Changes in ocular surface status and dry eye symptoms following femtosecond laser-assisted cataract surgery.

AIM: To observe the changes in ocular surface and the dry eye symptoms following femtosecond laser-assisted cataract surgery (FLACS). METHODS: Patients with no eye signs or symptoms in Guangzhou Aier Eye Hospital between October 2017 and September 2018, who underwent FLACS and intraocular lens (IOL) implantation for age-related cataract were enrolled. Tear film stability assessed with OCULUS Keratograph 5M, Schirmer's I test (SIT), and corneal fluorescein staining (CFS) were evaluated before and after surgery at 1d, 1wk, 1, and 3mo in order. Ocular Surface Disease Index scores (OSDI) and Subjective Symptom Questionnaires (SSQs) were recorded at the same time point. RESULTS: Thirty-eight eyes of 38 patients were enrolled. The noninvasive tear film break-up time (first break-up time and average break-up time) decreased in a peak at the 1wk visit, and then increased to basic levels at 1mo. The tear meniscus height (TMH) increased transiently at 1d, and declined in the following 3mo visits. The SIT had a transient increase at 1d (P=0.357) and a decrease at 1wk and 1mo (both P<0.05) but returned to the preoperative levels at 3mo after surgery (P=0.062). CFS scores were significantly improved compared with those before surgery, and had a statistical difference (P<0.05). OSDI scores and SSQs after surgery were obviously higher, and had a statistical difference (P<0.001) but didn't return to the basic level by 3mo. CONCLUSION: Dry eye signs and symptoms can occur immediately following FLACS and have a peak severity on day 7 postoperatively. Most signs of dry eye can return to preoperative basic levels within 3mo postoperatively. However, all cases can not recover from CFS and dry eye symptoms at 3mo postoperatively.

[Clinical investigation of iris-claw phakic intraocular lens implantation for high myopia].

OBJECTIVE: To investigate the efficacy and safety of an iris-claw phakic intraocular lens (ICPIOL) implantation for high myopia. METHODS: A consecutive group of 25 eyes in 13 patients with -7.88 to -22.88 diopters (D) of myopia was implanted with the Verisyse ICPIOL (AMO), and was examined preoperatively and 1, 7 days, 1, 3, 6, and 12 months postoperatively. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, intraocular pressure, and complications were evaluated. RESULTS: The implantation was successful in all of 25 eyes. Compared with preoperative data, UCVA, BCVA, and spherical equivalent (SE) were improved significantly. At 12-month postoperatively, UCVA was 0.5 or better in all eyes, in which the UCVA in 71.43% eyes was 0.8 or higher; No loss of BCVA was found, 2 lines of BCVA improvement was obtained in 95.24% of patients with ICPIOL, and 1 line BCVA improvement was seen in 4.76% of patients; the power of refraction in all eyes implanted with ICPIOL was stabilized within the variation of +/- 0.50D (71.43%), and +/- 1.00D (85.71%). The corneal endothelial loss was insignificant. No severe complications occurred. CONCLUSIONS: At short-term follow-up, the implantation of the ICPIOL proved to be safe and effective for the correction of myopia in phakic eyes. However, longer follow-up with larger numbers of patients is necessary to evaluate long-term complications.

[The posterior chamber phakic intraocular lens implantation for moderate to high myopia].

The posterior chamber phakic intraocular lens implantation (PCPIOLI) was designed to implant an IOL in front of the natural crystalline lens. PCPIOLI offers several advantages, such as potential reversibility, preservation of accommodation and minimal complications. Recent studies suggested that PCPIOLI was a promising alternative procedure for the correction of severe ametropia. This paper reviewed the safety and efficacy of PCPIOLI for the treatment of moderate to high degree of myopia.

[The preliminary study of photolysis for cataract surgery].

OBJECTIVE: To evaluate the safety and efficiency of Dodick-ARC photolysis machine (a kind of Nd:YAG laser system) in the using of cataract surgery. METHODS: 52 eyes of cataract (fifty-two patients) were undergone photolysis with Dodick-ARC laser system and foldable intraocular lenses (IOLs) implantation. The hardness of nuclei was graded as N(1.0) to N(4.0) of LOCS III classification system. Before and after operations, the intraocular conditions, visual acuity, corneal thickness and operative complications were recorded. The time of follow-ups was more than 6 months. RESULTS: The operations were accomplished in 28 eyes and were changed into Phacoemulsification in 24 eyes. Posterior capsule rupture occurred in 2 cases (3.8%). Severe corneal edema was found in 3 cases (5.8%) that disappeared in 1 to 2 weeks. Preoperative visual acuity was < 0.05 in 19 cases, 0.05 - 0.3 in 28 cases and 0.4 - 0.5 in 5 cases. Postoperative visual acuity was < or = 0.3 in 1 case, 0.4 - 0.5 in 12 cases, 0.6 - 0.9 in 25 cases and > or = 1.0 in 14 cases. The mean values of pachymetry was 0.59 mm preoperatively and 0.60 mm in 3 months postoperatively (P = 0.097). CONCLUSION: Photolysis using Dodick-ARC Nd:YAG laser system is a safe and effective method for cataract surgery. The further improvement of equipment and surgery techniques is needed.