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 comb...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.展开更多
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 rabb...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.展开更多
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 assign...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.展开更多
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(...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.展开更多
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.Subject...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.展开更多
AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patie...AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity (BCVA) of >= 0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (chi(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (chi(2)=4.535, P > 0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (chi(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.展开更多
Purpose:To investigate the distribution and changes in corneal four-order spherical aberration Z40 in patients with age-related cataract before and after phacoemulsification,and to direct the application of aspherical...Purpose:To investigate the distribution and changes in corneal four-order spherical aberration Z40 in patients with age-related cataract before and after phacoemulsification,and to direct the application of aspherical intraocular lens (IOL)in PHACO combined with IOL implantation.Methods:A total of 155 eyes in 93 patients with age-related cataract were included.All patients received a comprehensive ophthalmologic examination.Corneal Z40 at a pupil diameter of 6 mm was measured by using a Scheimpflug photography system (Pentacam) preoperatively and 3 months postoperatively.Results:The mean corneal Z40 before and after the PHACO at a diameter of 6 mm was(0.294 ±0.138)μm and(0.271 ± 0.130)μm,respectively,with statistical significance(P<0.05, t =4.384).There was no significant difference between male (n=45, 76 eyes) and female patients (n=48,79 eyes) regard- ing corneal Z40 (t=-0.418,P=0.676).The corneal Z40 for patients (35 eyes) aged from 50 to 59 years was (0.238±0.104) μm preoperatively;(0.308 ±0.104)μm for 60 to 69 years; (0.332±0.151)μm for 70 to 79 years; and (0.307±0.164) μm for 80 to 89 years.A significant difference in Z40 was observed among different age groups.A linear positive correlation was noted between corneal Z40 and ages (r=0.203,P<0.003). Conclusion:The corneal Z40 varied significantly among cataract patients. Patients' corneal Z40 , which should be considered when choosing aspherical IOL, increases slightly with age.Thus,customized aspheric IOLs are needed.展开更多
This review summarises the current evidence base and provides guidelines for obtaining good refractive outcomes following cataract surgery. Important background information is also provided. In summary, the requiremen...This review summarises the current evidence base and provides guidelines for obtaining good refractive outcomes following cataract surgery. Important background information is also provided. In summary, the requirements are:(1) standardisation of biometry equipment used for axial length and keratometry measurement and the use of optical or immersion ultrasound biometry;(2) sutureless cataract surgery with "in the bag" intraocular lens(IOL) placement;(3) an appropriate 3rd, 4th or 5th Generation IOL power formula should be used;(4) IOL formula constants must be optimized;(5) under certain conditions, the refractive outcome of the 2nd eye can be improved based on the refractive error of the first eye; and(6) results should be audited for refinement and to ensure that standards are met.展开更多
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity (BCVA) of >= 0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (chi(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (chi(2)=4.535, P > 0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (chi(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.
文摘Purpose:To investigate the distribution and changes in corneal four-order spherical aberration Z40 in patients with age-related cataract before and after phacoemulsification,and to direct the application of aspherical intraocular lens (IOL)in PHACO combined with IOL implantation.Methods:A total of 155 eyes in 93 patients with age-related cataract were included.All patients received a comprehensive ophthalmologic examination.Corneal Z40 at a pupil diameter of 6 mm was measured by using a Scheimpflug photography system (Pentacam) preoperatively and 3 months postoperatively.Results:The mean corneal Z40 before and after the PHACO at a diameter of 6 mm was(0.294 ±0.138)μm and(0.271 ± 0.130)μm,respectively,with statistical significance(P<0.05, t =4.384).There was no significant difference between male (n=45, 76 eyes) and female patients (n=48,79 eyes) regard- ing corneal Z40 (t=-0.418,P=0.676).The corneal Z40 for patients (35 eyes) aged from 50 to 59 years was (0.238±0.104) μm preoperatively;(0.308 ±0.104)μm for 60 to 69 years; (0.332±0.151)μm for 70 to 79 years; and (0.307±0.164) μm for 80 to 89 years.A significant difference in Z40 was observed among different age groups.A linear positive correlation was noted between corneal Z40 and ages (r=0.203,P<0.003). Conclusion:The corneal Z40 varied significantly among cataract patients. Patients' corneal Z40 , which should be considered when choosing aspherical IOL, increases slightly with age.Thus,customized aspheric IOLs are needed.
文摘This review summarises the current evidence base and provides guidelines for obtaining good refractive outcomes following cataract surgery. Important background information is also provided. In summary, the requirements are:(1) standardisation of biometry equipment used for axial length and keratometry measurement and the use of optical or immersion ultrasound biometry;(2) sutureless cataract surgery with "in the bag" intraocular lens(IOL) placement;(3) an appropriate 3rd, 4th or 5th Generation IOL power formula should be used;(4) IOL formula constants must be optimized;(5) under certain conditions, the refractive outcome of the 2nd eye can be improved based on the refractive error of the first eye; and(6) results should be audited for refinement and to ensure that standards are met.