RESUMO
·AIM: To compare the clinical effects of 2.2mm coaxial micro-incision and 3.0mm standard incision in cataract phacoemulsification surgery. ·METHODS: A total of 67 patients (80 eyes) were randomly divided into two groups. Cataract phacoemulsification and artificial lens implantation surgery was carried out with 2. 2mm coaxial micro -incision (Group A, 40 eyes) and 3. 0 mm standard incision(Group B, 40 eyes), respectively. The effective phacoemulsification time and average ultrasound energy, corneal endothelial cell count, corneal edema, corneal astigmatism, postoperative visual acuity and postoperative complications were compared between the two groups. ·RESULTS: Effective phacoemulsification time of Group A and Group B was 8. 18 ± 11. 22s and 7. 82 ± 2. 12s, respectively, and the difference had no statistical significance(P> 0. 05); average ultrasonic energy was (17.25 ± 4.22)% and (17.64 ± 4.27)%, respectively, and the difference was not statistical significance(P>0.05). There was no significant difference in endothelial cells between the two groups of corneal endothelial cells at 1wk after surgery compared with that before operation (P>0.05). On the first day after surgery, corneal edema was observed in some patients. There were 9 eyes in Group A,6 eyes in Group B,corneal edema relief or subsidence after 3d to 5d. There was significant difference in corneal astigmatism change between the two groups at 1wk (P<0.05), but there was no significant difference at 1 and 3mo after operation (P>0.05). The changes of corneal astigmatism before and after operation in Group A were insignificant (P>0. 05), while the changes of corneal astigmatism before and after operation in Group B were significantly different (P< 0. 05). At 1 and 3mo after operation, the astigmatism of each group tended to be stable, and the corneal astigmatism in the two groups after 1 and 3mo had no statistical significant difference (P> 0. 05). The uncorrected visual acuity (UCVA) differences of the two groups was statistically significant at 1d,1wk and 1mo after operation (P<0.05), but there was no significant difference between the two groups in UCVA after 3mo (P>0.05). ·CONCLUSION: For soft or medium - hard nucleus cataract, compared with the traditional 3. 0mm small-incision coaxial phacoemulsification, the 2.2mm micro-incision coaxial phacoemulsification can effectively reduce the surgically induced astigmatism, and the astigmatism state is relatively stable, and conducive to early recovery of visual acuity.
RESUMO
·AIM: To report the results of phacotrabeculectomy with 2.8mm scleral tunnel incision.·METHODS: Phacotrabeculectomy was performed through an identical 2.8mm scleral tunnel incision in 52 eyes of 49 patients with cataract and glaucoma. The incision was closed with out suture. Foldable intraocular lens was implanted in all eyes.·RESULTS: The control of intraocular pressure on 36 eyes was desirable. The average postoperative intraocular pressure was (8.24±3.61)mmHg, (13.22±4.12) mmHg, (12.11±4.23)mmHg and (12.59±4.26)mmHg at one week, one month, three months and six months. As compared with 56 eyes in which phacotrabeculectomy was performed with 5.5mm scleral tunnel sutureless incision, there was no statistical difference, between the two, regarding the mean postoperative intraocular pressure at six months (t=1.7536,P=0.08239).The retinal nerve fiber layer thickness was not statistically different between the preoperative and postoperative times in one year in 26 eyes. The uncorrected postoperative visual activity was 0 8 or better in 62% of 52 eyes.·CONCLUSION: The advantages of this operative method are minimal size scleral flap, smaller and sutureless incision, immediate chamber restoration, decrease in postoperative astigmatism, enhanced postoperative visual activity, reduced postoperative inflammatory response and complications.