Observation The Changes Of Iris By UBM After Vitrectomy Combined Phacoemulsification And IOL Implantation And Discuss The Clinical Significance

ObjectiveTo observate the changes of iris and pupil after vitrectomy combined phacoemulsification and IOL implantation,and the effection of clinical intervention.Methodvitrectomy combined phacoemulsification and IOL implantation were performed in 50 eyes of 50 patients and Cataract extraction combined IOL implantation were performed in 40 eyes of 44 patients. They were examined with ultrasound biomicroscopy(UBM) preoperatively,once every 1 week in 1 month and once every 2 weeks at 1 to 3 months after surgery,Central anterior chamber depth(AOD)and angle opening distance(AOD)were measured and results were tested by the t-pair test in combined surgery group.The condition of iris,pupil,IOL and the intraocular pressure were also recorded.Results1)In combined surgery group,after 3 months follow-up,the retina was anatomically reattached in 50 patients.Central anterior chamber depth meant(2305±289)μm before surgery and(3370±478)μm 1 week,(3455±456)μm 1 month,(3487±352)μm 3 month after surgery,the difference being statistically significant(P＜0.05)。AOD₅₀₀ meant(0.427±0.087)μm before surgery and(0.578±0.093)μm 1 week,(0.584±0.100)μm 1 month,(0.567±0.101)μm 3 month after surgery,the difference being statistically significant(P＜0.05)。2)There were 42(84%)eyes with synechia of iris and IOL in 50 eyes. The locations of synechia of iris and IOL of 42 eyes were 13(30.9%) eyes in above quadrant,19(45.2%)eyes in bitamporal quadrant,8 (19%)eyes in nasal side quadrant,2(4.9%)eyes in down quadrant.. There was no cases of synechia of iris after division the synechia.In 96% of the eyes the two haptics were in the bag,and in 6%part IOL were out. There were no case of synechia of iris in simple cataract surgery.3)In combined surgery,the pupil size meant(7.9±1.2)mm before surgery and(4.2±1.5)mm 3 month after surgery,the difference being statistically significant(P＜0.05).The pupil size meant(4.2±1.5)mm after surgery in combined surgery group and(7.8±1.2)mm in simple cataract surgery,the difference being statistically significant(P＜0.05). But there was not significant difference in pupil size between before surgery and post after surgery in simple cataract surgery group.ConclusionAfter vitrectomy combined phacoemulsification and IOL implantation,the rate of synechia of iris and IOL is very high than simple cataract surgery.The pupil hard dilate because of severity inflammation after combined surgery.It is effective to resolve synechia of iris that detach synechia by 1MM needle.