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Purpose: To investigate the clinical effect of sodium hyaluronate eye drops combined with tobramycin, dexamethasone, and pranoprofen eye drops in the treatment of dry eye after phacoemulsification. Methods: Medical records of 188 patients with dry eye after phacoemulsification, treated in our hospital from August 2020 to August 2021, were included and divided into groups based on the type of dry eye treatment. Patients in the control group (n = 90) were treated with tobramycin, dexamethasone, and pranoprofen eye drops. Patients in the test group (n = 98) were treated with sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops. The tear secretion test (TST), film rupture time (BUT), corneal fluorescence staining (FS) score, levels of interleukin (IL)?6, and tumor necrosis factor (TNF)?? before the treatment and at 1 month follow?up, the overall total effective rate and the number of completely cured cases were compared between the two groups. Multiple linear regression was used to calculate coefficients for predicting clinical variables. Ordinal logistic regression was used to compute coefficients and odds ratios for predicting effective scores. Results: The total effective rate in the observation group (99%) was significantly higher than that in the control group (80.00%). After the treatment, the TST and BUT indexes of the observation group were higher compared to the control group, and the FS score of the observation group was lower than that of the control group. TNF?? and IL?6 levels of the observation group were lower compared to the control group. Logistic regression analysis demonstrated that the differences in the effective rate and clinical variables between the two groups remained significant after adjusting for the effect of age. Conclusion: A combination of sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops for the treatment of dry eye after phacoemulsification can improve the curative effect, reduce corneal fluorescein staining and inflammatory factor index levels compared to the treatment regimen lacking sodium hyaluronate eye drops.
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@#AIM: To build up prediction model of corneal edema after cataract surgery in patients with diabetic. <p>METHODS: During January 2017 to December 2019, 312 patients with diabetic cataract underwent elective phacoemulsification cataract extraction combined with intraocular lens(IOL)implantation were enrolled. The patients were divided into corneal edema group(<i>n=</i>62)and non-corneal edema group(<i>n</i>=250)according to corneal edema status within 1wk after surgery. The gender, age, smoking history, drinking history, diabetes history, hypertension history, glaucoma history, corneal dystrophy, chronic uveitis, lens core hardness Emery classification, preoperative anterior chamber depth, intraoperative ultrasound energy and effective ultrasound time, IOL material and implant location, number of corneal endothelium after surgery were compared between the two groups. Stepwise Logistic regression analysis was used to determine the risk factors and a risk scoring system was constructed base on the determined risk factors. The ROC curve was drawn to analyze the predictive value of the risk score model for postoperative corneal edema.<p>RESULTS: Of the 312 diabetic cataract patients included, 62 cases(19.9%)had postoperative corneal edema. According to stepwise Logistic regression analysis, age >60 years(<i>OR</i>=2.657, 95% <i>CI</i>: 1.135-6.220), duration of diabetes >10 years(<i>OR</i>=6.932, 95%<i> CI</i>: 1.911-25.145), hypertension history(<i>OR</i>=2.783, 95% <i>CI</i>: 1.037-14.510),glaucoma history(<i>OR</i>=3.679, 95% <i>CI</i>: 1.128-11.999), chronic uveitis(<i>OR</i>=2.601, 95%<i> CI</i>: 1.099-6.156), lens nucleus hardness grade IV to V(<i>OR</i>=8.658, 95% <i>CI</i>: 2.595-28.887), preoperative shallow anterior chamber(<i>OR</i>=3.431, 95% <i>CI</i>:1.679-7.011), postoperative corneal endothelial cell count(<i>OR</i>=3.026, 95% <i>CI</i>: 1.137-8.053)were the risk factor for postoperative corneal edema in patients with diabetic cataract. The risk scoring system was constructed according to the above risk factors: age >60 years old, history of hypertension, history of glaucoma, chronic uveitis, corneal endothelial cell number loss≥10%, shallow anterior chamber corresponding to 1 point, duration of diabetes >10 years and lens hardness Ⅳ-V corresponds to 2 points, with a total score of 0-10 points. The risk score model predicts that the area under the ROC curve of postoperative corneal edema in diabetic cataract patients was 0.848(95% <i>CI</i>: 0.772-0.934)at cut-off value of 8.94, and the sensitivity and specificity were 85.3% and 80.2%, respectively.<p>CONCLUSION: Age>60 years old, course of diabetes >10 years, history of hypertension, history of glaucoma, chronic uveitis, lens nucleus hardness Ⅳ-Ⅴ, preoperative shallow anterior chamber, postoperative corneal endothelial cell loss is the postoperative occurrence of diabetic cataract patients. The risk factors of corneal edema, the risk scoring model constructed based on the above risk factors has good predictive value for postoperative corneal edema.
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AIM:To analyze clinical curative effect of small incision non - phacoemulsification cataract extraction and intraocular lens implantation in the treatment of the high myopia with cataract. METHODS:Seven-four cases (78 eyes) of patients with high myopia and cataract were randomly divided into control group and observation group, 37 cases (39 eyes) in each group. The control group underwent cataract phacoemulsification and intraocular lens implantation, the observation group received small incision non -phacoemulsification cataract extraction and intraocular lens implantation. The treatment effect was analyzed. RESULTS: After treatment, there was no significant difference in the ratio uncorrected visual acuity of 0. 5 and above in two groups. IOP was significantly decreased in two groups after treatment with no significant difference. Intraoperative and postoperative complications in observation group were significantly lower than that in control group. Wound healing time of observation group was significantly shorter than that of the control group.CONCLUSION:Small incision non-phacoemulsification cataract extraction and intraocular lens implantation in the treatment of high myopia with cataract has significant effect, lower complication rate, and is worthy of promotion in clinical.
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To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study. ●METHODS:Totally 103 cases (103 eyes) patients who had angle- closure glaucoma (ACG) with cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure (lOP) could be controlled in normal value using one or two anti -glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases (50 eyes), and control group had 50 cases (53 eyes). Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of lOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo. ●RESULTS: SPSS19. 0 statistics software was utilized to analyze the data, This study selected one- side test α =0. 05, adopted paired t - test or two- sample t - test. We obtained that experimental group lOP decreased 12. 42 ± 0. 04mmHg, anterior chamber depth increased 1. 276 ± 0. 201mm; that control group lOP decreased 6. 56 ± 0. 08mmHg, anterior chamber depth increased 0. 852 ± 0. 132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance (P ●CONCLUSlON: ln phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease lOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling lOP effectively.