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@#AIM:To evaluate the effect of two incision-making methods on operation and postoperative effect in manual small incision cataract surgery(MSICS)for patients with hard nucleus aged cataract and evaluate the advantages and disadvantages of two incision methods.<p>METHODS: A retrospective analysis of 56 patients with senile cataract with hard nucleus from February 2017 to February 2019 in our hospital was made, which was divided into two groups according to the different surgical methods. group A(31 eyes)with long incision(about 7-8mm), long tunnel(central 5mm length 3.5-4mm, internal incision of both sides extending about 1-1.5mm to the back of the side, making the front end of the incision trapezoid), thick scleral flap(about 2/3 film thickness). group B(25 eyes)with short incision(about 5.5mm), short tunnel(long 3mm, regular flush of internal incision, linear), and regular thickness scleral flap(about 1/2 film thickness). The best corrected visual acuity recovery of 1d, 1wk, 1mo and 3mo after operation, central corneal thickness after 1d, 1wk operation and corneal astigmatism degree, corneal endothelial cell loss degree after 3mo operation were compared.<p>RESULTS: The best corrected visual acuity(greater than or equal to 0.5)for 1d, 1wk, 1mo and 3mo after operation in the two groups(77%, 90%,94% and 94% in the A group and 32%, 72%, 88% and 88% in the B group)was statistically significant \〖<i>β</i>=-1.338, Exp<i>(β)</i>=0.262, <i>P</i><0.05\〗. The central corneal thickness of the two groups had time difference and interaction effect before and after operation(<i>P</i><0.05), and there was no difference between the two groups(<i>P</i>>0.05). There was a statistically significant difference in corneal endothelial cell density(2159.84±245.20/mm2 in the group A and 2019.68±203.97/mm2 in the group B)between the two groups after 3mo of operation(<i>t</i>=2.289, <i>P</i><0.05). There was no significant difference in corneal astigmatism between the two groups(group A 1.57±0.74D and group B 1.39±0.71D)after 3mo of operation(<i>t</i>=0.930,<i>P</i>>0.05).<p>CONCLUSION: MSICS with long incision, long tunnel, thick scleral flap and trapezoidal internal incision has less damage, quicker recovery and better effect on patients with hard nucleus aged cataract than short incision, short tunnel and linear internal incision.
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AIM: To observe the efficacy and safety of small incision manual nuncleofragmentation technology in hard-nucleus cataract.METHODS: Fifty-four patients (54 eyes) were performed with small incision manual nucleofragmentation and intraocular lens implantation.Uncorrected-visual acuity,corrected-visual acuity and astigmatism were measured before and after surgery.Anterior segment of eye,retina,surgical complications were observed.RESULTS: Preoperative uncorrected vision(LogMAR) was 1.095±0.171,corrected vision (LogMAR) was 0.994±0.158.Postoperative uncorrected vision(LogMAR) was 0.321±0.214 and corrected vision(LogMAR) was 0.276±0.179 at 1wk after operation.Both had statistical significance compared with uncorrected vision(LogMAR) (t=27.052,P0.05).No severe complications occurred in all cases.CONCLUSION: The technology of small incision manual nuncleofragmentation in hard-nucleus cataract is proved to be safe and effective.
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AIM:To explore the clinical effect of capsule membrane phacoemulsification and capsular bag in phacoemulsification in treatment of hard nuclear cataract with high myopia. METHODS:A total of 297 patients(322 eyes) with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus) and high myopia were selected from Mar. 2014 to Mar. 2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes) and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test. RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P 0. 05 ). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation ( P 0. 05 ). The intraoperative complication rate of observation group was significantly lower than that of the control group ( P0. 05). CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.
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AIM: To compare the efficiency and safety of torsional phacoemulsification with or without intelligent phacoemulsification ( IP ) software in hard nucleus cataract extraction. METHODS: Ninety two eyes with Ⅳ - Ⅴ grades cataracts were enrolled in this randomized prospective study. Operated eyes were divided into two groups -those operated without IP software ( non- IP group, n =43) and those operated using IP software (IP group, n =49 ). The two groups were compared in terms of ultrasound time (UST) and cumulative dissipated energy (CDE). Post- operative outcome measures included the corneal edema and best-corrected visual acuity (BCVA) at 1,7d and 3mo postoperatively, corneal endothelial cell density and percentage of hexagonal cell at 7d and 3mo postoperatively. RESULTS: UST was measured as 52. 51±9. 64s in non-IP Group and 48. 79±7. 13s in IP Group (P = 0. 030). CDE was 15. 78±3. 73% in non-IP Group and 14. 29±2. 77% in IP Group ( P = 0. 026). At the first postoperative day, the rate of BCVA>0. 1 in non-IP Group was 56%, and the rate in IP Group was 79% (P= 0. 066). Corneal edema in non-IP Group was 2. 98±0. 77 scores, and in IP Group it was 2. 61±0. 64 scores (P = 0. 021). At the postoperative 7 and 30d, the BCVA and corneal edema were no differences between two groups. At the postoperative 7d, corneal endothelial cell density in non- IP Group were 2497. 95 ±211. 48 / mm2 , less than 2586. 26±154. 71 / mm 2 in IP Group (P= 0. 029);percentage of hexagonal cell in IP group was 48. 33±8. 69%,higher than 44. 19±9. 48% of non-IP group(P= 0. 030).CONCLUSION: In hard nucleus cataract extraction, the IP software can combine the advantages of the two kinds of ultrasonic modes, which is more effective with lower ultrasound energy and less injury for the corneal endothclium, and is helpful for the recovery of vision at early stage after surgeries.