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Purpose: Functional recovery after cataract surgery depends on the anatomical recovery of the eye. This study compared the improvement in visual function parameters after uniocular manual small-incision cataract surgery (MSICS) and phacoemulsification cataract surgery. Methods: This study included 310 patients divided randomly into two groups: 155 who received MSICS (MSICS group) and 155 who underwent phacoemulsification (phaco group) for cataract treatment. Outcome measures assessed included vertical and horizontal keratometry reading. The mean corneal astigmatism tear function measured using Schirmer 1 test results were recorded preoperatively, and on postoperative day 1, day 7, and day 30. Optical coherence tomography (OCT) was done to record the average central macular thickness (?m) on day 7 and day 30. Results: The mean corneal astigmatism and anterior chamber inflammation were more in the MSICS group than in the phaco group immediately postoperatively. However, no statistically significant difference was found between the groups with respect to corneal sensation, mean corneal astigmatism, tear film function, and visual outcomes on postoperative day 30. Uncorrected visual acuity was better in the phacoemulsification group than in the manual SICS group on postoperative day 1, day 7, and day 30 (P < 0.001). Conclusion: Both phacoemulsification cataract surgery and manual small-incision sutureless cataract surgery (MSICS) are safe and effective for visual rehabilitation. Phacoemulsification is the preferred technique where resources are available with the advantages of less mean corneal astigmatism, less anterior chamber inflammation, and better uncorrected visual acuity (UCVA) in the immediate postoperative period
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@#AIM:To investigate the effect of small incision non-phacoemulsification cataract surgery on corneal endothelial cell.METHODS:Totally 140 cataract patients (152 eyes) treated in our hospital from August 2013 to March 2016 were selected.All of the patients underwent small incision non-phacoemulsification cataract surgery.Before surgery and at 1wk, 1mo and 3mo after surgery, we measured the corneal endothelium of upper cornea, the central cornea and the lower part of cornea.The proportion and density of hexagonal cells, loss rate and cell area in corneal endothelial cells were calculated and compared.RESULTS:Postoperatively 36 eyes had posterior elastic layer folds, aqueous flare, which disappeared after treatment.After surgery, corneal incision was found to have mild corneal edema.No other complications were found.A total of 128 patients (137 eyes) were followed up for a total of up to 3mo, with a loss of follow-up in 12 patients (15 eyes).After surgery, corneal endothelial cell density of the upper part of the cornea, the central cornea and the lower part of cornea, was statistically significantly different with each other (F=3.526, P=0.031), the difference in different time points was statistically significant (F=4.111, P=0.018).The postoperative corneal endothelial cell loss rate was statistically significant different between the three groups (F=3.526, P=0.031), at different time pionts (F=4.111, P=0.018).There was statistical significance of percentage of hexagonal cells between the three groups (F=4.348, P=0.014), the difference was significantly different between different time points (F=4.964, P=0.008).There was statistical significance of corneal endothelial cell area between the three groups (F=3.180, P=0.044), the difference was significantly different between the time points (F=3.511, P=0.032).CONCLUSION:After small incision non-phacoemulsification cataract surgery, corneal endothelial cell density decreased, hexagonal cell proportion decreased, corneal cell area expanded.
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Objective To compare the efficacy of two different surgery incisions on original corneal astigmatism in cataract surgery. Methods 300 patients (300 eyes) of cataract surgery from August 2012 to August 2013 in our hospital were included in the study,of which 150 patients in the observation group treated with transparent cornea incision in the steep axis of astigmatism,and the control group of 150 pa-tients received lateral ( right) or on the nose by the temporal side ( left) transparent cornea incision. Results In the third day,first month, third month,sixth month and 12th month after surgery,the average corneal astigmatism in the observation group was significantly lower than that before the surgery,which after a month the lowest ( +0. 79 ± 0. 92)D;average corneal astigmatism of patients in the control group were significantly higher than that before the surgery,corneal astigmatism after 3 days to reach the highest,( -5. 65 ± 0. 89)D,3 days after sur-gery,1 month, 3 months, 6 months and 12 months,patients in the observation group were significantly higher visual acuity patients,the differ-ence was statistically significant (P<0. 05). Conclusion Phacoemulsification clear corneal incision along the steep axis IOL implantation for cataract surgery can correct astigmatism original extent a certain extent,and to promote the recovery of visual acuity in patients with a grea-ter degree.
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To compare the curative effects of two surgical treatment methods for open angle glaucoma and cataract patients. ●METHODS: Totally 69 patients with primary open angle glaucoma and cataract were divided into two groups:group A and group B. Thirty- four patients (34 eyes) in group A underwent small incision non -phacoemulsification cataract surgery combined with trabeculectomy, just combined operations, 35 patients (35 eyes) in group B underwent small incision non -phacoemulsification cataract surgery beyond 6mo after trabeculectomy, just two stage operations. Postoperative intraocular pressure at 1wk and 3mo, postoperative corrected visual acuity and filtering bleb at 3mo were observed, and intraoperative and postoperative complications were compared. All the patients were followed up for 3-6mo. ● RESULTS: All the visual acuity were increased compared with that before surgery in two groups, the difference was not statistically significant. All the intraocular pressure was controlled in two groups, the difference was not statistically significant, and the difference about the filtering bleb was neither statistically significant ( P > 0. 05 ). There were no serious intraoperative and postoperative complications in two groups. ● CONCLUSlON: The two stage operations and the combined operations both can control theintraocular pressure and improved visual acuity of open angle glaucoma and cataract. The two stage operations may prevent a second operation for post trabeculectomy cataract, allowing earlier visual rehabilitation.
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AlM:To investigate the influence of phacoemulsification with different incision on tear film. METHODS:Tear film was monitored in 152 patients (169 eyes) after phacoemulsification. Patients were divided into two groups according to the type of incision:group A (76 patients, 83 eyes) with a 3. 2mm corneoscleral limbus incision phacoemulsification and group B (76 patients, 86 eyes ) with a sclemtic tunnel incision. Tear break-up time ( BUT ) , cornea fluorescein staining ( CFS ) , lid-parallel conjunctival folds ( LlPCOF) and lid-wiper epitheliopathy ( LWE ) were observed at 3d preoperatively and 1wk, 1, 3 and 6mo postoperatively. The results were analyzed using a Chi-square test and t-test with SPSS 17. 0. RESULTS:BUT: The BUT of two groups was obviously shorter at 1wk, 1mo postoperatively, the differences were statistically significant (P0. 05). CFS score:There was a large increase in CFS at 1wk, 1mo postoperatively, the differences were statistically significant between the two groups(P0. 05). LlPCOF:There was a large increase in LlPCOF at 1wk, 1 and 3mo postoperatively, the differences were statistically significant between the two groups (P0. 05). LWE: There was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The differences were statistically significant between the two groups (P0. 05). CONCLUSlON:The stability of tear film in patients with scleral tunnel incision is much better than in patients with 3. 2mm corneoscleral limbus incision phacoemulsification. There is no significant difference between the two groups during later postoperative periods.
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PURPOSE: To evaluate the stability and optical performance of the newly developed single-piece aspheric intraocular lens (IOL) by comparing the clinical outcome of the aspheric IOL with the new optic profile design (HOYA iSert, HOYA iMics) and the aspheric IOL (Akreos MI60), which has been proven effective and safe. METHODS: iSert, iMics, and MI60 were inserted into 55 eyes, 60 eyes, and 50 eyes, respectively, after microincision phacoemulsification cataract surgery. Best corrected visual acuity (BCVA), refraction in spherical equivalent, anterior chamber depth (ACD), total higher order aberration (HOA), contrast sensitivity, and surgically induced astigmatism (SIA) were measured and each IOL was evaluated on the functional stability, anterior-posterior stability, centration in the capsular bag, and quality of vision. RESULTS: No statistical differences in preoperative and postoperative BCVA among the 3 IOL groups were observed, however, MI60 showed significant myopic shift postoperatively. Anterior-posterior stability assessed with postoperative change in refractive error and ACD was slightly lower in the MI60 group. In terms of vision quality, while total aberration, total HOA, coma aberration, and contrast sensitivity for the 3 IOLs were not different significantly, spherical aberration of the MI60 group was higher than the other groups at 6 months postoperative. SIA was significantly increased in eyes implanted with iSert than in eyes with iMics or MI60 at 1 month postoperatively, however, the differences were no longer evident after 3 months postoperatively. CONCLUSIONS: The new aspheric IOLs, iSert and iMics, showed good stability and visual outcome equal to MI60 at the 6-month postoperative follow-up.
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Compostos de Anilina , Câmara Anterior , Astigmatismo , Catarata , Coma , Sensibilidades de Contraste , Olho , Seguimentos , Implante de Lente Intraocular , Lentes Intraoculares , Facoemulsificação , Erros de Refração , Visão Ocular , Acuidade VisualRESUMO
Background Cataract surgery can induce the occurrence of dry eye because of the influence of incision on corneal nerve fibers and the change of corneal regularity derived by surgery.Objective This study was to investigate the change of regularity of anterior corneal surface,tear film and astigmatism caused by the process of manual small-incision cataract surgery (manual SICS) and phacoemulsification (Phaco).Methods A prospective non-randomized controlled study was designed.Fifty eyes of 46 age-related cataract patients were included in this clinical study.Thirty eyes of 30 patients received the manual SICS,and other 20 eyes of 16 patients underwent Phaco.Corneal irregularity measurement (CIM),shape factor (SF) and corneal astigmatism were assessed by the corneal tomography examination,the subjective symptoms were scored and tear film break up time (BUT),Schirmer Ⅰ test (S Ⅰ t) were examined before surgery and 1 day,1 week,1 month after surgery.The examined parameters were compared among different time points and two groups.This study was approved by Ethic Committee of Affiliated Eye Hospital of Wenzhou Medical College,and written informed consent was obtained prior to operation.Results The CIM values were gradually increased with the prolong of time after operation,showing a statistically significant difference dependent on time (Ftime =22.864,P =0.000),and CIM value of 1 day,1 week and 1 month after operation was higher than that of before operation (P＜0.01).However,no significant difference was found in CIM value between two groups in different time points (Fgroup =0.062,P =0.804).There was no significant difference in SF values with time prolong (Ftime =4.600,P =0.428) and different groups (Fgroup =0.009,P =0.925).The BUT was gradually reduced with the time prolongs with the considerably difference (Ftime =39.384,P=0.000).Obviously decreases of BUT values were seen in 1 week and 1 month in comparison with 1 day after operation (both P=0.000).But no significant change was found in BUT between two groups in various time points (Fgroup =0.000,P=0.983).In the manual SICS group,the difference was found in S Ⅰ t values between before operation and 1 week or 1 month after surgery(P＜0.01).Surgery associated astigmatism (SIA) was existed in the operative eyes in various time points after operation.With time lapse,SIA value was declined with a significant difference (Ftime =21.479,P =0.000),the difference also was found in different groups (Fgroup =8.709,P =0.005),and SIA value in the Phaco was significantly lower than that in the manual SICS group (P＜0.01).Conclusions In the present study,in the early stage after manual SICS and Phaco,SIA appears due to the irregular change of the anterior corneal surface increases and stability of tear film worsens.