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AIM: To observe the efficacy of phacoemulsification combined with capsular tension ring and intraocular lens implantation in the treatment of high myopia with cataract.METHODS: Retrospective study. A total of 82 cases(82 eyes)of high myopia complicated with cataract who admitted to the cataract department of our hospital from December 2021 to April 2023 were selected as study objects, and they were divided into control group(n=39)and combination group(n=43)according to whether or not the capsular tension ring was used intraoperatively. Patients in the control group were treated with intraocular lens implantation alone, and those in the combination group were treated with phacoemulsification combined with capsular tension ring and intraocular lens implantation. The preoperative and postoperative best corrected visual acuity, central anterior chamber depth, trabecular ciliary process, visual quality and complications were compared.RESULTS: At 1 mo after surgery, the best corrected visual acuity(LogMAR)of both groups increased significantly(combination group: 0.64±0.28 vs 0.12±0.14; control group: 0.62±0.26 vs 0.23±0.25, both P<0.001). Central anterior chamber depth in both groups were higher than those before surgery(combination group: 2.57±0.56 vs 1.97±0.40 mm; control group: 2.22±0.45 vs 1.89±0.37 mm; both P<0.001), and the best corrected visual acuity and central anterior chamber depth of the combination group were significantly better than those of the control group(both P<0.05). The distance of trabecular ciliary process showed no statistical significance(combination group: 0.68±0.22 vs 0.74±0.20 mm; control group: 0.74±0.19 vs 0.78±0.17 mm, both P>0.05). The visual quality scores of the combination group were all higher than the control group at 1 mo after surgery [watching TV: 3.00±0.38 vs 2.22±0.46 points; reading books: 2.85±0.42 vs 2.21±0.44 points; night vision: 2.71±0.34 vs 2.37±0.41 points; fine operation: 2.82±0.38 vs 2.33±0.40 points, all P<0.001]. The incidence of complication in the combination group was significantly lower than that of the control group(33% vs 14%, P<0.05).CONCLUSION: Phacoemulsification combined with capsular tension ring and intraocular lens implantation can effectively promote the recovery of visual function, improve the structure of chamber angle, and reduce the incidence of complications in the treatment of patients with high myopia and cataract.
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Objective To compare the clinical effects of one-stage modified capsular tension ring (MCTR) scleral fixation and second-stage capsular tension ring (CTR) capsular bag complex scleral fixation in the treatment of moderate and severe subluxation of lens.Methods Retrospective study.Thirty cases (43 eyes) of patients with moderate and severe subluxation of lens from January 2012 to December 2015 were collected.Those patients were treated with phacoemulsification cataract extraction and MCTR or CTR and IOL intracapsular implantation under local anesthesia.23 eyes in group A were treated with MCTR combined with IOL implantation and one-stage scleral fixation.20 eyes in group B were treated with one-phase CTR combined with IOL implantation and second-stage of CTR-capsular bag complex scleral fixation after 3 to 6 months.The best corrected visual acuity,location of the postoperative capsular bag complex and complication were observed at 6 months after surgery.Results Postoperative 6-month,the best corrected visual acuity ≥0.6 were in 87％,95％ of the patients m group B,and there was no statistical significance difference (P ＞ 0.05).All CTR and IOL were located in the capsular bag after surgery.Two eyes in group A and 1 eye in group B were observed with moderate contraction and off-center of capsular bag,there was no significant difference (P ＞ 0.05).All groups achieved response after YAG laser anterior capsule relaxing incisions.Early complications of postoperative (1 month):3 eyes in group A and 1 eye in group B were observed with exudative membrane in anterior chamber;5 eyes in group A and 2 eyes in group B were with transient high intraocular pressure,and there was no significant difference (all P ＞ 0.05).Long-term complications of postoperative (6 months):3 eyes in group A and 1 eye in group B were observed with after cataract,and there was no significant difference (P ＞ 0.05).All groups conducted YAG laser posterior capsulotomy.Conclusion The location stability of the capsular complex after one-stage MCTR scleral fixation or secondstage CTR capsular bag sclera fixation is good.And the treatment is effective for moderate and severe lens dislocation.