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Background Carbachol solution (0.01％) is an agonist of M cholinoceptor and skeletal muscle N cholinoceptor,and it is used to play miotic effect and open peripheral iridectomic hole during the surgery of implantable collamer lens (ICL) implantation in order to lower intraocular pressure (IOP).However,the anterior chamber injection of 0.01％ carbachol solution often causes relevant complications,while whether lower dose of carbachol solution is effective and safe is unclear.Objective This study was to compare the effectiveness and safety between 0.01％ carbachol solution and 0.005％ carbachol solution after anterior chamber injection during the ICL implantation.Methods One hundred and fifty-two eyes of 76 cataract patients were included in Daping Hospital of Third Military Medical University from September 2014 to September 2015.ICL implantation and periphery iridectomy were carried out on both eyes of the patients and the 0.01％ carbachol solution was injected into the anterior chamber during the surgery of the right eyes and 0.01％ carbachol solution was used in the left eyes.The operation duration and IOP at postoperative 2 hours and systemic choline-like reaction were compared between 0.01％ carbachol solution group and 0.005％ carbachol solution group.Results The mean operation duration was (11.86± 2.39) minutes and (11.22 ± 1.85) minutes in the 0.01％ carbachol group and 0.005％ carbachol group,without significant difference between two groups (t =1.851,P =0.066).IOP was (15.76 ± 2.18) mmHg and (13.58 ±2.24)mmHg in the 0.01％ carbachol group before and after surgery,and those in the 0.005％ carbachol group was (15.70±2.35)mmHg and (13.12±2.17)mmHg,there was no significant difference in the IOP between the two concentrations of carbachol (Fsroup =0.986,P=O.322).The IOP at postoperative 2 hours was lower than that before operation,the difference was statistically significant(Ftime =97.339,P =0.000).There was no interaction between drug concentration and time (Fcorrelation =0.772,P =0.381).The incidences of complications,such as dizziness,nausea and vomiting,were lower in the 0.005％ carbachol group than those in the 0.01％ carbachol group (x2 =13.01,5.16,4.03,all at P＜0.05).Conclusions Carbachol solution (0.005％) can play intraoperative miosis effect and maintain effective operation duration in ICL implantation.In addition,the application of 0.005％ carbachol solution is quite safe in both intraoperation and postoperation.
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@#AIM: To evaluate the efficacy and safety of triamcinolone acetonide(TA)injected in anterior chamber during traumatic cataract surgery.<p>METHODS: From January 2013 to May 2016, 31 cases(31 eyes)of traumatic cataract were involved in our study. To identify whether there was vitreous loss and confirm the location of vitreous body, all the cases were injected TA into the anterior chamber respectively in surgery. Totally 13 cases(13 eyes)with intact posterior lens capsules were performed the small incision non-phacoemulsification cataract surgery. The others, 18 cases(18 eyes)with posterior capsule rupture and vitreous loss were performed with the anterior vitrectomy combined with small incision non-phacoemulsification cataract surgery. The follow-up time was for 6-12mo. <p>RESULTS: Tirty-one cases were completed the operation successfully. All the cases with second-stage penetrating corneal trauma were implanted intraocular lens(IOL). The other cases with first-stage penetrating corneal trauma were not implanted IOL. Eighteen cases, which were confirmed with posterior capsule rupture and vitreous loss by injecting TA into the anterior chamber,were consistently improved the visualization of vitreous cortex and treated with anterior vitrectomy successfully. During follow-up, 28 cases had best corrected visual acuity of more than 4.5. The postoperative inflammation of all cases was slight. There was no hard corneal edema and abiding intraocular pressure higher more than 1wk. The position of the pupil and IOL was normal. <p>CONCLUSION: Anterior chamber injection of TA can make the treatment of posterior capsule rupture and vitreous loss easier, and improve the safety of the traumatic cataract surgery. At the same time, it also can inhibit the postoperative inflammatory reaction.