Clinical Study On Changes Of Anterior Chamber Depth And Diopter After Two Different Types Of Intraocular Lens Implantation

Background And ObjectivesCataract ranked first among disease which lead to blind in the word.Theproportion is46%.In our country the proportion of cataract patients amongblindness is39%to75%.With the process of population aging in our society, thenumber of cataract patients has increased every year, the cumulative number hasreached more than400million.An average of nearly40million people becomeblindness annually.So far no effective drugs can inhibit the formation anddevelopment of cataract.Cataract surgery is the only effective treatment for patients torestore vision. From the late1970s until now, the cataract surgical methods advancedfrom intracapsular cataract extraction, extracapsular cataract extraction surgery tophacoemulsification cataract surgery. The laser used in cataract treatment nearly20years.1967phacoemulsification technique was first reported by Kleman,since thenphacoemulsification cataract surgery become popular with its advantage of smallincision, small astigmatism, light tissue reaction, good vision after surgery.It hasachieved great success worldwide but not perfect.Phacoemulsification learning curve is long and difficult, beginners even years of clinical experience surgeon can notcompletely avoid certain complications. How to make the surgeon, especiallybeginners, reducing postoperative and intraoperative complications, is still a questionworthing exploring.There are literatures reported the reason for surgery complications.Theycounted the number and type of surgery complications and analysis its reasons andtreatment measures to share experience and help to reduce the same kinds ofcomplications.Various causes of complications were summarized. However, riskfactors work in many aspects and a high-risk factor can cause a variety ofcomplications. Just think, if we ask medical history, take systemic and ocularexamination before surgery,be familiar with risk factors existing in different patientswe can take precautions,design surgery program in advance,consider unexpectedsituations during operation and make preoperative preparation.It’s helpful to reducecomplications and increase confidence of surgeon.In this study, preoperative risk factors and intraoperative and postoperativecomplications are counted.The influences and complications produced by risk factorsare analysed.In this way giving suggestions to reduce complications, providingmethods to avoid complications and then shortening the learning curve.Materials and Methods1.In this tudy,912(1052eyes) cases that receive phacoemulsification cataractsurgery and intraocular lens implantation from January2009to December2011inThe Second Clinical Hospital of Zhengzhou University were collected. Male392cases, female520cases, aged3to102years old, with an average67.1years old.2. Preoperative ExaminationIncluding:history, visual acuity, slit lamp, a non-contact tonometer, directophthalmoscope, retina sight gauge, eye A/B ultrasound, bounce biologicalmicroscope (UBM), measuring tear secretion, corneal curvature, IOL measurement,VEP/ERG, optical positioning, color vision examination.3. surgical methods:phacoemulsification cataract surgery with intraocular lensimplantation. Result1. Medical history:6kinds of systemic risk factors: hypertension,423cases(46.4%), diabetes mellitus351cases (38.5%), asthma28cases (3.1%), coronaryheart disease23cases (2.5%), humpback37cases (4.1%); using alpha blockers42cases (4.6%);5kinds of ocular risk factors: one-eyed19eyes (1.8%),glaucoma surgery in48eyes (4.6%), after vitrectomy surgery74eyes (7.0%),high myopia63eyes (6.0%), healed iridocyclitis51eyes (4.8%).2. eye examination:17kinds of risk factors: skin disease around eyes10(1.0%), small palpebral234eyes (23.1%), conjunctival relaxation328eyes(31.1%), pterygium96eyes (9.1%), arcus senilis367eyes (34.9%), achlys orkeratoleukoma57eyes (5.4%), shallow anterior chamber63eyes (6.0%), irisadhesions64eyes (6.1%), lens subluxation23eyes (2.2%), hypertonia of eye93eyes (8.8%), vitreous opacities694eyes (66.0%), posterior staphyloma142eyes(13.5%), retinal detachment9eyes (0.9%), eye axis≥25mm97eyes (9.2%),posterior cataract13eyes (1.5%), IV or V nuclear cataract (Emery gradingstandards)153eyes (18.3%), white cataract87eyes (8.3%).3.Intra-operative complications: anterior capsular rupture in6eyes（0.6%）,posterior capsular rupture in13eyes（1.2%）,tear of descemet’s membrane1eyes（0.1%）, iridoptosis in14eyes (1.3%), drop of lens fragments into vitreous in1eye (0.1%). Post-operative complications: corneal endothelial edema in57eyes（5.4%）,temporary intraocular hypertension in83eyes（7.9%）, pupillary dilatationin1eye (0.1%), retinal detachment in1eye (0.1%),macular edema in6eyes(0.6%).Conclusion1.Cataract patients may have several ocular and systemic diseases that affectmultiple aspects of cataract surgery. Surgeons should take them into consideringtogether.2. Reasonably predicting the postoperative conditions of patients according tothe risk factors,can reduce medical disputes and improve postoperative satisfaction.3.designing surgical methods and appropriate preparation according to the riskfactors can reduce surgical complications.4. Summary of experience can help the beginners take less mistakes.