Cataract Selection And Postoperative Curative Effect In Cataract Patients With Incomplete Dislocation Of Lens With >2 Quadrants

Research purpose:To investigate the clinical effect,surgical methods and timing of surgery of cataract combined lens dislocation greater than 2 quadrants patients after having phase I intracapsular cataract extraction and anterior vitrectomy,postoperative corrected vision greater than 0.3,and then taking phase II small incision suture-fixation of intraocular lens suspension.Methods:Totally 34 cases with cataract combined lens dislocation greater than 2 quadrants had been treated in our hospital from July 2015 to October 2017.We investigated their 1wk,1 and 3mo postoperative complications and the uncorrected visual acuity,best corrected visual acuity,intraocular pressure,corneal astigmatism,intraocular lens position who took phase II small incision suture-fixation of intraocular lens suspension with corrected vision greater than 0.3 after having phase I intracapsular cataract extraction and anterior vitrectomy.Results:Along with the recovery time extension,patients uncorrected visual acuity and best corrected visual acuity increased obviously than preoperative in each phase,and 3 months have stabilized.On the 3mo postoperatively,the best corrected visual acuity of 1 eyes was between 0.3 and 0.1,7 eyes was between 0.5 and 0.3,17 eyes was between 0.7 and 0.5,and 9 eyes was better than 0.7.The best corrected visual acuity was achieved or near the best corrected visual acuity before surgery.The UCVA and BCVA at each phase of the 3rd,1st,and 3rd month of the phase II surgery were significantly higher than those of the UCVA and BCVA before the phase I surgery(P<0.01).Comparing each time point at each time point,the difference between postoperative 3 days and 1mo and 3mo was statistically significant(P<0.05).The difference between 1mo and 3mo after operation was not statistically significant(P>0.05).The intraocular pressure was high(stage 22.35±8.97)mmHg in 15 eyes before the first phase of surgery,and the intraocular pressure was within the normal range in the first month(stage 14.97±3.12)mmHg and in the third month(stage 14.94±3.14)mmHg after phase II surgery.Corneal astigmatism(0.75 ± 0.38)D before stage I surgery;corneal astigmatism at 1mo(0.90 ± 0.45)D and 3mo(0.89 ± 0.38)D at stage II after surgery.Surgery did not significantly increase the corneal astigmatism.At 3 months after operation,the position of the intraocular lens was slightly deviated in 2 eyes and did not significantly affect the patient's visual acuity.The positive rate of intraocular lens was 94.12%.After 3 months of follow-up,there were no serious complications such as retinal detachment and corneal decompensation.Conclusion:It is a safe and effective way in improving eyesight effectively,with stable intraocular pressure and fewer complications towards cataract combined lens dislocation greater than 2 quadrants patients having phase I intracapsular cataract extraction and anterior vitrectomy,whose postoperative corrected vision greater than 0.3,and then phase II small incision suture-fixation of intraocular lens suspension.Treating such patients with staged surgery is more advantageous than primary surgery.Two-point suture fixation of intraocular lens ciliary sulcus can be used as an ideal surgical method for aphakic intraocular lens implantation without capsular support.