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AIM:To investigate the changes of anterior chamber depth(ACD)and lens suspensory ligament after phacoemulsification and intraocular lens(IOL)implantation in patients with ultra-high myopia cataract and related influencing factors.METHODS: A total of 45 patients(60 eyes)with ultra-high myopia and cataract in our hospital from October 2016 to December 2022 were selected. All patients received phacoemulsification and IOL implantation. The patients were randomly divided into implantation group and non-implantation group. Implantation group was combined with capsular tension ring(CTR)implantation, and non-implantation group did not implant CTR during operation. The changes of ACD and lens suspensory ligament length before and after operation were compared and the correlation was analyzed. To observe the differences of ACD and the length of lens suspensory ligament between the two groups before and after operation.RESULTS: The ACD of patients with ultra-high myopia complicated with cataract at 1 and 3mo after operation was higher than that before operation(all P<0.05). The positions of 3:00, 6:00, 9:00, 12:00 and the average length of lens suspensory ligament at 1 and 3mo post-operation were shorter than those pre-operation(all P<0.05). There was no significant difference in the positions of 3:00, 6:00, 9:00, 12:00 and average length of suspensory ligament between 1mo and 3mo after operation(all P>0.05). The preoperative average length of lens suspensory ligament in patients with ultra-high myopia cataract was positively correlated with the ocular axis and the preoperative ACD(all P<0.05). There was no significant difference in ACD between the implantation group and the non-implantation before and at 1 and 3mo after operation(P>0.05). There was no significant difference in the length of lens suspensory ligament between implantation group and non-implantation group at the position of 6:00 before operation and 1mo after operation(P>0.05), but there was difference in lens suspensory ligament between groups at 3mo after operation and the position of 6:00(P<0.05). Furthermore, there was no significant difference at the positions of 3:00, 9:00, 12:00 and the average length of lens suspensory ligament between the implantation group and non-implantation group before and at 1 and 3mo after operation(P>0.05).CONCLUSION: The ACD deepen and lens suspensory ligament shortened in patients with ultra-high myopia and cataract after phacoemulsification; the length of lens suspensory ligament was affected by the combined use of CTR.
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Objective:To observe the effects of polishing the anterior and posterior capsule with irrigation/aspiration (I/A) injection needle and capsular tension ring (CTR) implantation on intraocular lens (IOL) capsular stability after phacoemulsification for ultra-high myopia with 2.0 mm coaxial micro incision.Methods:This is a prospective randomized controlled study. There were 40 patients(80 eyes) aged 46-72 years old with ultra-high myopia cataract. The grade of lens opacity was grade II-IV, and the diopter was -10 D - -24 D. During 2.0 mm coaxial micro incision phacoemulsification, adopt coin tossing method randomly, 1 eye was operated using the anterior and posterior capsule polishing 360° with I/A injection needle combined with CTR implantation as the experimental group(40 eyes), the other eye was neither polished nor CTR implantated as the control group(40 eyes). The operation interval of both eyes was less than 1 week. The size of anterior capsular orifice, effective intraocular lens position(ELP), IOL eccentricity and posterior capsular opacification(PCO) were recorded at 1 week, 1, 3 and 6 months after operation in outpatient clinic. Two independent sample t-test and Fisher exact probability test were used to compare the differences between the 2 groups. P<0.05 was defined significant difference. Results:During the follow-up period, there were no significant change in the anterior capsule area, IOL eccentricity and ELP in the experimental group. However in the control group, the anterior capsular area decreased gradually with time, and gradually IOL eccentricity increased and ELP decreased. There was no significant difference between the 2 groups in each observation index at 1 week after operation, but it was ELP that first showed the difference tendency( P<0.01). The ELP of the control group was significantly lower than that of the experimental group at 1, 3 and 6 months after operation( P<0.05). There was no significant difference in anterior capsule area and IOL eccentricity between the 2 groups at 1 and 3 months after operation( P>0.05), but there was a significant difference at 6 months( P<0.05). In terms of PCO, the incidence of PCO was 0%, 2.5% and 7.5% in the experimental group and 5.0%, 17.5% and 32.5% in the control group respectively at 1, 3 and 6 months after operation. The incidence of PCO in the experimental group was significantly lower than that in the control group( P<0.05). Conclusion:Ultra-high myopia with cataract are prone to have capsular contraction after operation, which is characterized by IOL instability and anterior capsular orifice narrowing gradually. Combined 360° anterior and posterior capsular polishing with tension ring implantation in operation can effectively maintain the stability of ELP, reduce the degree of contraction of anterior capsular orifice, reduce the eccentricity of IOL and the incidence of PCO. Polishing the anterior and posterior capsule with I/A injection needle combined with CTR implantation, is safe and effective for patients with ultra-high myopia cataract.
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Objective To investigate the effect of phacoemulsification combined with capsular tension ring implantation in patients with ultra-high myopia and cataract.Methods A randomized-controlled study was performed.The clinical data of 48 eyes of 48 patients with ultra-high myopia and cataract were collected at Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus from October 2016 to December 2018.The patients were randomly divided into a control group and a clinical trial group using a random number table method,with 24.eyes in each group.The eyes in the control group underwent phacoemulsification,and capsular tension ring implantation was performed during the surgery in the trial group.The patients were followed up for 3 months.Best corrected visual acuity (BCVA),intraocular pressure,corneal endothelial cell count,intraocular lens (IOL) decentration,and subjective visual quality were observed and compared preoperatively and 1 week,1 month and 3 months postoperatively,and the postoperative inclination angle of the IOL and surgical complications were compared between the two groups.Written informed consent was obtained from each patient prior to entering the study cohort.This study conformed to the tenets of the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus (No.2016-KY-05).Results The operation procedure was successfully completed,and the IOL was implanted into capsular bag in all the eyes.The postoperative BCVA was higher than that before surgery in both groups,with significant differences between them (all at P＜0.05).There were no significant differences in intraocular pressure and the corneal endothelial cell count between the two groups (F=0.122,P=0.729;F=0.006,P=0.939).The level of IOL horizontal decentration,vertical decentration,or total decentration were not significantly different between the two groups at 1 month and 3 months after operation (all at P＞0.05).At 1 month after operation,the horizontal and total inclination angles of the IOL in the trial group were statistically significantly lower than those in the control group (P＜0.05).At 3 months after operation,the vertical and total inclination angles of the IOL were significantly lower than those in the control group (both at P＜0.05).The total inclination in the trail group was significantly lower than that of the control group (P＜0.05).The subjective visual quality scores of the patients in the trial group at 1 week,1 month,and 3 months after operation were 2.85 t 0.24,3.30± 0.36,and 3.43 ± 0.42,respectively,and those in the control group were 2.34±0.23,2.65 ±0.44,and 2.57 ± 0.39,respectively,both significantly improved over the preoperative 1.31 ± 0.22 and 1.19±0.17 (all at P＜0.01).Conclusions The use of a bag tension ring in phacoemulsification for ultra-high myopia with cataract is safe and effective,and can result in good visual quality.
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Objective@#To investigate the effect of phacoemulsification combined with capsular tension ring implantation in patients with ultra-high myopia and cataract.@*Methods@#A randomized-controlled study was performed.The clinical data of 48 eyes of 48 patients with ultra-high myopia and cataract were collected at Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus from October 2016 to December 2018.The patients were randomly divided into a control group and a clinical trial group using a random number table method, with 24 eyes in each group.The eyes in the control group underwent phacoemulsification, and capsular tension ring implantation was performed during the surgery in the trial group.The patients were followed up for 3 months.Best corrected visual acuity (BCVA), intraocular pressure, corneal endothelial cell count, intraocular lens (IOL) decentration, and subjective visual quality were observed and compared preoperatively and 1 week, 1 month and 3 months postoperatively, and the postoperative inclination angle of the IOL and surgical complications were compared between the two groups.Written informed consent was obtained from each patient prior to entering the study cohort.This study conformed to the tenets of the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus (No.2016-KY-05).@*Results@#The operation procedure was successfully completed, and the IOL was implanted into capsular bag in all the eyes.The postoperative BCVA was higher than that before surgery in both groups, with significant differences between them (all at P<0.05). There were no significant differences in intraocular pressure and the corneal endothelial cell count between the two groups (F=0.122, P=0.729; F=0.006, P=0.939). The level of IOL horizontal decentration, vertical decentration, or total decentration were not significantly different between the two groups at 1 month and 3 months after operation (all at P>0.05). At 1 month after operation, the horizontal and total inclination angles of the IOL in the trial group were statistically significantly lower than those in the control group (P<0.05). At 3 months after operation, the vertical and total inclination angles of the IOL were significantly lower than those in the control group (both at P<0.05). The total inclination in the trail group was significantly lower than that of the control group (P<0.05). The subjective visual quality scores of the patients in the trial group at 1 week, 1 month, and 3 months after operation were 2.85±0.24, 3.30±0.36, and 3.43±0.42, respectively, and those in the control group were 2.34±0.23, 2.65±0.44, and 2.57±0.39, respectively, both significantly improved over the preoperative 1.31±0.22 and 1.19±0.17 (all at P<0.01).@*Conclusions@#The use of a bag tension ring in phacoemulsification for ultra-high myopia with cataract is safe and effective, and can result in good visual quality.
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AIM: To analyze the results of phacovitrectomy with internal limiting membrane(ILM) peeling to treat foveoschisis in ultra-high myopia.METHODS: Totally 32 eyes of 32 ultra-high myopia patients with foveoschisis were selected retrospectively.The preoperative refractive errors ranged from-12.00D to-20.00D with the mean of-15.78±2.16D.The best corrected visiual acuity(BCVA) were converted to LogMAR acuity, and the average BCVA was 4.1±0.4.Conventional phacovitrectomy with ILM peeling by ICG dying were performed.Gas tamponade were performed to end the operation.The BCVA and the foveoschisis cavity were observed by 1-9mo after the surgery, with the mean of 4.5mo.RESULTS: The foveoschisis cavity of 30 eyes were healed with BCVA increased and visual distortion alleviated distinctly (94%)(t=-7.91, P<0.05).CONCLUSION: Phacovitrectomy with ILM peeling is useful in treating foveoschisis in ultra-high myopia with visual function preserving.