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Background: Current study highlights the burden of PCO related blindness, need of Nd YAG laser in rural set up and positive and negative outcomes of Nd-YAG laser capulotomy in treating PCO. Methods: This study was conducted in 2020 at the department of ophthalmology at a medical college in central india. A total 53 such eyes were studied. Results: A 408 individuals were included with pseudophakia in one or both eyes. Mean age of pseudophakic study population was 67.9±7.6 years (range 50-92 years). Nearly 50% of the eyes had a visual acuity of less than 6/18. 40% of the pseudophakic eyes had visually significant PCO. There were 53 eyes where the visual impairment was solely due to PCO and Nd-YAG Laser capsulotomy was done for these eyes. Post Laser Treatment 79.2% of treated eyes achieved a visual acuity of ?6/18. Most commonly encountered complications after YAG Laser Capsulotomy was IOP spike which was seen in 29.5% of eyes undergoing the procedure which was followed by IOL pitting seen in 29.7%. Conclusions: The reach of Nd-YAG laser capsulotomy is limited to these masses. A step to prevent blindness in this category of population would be to ensure vailibility of Nd-YAG laser capsulotomy. This procedure is relatively safe with few complications.
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Purpose: To study posterior capsular opacification (PCO) and neodymium?doped yttrium aluminum garnet (Nd:YAG) capsulotomy rates in patients implanted with square?edged and non?square?edged intraocular lenses (IOLs) in manual small?incision cataract surgery (MSICS). Setting: Tertiary eye care center. Design: Prospective, comparative, and randomized controlled study. Methods: This study included patients with senile cataracts scheduled for MSICS and IOL implantation. One eye of each patient was randomized to the implantation of square?edged (S group) or non?square?edged IOL (NSQ group). An independent observer analyzed PCO at 6, 12, 18, and 24 months under slit?lamp illumination. Results: A total of 104 eyes were included in this study. The mean age of the participants in the two groups was 63.2 (�2) years, and there were 65 (62.5%) men and 39 women (37.5%). The mean best?corrected visual acuity (BCVA) values at 6, 12, and 18 months were 0.157 (�10), 0.11 (�12), and 0.12 (�11), respectively, in the S group and 0.17 (�10), 0.17 (�12), and 0.20 (�17), respectively, in the NSQ group. At 12 (P = 0.03) and 18 months (P = 0.01) follow?up, the BCVA of the S group was significantly better than that of the NSQ group. Four eyes in the NSQ group and one eye in the S group required Nd:YAG. Conclusion: Evaluation of PCO and Nd:YAG capsulotomy rates showed that the 360� square of the posterior IOL edge plays a role in the prevention of PCO. Owing to the low cost of the material and the easy availability of IOLs manufactured from it, square?edged IOL has a definite role in the prevention of PCO in MSICS.
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Purpose: To study the complication rate following Nd: YAG posterior capsulotomy posterior capsular opacification (PCO) in patients with and without comorbid conditions. Methods: This was a prospective, interventional, comparative, and observational study. A total of 80 eyes, consisting of 40 eyes without ocular comorbidities (group A) and 40 eyes with ocular comorbidities (group B) that were being treated with Nd: YAG capsulotomy for PCO, were included. Visual outcome and complications of Nd: YAG capsulotomy were studied. Results: The mean age of group A patients was 61.65 ± 8.85 years and that of group B patients was 63 ± 10.46 years. Of the total, 38 (47.5%) were men and 42 (52.5%) were women. In group B, the ocular comorbidities were moderate nonproliferative diabetic retinopathy (NPDR) (n = 14 eyes; 14/40 = 35%), subluxated intraocular lens (IOL; <2 clock hours of subluxation; n = 6), age?related macular degeneration (ARMD; n = 6), post?uveitic eyes (having old signs of uveitis, no episode of uveitis since the last 1 year; n = 5), and operated cases of traumatic cataract (n = 4). The mean energy required in groups A and B was 46.95 ± 25.92 and 42.62 ± 21.85 mJ, respectively (P = 0.422). The average energy requirement in Grade 2, Grade 3, and Grade 4 PCO was 22.30, 41.62, and 79.52 mJ, respectively. An increase in intraocular pressure (IOP) of >5 mmHg from pre?YAG levels was observed in one patient in each group on day 1 postprocedure, for which medical treatment was given to both patients for 7 days. One patient in each group had IOL pitting. No patient had any other complications attributable to ND:YAG capsulotomy. Conclusion: Nd:YAG laser posterior capsulotomy is a safe procedure for PCO in patients with comorbidities. Visual outcomes were excellent after Nd:YAG posterior capsulotomy. Although a transient increase in IOP was noted, the response to treatment was good and a long?term increase in IOP was not observed
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Una de las causas de la disminución de la visión es la catarata. El tratamiento es la extracción del cristalino opaco con reemplazo por un lente intraocular (LIO). La opacidad de cápsula posterior (OCP) es una complicación frecuente a largo plazo. Las modificaciones en el diseño del LIO tanto del material y la forma tienen mayor importancia para prevenir la OCP. Como tratamiento está la capsulotomía neodimio YAG láser. Objetivo: identificar la OCP relacionado con el tipo de LIO implantado en pacientes pseudofáquicos en la FBO, entre el periodo de marzo del 2019 hasta febrero del 2022. Métodos: estudio observacional, tipo analítico, subtipo cohorte histórica, retro- prospectiva y longitudinal, con enfoque de análisis estadístico de tipo cuantitativo. Resultados: predominó el género femenino con un 60 % y un 40 % representaba al masculino; un 60,3 % del total tenían entre 65 a 80 años. La OCP en los 3 tipos de lentes intraoculares (acrílico y PMMA) ocasionó una disminución en la agudeza visual: el 37 %, predominó, por el LIO hidrofóbico, 36 % por el LIO PMMA y destacamos que el 27 % fue por el LIO hidrofílico. La incidencia de OCP a 5 años fue del 32 %. No se registró ningún efecto adverso en nuestro estudio. Conclusiones: la OCP provoca una baja de agudeza visual leve a moderada en los 3 tipos de LIOs; con un mínimo predominio de BAV leve para el tipo de LIO hidrofóbico comparado con el hidrofílico. Además después de la capsulotomía un gran porcentaje tiene entre 20/20 a 20/25 de AV mejor corregida.
One of the causes of decreased vision is cataract. Treatment is removal of the cloudy lens with replacement by an intraocular lens (IOL). Posterior capsule opacity (PCO) is a common long-term complication. Modifications in the design of the IOL both in terms of material and shape are of greater importance in preventing PCO. Treatment is neodymium YAG laser capsulotomy. Objective: to identify the PCO related to the type of IOL implanted in pseudophakic patients in the FBO, from March 2019 to February 2022. Methods: observational study, analytical type, historical cohort subtype, retro-prospective and longitudinal, with a quantitative statistical analysis approach. Results: the female gender predominated with 60% and 41% represented the male; 60.3% of the total was between 65 and 80 years old. PCO in the 3 types of intraocular lenses (acrylic and PMMA) caused a decrease in visual acuity: 37%, predominated, due to the hydrophobic IOL, 36% due to the PMMA IOL and we highlight that 27% was due to the hydrophilic IOL. The incidence of PCO at 5 years was 32%. No adverse effect was recorded in our study. Conclusion: PCO causes mild to moderate visual acuity loss in all 3 types of IOLs; with a minimal predominance of mild AVB for the hydrophobic IOL type compared to the hydrophilic one. In addition, after capsulotomy, a large percentage has between 20/20 and 20/25 better corrected visual acuity.
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Purpose: To study the effect of intraocular lens (IOL) implantation with and without ocular viscoelastic device (OVD) on posterior capsular opacification (PCO) in eyes with phacoemulsification. Methods: This prospective, comparative, and randomized case series included 70 patients (140 eyes) with senile cataracts scheduled for phacoemulsification and IOL implantation in a tertiary eye c are center. One eye of each patient was randomized to one of the two groups, namely, control and OVD. After phacoemulsification, the IOL was placed in the capsular bag under balanced salt solution (BSS) in the control group, whereas the IOL was placed under OVD in the OVD group. PCO was analyzed by an independent observer at 6, 12, and 18 months under slit?lamp illumination. Results: The mean age of the participants in the two groups was 61.2 (±9.9) years. Of the total participants, 68 (48.5%) were men and 72 (51.5%) were women. The mean keratometry (K1, K2) values of the OVD (44.26 ± 1.43, 44.93 ± 1.66) and control (44.51 ± 1.74, 44.69 ± 1.49) groups were similar. The mean IOL powers of the control and OVD groups were 21.25 (±1.94) and 21.53 (±1.86), respectively (P = 0.463). The mean best?corrected visual acuity (BCVA) of the control group at 6?, 12?, and 18?month follow?ups were 0.622 (±0.253), 0.315 (±0.203), and 0.063 (±0.163), respectively, whereas those of the OVD group were 0.592 (±0.253), 0.336 (±0.169), and 0.066 (±0.118), respectively (P = 0.922). None of the patients had postoperative raised intraocular pressure (IOP), uveitis, or endophthalmitis. Three and four eyes in the control and OVD groups, respectively, required neodymium?doped yttrium aluminum garnet (ND: YAG) capsulotomy at study termination (P = 0.999). Conclusion: The hydroimplantation technique of the placement of hydrophilic IOL did not reduce the PCO rate in the 18?month follow?up period. The ND: YAG capsulotomy rate did not differ between the groups
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@#AIM: To study the incidence and risk factors of posterior capsular opacification(PCO)after cataract surgery in diabetic patients.<p>METHODS: Clinical data of 182 cases(203 eyes)who underwent cataract phacoemulsification combined with intracellular lens implantation in our hospital from April 2016 to August were collected. The patients were divided into diabetic group(DM group, 98 eyes)and non-diabetic group(non-DM group, 105 eyes)according to whether they had diabetes before operation. DM group were divided into groups according to whether PCO occurred 30mo after cataract surgery, 26 eyes in the PCO group, and 72 eyes in non-PCO group. The incidence and grading of PCO in the DM group and the non-DM group were compared. The effects of preoperative diabetic course, HbA1c level and the presence of diabetic retinopathy on PCO in DM group were tested.<p>RESULTS: The incidence of PCO was 10.2%, 14.3%, 22.4%, 26.5% at 12, 18, 24 and 30mo in the DM group and 2.8%, 4.8%, 10.5%, and 14.3% in the non-DM group. Two groups of patients with the degree of PCO are gradually increasing, and the degree of each point in time the PCO patients with DM group were heavier than patients without DM group(all P<0.05). There were differences in the preoperative course of diabetes and the presence of DR between PCO and non-PCO groups(P<0.05), but there was no difference in the preoperative level of HbA1c(P>0.05).<p>CONCLUSION: The incidence of PCO in diabetic patients after cataract surgery was higher than that in non-diabetic patients, and the degree of opacity was more severe. Preoperative course of diabetes and the presence of DR were risk factors for PCO.
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Posterior cataract opacification(PCO)is the epithelial-mesenchymal transformation(EMT)of residual lens epithelial cells(LECs)after cataract surgery, resulting in opaque scar which is one of the main complications of cataract surgery. A large amount of fibronectin(FN)produced by LECs after cataract surgery binds to a variety of cell surface receptors, matrix components and growth factors to regulate cell behavior. The purpose of this article is to review the literatures on the treatment of PCO targeting fibronectin and provide references for clinical treatment of PCO. In this paper, the research status of fibronectin in PCO in recent years is reviewed.
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【Objective】 In recent years, granulocyte colony stimulating growth factor (G-CSF) has been proved to be expressed in the posterior capsule of the lens of posterior capsular opacification (PCO), but its specific role remains unclear. The purpose of this study was to explore whether G-CSF plays a role in PCO. 【Methods】 First, human lens epithelial cells (HLEC-B3) were treated with different concentration of recombinant G-CSF protein and screened for effective appropriate concentration. Then, Western blotting was used to detect the effects of extracellular matrix (ECM) synthesis and epithelial mesenchymal transdifferentiation (EMT) marker genes after G-CSF treatment on HLEC-B3 cells. Finally, the effects of G-CSF treatment on the migration and invasion of HLEC-B3 cells were detected by scratch experiment and Transwell test. 【Results】 G-CSF at 80 μg/L could promote the proliferation of HLEC-B3 cells. After G-CSF was treated for 48 h, the expressions of EMT and ECM synthesis marker genes in HLEC-B3 cells were significantly upregulated with time. G-CSF could significantly promote HLEC-B3 cell invasion after 48 h induction. Similarly, G-CSF could also significantly induce cell migration compared to the CTRL group. 【Conclusion】 G-CSF can promote the proliferation, migration and invasion of HLEC-B3 cells, as well as EMT and ECM synthesis, which might be involved in the occurrence of PCO. Inhibiting the expression of G-CSF may be a new strategy for PCO prevention.
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@#Posterior capsular opacification is the most common complication after cataract extraction, which seriously influences the quality of life of patients. At present, there is no effective measure to prevent posterior capsular opacification. Surgery or Nd:YAG laser is often used in clinical, and a new treatment is urgently needed. Hippo signaling pathway is involved in the steady-state regulation of many mammalian cells and organs. Recent studies have shown that Hippo signaling pathway can regulate the proliferation, apoptosis, differentiation and other behaviors of lens epithelial cells. Hippo signaling pathway may provide a new target in the treatment of posterior capsular opacification. This article reviews the composition, regulatory mechanism of Hippo signaling pathway and its application in posterior capsular opacification. In order to provide a broader idea for the prevention and treatment of posterior capsular opacification.
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@#AIM: To systematically evaluate the efficacy and safety of two different kinds of Nd:YAG laser posterior capsulotomy in the treatment of posterior capsular opacification after cataract surgery and provide reliable evidence for the selection of posterior capsulotomy in clinical practice.<p>METHODS: A literature search was implemented in CNKI, Wanfang database, VIP database, PubMed, Medline and Cochrane Library from 2000-01-01 to 2019-12-31. Two researchers independently performed literature search, screening, quality evaluation, and data extraction. Meta-analysis was performed by RevMan 5.3 software. The mean difference and 95% confidence interval were used to measure the measurement data, including best corrected visual acuity, postoperative intraocular pressure, and laser energy. The odds ratio was used to measure the count data, including the rate of lens damage and the incidence of vitreous floaters.<p>RESULTS: A total of 7 studies were included, including Nd:YAG laser circular posterior capsulotomy and cruciate posterior capsulotomy in 432 eyes. The Meta-analysis showed that there was no significant difference in postoperative best corrected visual acuity between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, <i>MD</i>=-0.01(95% <i>CI</i>: -0.03-0.01,<i> P</i>=0.32); there was no significant difference in postoperative IOP between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, <i>MD</i>=-0.60(95% <i>CI</i>: -1.31-0.11,<i> P</i>=0.10); there was no significant difference in laser energy between the two groups, <i>MD</i>=18.82(95% <i>CI</i>: -11.88-49.51, <i>P</i>=0.23); there was also no significant difference in the rate of lens damage and the incidence of vitreous floaters, <i>OR</i>=0.97(95% <i>CI</i>: 0.50-1.87, <i>P</i>=0.93); <i>OR</i>=2.88(95% <i>CI</i>: 0.28-29.26, <i>P</i>=0.37). <p>CONCLUSION:In the treatment of posterior capsular opacification after cataract surgery with Nd:YAG laser posterior capsulotomy, there is no significant difference in efficacy and safety between circular posterior capsulotomy and cruciate posterior capsulotomy.
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Purpose: To study the effect of rotation of intraocular lens (IOL) on posterior capsular opacification (PCO) in eyes with phacoemulsification. Methods: This was a prospective, comparative, randomized case series. One eye of each patient was randomized to one of two groups. The 360-degree rotation of IOL was carried out after its placement in the capsular bag (rotation group). The control group had no rotation of IOL. PCO was analyzed by an independent observer on EPCO computer analysis system at 6, 12, 24, and 36 months. Results: The study included 50 patients (100 eyes) with senile cataracts scheduled for phacoemulsification and IOL implantation. The median age in 2 groups was 66 years. 25% quartile age in both the group was 62 years (P = 0.06). There were 30 males, and 20 females. The median PCO score at 6, 12 and 24 months was significantly low in the rotation group (0.15, 0.13, 0.22) compared to the control group (0.22, 0.23, 0.25). There was no significant difference in PCO score between the two groups from 24-36 months. The median PCO score at 36 months was 0.2 in both the groups. At the end of three years, 4 eyes (8%) in the rotation group, and 10 eyes (20%) in the control group needed Nd:YAG capsulotomy (P = 0.04). Conclusion: Rotation of IOL in the capsular bag decreases PCO and Nd:YAG capsulotomy rate.
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Background: Posterior capsular opacification (PCO) which is also known as “after cataract” or “secondary cataract”, is the most common complication of cataract surgery, with an incidence of 20-50%. The current study was conducted in a tertiary hospital of Odisha with an objective to find out the determinants of PCO among patients with defective vision attending the outdoor patient department of Ophthalmology.Methods: A hospital based descriptive study was conducted among the patients attending the ophthalmology out patient department of a tertiary hospital of Odisha. The detail history regarding the type of surgical procedure used for cataract extraction and the type of Intra Ocular Lens (IOL) implanted, duration of post-operative period was collected from the available documents and ophthalmic examination of the participants.Results: In the present study, 184 participants were included and examined. Fifty percent of the participants had undergone conventional extra capsular cataract extraction procedure. In 86.95% participants, the IOL used was Poly Methyl Methacrylate lens (PMMA). In 26.08% of the participants the development of PCO was within 12 to 36 months of cataract surgery. The average duration of PCO development recorded for participants <20 years was 3 months.Conclusions: Most of the participants included in the study with PCO had undergone conventional ECCE surgery, implanted PMMA lens, IOL with round edge and had a duration of 12-36 months between cataract surgery and PCO development. The average duration of PCO development is less among younger participants which gradually increases with increase in age.
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@#Cataract is the first blinding eye disease in China and the main cause of blindness in most countries in the world. Currently, surgery operation is the only effective treatment. Posterior capsular opacification(PCO)is a common complication after cataract surgery, and it is also the crucial induction of vision decline. Studies have shown that epithelial-mesenchymal transition(EMT)of lens epithelial cells(LECs)remaining after surgery plays an important role in the occurrence and development of PCO. This article mainly summarizes the research progress of EMT in PCO in recent years.
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Objective To evaluate and compare the subjective and objective visual quality of YAG laser posterior capsulotomy.Methods A series of case observation study was designed.Twenty-eight patients (38 eyes)underwent Nd:YAG laser posterior capsulotomy in the Eye Hospital of Wenzhou Medical University were retrospectively collected from 2015 to 2016.Patients were divided into circular capsulotomy group (20 patients 23 eyes) and cruciate capsulotomy group (12 patients 15 eyes) based on the capsulotomy technique (round incision of posterior capsule or cross incision of posterior capsule).The uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were examined before and 2 weeks after operation,the intraocular pressure was also measured before operation,1 hour after operation and 2 weeks after operation.The Strehl ratio (SR),modulation transfer function (MTF) cut-off,objective scatter index (OSI),OQAS values (OVs) were analyzed by Two-channel visual quality analysis system OQAS Ⅱ at 1 h and 2 weeks after operation.The changes of intraocular scattering and visual quality at 1 h and 2 weeks after operation with different posterior capsulotomy methods were compared and analyzed.Results At 2 weeks after operation,the UCVA was 0.18±0.15 and 0.16±0.14,and the BCVA was 0.10±0.10 and 0.10±0.11,respectively in the circular capsulotomy group and cruciate capsulotomy group,which was higher than those before operation (all at P<0.05),but there was no significant difference in UCVA and BCVA between the two groups (all at P>0.05).There was no significant difference in intraocular pressure between the two groups at 1 hour and 2 weeks after operation (both at P>0.05).In the circular capsulotomy group,the incidence of black shadow drift was 39.1% and 30.4% respectively at 1 hour and 2 weeks after operation,which was higher than that in the cruciate capsulotomy group (6.7% and 6.7 %),with no significant differences between the two groups (P =0.065,0.177).No significant difference were found in the incidence of black shadow drift before eyes between the two groups (P>0.05),and there was no significant differences in the OQAS parameters OSI,MTF,SR,OV100%,OV20% and OV9% between the two groups (all at P>0.05).Conclusions After Nd:YAG laser capsulotomy,the incidence of black shadow drift in the cruciate capsulotomy group is lower than that in the circular capsulotomy group.There is no significant difference in the visual acuity,intraocular pressure,intraocular scattering and visual quality parameters between circular posterior capsulotomy and cross posterior capsulotomy.
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Cataract surgery is one of the most common and mature eye surgeries in the world,and the procedures include the removal of turbid lens and intraocular lens (IOL) implantation,which can better restore the patient' s vision.Posterior capsular opacification (PCO),also known as secondary cataract,is one of the most coramon complications after cataract surgery,seriously affecting the surgical efficacy.Two to five years after cataract surgery,PCO-induced loss of vision accounted for 20%-40% of patients.PCO is a fibrotic disease,and its mechanism has become an important medical topic.It has been demonstrated that the residual lens epithelial cells (LECs) in the equatorial and anterior capsule region after surgery have become fibroblasts and myofibroblasts via proliferation,migration and epithelial-mesenchymal transition (EMT) accompanied by extracellular matrix (ECM) synthesis,eventually leading to the occurrence of PCO.A series of growth factors and signaling pathways participate and play a key role in the initiation and development of PCO.In this review,recent advances in molecular regulation pathways associated with PCO will be summarized,and the possible methods interfering with PCO will be explored.
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Posterior capsular opacification (PCO) is a common complication after extracapsular cataract extraction,which is drawing more attentions because of secondary vision loss,and the study on PCO pathogenesis mechanism is a key for the targeting prevention and treatment of PCO.The study of PCO pathogenesis mechanism showed that autophagy and apoptosis are associated with PCO,and it was also determined that the activation of related signal-transduction pathway plays an important role in PCO formation,for example,the release of inflammatory factors and cytokines following cataract extraction activate the signal transduction and genetic transcription of lens epithelial cells (LECs) and further promote the proliferation,migration and epithelial-mesenchymal transition (EMT) of residual LECs,which is a pathological basis of PCO.It is a challenge for us to investigate the effective treating method of PCO basis on its pathogenesis.Up to now,the studies of drugs targeting PCO and genetic therapy which based on the advances in epigenetics have made great progress.Ophthalmic researchers should pay close attention to the latest trends of basic research,track the methodology and exploit the emerging spotlight,explore the novel means of treatments of PCO,and expand the promising future of PCO prevention and treatment.
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@#AIM:To investigate the influences of Nd:YAG laser capsulotomy with different size on visual acuity(VA), intraocular pressure(IOP), refraction, anterior chamber depth(ACD), and macular thickness(MT)in patients with posterior capsular opacification(PCO). <p>METHODS: In this retrospective, constantly study, 41 eyes of 41 patients treated with Nd:YAG laser posterior capsulotomy for PCO were divided into 2 groups according to the different incision sizes of capsulotomy: the patients received capsulotomy with the incision diameter less than or equal to 3.5mm were enrolled into group 1, while those received operation with incision diameter more than 3.5mm went to group 2. All patients were followed up before Nd:YAG laser capsulotomy, 1wk, 1 and 3mo after Nd:YAG laser capsulotomy, and the best-corrected visual acuity(BCVA), refraction, IOP, ACD, and MT were compared between two groups. <p>RESULTS: In both groups, BCVA were significantly improved postoperatively compared with base line(<i>P</i><0.001), but there was no significant difference between two groups(<i>P</i>>0.05). The diopter(SE)of the two groups were not significantly different before and after operation(<i>P</i>>0.05). Intraocular pressure in group 2 was higher than those in group1 at 1wk(<i>t</i>=-2.609, <i>P</i>=0.013). ACD decreased significantly at 1wk postoperatively(<i>P</i><0.01), but with no significant difference at 1 and 3mo(<i>P</i>>0.05). Both groups had increased macular thickness lightly at 1wk postoperatively, but with no statistical significance(<i>P</i>>0.05), and there was no significant difference between the two groups at 1wk, 1 and 3mo postoperatively(<i>P</i>>0.05). <p>CONCLUSION: The increase in intraocular pressure is more pronounced when the size of posterior capsulotomy was larger. However, the changes of BCVA, ACD, refraction, MT are not related with the incision size of posterior capsulotomy.
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PURPOSE: To compare changes in anterior segment parameters after Nd:YAG laser capsulotomy in eyes that underwent either combined phacovitrectomy or cataract surgery. METHODS: This retrospective study enrolled 37 eyes of 35 patients with posterior capsular opacification treated with combined phacovitrectomy (group A), and 35 eyes of 32 patients with posterior capsular opacification treated with cataract surgery (group B). Anterior segment parameters, including anterior chamber depth (ACD), anterior chamber angle, and anterior chamber volume, were measured by a Pentacam before Nd:YAG laser capsulotomy and 1 hour, 1 day, 1 week, 1 month, and 3 months after this treatment. RESULTS: In the cataract surgery group, the ACD was significantly lower 1 day (3.75 ± 0.74 mm), 1 week (3.73 ± 0.24 mm), and 3 months (3.74 ± 0.33 mm) after Nd:YAG laser capsulotomy compared with the pretreatment value (4.20 ± 0.62 mm, p = 0.002). By contrast, the ACD did not change significantly over time in the combined phacovitrectomy group. The ACD differed significantly between the two groups at 1 week, 1 month, and 3 months after capsulotomy. There were no significant changes in the anterior chamber volume, anterior chamber angle, central corneal thickness, or pupil size from before to after capsulotomy in either group. A non-significant trend toward myopic shift was observed in group A (p = 0.072) and B (p = 0.055). CONCLUSIONS: The results of the present study may help determine the power of the intraocular lens in patients who underwent combined surgery or cataract surgery and who will receive Nd:YAG laser capsulotomy.
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Humans , Anterior Chamber , Cataract , Lenses, Intraocular , Pupil , Retrospective StudiesABSTRACT
Posterior capsular opacification (PCO) is the most common complication that leads to loss of vision after cataract surgery.Neodymium doped:Yttrium-Aluminum-Garnet (Nd:Yag) laser capsulotomy is a common treatment for PCO, but still associated with several complications.In the past decades, the prevention and treatment of PCO have always been a hot spot of research in ophthalmology.This review will address the advances in the prevention and treatment of PCO in the aspects of surgical techniques and types of intraocular lens (IOL).
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PURPOSE: To compare the incidence of posterior capsular opacification (PCO) based on low and high fluid-dynamic parameters during cataract surgery and evaluate the importance of these findings. METHODS: This retrospective study included 125 eyes in 73 patients with senile cataract who received a cataract surgery between September 2013 and March 2014. Patients were divided into 2 groups: those with low (vacuum: 180 mm Hg, aspiration flow: 18 mL/min, bottle height: 55 cm) and high (vacuum: 400 mm Hg, aspiration flow: 22 mL/min, bottle height: 90 cm) fluidic parameters during the nucleus was removal. We measured the total surgery time, ultrasound time, and balanced salt solution consumption during phacoemulsification. Best corrected visual acuity (BCVA), PCO score, PCO percentage and severity were measured at 3, 6 and 12 months postoperatively. Endothelial cell density (ECD) was measured preoperatively and 12 months postoperatively. RESULTS: The study included 20 eyes of 13 patients with low parameters and 20 eyes of 15 patients with high parameters. There was no statistically significant difference in the mean total surgery time, ultrasound time or fluid consumption between the two groups. BCVA and ECD were not significantly different between the two groups during the postoperative follow-up. PCO score, percentage and severity were higher in the low parameter group at 3, 6 and 12 months postoperatively. CONCLUSIONS: Surgery with low fluid-dynamic parameters is equally effective as with high parameters in terms of surgical time and postoperative BCVA. However, the incidence of PCO was higher in the low fluid-dynamic parameter group up to 12 months. Surgical efforts to reduce remnant lens epithelial cells are needed during low fluidic-dynamic parameter surgery.