Effect of intraocular lens implantation on visual field in glaucoma and comorbid cataracts

AIM: To investigate the effects of intraocular lens(IOL) implantation on visual field(VF) in patients with glaucoma and comorbid cataracts(G&C) with different disease severities.METHODS: Totally 56 eyes of 50 patients with primary G&C were included. All patients were divided into three groups based on the severity of the VF defect: the mild, moderate, and severe stage. Phacoemulsification was performed for cataract removal combined with IOL implantation. Visual acuity(VA) and VF tests were performed for all enrolled patients, up to 3 mo after surgery. Changes in VF threshold and global VF index in various groups were also recorded before and after surgery. The mean light sensitivity(MS) values and the changes following surgery(DMS) were compared between the three groups. Advanced Glaucoma Intervention Study(AGIS) scoring was analyzed on all VF results for analysis of changes in VF before and after surgery.RESULTS: Following surgery, the MS values of the three groups of G&C increased significantly, while the AGIS scores decreased statistically in all groups. The DMS values for the three zones in moderate and severe stage but not mild stage were statistically different between zones. The DMS value was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.05). The DMS was significantly higher in zone I than that in zone III in moderate stage patients(zone I>zone II>zone III;P<0.01), while the DMS values in the severe stage patients was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.01). CONCLUSION: The mean VF sensitivity of glaucoma patients increased significantly after cataract removal and IOL implantation. Variations in the severity and distribution of characteristics of VF defects result in differences in postoperative VF improvements after cataract surgery. The magnitude of increase in VF sensitivity is associated with VF defect characteristic in glaucoma.

A Clinical Analysis of 120 Cases with Traumatic Cataract Treated by Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation

Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.

AN EXPERIMENTAL STUDY OF THE TUMOUR NECROSIS FACTOR LEVELSIN AQUEOUS HUMOR AFTER TRAUMATIC CATARACT AND INTRAOCULAR LENS IMPLANTATION

Purpose. This paper studies the tumour necrosis factor (TNF) levels in aqueous humor after traumatic cataract extraction and posterior chamber (PC) intraocular lens (IOL) implantation in rabbits,and discusses the effect of TNF on postoperative anterior ocular inflammation. Methods. Twenty seven pigmented rabbits were divided into three groups: for the first group, the IOL were placed in the capsular bag after traumatic cataract extraction; for the second, the Extracapsular cataract extraction without IOL implantation; and for the third, the control group without surgical intervention. On the 1st, 3rd, 7th and 14th day postoperatively, aqueous humor samples were obtained. A modified double antibodies indirect sandwich ELISA was used to detected for the presence of TNF. The data were studied by means of analysis of variance in SAS software. Result. The TNF level was increased in aqueous humor and reached its maximum on the 1st postoperative days after traumatic cataract extraction and PC IOLs implantation, and the TNF levels are significantly higher (P<0 05) on the 1st, 3rd, 7th and 14th day postoperatively in traumatic cataract extraction and PC IOL implanted group than that in the non surgical intervention group and extracapsular cataract extraction group. Conclusions. The increase of TNF levels had a close relationship with presence of the IOL itself which induces the secretion of TNF. This suggested that TNF as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after traumatic cataract extraction and IOL implantation.

Secondary positioning of rotationally asymmetric refractive multifocal intraocular lens in a patient with glaucoma:A case report

BACKGROUND Asymmetric multifocal intraocular lenses(IOLs)are now widely used in the modern cataract surgery,providing a good level of visual performance over a range of distances and high postoperative patient satisfaction.We report a case of improved visual quality after shifting the near segment of an asymmetrical multifocal IOL to the superotemporal placement in the dominant eye of a glaucoma patient.CASE SUMMARY A 72-year-old woman with bilateral glaucoma underwent phacoemulsification in the dominant eye(left eye)with implantation of an asymmetrical multifocal IOL.Postoperative uncorrected distance visual acuity(UDVA)was 0.0 logMAR(20/20 Snellen)and uncorrected near visual acuity(UNVA)was 0.1 logMAR(20/25 Snellen).Two weeks later,the patient presented to our clinic with decreased vision due to migration of lens epithelial cells to IOL anterior surface and edema of corneal endothelial cells.Anterior capsule polishing and superotemporal placement of near segment[+3.00 diopter(D)addition(add)]of IOL were performed.As a result,UDVA at the first week and first year after reposition was 0.0 logMAR(20/20 Snellen),and compared with 0.3 logMAR(20/40 Snellen)in the first week,the UNVA was improved to 0.0 logMAR(20/20 Snellen)one year after surgery.CONCLUSION The postoperative inflammatory reaction and lens epithelial cells proliferation were obvious in this glaucoma patient.Capsule polishing and rotation of the lens were beneficial to the patient,which not only enhanced the patient's vision,but also improved the patient's satisfaction.Therefore,glaucoma patients need to be cautious of implanting multifocal IOLs.Placement of a near segment of an asymmetrical multifocal IOL in the dominant eye should be performed on an individual basis.

Clinical study of customized aspherical intraocular lens implants

AIM:To compare if there is an improvement in visual functions with age-related cataracts between patients receiving a aspherical intraocular lens(IOL) based on corneal wavefront aberration and patients randomly assigned lenses.METHODS:A total of 124 eyes of 124 patients with age-related cataracts were placed in experimental group and a group receiving randomly assigned(RA) lenses.The experimental group was undergone Pentacam corneal spherical aberration measurement before surgery; the targeted range for residual total spherical aberration after surgery was set to 0-0.3 μm. Patients with a corneal spherical aberration 【0.3 μm were implanted with a zero-spherical aberration advanced optics(AO) aspherical IOL and patients with an aberration ≥0.3 μm received a Tecnis Z9003 aspherical lens in experimental group. RA patients were randomly implanted with an AO lens or a Tecnis Z9003 lens. Three months after surgery total spherical aberration, photopic/mesopic contrast sensitivities, photopic/mesopic with glare contrast sensitivities, and logMAR vision were measured.RESULTS:Statistical analysis on logMAR vision showed no significant difference between two groups(P =0.413). The post-surgical total spherical aberration was 0.126 ±0.097 μm and 0.152 ±0.151 μm in the experimental and RA groups, respectively(P =0.12). The mesopic contrast sensitivities at spatial frequencies of 6,12 and 18 c/d in the experimental group were significantly higher than of the RA group(P =0.00; P =0.04;P =0.02). The mesopic with glare contrast sensitivity in the experimental group at a spatial frequency of 18 c/d was also significantly higher vs the RA group(P =0.01).CONCLUSION:Pre-surgical corneal spherical aberration measurement in cataract patients followed bycustomized selection of aspherical IOL implants improved mesopic contrast sensitivities at high spatial frequencies, and thus is a superior strategy compared to the random selection of aspherical intraocular lens implants.

Secondary glaucoma after pediatric cataract surgery

AIM: To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery.METHODS: Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011. The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular pressure (IOP) ≥26mmHg, as measured on at least two occasions along with corneal or optic nerve changes.RESULTS: The mean follow-up periods of group 1 and 2 were (60.86 ±30.95) months (12-123 months) and (62.11±31.29) months (14-115 months) respectively. In group 1, 12 eyes of 8 patients (4.8% ) developed glaucoma. None of the patients developed glaucoma after surgery in group 2. The mean age of the patients at the cataract surgery was (2.58±0.90) months (1 month-4 months) and the average period for glaucoma development after surgery was (9.50 ±4.33) months (4-16 months) in group 1. Three of the 12 glaucomatous eyes were controlled with antiglaucomatous medication and 9 eyes underwent trabeculectomy+mitomycinC surgery.Onepatientunderwent a second trabeculectomy+mitomycin C operation for both of his eyes.CONCLUSION:The incidence of glaucoma after pediatric cataract surgery is very low in patients in whom IOL is implanted. The aphakic eyes after pediatric cataract surgery are at an increased risk for glaucoma development particularly if they underwent surgery before 4 months of age.

Evaluation of the Consistency of Total Spherical Aberration before and after Aspherical Intraocular Lens Implantation

Purpose:.To analyze the consistency between preoperatively estimated and postoperatively measured total spherical aberration and to evaluate the feasibility of personalized selection of an aspherical intraocular lens(IOL) based on the corneal spherical aberration measured by the Scheimpflug photography system(Pentacam).Methods:.A total of 47 patients.(82 eyes).with age-related cataract received a comprehensive ophthalmologic examination..Corneal spherical aberration was measured by using the Scheimpflug photography system. Patients with corneal spherical aberration ≤0.3 μm were implanted with a zero-spherical aberration advanced optics(AO) aspherical intraocular lens and those with corneal spherical aberration >0.3 μm received a Tecnis ZA9003 aspherical lens(-0.27 μm spherical aberration). Preoperative total remnant spherical aberration was estimated and actual total spherical aberration was measured 3months postoperatively. The consistency between preoperative and postoperative spherical aberration was analyzed by t-test,correlation analysis, and Blant-Altman plots.Results: The estimated and measured values of total spherical aberration were(0.189±0.151) μm and(0.141±0.131) μm,with a statistical difference(t=5.347,P<0.01). For 45 eyes implanted with AO lenses, preoperatively estimated and postoperatively measured total spherical aberration were(0.268±0.137) μm and(0.214 ±0.103) μm. For 37 eyes implanted with Tecnis ZA9003, preoperative estimate of total spherical aberration was(0.092±0.103) μm and postoperative measured value was(0.054±0.106) μm. Statistical significance was noted, as was a positive linear correlation between preoperative and postoperative values(γ=0.846,P<0.01). Bland-Altman analysis showed high consistency between the estimated and measured spherical aberration.Conclusion: The estimated total spherical aberration measured preoperatively differed from the value measured postoperatively, but the two values showed good agreement. It is clinically feasible to conduct personalized selection of asphericalIOL based on Scheimpflug photography system(Pentacam) to measure corneal spherical aberration.

The Relation of the Location of Haptics of Posterior Chamber Intraocular Lenses and Peripheral Anterior Synechia

Purpose:To investigate the occurrence,outcome and influencial factors of the pe-ripheral anterior synechia(PAS)following implantation of posterior chamber in-traocular lenses for finding a way to reduce thePAS.Subjects;40 eyes of 38senile cataract patients with normal chamber angle and in-traocular pressue(IOP)preoperatively were examined.Methods:Extracapsular cataract extraction was performed under microscope with insertion of a posterior chamber lens implant vaulted anteriorly by 10°.Go-nioscopy and slit-lamp examination and photography of the operated eyes were performed 3to 6months postoperatively.Results:PAS were found in 20(50%)of the 40eyes.Among the 20eyes with PAS the locations of 23haptics in17eyes corresponded with those of the PAS.PAS were seen more frequently with vertically sulcus-fixated haptics than with the horizontally capsular-fixated haptics.showing a significant difference(P<0.05).88%of the eyes withPAS had pupillary edformation,but their visual acuities and IOP were not affected.Conclusions:PAS is more likely to occur with vertically sulcus-fixated IOL.Rotat-ing the capsular-fixated haptics to the horizontal position may reduce the inci-dence of PAS.Gonioscopy should be a routine follow-up examination.

Acute lens-induced glaucomas: A review

Lens-induced factors are important and common mechanisms causing acute elevation of intraocular pressure. While in most cases, the diagnosis and management are straight-forward, in others it is difficult and can lead to improper procedures, complications and poor visual outcomes. This review was done with the aim of studying the various types of lens-induced glaucomas, classifying them in an easy way to understand manner, their clinical features, current management and future possibilities.

PEI联合术中房角镜下房角分离及房角切开术治疗中晚期PACG合并白内障

目的:评价超声乳化白内障吸除人工晶状体植入术(PEI)联合术中房角镜直视下房角分离术(GSL)及房角切开术(GT)治疗中晚期原发性闭角型青光眼(PACG)合并白内障的效果。方法:回顾性病例系列研究方法。收集2021-12-01/2023-03-31在安徽医科大学第二附属医院手术的中晚期PACG合并白内障患者62例65眼,根据手术方式不同分为两组:观察组30例32眼行PEI+GSL+GT,对照组32例33眼行PEI+GSL。评估两组患者术前,术后1 d, 1 wk, 1、3、6 mo眼压、最佳矫正视力(BCVA)和抗青光眼药物使用数量。术前和术后6 mo时分别评估视野、杯盘比、前房角开放范围、前房深度、RNFL平均厚度。结果:PEI+GSL+GT组术后6 mo眼压和平均眼压降幅(16.68±2.65、11.12±8.53 mmHg)与PEI+GSL组(18.71±2.51、8.32±4.17 mmHg)有显著差异(P<0.05),眼压降幅率无差异(44.57%±21.79%和35.20%±17.94%,P>0.05)。术后6 mo两组抗青光眼药物使用数量、BCVA、前房深度、房角关闭范围均较术前改善(均P<0.01),PEI+GSL+GT组术后6 mo的药物减少数量和房角开放范围均大于PEI+GSL组(P<0.05),其余指标两组间比较均无差异(均P>0.05)。两组术后6 mo的视野平均偏差、杯盘比及RNFL平均厚度较术前均无差异(均P>0.05)。PEI+GSL+GT组手术完全成功率为81%(26/32),手术条件成功率为94%(30/32);PEI+GSL组手术完全成功率为58%(19/33),手术条件成功率为76%(25/33)。两组间手术成功率均有差异(完全成功率χ^(2)=4.275,P=0.039;条件成功率χ^(2)=4.040,P=0.044)。两组患者均未见危及视力的并发症及再次手术。结论:对于中晚期原发性闭角型青光眼合并白内障患者,采用PEI+GSL+GT治疗比PEI+GSL治疗更有效。

原发性闭角型青光眼合并白内障术后视觉质量变化及影响因素

近年来,白内障超声乳化吸除加人工晶状体植入联合房角分离手术逐渐成为治疗原发性闭角型青光眼合并白内障的主要有效手段,然而随着医疗技术不断进步,术后眼压的控制不再是唯一的追求,患者对术后的视觉质量期望越来越高。为了使患者术后拥有更好的屈光状态和更高的视觉质量,需减少因原发性闭角型青光眼所带来的负面影响,个性化选择不同人工晶状体或计算公式等。视觉质量评价指标包括视力、对比敏感度、高阶像差、主观感受等。因此,本文就原发性闭角型青光眼合并白内障患者行白内障超声乳化吸除加人工晶状体植入联合房角分离手术术后屈光漂移、高阶像差、对比敏感度变化及其影响因素以及人工晶状体的选择做出综述。

房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效分析

目的:探讨房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效。方法:选取2022年1月至2023年1月间于北京康复医院就诊的198例白内障合并闭角型青光眼患者,根据治疗方法的不同将其分为对照组和观察组,每组99例。对照组行白内障超声乳化人工晶状体植入术联合小梁切除术;观察组行超声乳化人工晶状体植入术联合房角分离术。比较两组手术前后的临床相关指标与角膜内皮完整性、手术后3个月临床疗效,以及并发症发生情况。结果:观察组术后3个月临床疗效总有效率为95.96%,较对照组更佳,差异有统计学意义(x^(2)=4.352,P<0.05)。两组治疗后3个月视力水平均有所提高,但组间比较差异无统计学意义(P>0.05);前房深度和前房角度均有所增大,且观察组更大;眼压均有所降低,且观察组低于对照组,差异有统计学意义(t=7.654,P<0.05)。两组治疗后3个月角膜内皮细胞密度均有所减小,而观察组明显大于对照组;角膜内皮细胞平均面积与角膜中心厚度均有所增大,而观察组明显小于对照组,差异有统计学意义(t=25.233、16.608、6.698,P<0.05)。手术治疗后观察组并发症总检率为8.08%,低于对照组的19.19%,差异有统计学意义(x^(2)=5.189,P<0.05)。结论:白内障合并闭角型青光眼患者实施房角分离手术联合超声乳化人工晶体植入术疗效确切,可有效提高患者视力水平,同时也改善了前房深度、前房角度和眼压,更利于维持患者角膜内皮细胞的完整性,且安全性较好。

原发性急性闭角型青光眼合并白内障患者双眼联合植入单焦点和多焦点人工晶体的视觉质量

目的观察原发性急性闭角型青光眼(acute primary angle closure glaucoma,APACG)合并白内障患者在行白内障超声乳化后双眼分别植入单焦点人工晶体(single focus intraocular lens,SIOL)和多焦点人工晶体(multifocal intraocular lens,MIOL)后的视觉质量。方法选取28例(56眼)双眼APACG合并白内障患者的临床资料进行回顾性分析。28例(56眼)APACG合并白内障患者,发作眼诊断为APACG急性发作期或慢性期合并白内障,行PEI+GSL,植入SIOL,对侧眼诊断为APACG临床前期合并白内障,行PEI,植入MIOL。记录术后3个月裸眼远视力(uncorrected distant visual acuity,UDVA)、裸眼中视力(uncorrected intermediate visual acuity,UIVA)、裸眼近视力(uncorrected near visual acuity,UNVA)、眼压、离焦曲线、对比敏感度(contrast sensitivity,CS)、国际标准化视觉质量问卷(the quality of vision questionnaire,QoV)评分和脱镜率。结果术后3个月,APACG合并白皮障患者发作眼视力UDVA为(0.48±0.33),对侧眼UDVA为(0.12±0.11),较术前均有明显提高(P均<0.01);术后对侧眼及双眼的UDVA、UIVA、UNVA均优于发作眼(P均<0.05);发作眼术后眼压较术前明显下降(P<0.001)。术后APACG合并白内障患者对侧眼、双眼的离焦曲线呈双峰型,在任意距离,双眼的离焦曲线均在对侧眼之上。明视和暗视条件下,对侧眼及双眼在3 c/d、6 c/d、12 c/d、18 c/d各空间频率处的CS均高于发作眼(P均<0.05);明视条件下12 c/d、18 c/d空间频率处双眼的CS高于对侧眼,暗视条件下6 c/d、12 c/d、18 c/d空间频率处双眼的CS高于对侧眼(P均<0.05)。28.57%(8/28)的患者主诉术后有明显眩光和严重聚焦困难,92.86%(26/28)的患者术后不需要佩戴眼镜。结论APACG合并白内障患者行白内障超声乳化联合眼内分别植入SIOL和MIOL,可以在降低眼压的同时,为患者提供更好的全程视力,提高术后脱镜率。

两种术式联合治疗白内障合并青光眼的疗效分析

目的探究白内障合并青光眼运用两种术式的有效性。方法选取聊城市第三人民医院于2021年2月—2023年2月收治的100例白内障合并青光眼患者为研究对象,利用随机数表法分为参照组(50例,白内障超声乳化人工晶体植入手术治疗)和研究组(50例,改良小切口非超声乳化白内障摘除人工晶状体植入与小梁切除术联合治疗),比较两组患者的眼压、视力水平及前房深度。结果术后,研究组的眼压小于参照组,视力水平优于参照组,前房深度大于参照组,差异有统计学意义(P均<0.05)。研究组术后并发症总发生率(4.00%)低于参照组(16.00%),差异有统计学意义(χ^(2)=4.000,P=0.045)。结论白内障合并青光眼运用改良小切口非超声乳化白内障摘除人工晶状体植入与小梁切除术联合治疗的效果突出,可以更好地降低术后的眼压,提高视力水平和前房深度,降低并发症发生率。

白内障超声乳化+人工晶体植入术联合小梁切除术治疗原发性闭角型青光眼合并白内障的临床效果分析

目的探讨白内障超声乳化(Phacoemulsification of Cataract,BCI)、人工晶体植入术(Implantable Collamer Lens,ICL)联合小梁切除术治疗原发性闭角型青光眼合并白内障的效果。方法选取2019年1月—2023年10月南京市六合区人民医院诊治的76例原发性闭角型青光眼合并白内障患者为研究对象,按随机数表法分为对照组和观察组,各38例。对照组行小梁切除术治疗,观察组联合BCI及ICL治疗,对比两组手术治疗效果。结果观察组治疗总有效率高于对照组(94.74%vs 76.32%),差异有统计学意义(χ^(2)=5.208,P<0.05)。与对照组比,观察组术后视力更优,前房深度、前房角度更大,眼压更低,差异有统计学意义(P均<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论原发性闭角型青光眼合并白内障采取小梁切除术联合BCI+ICL的疗效可靠,安全性较高。

白内障超声乳化吸除、人工晶状体植入联合房角分离术治疗白内障合并闭角型青光眼的临床效果分析

目的:分析超声乳化内障吸除术(Phaco)、人工晶状体植入(ICL)联合房角分离术治疗白内障合并闭角型青光眼(ACG)的临床效果。方法:选取2020年10月-2022年10月兖州区人民医院收治的60例白内障合并ACG患者作为研究对象,采用随机数字表法分为参照组和研究组,各30例。参照组进行Phaco联合ICL治疗,研究组在参照组基础上联合房角分离术治疗。比较两组眼压、矫正视力、生活质量和并发症发生情况。结果:术后6个月,两组眼压低于术前,且研究组低于参照组,两组矫正视力高于术前,且研究组高于参照组(P<0.05)。术后6个月,两组视功能指数量表评分均较术前高,且研究组高于参照组(P<0.05)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论:Phaco、ICL联合房角分离术治疗白内障合并ACG的临床效果较好,能够控制眼压,改善患者视力,提高其生活质量,且术后并发症较少。

超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼患者的效果

目的:观察超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼患者的效果。方法:选取2021年9月至2023年9月黔东南五州眼科医院收治的100例白内障合并急性原发性闭角型青光眼患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。观察组采用超声乳化吸除联合房角分离术治疗,对照组采用超声乳化吸除联合小梁切除术治疗,两组术后均随访3个月。比较两组临床疗效,手术前后眼压水平、矫正视力水平、眼科指标(中央前房深度、小梁虹膜角、小梁睫状体距离)水平、术后不同时间(术后1周和术后1、3个月)角膜内皮细胞丢失率,以及并发症发生率。结果:观察组治疗总有效率为96.00%(48/50),高于对照组的78.00%(39/50),差异有统计学意义(P<0.05);术后,观察组眼压水平低于对照组,矫正视力水平高于对照组,差异均有统计学意义(P<0.05);术后,观察组中央前房深度、小梁虹膜角、小梁睫状体距离均大于对照组,差异有统计学意义(P<0.05);术后1周和术后1、3个月,观察组角膜内皮细胞丢失率均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.00%(3/50),低于对照组的22.00%(11/50),差异有统计学意义(P<0.05)。结论:超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼患者可提高治疗总有效率、矫正视力水平和眼科指标水平,降低眼压水平、角膜内皮细胞丢失率和并发症发生率,效果优于超声乳化吸除联合小梁切除术治疗。

白内障超声乳化吸除术、人工晶状体植入术联合房角分离术治疗急性闭角型青光眼合并白内障的效果分析

目的:分析白内障超声乳化吸除术(Phaco)、人工晶状体植入术(IOL)联合房角分离术(GSL)治疗急性闭角型青光眼合并白内障的效果。方法:选取2019年11月—2022年10月广西南宁市第二人民医院收治的急性闭角型青光眼合并白内障患者80例(80眼)作为研究对象,随机分为研究组与对照组,各40例(40眼)。对照组采用白内障Phaco联合IOL治疗,研究组在对照组基础上实施GSL治疗。比较两组视力、眼压、前房深度、房角粘连情况。结果:术后7 d、术后1个月、术后3个月,两组视力优于术前,差异有统计学意义(P<0.05)。术后1、3个月,两组眼压低于术前,差异有统计学意义(P<0.05);术后3个月,研究组眼压低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率低于对照组,差异有统计学意义(P=0.025)。术后3个月,两组前房深度大于术前,且研究组大于对照组,两组房角粘连<90°占比高于术前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:白内障Phaco、IOL联合GSL治疗急性闭角型青光眼合并白内障的效果显著,可改善患者视力,降低眼压,且安全性较高。

超声乳化、人工晶体植入联合房角分离术治疗原发性急性闭角型青光眼合并白内障患者的效果

目的:观察超声乳化、人工晶体植入联合房角分离术治疗原发性急性闭角型青光眼(APACG)合并白内障患者的效果。方法:回顾性分析2019年1月至2022年2月该院收治的102例APACG合并白内障患者的临床资料,按照手术方法不同将其分为观察组和对照组各51例。观察组实施超声乳化、人工晶体植入联合房角分离术治疗,对照组实施超声乳化、人工晶体植入联合小梁切除术治疗,两组术后均随访3个月。比较两组临床疗效,手术前后眼压水平、最佳矫正视力(BCVA)水平、眼功能指标(前房深度、小梁虹膜角、视野缺损值)水平,以及并发症发生率。结果:观察组治疗总有效率为98.04%(50/51),高于对照组的84.31%(43/51),差异有统计学意义(P<0.05);术后3个月,观察组眼压水平小于对照组,BCVA水平高于对照组,差异均有统计学意义(P<0.05);术后3个月,观察组前房深度、小梁虹膜角大于对照组,视野缺损值低于对照组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:超声乳化、人工晶体植入联合房角分离术治疗APACG合并白内障患者可提高治疗总有效率和BCVA水平,降低眼压水平,改善眼功能指标水平,效果优于超声乳化、人工晶体植入联合小梁切除术治疗。

小切口囊外摘除术与超声乳化术分别联合人工晶状体植入术治疗白内障患者的效果比较

目的:比较小切口囊外摘除术与超声乳化术分别联合人工晶状体植入术治疗白内障患者的效果。方法:选取2020年1月至2022年12月该院收治的70例白内障患者进行前瞻性研究,按照随机数字表法分为研究组与对照组各35例。对照组采取超声乳化术联合人工晶状体植入术治疗,研究组采取小切口囊外摘除术联合人工晶状体植入术治疗,比较两组手术前后视力水平、角膜内皮细胞密度、六角形细胞占比和并发症发生率。结果:术后1 d、3 d、7 d、1个月,研究组视力水平高于对照组,差异均有统计学意义(P<0.05);术后3个月,两组角膜内皮细胞密度、六角形细胞占比均低于术前,但研究组高于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为8.57%,低于对照组的28.57%,差异有统计学意义(P<0.05)。结论:小切口囊外摘除术联合人工晶状体植入术治疗白内障患者可提高其术后视力水平和角膜内皮细胞密度、六角形细胞占比,降低其并发症发生率,效果优于超声乳化术联合人工晶状体植入术治疗。