ABSTRACT
@#AIM: To investigate the curative effect of microincision phacoemulsification and ultra-thin artificial lens implantation combined with trabeculectomy in the treatment of age-related cataract complicated with acute primary angle-closure glaucoma(PACG). <p>METHODS: Totally 85 elderly cataract patients(85 eyes)with acute PACG admitted between January 2017 and July 2020 were enrolled. According to the operation method, they were divided into study group(46 cases, 46 eyes)and control group(39 cases, 39 eyes). The control group was treated with 1.8mm microincision phacoemulsification and ultra-thin artificial lens implantation, while the study group was treated with trabeculectomy on the basis of the treatment of control group. The best corrected visual acuity(BCVA), intraocular pressure, anterior chamber angle width classification, corneal endothelial cell count and surgical complications of the two groups were compared. <p>RESULTS: Compared with the same group before operation, the BCVA(LogMAR)of the two groups was significantly reduced at 1, 3 and 6mo after operation(all <i>P</i><0.05), and the study group had lower LogMAR BCVA than the control group(all <i>P</i><0.05). At 1, 3 and 6mo after operation, intraocular pressure of the two groups was significantly reduced(<i>P</i><0.05), and the study group had lower intraocular pressure than the control group(<i>P</i><0.05). Meanwhile, the proportion of anterior chamber angle width grade NⅠwas increased, and the proportion of grade N Ⅳ was reduced in the two groups(<i>P</i><0.05). The proportion of grade NⅠwas higher in the study group than in the control group(<i>P</i><0.05). No significant differences were found between the two groups in terms of corneal endothelial cell count(<i>P</i>>0.05)and the incidence of complications(28% <i>vs</i> 26%; <i>P</i>>0.05). <p>CONCLUSION: For patients with senile cataract complicated with acute PACG, trabeculectomy based on microincision phacoemulsification and ultra-thin artificial lens implantation can significantly lower intraocular pressure, relieve glaucoma, and reduce visual impairment, with little damage to corneal endothelial cells and few complications. Besides, the clinical effect is marked.
ABSTRACT
To investigate the methods of learning coaxial microincision phacoemulsification and assess the related complications.METHODS:The clinical data of 1 080 eyes of coaxial microincision phacoemulsification performed by beginners from October 2011 to December 2013 was retrospectively analyzed. ln order of surgery dates, the patients were equally divided into groups A, B, C and D, 270 eyes in each group. Comparisons were made among the four groups in operation time, cumulative dissipated energy (CDE), rate of intraoperative, and postoperative complications at 1d; and best corrected distance visual acuity (BCDVA) at 1mo postoperatively.RESULTS:No significant differences were found in age, sex, lens grading, BCDVA at 1mo postoperatively among the four groups ( P> 0. 05 ). The operation time was significantly longer in group A than in groups B, C and D (25. 15 ± 3. 11min vs 15. 20 ± 3. 40min, 14. 71 ± 3. 02min and 14. 41±2. 91min, P0. 05). The CDE of grade ‖ and Ⅲ was significantly higher in group A than that in groups B, C and D (95. 9%, 97. 8% and 98. 5%) (P0. 05). There were no significant differences both in the number of corneal edema and BCDVA at 1d between group A and group B. (P=0. 66, P=0. 53).CONCLUSlON: With learning step by step, appropriate training program, careful case selection, and accurate managing complications, coxial microincision phacoemusification can be safe for a beginner.
ABSTRACT
PURPOSE: To evaluate the stability and optical performance of the newly developed single-piece aspheric intraocular lens (IOL) by comparing the clinical outcome of the aspheric IOL with the new optic profile design (HOYA iSert, HOYA iMics) and the aspheric IOL (Akreos MI60), which has been proven effective and safe. METHODS: iSert, iMics, and MI60 were inserted into 55 eyes, 60 eyes, and 50 eyes, respectively, after microincision phacoemulsification cataract surgery. Best corrected visual acuity (BCVA), refraction in spherical equivalent, anterior chamber depth (ACD), total higher order aberration (HOA), contrast sensitivity, and surgically induced astigmatism (SIA) were measured and each IOL was evaluated on the functional stability, anterior-posterior stability, centration in the capsular bag, and quality of vision. RESULTS: No statistical differences in preoperative and postoperative BCVA among the 3 IOL groups were observed, however, MI60 showed significant myopic shift postoperatively. Anterior-posterior stability assessed with postoperative change in refractive error and ACD was slightly lower in the MI60 group. In terms of vision quality, while total aberration, total HOA, coma aberration, and contrast sensitivity for the 3 IOLs were not different significantly, spherical aberration of the MI60 group was higher than the other groups at 6 months postoperative. SIA was significantly increased in eyes implanted with iSert than in eyes with iMics or MI60 at 1 month postoperatively, however, the differences were no longer evident after 3 months postoperatively. CONCLUSIONS: The new aspheric IOLs, iSert and iMics, showed good stability and visual outcome equal to MI60 at the 6-month postoperative follow-up.