Different sized incisions for phacoemulsification combined with vitrectomy in the treatment of age- related cataract associated with maculopathy / 中国医师进修杂志

ABSTRACT

Objective To compare the clinical efficacy of different sized incisions for phacoemulsification combined with vitrectomy in the treatment of age-related cataract associated with maculopathy. Methods From January 2016 to October 2016, a total of 60 eyes of 60 senile cataract patients with maculopathy were prospectively divided into the micro incision group and the standard incision group according the random number table,with 30 cases in each group.The micro incision group received a 1.8 mm micro incision for phacoemulsification combined with 23G vitrectomy and the standard incision group underwent a 2.8 mm incision for phacoemulsification combined with 23G vitrectomy.The intraoperative conditions and the postoperative complications of the two groups at 1 d, 1 and 6 months after surgery were compared. The intraocular pressure (IOP), best corrected visual acuity (BCVA), surgically induced astigmatism (SIA), dry eye symptoms (Sx), break-up time (tBUT), schirmer test (ST)-Ⅱwere respectively measured at 1 and 6 months after surgery.Results The operation procedures were similar in two groups,and there were no significant differences in the operative time and the incidence of intraoperative complications(P>0.05).There were no significant differences in IOP and the incidence of postoperative complications between two groups at 1 d, 1 and 6 months after surgery (P>0.05). At the time point of 1 month after operation,there was no significant difference in BCVA between two groups,but the level of SIA in micro incision group was lower0.4 ± 0.2 vs.0.6 ± 0.3,t=3.038,P=0.004;the level of Sx micro incision group was lower (1.2 ± 0.8)score vs. (1.8 ± 1.1) scores, t = 2.416, P = 0.019; the level of tBUT was higher(5.2 ± 1.6)s vs.(3.8 ± 1.3)s, t = 3.454,P = 0.001;the level of ST-Ⅱwas higher (4.7 ± 2.1) mm vs. (3.5 ± 1.8), t = 2.376, P = 0.021; there were significant differences. At 6 months after operation,there were no significant differences in the indexes of BCVA,SIA,Sx,tBUT and ST-Ⅱbetween two groups(P>0.05).Conclusions The different sized incisions for phacoemulsification combined with vitrectomy in the treatment of senile cataract associated with maculopathy are similarly safe and effective. However, the micro incision surgery can improve the surgically-induced astigmatism and dry eye in the early stage,with a shorter postoperative recovery time.