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AIM: To investigate the postoperative ocular surface changes in acute attack eye and contralateral eye with primary angle-closure glaucoma(PACG)and cataract.METHODS: A total of 40 patients with monocular acute PACG combined with cataract who admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to January 2022 were selected. Trabeculectomy combined with phacoemulsification and intraocular lens implantation was carried out in the acute attack eyes, and phacoemulsification and intraocular lens implantation were carried out in the contralateral eyes. The ocular surface disease index(OSDI)questionnaire, noninvasive first tear film break-up time(NifBUT), noninvasive average tear film break-up time(NiaBUT)and tear meniscus height(TMH)were assessed preoperatively and 1, 3 and 6mo postoperatively.RESULTS: The OSDI scores of the included patients at 1 and 3mo postoperatively(14.72±3.07, 11.39±2.24)were significantly higher than those preoperatively(9.68±1.98; all P<0.0083), and there was no significant difference between 6mo postoperatively(10.18±1.84)and preoperatively. NifBUT of the acute attack eyes at 1 and 3mo postoperatively was significantly lower than that preoperatively, and NiaBUT of the acute attack eyes at 1, 3 and 6mo postoperatively was significantly lower than that preoperatively(all P<0.0083). The NifBUT and NiaBUT of the contralateral eyes at 1mo postoperatively were significantly lower than those preoperatively(all P<0.0083), and there was no significant difference between 3 and 6mo postoperatively and preoperatively. There was no significant difference in TMH of the attack eyes and the contralateral eyes postoperatively and preoperatively(P>0.05).CONCLUSION: The stability of tear film after surgery of PACG and cataract is decreased. The acute attack eye needs 6mo or even longer to recover, while the contralateral eye needs roughly 3mo.
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@#AIM: To explore the effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells(CECs)in patients with glaucoma and cataract. <p>METHODS: The clinical data of 107 patients(113 affected eyes)with glaucoma and cataract who were treated in the hospital during the period from October 2016 to October 2018 were retrospectively analyzed. Patients treated with trabeculectomy or phacoemulsification combined with intraocular lens implantation were included in the control group(<i>n</i>=52, 54 affected eyes)and the study group(<i>n</i>=55, 59 affected eyes). The changes in visual acuity, anterior chamber depth and intraocular pressure before and after surgery, CECs related indexes and incidence of postoperative complications were compared between the two groups. <p>RESULTS: There was no significant difference in visual acuity between the two groups before surgery(<i>P</i>>0.05). The visual acuity of both groups were significantly improved after surgery(<i>P</i><0.05), and the improvement in study group was better than that in control group(<i>P</i><0.05).The anterior chamber depth in both groups increased, while intraocular pressure decreased after surgery(<i>P</i><0.05). After surgery, anterior chamber depth in study group was significantly larger than that in control group(<i>P</i><0.05), but there was no significant difference in intraocular pressure between the two groups(<i>P</i>>0.05). The cell area variation coefficient, hexagonal cell ratio, average cell area and corneal center thickness in control group increased significantly, while CECs density decreased significantly after surgery(<i>P</i><0.05). However, there was no significant difference in CECs related indexes in study group before and after surgery(<i>P</i>>0.05). After surgery, changes levels of CECs related indexes in study group were significantly lower than those in control group(<i>P</i><0.05). The incidence rates of postoperative complications in study group and control group were 5.1% and 20.4%, respectively(<i>P</i><0.05).<p>CONCLUSION: The application of phacoemulsification and intraocular lens implantation in the treatment of glaucoma with cataract can improve the visual acuity and intraocular pressure of patients, maintain structural integrity of CECs, with safety.
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OBJECTIVE:To compare the efficacy and safety of Sodium hyaluronate versus Carbomer,Polyethylene glycol,To-bramycin and Dexamethasone in the treatment of glaucoma with cataract. METHODS:464 glaucoma patients with cataract were randomly divided into group A(116 cases),group B(116 cases),group C(116 cases)and group D(116 cases). All patients re-ceived intraocular lens implantation;1-1.5 cm to Tramycin and Dexamethasone eye ointment,3-5 times a day. Based on it,group A received 1-2 Sodium hyaluronate eye drops,4 times a day. Group B received 1 Carbomer eye drop,3-5 times a day. Group C re-ceived 1-2 Polyethylene glycol eye drops,3-5 times a day. Group D received Tobramycin and dexamethasone eye ointment,1-1.5 cm every times,1-3 times a day. They treated for 1 month. Clinical efficacy,recovery of visual acuity and ocular surface functions [dry eye symptom score,tear film break-up time(BUT),corneal fluorescein staining(CFS),basal tear secretion(SIt),ocular sur-face disease index(OSDI)] and the incidence of adverse reactions in all groups were observed. RESULTS:The total effective rate sorted,patients with visual acuity higher than 0.6,BUT,OSDI by group A>group B>group C>group D,with significant differenc-es (P0.05). CONCLUSIONS:Sodium hyaluronate shows superior efficacy and safety to Carbomer,Polyethylene glycol,Tobramycin and Dexamethasone in the treatment of glaucoma with cataract,it can significantly improve visual acuity and ocular surface function.