| BackgroundWith the development of the equipment of phacoemulsification and intraocularlens(IOL), modern cataract surgery has gained widespread popularity and obtained goodeffect, its philosophy is gradually from preventing blindness to refractive surgery.Compared to the previous cataract surgery, standard coaxial incision phacoemulsificationhas the strong point of less intraocular tissue injury and rapid postoperative visual acuity,but it still have the shortcomings in the poor stability of anterior chamber and obvioussurgical astigmatism. And with the popularization and application of a corneal incision, theincidence of postoperative endophthalmitis has increased. Previous research shows that,within a certain range, the smaller the incision, the higher the stability of anterior chamber.And the smaller incision will induce less surgical astigmatism. So, microincisionalphacoemulsification is a new trend of cataract surgery.ObjectiveTo investigate the clinical outcomes and the architecture of clear corneal incisions ofcoaxial1.8mm microincision phacoemulsification and compare it to standard3.2-mmincision phacoemulsification.Methods68eyes of52patients with age-related cataract (grade Ⅲ nucleus) were randomlydivided into two groups. The age range was55-78years. There were33eyes in Group Aand35eyes in Group B. Group A underwent1.8mm microincision phacoemulsificationwhile Group B underwent traditional3.2mm incision phacoemulsification.Phacoemulsification (Phaco) power and time were recorded for each procedure. Follow-upexams were performed on1day,1week and1month after surgery. Preoperative and postoperative astigmatism changes，postoperative visual acuity, corneal endothelial cellcount and complications were assessed for the two groups. Corneal incision quality wasanalyzed using anterior segment optical coherence tomography(OCT) on1day,1week and1month after surgery. Record the thickness of incision, incision length, incision angle, theendothelial and epithelial gaping, and Descemet’s membrane detachment． Statisticalanalysis was done with a X~2test and t-test.Results1. No statistically significant difference was found in the average phaco time(APT),the effective phaco time (EPT) and the average phaco power(AVE) of the twogroups（P>0.05）.2. On the first day, first month after surgery, there was no statistically significantdifference in the visual acuity of the two groups,but the visual acuity of Group A was betterthan in GroupB on the first week（X~2=43.26,P<0.05）. There were statistically significantdifferences between preoperative and postoperative astigmatism changes in both groups.There was a statistically significant difference in astigmatism between the two groups inevery time position after surgery（t=-3.852，-3.643，-3.169，P<0.05）. No statisticallysignificant difference was found in the corneal endothelial cell count between the twogroups in every time position after surgery（P>0.05）.3. On the first day, first week and first month after surgery, the thickness of incision ofthe two groups had no no statistically significant difference（t=-5.01,-4.13,-4.34, P>0.05）,and the incision length was longer(t=12.53,11.34,11.62,P<0.05), the incision angle wassmaller(t=-5.62,-5.01,-5.34, P<0.05)in Group A than that of Group B; On the first day andfirst week, the percentage of the endothelial gaping of Group A was less than that of GroupB（X~2=12.54，5.44，P<0.05）, no statistically significant difference was found On the firstmonth; On the first day, the percentage of the Descemet’s membrane detachment of GroupA was less than that of Group B（X~2=11.39，P<0.05）,and no statistically significantdifference was found On the first week and first month.ConclusionCoaxial1.8mm microincision phacoemulsification is a safe and reliable operation, and can result in a smaller change in corneal astigmatism; The incision of coaxial1.8mmmicroincision phacoemulsification can be well self–sealing, and induce good stability ofanterior chamber. |
PDF Full Text Request