ABSTRACT
AIM: To compare the effect of cataract surgery in renal transplantation and hemodialysis patients. METHODS: We evaluated 51 eyes of 31 renal transplantation patients, 41 eyes of 29 hemodialysis patients and 45 eyes of 32 normal control patients who received phacoemulsification and intraocular lens (IOL) implantation from January, 2000 to August, 2014 in the Beijing Friendship Hospital. Each individual underwent a blood routine and a kidney function examination. Routine ophthalmologic examination included best-corrected visual acuity (BCVA), a slit-lamp examination to detect cataract type, determination of intraocular pressure, a corneal endothelial count, and fundus examination. All patients received phacoemulsification and an IOL implantation. RESULTS: For the types of cataract in the three groups, transplantation group was significantly different from normal control group (P=0.04), the most kind is posterior subcapsular cataract (PSC) in transplantation group 33 (64.7%), hemodialysis group had no significantly difference from normal control group (P=0.43), and the difference between transplantation group and hemodialysis group also had significantly difference (P=0.02). For postoperative BCVA in the three groups, transplantation group had significantly difference from normal control group (P=0.03), hemodialysis group was significantly different from normal control group (P=0.00), and the difference between transplantation group and hemodialysis group also had significantly difference (P=0.00). The multiple linear regression equation is Y=0.007 hemoglobin (Hb)-0.000233 serum creatinine (Cr), R(2)=0.898. Postoperative fundus examination showed that hemorrhage, exudation, and macular degeneration were greater in the hemodialysis group. CONCLUSION: This study showed that the PSC was more in the renal transplantation patients. BCVA was better and fundus lesions were less frequent in the renal transplantation group than in the hemodialysis group after cataract surgery. The multiple linear regression was showed that the Hb was positively correlated with postoperative BCVA, while Cr was negatively correlated with postoperative BCVA. These results may act as indicators in predicting visual acuity for the renal transplantation and hemodialysis patients.
ABSTRACT
BACKGROUND: Anterior capsular contraction syndrome is a potential complication of continuous curvilinear capsulorhexis (CCC). Three neodymium: yttrium-aluminum-garnet (Nd:YAG) laser relaxing incisions decrease anterior capsular contraction but the mechanism is unknown. The present study analyzed the biomechanical mechanism of three Nd:YAG laser relaxing incisions made to reduce anterior capsular contraction. METHODS: A three-dimensional control model and a three-dimensional Nd:YAG model of the anterior capsule with an opening diameter of 6 mm were created. Three incisions of 1 mm in length were made centrifugally at intervals of 120° around the opening circle. The stress alterations of the anterior capsule after CCC with and without Nd:YAG relaxation were numerically simulated and compared. RESULTS: In the control model, the stress was axially uniform in the inner area and relatively high near the inner rim of the opening. Meanwhile, in the Nd:YAG model, the stress level was very low in the inner opening areas, especially near the three incisions. The relaxing incisions in the Nd:YAG model significantly released the relatively high stress on the anterior capsule. Additionally, there was a high stress gradient near the relaxing incisions. CONCLUSION: Biomechanical effects of stress release may be the preventive mechanism of Nd:YAG incision against anterior capsular contraction syndrome.
Subject(s)
Aluminum/therapeutic use , Finite Element Analysis , Lens Diseases/prevention & control , Yttrium/therapeutic use , Capsulorhexis , HumansABSTRACT
BACKGROUND: Ophthalmic gel has been developed to increase the drug concentration in aqueous humor and to retard the loss of drug from the conjunctival sac. The research was to compare the drug concentration in aqueous humor of cataract patients administered 0.3% gatifloxacin ophthalmic gel with that in patients administered 0.3% gatifloxacin ophthalmic solution. METHODS: Ninety-six patients with cataract (96 eyes) were randomly assigned to 8 groups. The patients in groups 1-4 received topical gatifloxacin 0.3% ophthalmic gel and those in groups 5-8 received gatifloxacin 0.3% ophthalmic solution. The dose regimen was 1 drop, 4 times a day for 3 consecutive days prior to cataract surgery. On the day of surgery, 1 drop was applied at 15, 30, 60 or 120 minutes before commencement of cataract surgery in groups 1 and 5, groups 2 and 6, groups 3 and 7, and groups 4 and 8, respectively. Aqueous humor was extracted during the cataract surgery for the analysis of gatifloxacin concentration.. RESULTS: The concentrations of gatifloxacin in aqueous humor were (0.24 +/- 0.25) microg/ml, (1.11 +/- 0.74) microg/ml, (2.32 +/- 2.01) microg/ml and (1.85 +/- 1.14) microg/ml in groups 1 to 4, and (0.16 +/- 0.25) microg/ml, (0.31 +/- 0.24) microg/ml, (0.75 +/- 0.28) microg/ml and (0.33 +/- 0.22) microg/ml in groups 5 to 8, respectively. Patients receiving gatifloxacin ophthalmic gel showed greater mean values of gatifloxacin concentration in aqueous humor than those receiving gatifloxacin solution, and such differences were significant with P < 0.05 for all comparisons except that between groups 1 and 5. CONCLUSION: Topical gatifloxacin ophthalmic gel can attain significantly greater drug concentrations in human aqueous humor than gatifloxacin ophthalmic solution.
