Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected an...Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected and randomly grouped into group A(ultrasonic emulsification)and group B(small-incision extracapsular cataract extraction),with 48 cases each.Results:At 1 week,1-month,and 3 months post-operation,the visual acuity of group A was higher and the astigmatism value was lower than that of group B(P<0.05);at 12h,24h,and 48h post-operation,the intraocular pressure of group A was higher than that of group B(P<0.05);the thickness of macular area of group A was lower than that of group B at 1 week and 1-month post-operation(P<0.05).Conclusion:Ultrasonic emulsification in cataract patients was slightly better than small incision cataract extracapsular extraction in correcting astigmatism,improving visual acuity,and regulating macular thickness.However,due to the high energy of ultrasonic emulsification,the risk of complications such as high postoperative intraocular pressure was higher.Small-incision extracapsular cataract extraction has better application value in economically disadvantaged areas.展开更多
AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients w...AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically significant.RESULTSOne hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance visual acuity (CDVA) was 20/60 or better in 60 (90.9%) patients in Phaco group and 53 (88.3%) in the manual SICS group (P=0.478). The mean surgical time was significantly shorter in the manual SICS group (10.8±2.9 versus 13.2±2.6min) (P<0.001). Oral prednisolone, 1 mg/kg body weight was given 7d prior to surgery, continued post-operatively and tapered according to the inflammatory response over 4-6wk in patients with previously documented macular edema, recurrent uveitis, chronic anterior uveitis and intermediate uveitis. Rate of complications like macular edema (Chi-square, P=0.459), persistent uveitis (Chi-square, P=0.289) and posterior capsule opacification (Chi-square, P=0.474) were comparable between both the groups.CONCLUSIONManual SICS and phacoemulsification do not differ significantly in complication rates and final CDVA outcomes. However, manual SICS is significantly faster. It may be the preferred technique in settings where surgical volume is high and access to phacoemulsification is limited, such as in eye camps. It may also be the appropriate technique for uveitic cataract under such circumstances.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
Background： The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell...Background： The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts. Methods： A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty （PKP） eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density （ECD）, and best-corrected visual acuity （BCVA） were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD. Results： Of the 54 eyes included in this study, extracapsular cataract extraction （ECCE） was performed in 34 eyes of 33 patients （ECCE group） whereas phacoemulsification was performed in 20 eyes of 20 patients （phacoemulsification group）. There was no signifcant difference in the median age （P = 0.081） or preoperative ECD （P = 0.585） between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group （P = 0.043）. In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months （P = 0.018）, 4 months （P 〈 0.001）, and 6 months （P 〈 0.001） after cataract surgery. Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group （P 〈 0.001） and phacoemulsification group （P 〈 0.001）, but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts （P 〈 0.001）. There was no signifcant difference in postoperative BCVA between the two groups （P = 0.065）. Conclusion： ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.展开更多
Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral...Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.展开更多
文摘Objective:To analyze the efficacy of ultrasonic emulsification and small incision cataract extracapsular extraction in cataract patients.Methods:96 cataract patients admitted from May 2021 to May 2023 were selected and randomly grouped into group A(ultrasonic emulsification)and group B(small-incision extracapsular cataract extraction),with 48 cases each.Results:At 1 week,1-month,and 3 months post-operation,the visual acuity of group A was higher and the astigmatism value was lower than that of group B(P<0.05);at 12h,24h,and 48h post-operation,the intraocular pressure of group A was higher than that of group B(P<0.05);the thickness of macular area of group A was lower than that of group B at 1 week and 1-month post-operation(P<0.05).Conclusion:Ultrasonic emulsification in cataract patients was slightly better than small incision cataract extracapsular extraction in correcting astigmatism,improving visual acuity,and regulating macular thickness.However,due to the high energy of ultrasonic emulsification,the risk of complications such as high postoperative intraocular pressure was higher.Small-incision extracapsular cataract extraction has better application value in economically disadvantaged areas.
文摘AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically significant.RESULTSOne hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance visual acuity (CDVA) was 20/60 or better in 60 (90.9%) patients in Phaco group and 53 (88.3%) in the manual SICS group (P=0.478). The mean surgical time was significantly shorter in the manual SICS group (10.8±2.9 versus 13.2±2.6min) (P<0.001). Oral prednisolone, 1 mg/kg body weight was given 7d prior to surgery, continued post-operatively and tapered according to the inflammatory response over 4-6wk in patients with previously documented macular edema, recurrent uveitis, chronic anterior uveitis and intermediate uveitis. Rate of complications like macular edema (Chi-square, P=0.459), persistent uveitis (Chi-square, P=0.289) and posterior capsule opacification (Chi-square, P=0.474) were comparable between both the groups.CONCLUSIONManual SICS and phacoemulsification do not differ significantly in complication rates and final CDVA outcomes. However, manual SICS is significantly faster. It may be the preferred technique in settings where surgical volume is high and access to phacoemulsification is limited, such as in eye camps. It may also be the appropriate technique for uveitic cataract under such circumstances.
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Background： The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts. Methods： A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty （PKP） eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density （ECD）, and best-corrected visual acuity （BCVA） were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD. Results： Of the 54 eyes included in this study, extracapsular cataract extraction （ECCE） was performed in 34 eyes of 33 patients （ECCE group） whereas phacoemulsification was performed in 20 eyes of 20 patients （phacoemulsification group）. There was no signifcant difference in the median age （P = 0.081） or preoperative ECD （P = 0.585） between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group （P = 0.043）. In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months （P = 0.018）, 4 months （P 〈 0.001）, and 6 months （P 〈 0.001） after cataract surgery. Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group （P 〈 0.001） and phacoemulsification group （P 〈 0.001）, but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts （P 〈 0.001）. There was no signifcant difference in postoperative BCVA between the two groups （P = 0.065）. Conclusion： ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.
文摘Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.
