Effect of sequential nursing care combined with communication intervention on visual recovery and pain after cataract ultrasound emulsification

BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsi-fication.METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery.They were randomly assigned to an experimental group or a control group.The experimental group received procedural nursing combined with Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication intervention,whereas the control group received conventional nursing.The effectiveness of the nursing model was assessed by comparing differences in vision recovery,pain scores,and mental health status between the two groups.RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group(P<0.05).CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.

Effect of capsule treatment on visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataract

BACKGROUND Cataracts pose a significant clinical burden due to their complex pathogenesis.In recent years,an increase in cataracts coexisting with myopia has heightened the incidence of retinopathy and posterior vitreous detachment.Additionally,symptoms of ocular axis elongation,lens nucleus hardening,and vitreous liquefaction have become more prevalent.While conventional extracapsular cataract extraction is commonly employed,it often yields suboptimal visual outcomes.Subsequent advancements in cataract phacoemulsification and lens implantation surgeries have gained widespread acceptance for their ability to improve refraction and significantly improve uncorrected visual acuity.AIM To investigate the effect of capsular treatment after phacoemulsification lens implantation in myopic patients with cataract.METHODS We selected 110 patients(with 134 eyes)with myopia and cataracts treated.These patients were categorized into two groups:an observation group(57 patients with 70 eyes)and a control group(53 patients with 64 eyes).The control group underwent cataract phacoemulsification and lens implantation,while the observation group received a refined capsular treatment based on the control group’s procedure.We assessed the differences in visual acuity and quality between the two groups before and after surgery.RESULTS At six months post-operation,the observation group exhibited significantly improved far vision,intermediate vision,near vision,lower objective scattering index,higher Modulation transfer function cut-off frequency,and overall vision metrics at different contrast levels(100%,20%and 9%)compared to the control group(P<0.05).The total score of the National Eye Institute Visual Function Questionnaire in the observation group at 6 months after operation was significantly higher than that in the control group(P<0.05).No significant difference in the incidence of adverse reactions was observed between the observation group and control group(P>0.05).CONCLUSION Capsular treatment demonstrates efficacy in improving visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataracts,warranting its clinical application.

Clinical Observation of Recombinant Bovine Basic Fibroblast Growth Factor Eye Gel Combined with Tobramycin Dexamethasone Eye Drops in the Treatment of Dry Eye Syndrome in Patients after Cataract Surgery

Objective:To evaluate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rbFGF)eye gel combined with tobramycin-dexamethasone(TOB-Dex)eye drops on dry eye syndrome(DES)after cataract surgery.Methods:86 patients with DES after cataract surgery,admitted from November 2021 to November 2023,were randomly divided into groups.The observation group included 43 patients treated with rbFGF eye gel combined with TOB-Dex eye drops.The reference group included 43 patients treated with TOB-Dex eye drops alone.Multiple indicators,including total effective rate and clinical symptom scores,were compared between the two groups.Results:The total effective rate in the observation group was higher than in the reference group(P<0.05).Before treatment,there were no differences in clinical symptom scores,serum factors,or disease severity scores between the two groups(P>0.05).Three weeks after treatment,the observation group had lower clinical symptom scores,serum factors,and disease severity scores compared to the reference group(P<0.05).The adverse reaction rate in the observation group was lower than in the reference group(P<0.05).Conclusion:rbFGF eye gel combined with TOB-Dex eye drops can improve the clinical efficacy for patients with DES after cataract surgery,alleviate disease symptoms,reduce inflammatory responses,and have fewer adverse reactions.

Corneal astigmatic outcomes after femtosecond laser-assisted cataract surgery combined with surface penetrating arcuate keratotomies

AIM:To evaluate corneal astigmatic outcomes of femtosecond laser-assisted arcuate keratotomies(FAKs)combined with femtosecond-laser assisted cataract surgery(FLACS)over 12mo follow-up.METHODS:Totally 145 patients with bilateral cataracts and no ocular co-morbidities were recruited to a singlecentre,single-masked,prospective randomized controlled trial(RCT)comparing two monofocal hydrophobic acrylic intraocular lenses.Eyes with corneal astigmatism(CA)of>0.8 dioptres(D)received unpaired,unopened,surface penetrating FAKs at the time of FLACS.Visual acuity,subjective refraction and Scheimpflug tomography were recorded at 1,6,and 12mo.Alpins vectoral analyses were performed.RESULTS:Fifty-one patients(61 eyes),mean age 68.2±9.6y[standard deviation(SD)],received FAKs.Sixty eyes were available for analysis,except at 12mo when 59 attended.There were no complications due to FAKs.Mean pre-operative CA was 1.13±0.20 D.There was a reduction of astigmatism at all post-operative visits(residual CA 1mo:0.85±0.42 D,P=0.0001;6mo:0.86±0.35 D,P=0001;and 12mo:0.90±0.39,P=0.0001).Alpins indices remained stable over 12mo.Overall,the cohort was under-corrected at all time points.At 12mo,61%of eyes were within±15 degrees of pre-operative astigmatic meridian.CONCLUSION:Unpaired unopened penetrating FAKs combined with on-axis phacoemulsification are safe but minimally effective.CA is largely under-corrected in this cohort using an existing unmodified nomogram.The effect of arcuate keratotomies on CA remained stable over 12mo.

Factors influencing stereoacuity levels after surgery to correct unilateral developmental cataracts in children

·AIM: To evaluate factors influencing stereoacuity after surgery to correct unilateral developmental pediatric cataracts. ·METHODS: We retrospectively surveyed 110 patients who had undergone removal of unilateral acquired developmental cataracts and primary posterior chamber intraocular lens implantation between February 1992 and December 2009. In all patients, stereoacuity was assessed using the Titmus test at the last follow -up period of minimum 2 years after surgery. Patients were divided into two groups according to the extent of stereoacuity : group 1 ( = 42 ) had stereoacuity values ≤ 100sec/arc and group 2 ( =68) values 】100sec/arc. The values of ten parameters associated with stereoacuity were measured in each group: Cataract types, preoperative best corrected visual acuity (BCVA) of the affected eyes, preoperative inter -ocular difference of BCVA, age at cataract surgery, operative method, secondary cataract, postoperative strabismus, postoperative BCVA of the affected eyes, postoperative inter-ocular difference of BCVA, and anisometropia. ·RESULTS: The extent of stereoacuity was significantly associated with both operative method and secondary cataract ( =0.000 and =0.016, respectively). All patients in whom the posterior capsule was preserved, had poor stereoacuity 】100sec/arc. Significant correlations with the extent of stereoacuity were found with postoperative strabismus ( =0.048),postoperative BCVA of the affected eyes ( =0.002), anisometropia ( =0.034). ·CONCLUSION: Postoperative stereoacuity was better in patients who underwent either optic capture or anterior vitrectomy after posterior continuous curvilinear capsulorhexis, and who didn’t develop secondary cataracts or strabismus postoperatively. Furthermore, postoperative BCVA of the affected eyes, and anisometropia influenced the stereoacuity of the patients surgically treated for unilateral developmental pediatric cataracts. ·

Changes of lactate dehydrogenase in corneal edema after cataract surgery treated with trans-corneal oxygenation therapy

AIM:To investigate the changes in levels of the lactate dehydrogenase(LDH)enzyme in corneal edema after cataract surgery with trans-corneal oxygenation therapy.METHODS:This pre-post design study design conducted on 15 patients with corneal edema after cataract surgery and receiving trans-corneal oxygenation therapy.Tear sample(using Schirmer paper,from the inferior fornix of the conjunctiva)was carried out prior to trans-corneal oxygenation therapy,on the day 2(D2)and day 5(D5)postoperatively before and after trans-corneal oxygenation therapy.Visual acuity[VA(Log MAR)],corneal endothelial density,central corneal thickness(CCT),and coefficient of variation corneal endothelial(Co V)were recorded.The value of LDH was measured using ELISA.The difference in mean LDH value before and after trans-corneal oxygenation therapy,between two groups were analyzed using Wilcoxon signed rank test.RESULTS:There was a decrease in LDH tear concentration at D2(pre vs post:1127.54±497.09 vs 696.91±489.49;P=0.002)and D5(pre vs post:1064.17±677.77 vs 780.28±428.95;P=0.027)after trans-corneal oxygenation therapy as well as decrease in LDH concentration on the D2 compared to D5(P=0.041).The mean CCT was decreased significantly after the administration of trans-corneal oxygenation(pre vs post:632.10±25.66 vs 563.90±51.54;P=0.005).The mean VA and Co V increased significantly after the administration of trans-corneal oxygenation(P=0.001 and P=0.028,respectively).However,there was no difference in mean of corneal endothelial density(P=0.814).CONCLUSION:Trans-corneal oxygenation therapy is associated with significant decrease of tears LDH levels in post cataract surgery with corneal edema.It is accompanied by clinical improvement such as significant reduction of CCT.

Analysis of proteomic differences between liquefied aftercataracts and normal lenses using two-dimensional gel electrophoresis and mass spectrometry

AIM：To analyze and identify the proteomic differences between liquefied after-cataracts and normal lenses by means of liquefied chromatography-tandem mass spectrometry（LC-MS/MS）.METHODS：Three normal lenses and three liquefied after-cataracts were exposed to depolymerizing reagents to extract the total proteins.Protein concentrations were separated using two-dimensional gel electrophoresis（2-DE）.The digitized images obtained with a GS-800 scanner were then analyzed with PDQuest7.0 software to detect the differentially-expressed protein spots.These protein spots were cut from the gel using a proteome work spot cutter and subjected to in-gel digestion with trypsin.The digested peptide separation was conducted by LC-MS/MS.RESULTS：The 2-DE maps showed that lens proteins were in a p H range of 3-10 with a relative molecular weight of21-70 kD.The relative molecular weight of the more abundant proteins was localized at 25-50 kD,and the isoelectric points were found to lie between PI 4-9.The maps also showed that the protein level within the liquefied after-cataracts was at 29 points and significantly lower than in normal lenses.The 29 points were identified by LC-MS/MS,and ten of these proteins were identified by mass spectrometry and database queries：beta-crystallin B1,glyceraldehyde-3-phosphate dehydrogenase,carbonyl reductase（NADPH）1,c DNA FLJ55253,gamma-crystallin D,GAS2-like protein 3,sorbitol dehydrogenase,DNA FLJ60282,phosphoglycerate kinase,and filensin.CONCLUSION：The level of the ten proteins may play an important role in the development of liquefied aftercataracts.

Severe prelenticular membrane formation on the surface of a hydrophilic acrylic intraocular lens after cataract surgery in an eye with an Ahmed valve implant

【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the

Macular edema after cataract surgery in diabetic eyes evaluated by optical coherence tomography

AIM：To assess quantitative changes of the macula in diabetic eyes after cataract surgery using optical coherence tomography（OCT）and to estimate the incidence of development or worsening of macular edema（ME）in diabetic eyes with or without pre-existing ME.·METHODS：In this prospective,observational study,92eyes of 60 diabetic patients who underwent cataract surgery were evaluated before surgery and 1,3mo after surgery using OCT.Macular thickness was measured with OCT at nine macular subfields defined by the 9zones early treatment of diabetic retinopathy study（ETDRS）,as well as total macular volume obtained by OCT at 1,3mo after surgery were compared with baseline features obtained before surgery.In addition,the incidence of development or worsening of ME was analyzed in diabetic eyes with or without pre-existing ME.·R ESULTS：The central subfield mean thickness increased 21.0μm and 25.5μm at 1,3mo follow-up,respectively（〈0.01）.The average thickness of inner ring and outer ring increased 14.2μm and 9.5μm at 1mo,18.2μm and 12.9μm at 3mo.Central-involved ME developed in 12 eyes at 3mo,including 4 eyes with preexisting central-involved and 8 eyes with pre-existing non-central involved ME.Pre-existing diabetic macular edema（DME）was significantly associated with centralinvolved ME development（〈0.001）.·C ONCLUSION：A statistically significant increase could be detected in the central subfield as well as perifoveal and parafoveal sectors though the increase was mild.And eyes with pre-operative DME prior to cataract surgery are at higher risk for developing central-involved ME.

High order aberration and straylight evaluation after cataract surgery with implantation of an aspheric,aberration correcting monofocal intraocular lens

·AIM: To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting,monofocal intraocular lens(IOL).·METHODS: Twenty-one patients(34 eyes) aged 50 to83 y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL(Tecnis ZCB00,Abbott Medical Optics). Three months after surgery they were examined for uncorrected(UDVA) and corrected distance visual acuity(CDVA), contrast sensitivity(CS)under photopic and mesopic conditions with and without glare source, ocular high order aberrations(HOA, Zywave II) and retinal straylight(C-Quant).· RESULTS: Postoperatively, patients achieved a postoperative CDVA of 0.0 log MAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27(primary coma components) and-0.04 ±0.16(spherical aberration term). Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed(P ≥0.28).· CONCLUSION: The implantation of an aspherical aberration correcting monofocal IOL after cataractsurgery resulted in very low residual higher order aberration(HOA) and normal straylight.

Risk factors for endophthalmitis after cataract surgery in diabetic patients: a case control study

AIM: To identify risk factors associated with post-cataract surgery endophthalmitis(PCE) in type 2 diabetic patients.METHODS: A hospital-based retrospective case-control study was conducted on 194 type 2 diabetic patients undergoing cataract surgery in Rajavithi Hospital from January 2007 to December 2015. Fifteen patients with PCE were included as the case group and 179 patients without PCE were included as the control group. Potential factors associated with PCE among both groups including demographics, pre-operative characteristics, surgical settings and complications, were statistically analyzed using Chi-square testing and a logistic regression model.RESULTS: Within the case group, 53% were females and the median age was 68 y. Univariate analysis of pre-operative characteristics, surgical settings and complications revealed that recent pre-operative fasting plasma glucose, insulin therapy, presence of diabetic retinopathy, and severe non-proliferative or proliferative diabetic retinopathy were significantly associated with PCE. In a multivariate analysis adjusting for blood glucose level, insulin treatment was the only significant factor associated with an increased risk of PCE(OR 3.9, 95%CI 1.0-15.0, P=0.04) compared to patients without insulin treatment. The most common causative organisms were gram-positive bacteria(89%). Staphylococcus species represented the most common group(67%). Median best corrected visual acuity at 1-month and 3-month follow-up was equal at 0.7 logMAR(20/100).CONCLUSION: The authors identify insulin treatment as the only risk factor associated with endophthalmitis after cataract surgery in type 2 diabetic patients. Further studies with serum levels of pre-operative glycated hemoglobin(HbA_(1c)) and post-operative fasting plasma glucose level are essential to truly demonstrate the role of peri-operative glycemic markers as a risk factor for PCE.

Factors associated with strabismus after cataract extraction and primary intraocular lens implantation in congenital cataracts

AIM:To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation.METHODS:The medical records of 122 patients,aged1.5mo to 9y,who had undergone cataract extraction with primary intraocular lens implantation between January1993 and August 2011 were reviewed.Fourteen patients(17 eyes)with strabismus before cataract surgery were excluded.Patients were divided into those with congenital bilateral cataracts(64 patients,128 eyes)and those with unilateral cataracts(44 patients,44 eyes).The associations between the development of strabismus and age at cataract surgery,pre-and post-cataract extraction corrected distance visual acuity(CDVA),interocular CDVA difference,nystagmus,surgical method,and secondary cataract were evaluated.RESULTS:Factors significantly associated with the development of strabismus included age at cataract surgery(≤1y),preoperative mean CDVA≤20/100,presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference】20/70 in the unilateral group.Postoperative CDVA≤20/100 and preservation of posterior capsule,and presence of secondary cataract were significant factors in both groups.CONCLUSION:Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus,especially when they underwent surgery at age≤1y,and they have nystagmus,large postoperative interocular CDVA difference,poor preoperative and postoperative CDVA,preservation of the posterior capsule,or secondary cataract.

Incidence of endophthalmitis after phacoemulsification cataract surgery:a Meta-analysis

AIM:To evaluate the overall endophthalmitis incidence and the effectiveness of potential prophylaxis measures following phacoemulsification cataract surgery(PCS).METHODS:The Pub Med and Web of Science databases were searched from inception to April 30^(th),2021.We included studies that reported on the incidence of endophthalmitis following PCS.The quality of the included studies was critically evaluated with the Newcastle-Ottawa quality assessment scale.The random effect or the fixed-effects model was used to evaluated the pooled incidence based on the heterogeneity.The publication bias was assessed by Egger’s linear regression and Begg’s rank correlation tests.RESULTS:A total of 39 studies containing 5 878 114 eyes were included and critically appraised in the Meta-analysis.For overall incidence of endophthalmitis after PCS,the Meta-analysis yielded a pooled estimate of 0.092%(95%CI:0.083%-0.101%).The incidence appeared to decrease with time(before 2000:0.097%,95%CI:0.060%-0.135%;2000 to 2010:0.089%,95%CI:0.076%-0.101%;after 2010:0.063%,95%CI:0.050%-0.077%).Compared with typical povidone-iodine solution(0.178%,95%CI:0.071%-0.285%) and antibiotics subconjunctival injections(0.047%,95%CI:0.001%-0.095%),the use of intracameral antibiotics significantly reduced the incidence of endophthalmitis after PCS(0.045%,95%CI:0.034%-0.055%,RR:7.942,95%CI:4.510-13.985).CONCLUSION:Due to the advancement of phacoemulsification technology and the widespread use of intracameral antibiotics,the incidence of endophthalmitis following PCS shows a decreasing trend over time.The use of intracameral antibiotics administration will significantly reduce the risk of endophthalmitis.

Dynamic profile of ocular refraction in pediatric cataract patients after lens surgeries

AIM: To study the change in ocular refraction in patients with pediatric cataracts(PCs) after lens extraction. METHODS: A total of 1258 patients who were undergoing cataract extraction with/without intraocular lens(IOL)implantation were recruited during preoperative examinations between Jan 2010 and Oct 2013. Patient ages ranged from 1.5 mo to 14y. Follow-ups were conducted at1 wk, 1, and 3 mo postoperatively and every 3 mo in the first year, then 6 mo thereafter. Ocular refraction [evaluated as spherical equivalent(SE)] and yearly myopic shift(YMS)were recorded and statistically analyzed among patients with age at surgery, baseline ocular refraction, gender,postoperative time and laterality(bilateral vs unilateral). RESULTS: By Dec 31st 2015, 1172 participants had been followed for more than 2y. The median follow-up period was 3y. The critical factors affecting the ocular refraction of PC patients were baseline ocular refraction, postoperative time for both aphakic and pseudophakic eyes. YMS grew most rapidly in young childhood and early adolescence. CONCLUSION: After lens surgeries, ocular refraction in PC patients shows an individual difference of change.Further concerns should be raising to monitor the rapid myopic shift at early adolescence of these patients.

The change of anterior segment parameters after cataract surgery in normal-tension glaucoma

AIM： To investigate the change of anterior chamber angle morphology and intraocular pressure （lOP） reduction after cataract surgery in patients with normal-tension glaucoma （NTG） using swept-source optical coherence tomography （SS-OCT）. METHODS： This prospective, comparative, observational study recruited patients into two groups. Group 1 was the control group including normal subjects except those with cataracts （cataract group, n=67 eyes of 67 patients）, and group 2 was NTG group including patients who were diagnosed with NTG and cataracts （n=43 eyes of 43 patients）, which were treated with phacoemulsification and intraocular lens implantation. Before surgery, and at postoperative 1 and 6too, anterior chamber angles were evaluated by SS-OCT under dark conditions using three- dimensional angle analysis scan protocol. Angle opening distance （AOD）, angle recess area （ARA）, and trabecular- iris surface area （TISA） at four quadrants （temporal, nasal, superior, and inferior） were calculated automatically by SS-OGT, after the observer marked scleral spurs. RESULTS： A total of 106 patients （54 males and 52 females） were enrolled in the study. Angle parameters, AOD, ARA, and TISA were increased after surgery in both groups. However, changes of angle parameters were only significant in group 2. In group 2, preoperative lOP was 13.2＋2.9 mm Hg, and postoperative lOP at 1 and 6mo were 10.5＋3.0 and 10.7＋2.8 mm Hg, respectively. In group 1, preoperative lOP was 12.42.8 mm Hg, and postoperative lOP at 1 and 6mo were 11.6＋2.5 and 12.0＋2.8 mm Hg, respectively. After cataract surgery, angle parameters changed significantly while IOP significantly reduced and was maintained in group 2 （P〈0.001）. The changes in angle parameters （＆AOD500, ATISAS00 at temporal; ＆AOD500, S, RA500 at nasal） were linearly correlated with postoperative IOP changes. CONCLUSION： Cataract surgery may have improved antedor chamber angle parameters and decreased lOP in NTG patients.

Intraocular lens removal or not during vitrectomy for acute infectious endophthalmitis after cataract surgery

At present, the incidence of infectious endophthalmitis after cataract surgery has been significantly reduced, but it is still a serious complication. Removal or not of the intraocular lens(IOL) during vitrectomy in cases with a moderate or severe inflammation is controversial. In order to call upon more discussion, we publish the article entitled “Timely vitrectomy without intraocular lens removal for acute endophthalmitis after cataract surgery” written by Guo et al in this issue. With recent advanced vitrectomy techniques, and critical measures for management of risk factors related to occurrence of infection, IOL remaining during timely vitrectomy for acute endophthalmitis can possibly be safe and effective in selected cases.

Effect of 1%brinzolamide and 0.5%timolol fixed combination on intraocular pressure after cataract surgery with phacoemulsification

AIM:To evaluate the effect of brinzolamide-timolol fixed combination on intraocular pressure(IOP)after cataract surgery.METHODS:The study included 92 eyes of 87 patients who underwent cataract surgery and intraocular lens implantation.Patients scheduled for phacoemulsification were assigned to 1 of 2 groups.The treatment group received 1 drop of brinzolamide-timolol fixed combination immediately after surgery,and the control group received no treatment.The IOP was measured preoperatively and at 2h and 24h postoperatively.RESULTS:The mean IOP change was lower in the treatment group than in the control group at 2h postoperatively.The difference between the mean IOP values of the two groups at 2h postoperatively was found to be statistically significant.Twenty-four hours after the surgery,the mean IOP change was still higher in the control group when compared to the treatment group.CONCLUSION:The fixed combination brinzolamidetimolol can effectively reduce IOP after cataract surgery.

Confocal microscopic evaluation of cornea after AquaLase liquefaction cataract extraction

AIM: The most recent and innovative AquaLase liquefaction technology has offered an alternative to lens extraction. Many studies have investigated its functions and advantages. This article focuses on evaluating the vivo microscopic cornea changes after AquaLase liquefaction by using a laser confocal microscope. METHODS: In this perspective, randomized case study, 37 eyes of 35 patients submitted to cataract surgery were chosen to undergo AquaLase liquefaction cataract extraction. Each patient was assessed before the operation, on the 1(st), 7(th), and 30(th) postoperative days, and 6 months after the cataract extraction. The morphologies and quantitative comparisons of corneal cells and corneal nerves layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope. ANOVA and Post-Hoc Bonferroni test were carried out to compare the results pre- and post-operation. RESULTS: ANOVA results indicated no post-operation changes for epithelium and anterior stroma cells. Irregular segments of sub-basal nerve fiber were most pronounced seven days post-operation. In the mid and posterior stroma, keratocytes were obvious compared with the preoperative condition. Corneal endothelium cells became obviously swollen in cytoplasm and nucleus. The mid and posterior stroma cell density decreased from the 1(st) to 7(th) postoperative days (P < 0.05). The corneal endothelium cell density decreased (P < 0.05) and did not revert to the preoperative level after six months (P < 0.05). CONCLUSION: Slight microstructural abnormalities were identified in the corneal recovery process after AquaLase liquefaction. AquaLase liquefaction cataract extraction is safe for cornea.

Optimal incision sites to reduce corneal aberration variations after small incision phacoemulsification cataract surgery

AIM： To analyze the effect of steep meridian small incision phacoemulsification cataract surgery on anterior,posterior and total corneal wavefront aberration.· METHODS： Steep meridian small incision phacoemulsification cataract surgery was performed in age-related cataract patients which were divided into three groups according to the incision site： 12 o＇clock, 9o＇clock and between 9 and 12 o＇clock（BENT） incision groups. The preoperative and 3-month postoperative root mean square（RMS） values of anterior, posterior and total corneal wavefront aberration including coma,spherical aberration, and total higher-order aberrations（HOAs）, were measured by Pentacam scheimpflug imaging. The mean preoperative and postoperative corneal wavefront aberrations were documented.·RESULTS： Total corneal aberration and total lower-order aberrations decreased significantly in three groups after operation. RMS value of total HOAs decreased significantly postoperatively in the 12 o＇clock incision group（P 〈0.001）. Corneal spherical aberration was statistically significantly lower after steep meridian small incision phacoemulsification cataract surgery in BENT incision group（P 〈0.05） and Pearson correlation analysisindicated that spherical aberration changes had no significant relationship with total astigmatism changes in all three corneal incision location.·CONCLUSION： Corneal incision of phacoemulsification cataract surgery can affect corneal wavefront aberration.The 12 o＇clock corneal incision eliminated more HOAs and the spherical aberrations decreased in BENT incision group obviously when we selected steep meridian small incision. Cataract lens replacement using wavefront-corrected intraocular lens combined with optimized corneal incision site would improve ocular aberration results.

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.