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AIM:To investigate the effect of the size of cataract surgical incision on original astigmatism and tear film stability of corrected cornea.METHODS: Totally 92 cataract patients (92 eyes) who were admitted to our hospital from July 2014 to July 2016 were randomly divided into the control group and the observation group,46 cases (46 eyes) in each group.Both groups were treated by clear corneal tunnel incision phacoemulsification combined with intraocular lens implantation.The incision of the control group was 3.0mm while of the observation group was 1.8mm.The uncorrected visual acuity,corneal astigmatism,Schirmer I test (SⅠt) and break-up time (BUT) were detected before surgery and at 1d,1wk,1mo and 3mo after surgery.The surgery induced astigmatism (SIA) was recorded at 1d,1wk,1 and 3mo after surgery.RESULTS: There were significant differences in the uncorrected visual acuity between the two groups at 1 and 3mo before surgery (P0.05).At 1wk,1 and 3mo after surgery,SIA of two groups decreased continuously,and the SIA of the observation group was significantly lower than that of the control group at 1d,1wk and 1mo after surgery (P0.05).SⅠt and BUT in the observation group were less or shorter than those in the control group at 1wk after surgery (P0.05).CONCLUSION: Compared with 3.0mm standard incision,1.8mm clear corneal incision can reduce SIA and shorten the time for corneal stability recovery.
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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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AIM:To observe and compare clinical effects of coaxial 1. 8mm microincision phacoemulsification and 3. 2mm small incision phacoemulsification. ●METHODS:A total of 117 eyes of 85 patients with age-related cataract in our hospital were divided randomly into two groups:43 patients (59 eyes) in the coaxial 1. 8 mm microincision cataract surgery group ( C - MlCS ) , 42 patients (58 eyes) in the coaxial 3. 2 mm traditional small incision cataract surgery group (C-SlCS). A total of 117 eyes were received phacoemulsification with intraocular lens implantation. Uncorrected visual acuity was recorded preoperatively and postoperatively at 1, 7, 30 and 90d. The effective phacoemulsification time and average ultrasound energy were recorded in surgery. Corneal endothelial cell and corneal topography were recorded preoperatively and postoperatively at 90 d. ●RESULTS:Uncorrected visual acuity ( logMAR) was no overall statistical significance difference between C-MlCS group and C-SlCS group (P>0. 05), but was significant statistical difference in different time-point within both groups(P0. 05). On the 1 day after surgery, uncorrected visual acuity was 0. 16±0. 11 in C-MlCS group and 0. 22±0. 18 in C-SlCS group(P0. 05). EPT was (3. 09±1. 61)s in C-MlCS group and (3. 20±1. 92)s in C-SlCS group (P>0. 05). At 90 d after surgery, corneal endothelial cell loss percentage was (5. 81±2. 28)% in C-MlCS group and (5. 69±2. 38)% in C-SlCS group (P>0.05), SlA was (0.35±0.11) Din C-MlCS group and (0. 61±0. 13) D in C-SlCS group (P ● CONCLUSION: Compared with coaxial 3. 2mm traditional small incision cataract surgery, 1. 8mm coaxial microincision cataract surgery can get earlier visual rehabilitation and significantly reduce SlA. The coaxial 1. 8mm microincision cataract surgery is safe, effective and deserves further clinical applications.
ABSTRACT
Background The different incisions in phacoemulsification,including the length,location and shape etc.,can cause surgery-induced astigmatism ( SIA ).But the SIA caused by 2.2 mm,3.0 mm corneal limbal incision after phacoemulsification,especially the change of posterior corneal surface astigmatism is still rarely reported. Objective This study was to investigate the anterior,posterior and total corneal SIA and compare their differences between phacoemulsification and foldable intraocular lens (IOL) implantation with 2.2 mm and 3.0 mm corneal limbal incisions. Methods Seventy-one eyes of 47 cases were randomly divided into two groups with matched age,visual acuity and astigmatism degree.Phacoemulsification and IOL implantation with 2.2 mm incision at the steepest corneal meridian was performed on the patients of 2.2 mm incision group,and the same surgery was adopted with 3.0 mm incision as 3.0 mm incision group.Corneal curvature radius and central corneal thickness were measured by Pentacam at 1 day before surgery and 1 week,1 month and 3 months after surgery respectively.The anterior and posterior corneal surface SIAs were calculated according to the flat axis and steep axis of corneal curvature and the air and the cornea refractive index.Based on the anterior and posterior surface SIAs,the total corneal SIA was then calculated using the vector analysis method.Jaffe/Clayman vector method was used to calculate the anterior and posterior and total corneal SIAs in the different time points,and the differences were compared between the two groups.Oral informed consent was obtained from each subject prior to the trial. Results The mean anterior and posterior surface corneal SIAs appeared to be lower in 2.2 mm incision group compared with 3.0 mm incision group at postoperative 1 day,1 week,1 month and 3 months but were not significantly different among groups at various time points ( anterior SIA:P =0.290 ; posterior SIA:P =0.740 ; total SIA:0.434 ).The mean anterior corneal surface SIAs were significantly lower at the postoperative 3 months than those at postoperative 1 day,1 week in both groups(2.2 mm incision group:P=0.020,0.036;3.0 mm incision group:P=0.006,0.023 ).The posterior corneal surface SIAs were (0.70±0.43 ) D and (0.75 ±0.54 ) D at 1 day in 2.2 mm incision group and 3.0 mm inscision group,respectively,and significantly decreased posterior corneal surface SIAs were found in postoperative 1 week,1 month and 3 months compared with 1 day in both groups ( 2.2 mm incision group:all P =0.001 ; 3.0 mm incision group:P=0.028,0.044,0.032).The total corneal surface SIA showed significant differences between 1 day and 1 week,1 month,3 months after surgery ( 2.2 mm incision group:P =0.015,0.002,0.002 ; 3.0 mm incision group:P =0.049,0.007,0.016 ). Conclusions There are no significant differences in the anterior,posterior and total corneal surface SIAs between 2.2 mm and 3.0 mm incisions after phacoemulsification with IOL implantation.The SIA is gradually reduced with the prolongation of postoperative time.