Effect of phacoemulsification versus extracapsular cataract extraction in patients with intumescent senile cataract / 中华老年医学杂志

ABSTRACT

Objective To compare the safety and effect of the phacoemulsification (PHACO) versus extracapsular cataract extraction (ECCE) in patients with intumescent senile cataract.Methods 200 eyes from patients with intumescent cataract were included and randomly divided into 2 groupsPE group (108 eyes,received PHACO) and ECCE group (92 eyes,received small incision ECCE) respectively.Superior quadrant sclera tunnel incisions were made with stabs of 2.8 mm diameters.Trypan-blue was used to show the anterior lens capsular membrane.In the PHACO group,a 4 mm diameters continuous curvilinear capsulorhexis (CCC) was made,which was enlarged to 6-7 mm after the intraocular lenses (IOL) implantation.For the ECCE group,a 8 mm-diameter CCC was made.Then the lens nucleus was either phacoemulsificated or delivered and IOL was implanted.The complications during and after surgery and the visual outcomes were recorded and statistically analyzed by SPSS 13.0 software.Results Age,sex and the hardness of the nucleus were comparable between the two groups.The best corrected vision acuity (BCVA) was 0.05 and worse in all patients before surgery.While 3 days after operation,in PE group,105 eyes (97.2％,105/108) gained postoperative vision 0.05 and better,and 82 of them were better than 0.3; in group ECCE,97.2％ (89/92) of the operated eyes gained vision 0.05 and better,72 (78.3％,72/92) eyes were better than 0.3.No statistical differences were found between the two groups in postoperative vision recovery.While,there were more failure rates of the CCC,tear of the anterior and posterior capsular,loss of the vitreous and iris injury rate in the ECCE group than in the PE group (20.7％ vs.8.3％,17.4％ vs.12.0％,7.6％ vs.0.9％,15.2％ vs.0％,P=0.01,P=0.00,P=0.02,P＜ 0.001).Prolapse of iris and discoria were found in ECCE group.Conclusions With small CCC,phacoemulsification can lead to better surgical outcomes than small incision ECCE procedures,and the operative and post-operative complications are less in PE group than in ECCE group.