| Objective:To observe the curative effect of phacoemulsification for catara ct after vitrectomy with procedure of 25-gauge vitrectomy irrigation in the eyes and provide a safe operation method for these patients.Methods:A total of 64 patients(64 eyes)with cataract after pars plana vitrectomy were selected in this retrospective study in the second h ospital of Jilin University from January 2016 to January 2018,which were randomly divided into two groups.Each group included 32 ca ses(32 eyes).We performed phacoemulsification and implantation o f artificial lens with 25-gauge tansconjunctival sutureless vitrectomy irrigation system in the patients of experimental group,while phacoe mulsification with non-vitreous irrigation was performed in patients of control group.The best corrected visual acuity(BCVA),intraocular pressure(IOP),corneal endothelial cell loss,operation time,ultrasonic e nergy,intraoperative and postoperative complications were observed.Results:1?The postoperative best corrected visual acuity(BCVA):the BCVA of postoperative after one month was increased to different extent in both experimental group and control group.There were st atistical differences in each group(group A:t=-4.305,p<0.01)(gr oup B:t=-4.662,p<0.01).But in early period after operation,the B CVA of experimental group was better than control group with a st atistical differences(x~2=4.267,p=0.039).One month after operation,t here were no statistical differences(x~2=1.333,p=0.248).2?The intraocular pressure(IOP):the IOP in group A before operation and 1day,1month after operation were(16.9±2.9),(17.1±4.1)and(17.2±2.6)mmHg.The IOP in group B before operati on and 1day,1month after operation were(17.3±3.4),(21.2±4.7)and(17.4±3.3)mmHg.The IOP of patients in group B at 1day after operation had significant difference compared with that before operation and group A(t=-3.604,p=0.01)(t=-3.747,p<0.01).N o statistically significant differences of IOP were found between tw o groups at 1month after operation(t=-0.295,p=0.769).3?The loss of corneal endothelial cells:the numbers of corne al endothelial cells before operation in two groups showed no differ ence by using independent sample t-test(t=-1.214,p=0.230).But 1month after operation,the numbers of corneal endothelial cells all e xhibited different degree of decrease.Cells loss in the experimental group was less than that in the control group(t=2.082,p=0.041)4?The operation time:the average time spent in group A was12.9±1.8 min and the mean time taken in group B was 10.7±1.6min.Independent sample t-test was used in these two groups and t here exists statistical difference(t=5.209,p<0.01).5?Cumulative dissipated energy(CDE)and ultrasound time(UST):the CDE was 9.64±1.70%in group A and 10.69±2.07 in group B.The energy produced by ultrasound in two groups differed with a statistical difference(t=-2.216,p=0.03).The UST was 1.02±0.22 min in experimental group and 1.17±0.23 min in control group with a statistical difference(t=-2.532,p=0.014).6?The complications:there was no sever complications such as retinal detachment,detachment of choroid or suprachoroidal hem orrahage during operation and after operation.Patients in group A un derwent surgeries successfully with no sever complications.However a case of capsular rupture and anther case of zonular fibers fracture which led into a failure of implanting artificial lens occurred intra operatively in group B.Conclusion:Phacoemulsification for cataract with stable intraocular pressure of 25G vitreous cavity perfusion is an effective way for treating t he cataract patients after vitrectomy.It can maintain IOP,reduce pos sible complications and enhance the security in cataract surgery. |
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