Changes of tear film and tear secretion after phacoemulsification in diabetic patients

Objective: To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. Methods: Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent pha- coemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. Results: Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluo- rescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups. Conclusion: Tear secretion was reduced in diabetic cataract patients after phacoe- mulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage.

Corneal relaxing incision combined with phacoemulsification and IOL implantation

Objective: To analyze the effectiveness and safety of corneal relaxing incisions (CRI) in correcting keratometric astigmatism during cataract surgery. Methods: A prospective study of two groups: control group and treatment group. A treatment group included 25 eyes of 25 patients who had combined clear corneal phacoemulsification, IOL implantation and CRI. A control group included 25 eyes of 25 patients who had clear corneal phacoemulsification and IOL implantation.Postoperative keratometric astigmatism was measured at 1 week, 1 month, 3 months and 6 months. Results: CRI signifi-cantly decreased keratometric astigmatism in patients with preexisting astigmatism compared with astigmatic changes in the control group. In eyes with CRI, the mean keratometric astigmatism was 0.29±0.17 D(range 0 to 0.5 D) at 1 week, 0.41±0.21 D (range 0 to 0.82 D) at 1 month, respectively reduced by 2.42 D and 2.30 D at 1 week and 1 month postoperatively (P=0.000, P=0.000), and postoperative astigmatism was stable until 6 months follow-up. The keratometric astigmatism of all patients decreased to less than 1.00 D postoperatively. Conclusions: CRI is a practical, simple, safe and effective method to reduce preexisting astigmatism during cataract surgery. A modified nomogram is proposed. The long-term effect of CRI should be investigated.

Changes of Blood Aqueous Barrier after Phacoemulsification in Rabbits

Purpose: To evaluate the function and the morphological changes of the blood aqueousbarrier (BAB) after phacoemulsification and to provide the physiological mechanism ofBAB dysfunction.Methods: Phacoemulsification was performed on 12 rabbit eyes. Aqueous humor wasabstracted and the concentrations of aqueous humor protein were examined preoperativelyand on postoperative days 1, 7, 14, 21, 30 with Lowry. After the iris and the ciliarybody were removed from the rabbit eyes, we selected lanthanum nitrate as a tracer,then ultrastructural changes of BAB were investigated with transmission electronmicroscopy.Results: Highly statistically significant differences (P ＜ 0.05) were found betweenpreoperative aqueous humor protein concentration and those measured on days 1, 7, 14,2 1and 30 after surgery. Under transmission electron microscopy, a part of the endothelialcells and BAB damaged as shown by the leakage of lanthanum tracing into intravesselsthrough the broad space were observed.Conclusion: The results suggest that there is a blood aqueous barrier breakdown afterphacoemulsification. The morphological basis of BAB damage is the reversible opening oftight junctions between endothelial cells.

The Changes of Quality of Life in the Patients after Phacoemulsification with IntraocularLens Implantation

Purpose:To investigate the improvement and maintenance of the quality of life in the patients after phacoemulsification with intraocular lens implantation.Methods:The study population consisted of 116 patients receiving phacoemulsification with intraocular lens implantation. They were interviewed using the quality of life questionnaire, and the clinical outcomes were evaluated before surgery and at 1 week, 1 month, 3 months, 6 months after surgery respectively.Results:Patients reported similar scores of quality of life and all the four subscales among 1-week ,1-month ,3-month and 6-month follow-up visit after surgery, all of which were higher than the scores before surgery.Conclusion:Patients receiving phacoemulsification reported rapid improvement in quality of life after surgery, and the quality of life scores were not changed significantly from 1 week to 6 months after surgery.

Comparison of the Inflammatory Reaction to Laser Photolysis and Conventional Phacoemulsification

Purpose:To compare the postoperative inflammatory reaction induced by laser photolysis and conventional phacoemulification. Methods:Anterior chamber flare and cells were measured preoperatively and 1 day, 1 week, 1 month and 3 months postoperatively in two groups. In group 1, thirty-two eyes underwent laser photolysis. In group 2, thirty-five eyes underwent conventional phacoe-mulification. Results:Anterior chamber flare and cell measurements had no significant difference between two groups preoperatively and 1 day, 1 week, 1 month and 3 months postoper-atively. Flare and cell values returned to preoperative values by the third month. Conclusions:Postoperative inflammatory response to laser photolysis was equal to conventional phacoemulsification, and recovery occurred in 3 months postoperatively.Eye Science 2004;20:6-9.