Evaluation Of Phacoemulsification In Combination With Intraocular Lens Implantation Following Pars Plana Vitrectomy

Objective:1. To compare the stability in pouch of two different design of the intraocular lens in phacoemulsification in combination with intraocular lens implantation following pars plana vitrectomy(phase ii group) and simple excision of cataract ultrasonic emulsification combined intraocular lens implantation(simple cataract group). To investigate a more suitable intraocular lens for phase ii group.2.To investigate the law of refractive shift for phase ii group by comparing the difference between the predictive and postoperative refractive power. To provide the basis for the selection of intraocular lens degree for phase ii group. Method:1.Group From January 2013 to December 2014 at the Second Affiliated Hospital of Dalian Medical University, second stage surgery of 20 cases( 20 eyes) are analyzed, including the male of 11 cases(11 eyes) and female 9 cases(9 eyes) in aged of 55 to 78 years(average 67±8.72). All the cases are with phacoemulsification in combination with intraocular lens implantation following pars plana vitrectomy. Posterior capsular are complete, including all of the patients no obvious fracture lens zonular ligament. Vitreous body cavity are filled with water fluid. Pars plana vitrectomy condition are stable. Emery grade of nuclear type cataract Ⅱ 3 eyes, Ⅲ15 eyes, Ⅳ 2 eyes(phase ii group). According to different intraocular lens implantation, the patients are divided into group A including 10 eyes with one chip hydrophobic acrylic intraocular lens(IQ) and group B including 10 eyes with three chip hydrophobic intraocular lens(HOYA).Select the patients in the same period in our hospital to accept simple cataract ultrasonic emulsification excision combined intraocular lens implantation of 12 cases(20eyes), including the male of 5cases(8eyes) and female 7 cases(12 eyes) in aged of 52 to 75 years(average 65±8.53). Emery grade of nuclear type cataract Ⅱ4 eyes, Ⅲ14 eyes, Ⅳ 2 eyes. According to different intraocular lens implantation, the patients are divided into group A including 10 eyes with one chip hydrophobic acrylic intraocular lens(IQ) and group B including 10 eyes with three chip hydrophobic intraocular lens(HOYA).2.Observation index 3 months after operation, the uncorrected visual acuity,the corrected visual acuity, intraocular pressure, optometry, anterior segment under the slit lamp, fundus and intraocular lens decentration and tilt angle, axial length, corneal curvature, anterior chamber depth and the postoperative refractive power. Using SPSS17.0 for Windows statistical software package for statistical processing. Results:1. Decentration valueHorizontal direction in group A(0.17 士 0.02) mm, group B(0.16 士 0.03) mm, group C(0.16 士 0.02) mm, group D(0.15 士 0.03) mm. there was no statistical difference along groups(F = 1.333, P = 0.279).Vertical direction in group A(0.17 士 0.02) mm, group B(0.17 士 0.02)mm, group C(0.16 士 0.02) mm, group D(0.14 士 0.03) mm, there was no statistical difference along groups(F = 2.331, P = 2.331).Tilt angle valueHorizontal direction in group A(2.28 士 0.32)°, group B(1.97 士 0.16)°, group C(1.90 士 0.38) °, group D(1.78 士 0.41) °,the difference between group A and B has statistical significance(P = 0.042); the difference between group A and C has statistical significance(P = 0.013), The difference between B and D has no statistical significance(P = 0.211), The difference between C and D has no statistical significance(P = 0.441).Vertical direction in group A(2.34 士 0.30)°, group B(1.95 士 0.16)°, group C(1.83 士 0.43)°, group D(1.79 士 0.35)°. The difference between group A and B has statistical significance(P = 0.010); The difference between group A and C has statistical significance(P = 0.001), The difference between B and D has no statistical significance(P = 0.279), The difference between C and D has no statistical significance(P = 0.723).2. Refractive shift(postoperative value- predictive value) group A(+0.73 士0.35) D, group B(+0.78 士 0.34) D, group C(+0.45 士 0.28) D, group D(+ 0.49 士0.26)D. The difference between group A and B has no statistical significance(P = 0.715), The difference between group A and C has statistical significance(P = 0.041), The difference between group B and D has statistical significance(P = 0.043), The difference between group C and D has no statistical significance(P = 0.704). Conclusions:1. Both of the different design of intraocular lens are safe and effective for the patient of phacoemulsification in combination with intraocular lens implantation following pars plana vitrectomy, which show no obvious decentration.2. For the patients of phacoemulsification in combination with intraocular lens implantation following pars plana vitrectomy, tilt angle value in three chip intraocular lens is less than in one chip intraocular lens.3. Actual refractive errors in phase ii group show the hyperopia migration.