Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Metho...Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.展开更多
目的:探讨预劈核技术和常规拦截劈核技术在超声乳化白内障摘除手术的应用,对比其临床疗效及对角膜内皮细胞的影响。方法:选取蚌埠医学院第一附属医院2016年1月至2017年4月收集的60例(60眼)白内障患者进行研究,根据手术方法分为A组30例(3...目的:探讨预劈核技术和常规拦截劈核技术在超声乳化白内障摘除手术的应用,对比其临床疗效及对角膜内皮细胞的影响。方法:选取蚌埠医学院第一附属医院2016年1月至2017年4月收集的60例(60眼)白内障患者进行研究,根据手术方法分为A组30例(30眼,采用预劈核技术行超声乳化白内障摘除手术)、B组30例(30眼,采用常规拦截劈核技术行超声乳化白内障摘除手术),观察2组患者手术疗效及角膜内皮细胞变化情况。结果:A组实际超声能量[(50.36±2.47)%]明显低于B组[(55.42±3.28)%],A组有效超声时间[(56.56±10.20)s]明显低于B组[(67.79±11.45)s],差异具有统计学意义(P<0.05)。重复测量数据的方差分析显示,不同时间点的最佳矫正视力(best corrected visual acuity,BCVA)、角膜内皮细胞密度(endothelial cell density,ECD)和六角形细胞比例均有差别(P<0.05),2组的BCVA、ECD和六角形细胞比例测量时间和组别不存在交互作用(P>0.05)。术后1 d A组患者角膜水肿较B组轻,差异具有统计学意义(P<0.05);术后7 d 2组患者角膜水肿消退,差异无统计学意义(P>0.05)。结论:2种手术方式均具有良好的临床疗效,采用预劈核技术能有效降低白内障术中超声能量和超声时间,降低角膜内皮细胞损伤,且操作方便,值得临床推广。展开更多
文摘Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.
文摘目的:探讨预劈核技术和常规拦截劈核技术在超声乳化白内障摘除手术的应用,对比其临床疗效及对角膜内皮细胞的影响。方法:选取蚌埠医学院第一附属医院2016年1月至2017年4月收集的60例(60眼)白内障患者进行研究,根据手术方法分为A组30例(30眼,采用预劈核技术行超声乳化白内障摘除手术)、B组30例(30眼,采用常规拦截劈核技术行超声乳化白内障摘除手术),观察2组患者手术疗效及角膜内皮细胞变化情况。结果:A组实际超声能量[(50.36±2.47)%]明显低于B组[(55.42±3.28)%],A组有效超声时间[(56.56±10.20)s]明显低于B组[(67.79±11.45)s],差异具有统计学意义(P<0.05)。重复测量数据的方差分析显示,不同时间点的最佳矫正视力(best corrected visual acuity,BCVA)、角膜内皮细胞密度(endothelial cell density,ECD)和六角形细胞比例均有差别(P<0.05),2组的BCVA、ECD和六角形细胞比例测量时间和组别不存在交互作用(P>0.05)。术后1 d A组患者角膜水肿较B组轻,差异具有统计学意义(P<0.05);术后7 d 2组患者角膜水肿消退,差异无统计学意义(P>0.05)。结论:2种手术方式均具有良好的临床疗效,采用预劈核技术能有效降低白内障术中超声能量和超声时间,降低角膜内皮细胞损伤,且操作方便,值得临床推广。
