Objective To investigate the refractive shift after combined surgery （phacoemulsification, intraocular lens implantation and vitrectomy） by comparing the difference between the predictive and postoperative refractive power.Methods The clinical data of 44 patients (48 eyes) underwent combined surgery (combined group) and 30 patients (50 eyes) underwent cataract surgery (cataract group) were retrospective analyzed. Combined group was further divided into two sub-groups by the kind of tamponade: balanced salt solution group and gas group. Before surgery, axial length and corneal curvature were measured, and the predictive spherical equivalent (PSE) was calculated. Axial length, corneal curvature and actual spherical equivalent (ASE) were measured in six months after surgery. The differences between PSE and ASE were compared between combined group and cataract group, balanced salt solution group and gas group.Results In combined group,the mean PSE was (-0.10plusmn;0.42) D and ASE was（-1.00plusmn;1.10） D, and the difference was significant（t=6.687, P＜0.05）. Patients underwent combined surgery showed a statistically significant myopic shift compared with those underwent simple cataract surgery （t=-3.792,P＜0.05）, the refractive shift of balanced salt solution group and gas group were (-0.76plusmn;0.89） and （-1.19plusmn;0.94） D respectively, and there was no significant difference（t=-1.530,P＞0.05）.Conclusion Combined surgery of phacoemulsification and vitrectomy tends to shift the actual refractive status to myopia.
Objective To compare the effectiveness of aspheric intraocular lenses(IOL) versus spherical IOL in the treatment of cataract. Method Randomized controlled trials comparing aspheric IOL with spherical IOL were identified by searching PubMed (2000 to October, 2008), EMbase (2000 to October, 2008), MEDLINE (2000 to October, 2008), and The Cochrane Library (Issue 3, 2008). Two reviewers independently assessed trials for eligibility and quality, as well as the extracted data. Data were synthesized using RevMan software (release 5) provided by the Cochrane Collaboration. Results A total of 14 trials (1383 eyes) were included for systematic review, and 11 out of 14 studies were included in the meta-analysis. Subgroup analyses were used according to different aberrations of aspheric IOL. The results showed a significant difference in the mean best corrected visual acuity at 3 months after cataract surgery in the AcrySof IQ IOL group with WMD -0.02, 95% CI -0.03 to -0.01(Plt;0.0001). It showed a significantly worse difference in the mean of the best corrected visual acuity at 3 months after cataract surgery in the AcrySof IQ IOL group with WMD –0.02, 95%CI –0.03 to –0.01 (Plt;0.000 1). It showed a significant worse in the mean the best corrected visual acuity in the Tecnis Z9000 IOL group with WMD 0.02, 95%CI 0.01 to 0.03 (P=0.002); and there was no significant difference between the two groups with WMD 0.00, 95%CI –0.02 to –0.03 (P=0.71). The results did display markedly less spherical aberration and total higher order aberrations than eyes implanted with the traditional spheric IOL in all subgroups (WMD –0.06, 95%CI –0.07 to –0.06, Plt;0.000 01, WMD –0.06, 95%CI –0.07 to –0.02, Plt;0.000 1, respectively). The majority of studies suggested significant improvement in the aspheric IOL group in contrast sensitivity, especially at mesopic low spatial frequencies, although some trials showed no significant difference. Conclusion The effectiveness of aspheric IOL is superior to spherical IOL during cataract surgery. No differences in aspheric IOL with different aberration are found in this series, and further study is required.
【摘要】 目的 研究高度近视患者白内障术后后发性白内障接受后囊切开手术的治疗效果，探讨高度近视患者后发性白内障的安全手术方法。 方法 2009年10月-2010年5月对高度近视白内障术后后发性白内障患者29例42眼行手术后囊切开，平均眼轴长度27.43 mm，术中记录手术情况，术后检查测量患者视力及眼部情况。 结果 3个月内所有患者术后裸眼及矫正视力提高，视力提高2行者90.48%，其中矫正视力gt;0.5者为80.95%，术中及术后未发生手术相关并发症。 结论 手术后囊切开对于高度近视白内障术后后发性白内障患者安全有效。【Abstract】 Objective To investigate the therapeutic effect of posterior capsulotomy in order to evaluate the effective and safe therapeutic method for myopia after cataract patients with high myopia. Methods Between October 2009 and May 2010, 29 cases (42 eyes) of after cataract with high myopia were chosen and undergone posterior capsulotomy.Data of operation details, vision acuity (VA) and eye examination were analyzed. Results The post-operative naked vision and best-corrected visual acuity (BCVA) were improved in all patients.No surgery-related complication was found. Conclusion Posterior capsulotomy in treating posterior capsular opacification (PCO) of after cataract with high myopia is a safe and effective method.
Objective To evaluate the effect of optimizing the management measures of cataract ambulatory surgery. Methods The patients who underwent cataract phacoemulsification combined with intraocular lens implantation in the Ambulatory Surgery Center of East District of Beijing Tongren Hospital affiliated to Capital Medical University were selected. Patients between January and December 2021 (after the optimization of ambulatory surgery process) were included, and patients between January and December 2020 (before the optimization of ambulatory surgery process) were included as control. The three factors of age, gender and surgical eye type were used as predictive variables for propensity score matching. The proportion of patients who completed the surgery according to the scheduled time, the proportion of eye drops used according to the doctor’s instructions and the number of hospital visits before and after the optimization of the ambulatory surgery process were compared with the patients who successfully matched. Results A total of 28306 patients were included, including 13284 before and 15022 after process optimization. There were 13467 males and 14839 females, with a median age of 70 (60, 78) years. There was no statistically significant difference in the age of patients before the process optimization (P>0.05), but there was statistically significant difference in gender and surgical eye (P<0.05). After the propensity score matching, a total of 12932 pairs of patients were matched successfully. After the propensity score matching, there was no statistically significant difference between the two groups in age, gender and surgical eye (P>0.05). After the process optimization, the proportion of patients who completed surgery on schedule (98.8% vs. 93.3%) and used eyedrops according to the doctor’s instructions (97.4% vs. 93.0%) were higher than that before the process optimization, and the proportion of patients who came to hospital more than 3 times (0.7% vs. 1.9%) was lower than that before the process optimization (P<0.05). Conclusion The optimized ambulatory surgery process can help patients complete the surgery according to the scheduled time and use eye medication according to the doctor’s instructions, and can reduce the number of patients coming to the hospital.
Objective To observe the therapeutic efficacy and postoperative complications of combined surgery and sequential surgery in treating proliferative diabetic retinopathy (PDR) and cataract. Methods The cilinical data of 59 patients (66 eyes) with PDR were retrospectively analyzed. The patients were divided into combinedsurgery group and sequential surgery group. Combined surgery was performed on patients with obvious lens opacity which was an obstacle to the ocular fundus surgery, while sequential surgery was performed on the patients with transparent lens or lens with light opacity on which ocular fundus surgery could be performed. Lens excision in cataractopoiesis could only be performed when the state of ocular fundus was stable and cataractopoiesis was the main cause of vision damage. A total of 28 patients (32 eyes) in combinedsurgery group underwent vitrectomy combined with phacoemulsification and IOL implantation; 31 patients (34 eyes ) in sequentialsurgery group underwent vitrectomy, lens excision and IOL implantation. Corrected visual acuity (BCVA) and complications were observed. The mean followup period was (25plusmn;8.5) months. The measurement data were analyzed with t test and enumeration data with 2 test. Results In combinedsurgery group, visual acuity improvement was achieved in 27 eyes （84.4%）, remained unchanged in 2 eyes （6.3%）and decreased in 3 eyes （9.4%）. In sequentialsurgery group, visual acuity improved in 26 eyes （76.5%）, remained unchanged in 2 eyes（5.8%）and decreased in 6 eyes（17.7%.）. However, anterior chamber fibrin exudation occurred in 4 eyes in the combinedsurgery group and no eyes in the sequentialsurgery group; compared with each other, the difference is statistically significant (chi;2=4.524，P=0.033). Conclusion Combined surgery and sequential surgery are all safe and effective on treating PDR and postoperative complications have no obvious correlation with the surgery procedure.
ObjectiveTo observe the application value with color Doppler flow imaging (CDFI) in the detection of macular diseases in senile cataract.MethodsA cross-sectional descriptive study. From December 1 to December 30, 2017, 720 senile cataract patients (1380 eyes) diagnosed in Beijing Tongren Eye Center were included in this study. There were 330 males (629 eyes) and 390 females (751 eyes), with the mean age of 70.35±19.05 years. There were 716 right eyes and 664 left eyes, with the visual acuity 0.05-0.8. The fundus of all the patients can be observed. All patients were examined by OCT using Cirrus HD-Model 5000 produced by German Carl Zeiss company and CDFI using MyLab90 color Doppler ultrasound system produced by ESAOTE S.P.A. Comparing the detection rate of macular lesions between the two methods by using χ2 test. Using statistical methods to evaluate diagnostic tests, a crosstabulation was made to compare the consistency of frequency-domain OCT and CDFI in the diagnosis of macular lesions. Logistic regression analysis of correlation between detection of CDFI macular lesions and central foveal thickness (CFT), average thickness (AT), with or without macular anterior membrane, retinal folds, retinal cystoid edema, hard exudation, macular hole or lamellar macular hole, superficial detachment of neuroepithelium, detachment of pigment epithelium, vitreous macular traction.ResultsTwo hundreds and thirty-nine eyes (17.3%) showed macular disease by OCT, and 161 eyes (11.7%) showed the abnormal echo in the macular region by CDFI. The detection rate of the macular disease between two methods were statistically significant (χ2=851.661, P＜0.001), however, the consistency was well (κ=0.766, P=0.000). Logistic analysis showed that the detection rate of macular lesions was related to retinal folds, cysts in retina and CFT (r=1.396, 1.041, 0.12; P＜0.01).ConclusionCDFI can effectively detect macular lesions that affect the visual prognosis of senile cataract patients.