOL)implantation.<p>METHODS: Retrospective analysis of 95 cases(107 eyes)cataract patients treated in our hospital, and all patients were given 3.2mm clear corneal incision Phaco combined with IOL implantation. The postoperative visual acuity, corneal curvature, corneal astigmatism, anterior chamber depth and complications were observed.<p>RESULTS: Postoperative 3d, 1wk, 1mo patients with the uncorrected visual acuity(0.16±0.06, 0.15±0.05, 0.14±0.04)were significantly better than preoperative(0.48±0.15). The anterior chamber depth(3.86±1.09, 3.69±1.04, 3.84±1.07mm)was significantly higher than the preoperative(2.71±0.88mm)(<i>P</i><0.05), but there was no significant difference in corneal curvature and corneal astigmatism before operation. There was no difference in surgical astigmatism after operation(<i>P</i>>0.05).<p>CONCLUSION: 3.2mm clear corneal incision Phaco combined with IOL implantation can effectively improve the recovery of postoperative visual acuity and reduce the corneal astigmatism, and it is a safe and effective surgical treatment of cataract.
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OBJECTIVE@#To determine the safe distance range of clear corneal incision (CCI) from the corneal limbus and how different CCI sites affect surgery efficacy and anterior segment parameters in patients undergoing phacoemulsification.@*METHODS@#This retrospective case-control study was conducted in 44 patients (44 eyes) undergoing phacoemulsification and IOL implantation. The patients were divided into two groups with CCI distances ranging from 1 mm to 1.5 mm (group A, = 22) and from 0.5 mm to 1.0 mm (group B, = 22). The visual acuity, surgically induced astigmatism (SIA), corneal aberration, and anterior segment parameters were analyzed.@*RESULTS@#Compared with the preoperative data, all the patients showed significant improvements in the postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), anterior chamber depth (ACD), and anterior chamber angle (ACA) after the surgery ( < 0.05). No significant differences were found between the two groups in postoperative UCVA, BCVA, SIA, total corneal aberration RMS, lower- and higher-order aberration RMS, spherical aberration (Z), horizontal three leaf clover (Z), vertical three leaf clover(Z), horizontal coma(Z), vertical coma(Z), ACD, ACA, anterior chamber volume, or central corneal thickness (>0.05).@*CONCLUSIONS@#Phacoemulsification is an effective therapy for cataract with a CCI distance range either of 1-1.5 mm or 0.5-1.0 mm. These two CCI distance ranges produce no significant differences in the visual quality following phacoemulsification, indicating that a CCI distance range of 0.5-1.5 mm can be safe for phacoemulsification.
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Humans , Anterior Eye Segment , Astigmatism , Case-Control Studies , Cornea , General Surgery , Lens Implantation, Intraocular , Limbus Corneae , Phacoemulsification , Methods , Postoperative Complications , Retrospective Studies , Surgical Wound , Treatment Outcome , Visual AcuityABSTRACT
·AIM: To explore the effect of different incision phacoemulsification on corneal endothelial function and tear film function in senile cataract (SC) patients. ·METHODS: Totally 90 SC patients (90 eyes) admitted to our hospital were randomly divided into the 2. 2mm group ( n = 47, 47 eyes, 2. 2mm corneal micro - incision phacoemulsification) and the 3. 0mm group ( n= 43, 43 eyes, 3. 0 mm clear corneal micro - incision phacoemulsification). The indexes of corneal endothelial function and tear film function were compared between the two groups before and after operation. ·RESULTS: There was no statistical difference on the average phacoemulsification time (APT), mean effective phacoemulsification time( EPT ),average phacoemulsification energy ( AVE) and preoperative and postoperative intraocular pressure between the two groups (P>0. 05). There were statistical differences on the tear break-up time (BUT), basal tear secretion test (ST-Ⅱ), corneal sodium fluorescein staining (SCSF) score, corneal endothelial cell count, central corneal thickness and the variation coefficient of corneal endothelial cells between the two groups (P<0. 05). At 1wk and 1mo after operation, the BUT in the two groups was significantly lower than that before operation (P<0. 05) while the ST-Ⅱ was significantly higher than that before operation ( P< 0. 05), and the SCSF first increased and then decreased (P < 0. 05 ), and corneal endothelial cell count was significantly lower than that before operation (P<0. 05), and the central corneal thickness and the variation coefficient of corneal endothelial cells significantly increased (P<0. 05). The changed degrees of BUT, ST-Ⅱ, SCSF score, corneal endothelial cell count, central corneal thickness and corneal endothelial cell variation coefficient in the 2. 2mm group were less than those in the 3. 0mm group (P<0. 05). ·CONCLUSION: Phacoemulsification for SC patients can cause some damage in corneal endothelial function and tear film function, and 2. 2mm corneal micro-incision have less damage and faster early recovery.
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Objective To investigate the effects of cataract surgery with transparent corneal incision in different directions,and discuss the application of dual channel visual quality analysis system in the evaluation of visual quality before and after cataract surgery.Methods Sixty-four patients (64 eyes) with cataract phacoemulsification combined with intraocuiar lens (IOL) implantation were enrolled in our hospital from January to May in 2016,and randomly divided into 2 groups:Group A with corneal incision in the temporal side of the eyes,group B with upper corneal incision.All the cases were examined with standard logarithmic optical acuity and dual-channel optical quality analysis system.The visual acuity,MTF cutoff,Strehl ratio (SR),objective scattering index (OSI) and contrast ratio were compared between the two groups.The OQAS values were 100％,20％ and 9％.Results (1) The visual acuity and corrected visual acuity of all patients increased gradually from postoperative 1 day to 1 week (P ＜0.05),and the visual acuity gradually stabilized after 1 week.The uncorrected visual acuity and corrected visual acuity at postoperative 1 day and 1 week in group A were significantly higher than those in group B at the same time point(P ＜ 0.05).There was no significant difference in uncorrected visual acuity and corrected visual acuity between the two groups at postoperative 1 month and 3 months (P ＞ 0.05).(2) At postoperative 1 day and 1 week,the OSI values of two groups were higher than those before operation,and all the time points were statistically significant (all P ＜ 0.05).The OSI values of group A at postoperative 1 day(2.81 ±0.89) and 1 week(1.98 ±0.73) were significantly lower than those of group B at 1 day(3.46 ± 1.17) and 1 week(2.61 ± 1.20) (all P ＜ 0.05).There was no significant difference in OSI between postoperative 1 month and 3 months (all P ＞ 0.05).The OV9％ values of the two groups were increased at postoperative 1 day,1 week,1 month and 3 months,and all the time points were statistically significant(all P＜0.05).The value of OV9％ in group A at postoperative 1 day(0.29 ±0.09),1 week(0.33 ±0.12),1 month (0.37 ± 0.14) and 3 months (0.42 ± 0.17) were significantly higher than those in group B at 1 day (0.24 ± 0.10),1 week (0.27 ± 0.09),1 month (0.31 ± 0.09) and 3 months (0.34 ± 0.14),which was statistically significant (all P ＜ 0.05).The MTF,SR,OV100％ and OV20％ values of all the patients were not statistically significant (all P ＞ 0.05).Conclusion In the operation of cataract with the temporal and transparent corneal incision,the postoperative intraocular scattering is small,early visual recovery is fast and the visual quality is high.The long-term effect needs further study.Dual channel visual quality analysis system can further quantify the visual quality parameters,has certain advantage in visual quality assessment.
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AIM:To compare the changes of surgically induced corneal higher order aberrations after phacoemulsification with 2.8mm clear corneal incisions at different sites.METHODS:The clinical data of 100 cases (100 eyes) of patients with cataract treated by phacoemulsification with 2.8mm clear corneal incision in our hospital from March 2015 to April 2016 were analyzed retrospectively.According to the site of incision,they were divided into Group A (temporal clear corneal incision,n =55) and Group B (upper clear corneal incision,n=45).Changes of the best corrected visual acuity (BCVA),surgically induced astigmatism (SIA) and corneal topography were compared between the two groups before surgery,at 1d,1wk,1 and 3mo after surgery.The corneal wavefront aberrations were measured by wavefront aberration analyzer,and the changes of higher-order aberrations in corneal 6mm range were recorded.RESULTS:The BCVA of two groups decreased at 1d,1wk,1 and 3mo after surgery (P＜0.05),and the BCVA of Group A at 1d,1wk,and 1mo after surgery was lower than that of Group B (P＜0.05).SIA of the two groups decreased at 1wk,1 and 3mo after surgery (P＜0.05),and the SIA of Group A at different time points after surgery were lower than those of Group B (P＜0.05).The surface asymmetry index (SAI) and the surface rule index (SRI) of the two groups increased at 1 d after surgery,and were gradually decreased at 1wk,1 and 3mo after surgery.The SRI and SAI in Group A were lower than those in Group B at 1d and 1wk after surgery (P＜ 0.05).The total corneal higher-order aberrations (tHOAs) and four-order spherical aberration (SA)showed significant differences between the two groups at 3mo after surgery (P＜0.05).CONCLUSION:The application of 2.8mm temporal clear corneal incision in phacoemulsification can promote the recovery of visual acuity,reduce the effect of surgery on corneal shape,and reduce corneal higher-order aberrations.
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PURPOSE: To determine the risk factors of intraoperative complications in femtosecond laser-assisted cataract surgery. METHODS: This study included 598 eyes of 337 patients who underwent femtosecond laser-assisted cataract surgery (FLACS) between July, 2012 and January, 2017. All eyes had corneal incisions, anterior capsulotomy, nuclear fragmentation, and limbal relaxing incisions (if required). Intraoperative complications were analyzed by watching videos, and the related factors of each complication were retrospectively reviewed alongside the medical records. RESULTS: The mean age of the patients was 62.1 ± 11.9 years. Among the study group, 18 eyes required manual creation of corneal incisions; because the corneal incisions could not be made due to corneal central opacity, corneal peripheral degeneration, ptreygium, conjunctival chalasis, or idiopathic. The anterior capsulotomy was incomplete in 43 cases and manual capsulorrhexis was required for completion. These cases were associated with various conditions, including hypermature cataract, anterior polar or subcapsular cataract, corneal central opacity, pupillary abnormality, lens subluxation, poor pupil dilation, and idiopathic. Overall, 22 eyes had difficulties with nuclear fragmentation, with either mature cataract, lens subluxation, corneal central opacity, anterior polar or subcapsular cataract, or pupillary abnormality. Using the Laser SoftFit™ patient interface decreased the incidences of incomplete corneal incision (from 3.56% to 2.24%, p = 0.367), anterior capsulotomy (from 9.31% to 4.03%, p < 0.05), and nuclear fragmentation (from 5.20% to 1.34%, p < 0.05). The incidences of complications in the experienced group was statistically lower compared with the novice group (p < 0.05 for all comparisons). CONCLUSIONS: The femtosecond laser platform was effective and safe for cataract surgery. However, in the presence of related factors, use of this platform might need to be re-assessed and should be considered for intraoperative complications. Additionally, with the Laser SoftFit™ patient interface and improved surgeon experience, better intraoperative results can be expected for FLACS surgery.
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Humans , Capsulorhexis , Cataract , Corneal Opacity , Incidence , Intraoperative Complications , Lens Subluxation , Medical Records , Pupil , Retrospective Studies , Risk FactorsABSTRACT
AIM:To analyze effect of the inside incision positions of clear corneal incisions of cataract on astigmatism after surgery was analysis using anterior segment optical coherence tomography. METHODS: A total of 40 patients of 43 eyes of age-related cataract were chosen. All of them were done 2.8mm clear corneal incision and phacoemulsification with foldable intraocular lens implantation. Preoperative and postoperative 1wk, 1 and 3mo, the corrected visual acuity were examined. Postoperative 1wk, 1 and 3mo, the positions and lengths of the incisions were measured. Depending on the location of the incisions, the patients were divided into two groups. Group 1:the inside mouth of the incisions(22 patients of 23 eyes) were far from the corneal vertex central line> 3mm. Group 2: the inside mouth of the incisions ( 20 patients of 20 eyes ) were far from the corneal vertex central line ≤3mm. RESULTS:One day before the surgery between Group 1 and Group 2 patients, there were no statistically significant difference(P>0. 05) in corrected visual acuity and corneal astigmatism. After the surgery, corrected visual acuity gradually increased, astigmatism and cut lengths gradually decreased. But, there were no statistically significant difference at 1wk, 1 and 3mo ( P CONCLUSION:The length of the inside mouth located within radius of the central cornea 3mm was rather longer than the length of the inside mouth located without radius of the central cornea 3mm. The SIA after surgery is greater, and postoperative visual acuity gained maybe less than the latter.
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?AlM: To study the effects of different position of clear corneal incision of cataract surgery on visual function and quality of life. ?METHODS: ln this study, 126 cases (126 eyes) in our hospital from April 2013 to April 2014 were selected, who were accepted the transparent corneal incision phacoemulsification and intraocular lens implantation in treatment of senile cataract patients. With digital method were divided into observation group and control group with 63 cases in each group, included the observation group selected the maximum refractive power of the cornea radial axial transparent angle incision, and the control group in the temporal clear corneal incision, compared the two groups of patients with postoperative visual function ( VF) and quality of life ( QOL) , and made statistics of uncorrected visual acuity. ? RESULTS: ln the observation group, postoperative visual function and the scores of quality of life were 80. 3±5. 63 and 80. 9±0. 79, was significantly higher than the control group (74. 9±5. 24) and (76. 5±0. 76). And the postoperative uncorrected visual acuity of patients in the observation group was less than that of the control group, while ≤1. 0 of patients than that in the control group. There was statistically significantdifference (P ?CONCLUSlON: Transparent cornea in cataract surgery to choose the largest cornea diopter longitude as incision can effectively improve the therapeutic effect, especially on the visual function of patients and to improve the quality of life.
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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.
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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.
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AlM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens (lOL) implantation with a 1. 8mm or 3. 0mm clear corneal incision on total root mean square ( RMS ) value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film. METHODS:ln a prospective study, 156 age- related patients ( 196 eyes ) were randomly distributed into two groups. 1. 8mm-group comprised 94 eyes that had a silicone lOL inserted through a 1. 8mm sutureless clear corneal incision, while, 3. 0mm- group comprised 102 eyes through a 3. 0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively. RESULTS:ln both groups, postoperatively at 1wk,there were statistically significant differences ( P 0. 05 ) between two groups at 3mo postoperative. CONCLUSlON:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3. 0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1. 8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.
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PURPOSE: To analyze the difference in astigmatism and the mean change in total astigmatism between inferior clear corneal incision and superior clear corneal incision following cataract surgery in surgically-induced astigmatism (SIA). METHODS: Fifty-five eyes of 55 patients with with-the-rule astigmatism >0.5 diopters were evaluated. Patients were divided into two groups according to incision location (Group 1, 26 eyes with an inferior incision; Group 2, 29 eyes with a superior incision). Patients were evaluatied one month postoperatively. Uncorrected visual acuity (UCVA, log MAR), best-corrected visual acuity (BCVA, log MAR), SIA and mean change in corneal astigmatism were measured in both groups. RESULTS: One month postoperatively, mean UCVA was 0.15 +/- 0.17 log MAR in Group 1 and 0.23 +/- 0.24 log MAR in Group 2 (p = 0.253). Mean BCVA was 0.08 +/- 0.13 and 0.08 +/- 0.12 log MAR in Groups 1 and 2, respectively (p = 0.926). The SIA was 0.50 +/- 0.17 diopter and 0.57 +/- 0.34 diopter (p = 0.253) and mean change in total astigmatism was 0.50 +/- 0.96 diopter and 0.38 +/- 0.86 diopter in Groups 1 and 2, respectively (p = 0.426). CONCLUSIONS: There was no statistically significant difference between the two groups. Thus, corneal incision on the inferior side in patients of with-the-rule astigmatism can reduce the SIA and mean change in corneal astigmatism for patients with glaucoma, hard upper eyelid tension or sunken eye.
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Humans , Astigmatism , Cataract , Eyelids , Glaucoma , Visual AcuityABSTRACT
Objective To discuss the effect of different cataract ultrasonic emulsification incision on the stability of the tear film after operation.Methods 82 patients (149 eyes) in our hospital from January 2010 to December 2012 were adopted as the research object.Patients were randomly divided into group A (40 cases,72 eyes) and group B(42 cases,77 eyes) used stratified random block method.Patients in group B were treated with anti-eyebrow scleral tunnel incision,and patients in group A were treated with corneal incision.The subjective feeling,tear secretion,tear film break-up time and the corneal incision staining of patients were compared and the results were analyzed between two groups.Results There were statistically significant differences in the subjective feeling of patients,the amount of tear secretion and the tear film breakup time (BUT) between the first day and the seventh day after operation.Conclusions Anti-eyebrow scleral tunnel incision is an ideal incision method for phacoemulsification.It has less impact on the stability of the cornea,and the damage to nerve is also light.
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Objective To evaluate the corneal astigmatism changes after phacoemulsification performed using clear corneal incision with different locations.Methods Seventy-two eyes of 72 patients having phacoemulsification and implantation of foldable intraocular lens through a clear corneal incision were chosen.Patients were divided into two groups by table of random digit:group A (incision at 11:00),group B (incision at the steepest corneal meridian).The change of corneal astigmatism was compared between group A and B postoperatively.Surgically-induced astigmatism (SIA) was calculated by vector analyses using the HoHaday-Cravy-Koch method.Results Preoperative corneal astigmatism between group A and group B had no significant difference [(0.96 ± 0.52) D vs.(0.94 ± 0.56) D,P ＞ 0.05].One and three months after operation,the corneal astigmatism in group A were significantly higher than those in group B [(1.15 ± 0.32)D vs.(0.82 ± 0.43) D,(0.85 ± 0.38) D vs.(0.63 ± 0.40) D,P＜ 0.05].The SIA in group A was significantly higher than that in group B 1 month after operation [(0.85 ± 0.37) D vs.(0.75 ± 0.54) D,P ＜ 0.05],there was no significant difference between group A and group B 3 months after operation [(0.60 ±0.35) D vs.(0.58 ±0.30) D,P ＞0.05].Conclusions Corneal astigmatism is prｅsent in most cataract surgery candidates.Cataract surgery using steepest corneal meridian incision induces significantly less SIA,and correct corneal astigmatism already present preoperatively.
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PURPOSE: To investigate wound characteristics and ultrastructural changes in the 2.2-mm and 2.8-mm main corneal incisions. METHODS: Forty-four eyes of 34 patients undergoing cataract surgery were randomized to receive a 2.2-mm or 2.8-mm main corneal incision. All incisions were evaluated 1, 7, and 30 days postoperatively using anterior segment optical coherence tomography. The angle, length, maximal thickness of the incision, and if present, corneal gap length and incision gap area were calculated. The existence of Descemet's membrane detachment was recorded. RESULTS: The mean endothelial gap length and gap area of the 2.2-mm wound were larger than the 2.8-mm, with the only statistically significant difference observed on postoperative day 30 (p = 0.015 and 0.027, respectively). There was no difference in the mean incision angle, length, and corneal thickness between the 2 incision sizes. The ratio of Descemet's membrane detachment increased with older age and low postoperative IOP, but not associated with incision size (p < 0.05). CONCLUSIONS: Both the 2.2-mm and 2.8-mm main corneal incisions showed excellent wound healing outcome without significant postoperative complications. Older patients with low postoperative IOP required a more careful wound care management. The incision parameters in the present study can be used as an indicator of the healing process to reduce wound-related complications.
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Humans , Cataract , Descemet Membrane , Eye , Phacoemulsification , Postoperative Complications , Tomography, Optical Coherence , Wound HealingABSTRACT
PURPOSE: In the present study we compared the intraocular pressure (IOP) after cataract surgery according to incisional techniques. METHODS: Patients who underwent phacoemulsification with intraocular lens implantation were divided into 2 groups: clear corneal incision group (CC group), and scleral tunnel incision group (ST group). All complicated cases were excluded. IOP was measured preoperatively and at 1 week, 1, 3, 6, 12, 18 and 24 months after surgery. RESULTS: Seventy-seven patients (100 eyes) were enrolled in the present study; CC group (28 patients, 33 eyes), ST group (49 patients 67 eyes). Preoperative IOPs in both groups were not significantly different (p = 0.908, student's t-test). IOP in the CC group at 1 week after surgery significantly decreased 2.22 +/- 2.57 mm Hg compared to preoperative IOP (p < 0.001, repeated-measures ANOVA with post hoc analysis), and the IOP of the ST group decreased 2.11 +/- 2.50 mm Hg (p < 0.001, repeated-measures ANOVA with post hoc analysis). The lowered IOP was maintained for 24 months postoperatively. There was no significant difference in IOP change after surgery depending on incisional techniques (p = 0.848, repeated measures ANOVA). CONCLUSIONS: There may be no difference in IOP lowering effect after surgery depending on incisional techniques.