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ABSTRACT: To evaluate the effect of trabeculectomy and/or phacoemulsification surgery on blood-aqueous barrier function.
Phacoemulsification with implantation of intraocular lens was performed on 46 cataract eyes of 40 glaucoma patients following previous trabeculectomy (group 1), and 64 cataract eyes of 60 patients (group 2). The aqueous flare and cells were examined preoperatively and on days 1, 7, 30, 90 postoperatively using a laser flare-cell meter (LFCM).
The mean aqueous flare values were (15.12 +/- 2.87), (40.24 +/- 3.75), (24.33 +/- 3.38), (21.18 +/- 1.77), (16.51 +/- 1.70) photon counts/ms in group 1 preoperatively and on days 1, 7, 30, 90 after surgery (P < 0.05) respectively; and were (6.94 +/- 2.34), (26.27 +/- 10.21), (13.96 +/- 6.44), (9.07 +/- 2.67), (7.16 +/- 1.89) photon counts/ms in group 2 (P < 0.05) respectively.
Trabeculectomy can breakdown blood-aqueous barrier permanently while phacoemulsification damage the blood-aqueous barrier transiently. Phacoemulsification combined with a previous trabeculectomy can enhance this damage.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 02/2005; 41(2):132-5.
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ABSTRACT: To evaluate the surgical technique, feasibility, and outcome of bimanual microphacoemulsification.
The preliminary clinical study included 132 senile cataract eyes. A temporal clear cornea incision was made using 19G microvitreoretinal blade with the exterior incision length of 1.4 mm, the interior incision length of 1.2 mm, and the tunnel length of 1.0 mm. A 1.2 mm x 1.0 mm clear cornea side port was created with 19G microvitreoretinal blade at 12 o'clock in the right eye or 6 o'clock in the left eye. A sleeveless titanium phaco needle with an outer diameter of 0.9 mm was inserted through the temporal clear cornea incision. An irrigating chopper was inserted through the side port as the left-hand instrument, bimanual nucleofractis and nuclear emulsification were performed using quick chop technique. The lens cortical removal was performed bimanually with the Duet Bimanual I/A System. The study parameters included phacoemulsification time, intraoperative complications and early postoperative outcome.
The mean Phacoemulsification time was 0.75 +/- 0.64 min. vision acuity equal or better than 0.5 were 55.30%, 87.12% and 90.15% after surgery one day, one week and one mother respectively. Eyes with 0.5 best corrected visual acuity amounted to 90.91%, while with 0.8, amounted to 77.27% all the treated eyes 1 month postoperation. The formation of anterior chamber was successfully maintained in every case. There was various degree of nuclear hardness in all of case studied.
Bimanual microphacoemulsification is a feasible, secure, and effective surgery for cataract extraction through a sub-1.5 mm clear cornea incision.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 06/2004; 40(5):302-5.
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ABSTRACT: To analyze the cause of fixed intraocular lens (IOLs) pupillary capture in children and investigate the rational methods to reposit intraocular lens.
Thirty-one eyes (30 cases) with fixed intraocular lens pupillary capture under 14 years old were analyzed based on clinical data; the causes and the complications were also evaluated. The IOL reposition procedure was performed in 8 cases (8 eyes) with severe complications.
Different extent of secondary cataract, posterior iris synechia caused by severe postoperative uveal tract reaction were existed in all 30 cases, corecleisis was occurred in some severe cases. During reposition operation, different extent of lens cortex regeneration in the equator portion of capsule bag was found in all eight cases.
Fixed pupillary capture of IOL is the common complication in children after cataract surgery. Severe postoperative uveal tract reaction and secondary cataract and lens cortex regeneration are the major causes of intraocular lens pupillary capture. The intraocular lens could be reposited through iris synechia separation, regenerated lens cortex cleaning and secondary cataract extraction.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 04/2004; 40(3):190-2.
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ABSTRACT: To evaluate the clinical value in diagnosis and treatment of lens subluxation using ultrasound biomicroscopy (UBM).
This study comprised 29 patients (32 eyes) that had cataract with subluxated lenses due to different causes admitted into our hospital between November 2000 and January 2002. All eyes received UBM examination preoperatively and postoperatively. Capsular tension ring (CTR) implantations were performed using different technique according to UBM examination. Then all patients received phacoemulsification and intraocular lens (IOL) implantation. The location of IOL and CTR and complications were evaluated postoperatively.
Different kinds of subluxated lens shown different manifestations in UBM. The degree of zonular defect can be evaluated with UBM preoperatively. With UBM examination preoperatively, extent of lens subluxation less than 1/2 quadrant in 19 eyes while more than 1/2 quadrant in other 13 eyes were observed. Postoperative UBM examination in this series shown that CTRs were holding in place except one attached to the iris root. IOLs in 29 eyes were in proper position while IOLs in 3 patients were slightly tilted.
The degree and extent of lens subluxation can be evaluated using UBM examinations preoperatively, which is necessary in the selection of surgical protocol. With postoperative UBM examinations, a precise observation on the actual location of CTR and IOL can be achieved to produce an objective evaluation of the surgical outcomes.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 04/2004; 40(3):186-9.
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ABSTRACT: To determine the status of blood-aqueous barrier after small incision phacoemulsification with implantation of foldable intraocular lens.
The blood-aqueous barrier status in 64 eyes of 60 patients who underwent cataract surgery was examined using a laser flare cell meter. The protein level of anterior chamber aqueous humor was evaluated by measurement of the flare value preoperatively and postoperatively.
The mean preoperative flare intensity was (6.94 +/- 0.34) photon counts/ms, which increased to (26.27 +/- 1.37), (13.96 +/- 1.05), (9.07 +/- 0.43) and (7.16 +/- 0.27) photon counts/ms on days 1, 7, 30 and 90 after the surgery, respectively. Significantly statistical differences on flare values were found between preoperative data and those on days 1, 7 and 30 after surgery. The blood-aqueous barrier was recovered on day 90 postoperatively. The variables such as age, gender, eye (left/right) had no influence on the flare value. Patients with iris prolapse had a higher flare value at day 1 and day 7 after the surgery.
Blood-aqueous barrier after phacoemulsification with implantation of intraocular lens can be measured quantitatively by the laser flare cell meter. The blood-aqueous barrier disorders can be recovered shortly after phacoemulsification.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 02/2004; 40(1):26-9.
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ABSTRACT: To observe the changes in the lens capsule after phacoemulsification and its effects on the position of intraocular lens (IOL) and to demonstrate the best position of IOL in relation to the anterior capsule.
The present series comprised 141 eyes in 127 patients underwent phacoemulsification and foldable lens implantation with 5 mm continuous curvilinear capsulorhexis. The changes in the lens capsule and the position of IOL with dilated pupil were observed using slit lamp microscope 3 months after the operation.
Capsular bag shrinkage and white Soemmering ring along the margin of capsulorhexis were observed in all cases. Three different kinds of relationship between anterior capsule opening and the IOL optic surface were found, including the non-capture (68 eyes), partial-capture (52 eyes) and total-capture (21 eyes) relationships. The incidence of central posterior capsule opacification (PCO) was significantly higher in the total-capture group (47.6%) than that in the non-capture (11.7%) and partial-capture (21.2%) groups (P < 0.01). IOL in well centered position was significantly higher in the non-capture (91.2%) and total-capture (81.0%) groups than that in the partial-capture group (42.3%) (P < 0.01).
In the present study, various changes in the lens capsule were observed after phacoemulsification and foldable lens implantation. It is suggested that keeping the IOL in a non-capture position is a key point to avoid the occurrence of PCO and IOL decentration.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 05/2003; 39(5):283-5.
