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@#AIM: To investigate the curative effect of 3.0mm incision phacoemulsification and 1.8mm coaxial micro-incision phacoemulsification and the influence on corneal endothelial cells.<p>METHODS: A total of 78 patients(78 eyes)with age-related cataract who were hospitalized in the hospital from December 2016 to December 2018 were selected as subjects. They were divided into the standard incision group and the micro-incision group with 39 cases(39 eyes)in each group. Patients in the standard incision group were treated with 3.0mm standard incision phacoemulsification and intraocular lens implantation, while the patients in the micro-incision group were treated with 1.8mm coaxial micro-incision phacoemulsification and intraocular lens implantation. The surgical outcome and corneal endothelial cell parameters were compared between the two groups. <p>RESULTS: The phacoemulsification time of the standard incision group and the micro-incision group were(7.05±0.98)s and(7.22±0.96)s, respectively. The phacoemulsification energy was(17.01±1.89)% and(16.89±1.53)%, respectively(<i>P</i>>0.05). The LogMAR of naked eyes of both groups decreased significantly at 1d, 1wk and 1mo after surgery(<i>P</i><0.001), while the degree of astigmatism increased(<i>P</i><0.001). The naked vision and astigmatism of the micro-incision group were better than those of the standard incision group at 1d and 1wk after surgery(<i>P</i><0.05). Endothelial cell density was significantly decreased at 1d, 1wk and 1mo after surgery(<i>P</i><0.05). The coefficient of variation of corneal endothelial cells and the thickness of central cornea increased. There was no significant difference between the standard incision group and the micro-incision group at each time poilt(<i>P</i>>0.05). There were no severe complications in either group. There was one patient with transient high intraocular pressure in the standard incision group, and the intraocular pressure returned to normal after drug treatment.<p>CONCLUSION: Both coaxial micro-incision phacoemulsification and standard small incision surgery have certain effects on the morphology and function of endothelial cells. Besides, there is no significant difference between them. However, coaxial micro-incision phacoemulsification can minimize the surgical incision and reduce the degree of surgically induced astigmatism, and patients can recover quickly after surgery. It is a relatively safer surgical procedure.
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@#AIM:To investigate the effects of 1.8mm coaxial micro-incision phacoemulsification in cataract patients with diabetic.<p>METHODS: Totally 130 eyes in 130 patients with type 2 diabetes mellitus were underwent phacoemulsification from January 2017 to December 2018, and they were randomly divided into observation group of 63 cases(63 eyes)and control group of 67 cases(67 eyes). The best corrected visual acuity(BCVA)of the two groups were compared. Average phacoemulsification energy(AVE), effective phacoemulsification time(EPT)were recorded of two groups. Corneal endothelial cell counts, corneal astigmatism and complications of two groups were compared preoperatively and 1wk, 1mo and 3mo postoperatively.<p>RESULTS: The BCVA in observation and control groups were improved after 7d, 1, 3mo operation(<i>P</i><0.05). The differences of AVE(<i>t</i>=3.89, <i>P</i><0.05)in observation and control groups were significant, while EPT(<i>t</i>=0.773, <i>P</i>=0.221)between them were not. The corneal endothelial cell counts between the two groups was not significantly different before surgery(<i>t</i>=1.21, <i>P</i>=0.114), while it reduced a lot postoperatively in both groups. The surgically induced corneal astigmatism of the observation group was much smaller than that of the control group, and the differences were statistically significant. The main complication was corneal edema.<p>CONCLUSION: The 1.8mm coaxial micro-incision phacoemulsification is helpful to reduce surgically induced astigmatism and has less effect on corneal endothelial cell of patients with type 2 diabetic comparing to normal 3.0mm incision phacoemulsification.
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AIM:To investigate the effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity.METHODS: Totally 145 eyes in 120 patients underwent phacoemulsification from July 2013 to July 2015 were randomly divided into observation group 60 cases (73 eyes) and control group 60 cases (72 eyes).The observation group 60 cases were given 1.8mm coaxial micro incision cataract phacoemulsification operation,while the control group were given traditional 3.2mm coaxial micro incision cataract surgery.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),corneal thickness of incision area,incision width,incision length,macular retinal thickness,surgically induced astigmatism,corneal endothelial cell counts and complications of the two groups were compared.RESULTS: The UCVA and BCVA on 1wk after surgery of the observation group were significantly higher than the control group (t=3.604,7.109;P0.05).CONCLUSION: The 1.8mm micro incision phacoemulsification is helpful to improve the visual acuity of patients with cataract phacoemulsification,which may be related to the reduction of corneal cell injury,enhancement of corneal closure and decrease post-operation corneal original astigmatism.
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@#AIM: To analyze the clinical efficacy and postoperative impacts of coaxial micro-incision phacoemulsification on patients with cataract, and explore the application value of the surgical method. <p>METHODS: Totally 300 patients(300 eyes)who received the coaxial micro-incision phacoemulsification were randomly divided into the observation group(150 case)and the control group(150 case). Patients in the observation group and control group were treated by coaxial micro-incision phacoemulsification and traditional coaxial phacoemulsification, respectively. The effective phaco time(EPT), average ultrasound energy(AVE), intraoperative anterior chamber stability and postoperative recovery time were compared between the two groups, as well as the uncorrected visual acuity(UCVA), the surgically induced astigmatism(SIA)and the loss rate of corneal endothelial cells at 1d, 1wk, 1 and 3mo after surgery. <p>RESULTS: No significant difference of EPT, AVE and the rate of patients with stable anterior chamber were found between the two groups(<i>P</i>>0.05), as well as the UCVA, SIA and the corneal endothelial cells in patients before surgery(<i>P</i>>0.05).The postoperative recovery time of patients in the observation group was obviously shorter than that in the control group(<i>P</i><0.05). At 1d, 1wk and 1mo of postoperative, the UCVA of patients in the observation group were better than those in the control group(<i>P</i><0.05). In 1wk, 1 and 3mo of postoperative, the SIA of patients in the observation group were lower than those in the control group(<i>P</i><0.05). And in all the time of postoperative, the loss rate of corneal endothelial cells of patients in the observation group were lower than those in the control group(<i>P</i><0.05). Between the two groups, significant difference of the UCVA, SIA and the loss rate of corneal endothelial cells were found in the different time points after surgery(<i>P</i><0.05). <p>CONCLUSION: The coaxial micro-incision phacoemulsification had a high clinical value as it possesses the advantages of more rapid UCVA recovery, less influence on SIA and less loss of corneal endothelial cell.
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? AIM: To investigate the efficacy and safety of phacoemulsification combined with intraocular lens implantation in the treatment of shallow anterior chamber with cataract.?METHODS: Retrospective case series. From February 2014 to July 2015 in our hospital,65 eyes in 65 patients with cataract were enrolled and divided into mild and high risk of shallow anterior chamber group. Best-corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) , central anterior chamber dept ( CACD ) , angle opening distance ( AOD ) , complications pre- and post treatment, were observed and analyzed as outcome measures.?RESULTS: In this study, the mild shallow anterior chamber group included 34 eyes; postoperative BCVA were improved in 29 eyes, with 4 eyes remaining stable and decreased in 1 eye; BCVA was improved in 16 eyes, with 10 eyes remaining stable and decreased in 5 eyes in high risk of shallow anterior chamber group postoperatively. BCVA had a better prognosis in the mild shallow anterior chamber group than another group ( t=-2. 956, P<0. 05). Meanwhile, IOP decreased by 5. 71± 2. 07mmHg and CACD increased by 1. 37 ± 0. 38mm in the mild shallow anterior chamber group, by 9. 77±4. 04mmHg and 1. 67±0. 43mm respectively in high risk group, and the difference has statistical significance ( t=-5. 02,-3. 04; P<0. 05). The mean preoperative nasal AOD500 was 200. 57± 33. 74μm, and they were 346. 62 ± 101. 37μm and 410. 75 ± 137. 48μm and 398. 69 ± 122. 28μm respectively at postoperative 1d, 1 and 3mo, and all nAOD500 comparing with preoperative were increased obviously, and the difference has statistical significance (F=203. 75, P<0. 01). And AOD500 at temporal, superior and inferior presented similar trends. Complications were corneal edema ( 5 eyes ) , transient intraocular hypertension ( 2 eyes ) , posterior capsular opacification ( 4 eyes ) , and posterior capsular rupture (1 eye).?CONCLUSION:Micro incision cataract surgery is useful, effective and safe in patients with cataract and shallow anterior chamber which can stabilize or improve BCVA, reduce IOP, deepen CACD and open the anterior chamber angle.
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Abstract?Since the introduction of 25-gauge/23-gauge ( 25G/23G ) sutureless micro -incision vitrectomy surgery ( MIVS ) at the beginning of the 21 century, we have stepped into an era of micro-incision vitreoretinal surgery more than10a. The current 25/23G MIVS provide numerous advantages over the conventional 20G vitrectomy surgery including simplified surgical procedure, shortened operating time, decreased complications as well as smaller sclerotomy wound.As a result, vitreoretinal surgeons have been shifting gradually from 20-gauge to 25/23-gauge vitrectomy in the past decade. As the 25/23G MIVS adapted worldwide, however, its drawbacks were also increasingly reported. Most criticism regarding to current 25/23G MIVS are focusing on would sealing related complications.Based on stablished notion regarding vitrectomy -“the smaller the better”, researchers and doctors were keeping on exploring the next generation of vitrectomy system. Thanks to the innovation and development in new generation vitrectomy machines, high lumen output light source, more delicate manufacturing technology and clear wild angle fundus view system, Dr.Oshima from Japan launched the first 27-gauge vitrectomy surgery system.It provided us novel surgical experience with smaller sclerotomy wound and faster cut rate. Further development and refinement of vitrectomy with 27-gauge or more are still on its way and will continue in the future. Undoubtedly, MIVS would be heated debated regarding its pro/con, complications, indications and future development.Combined with our own experiences, here we briefly reviewed the 27-gauge vitrectomy surgery.
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AIM:To study the changes of tear film and ocular surface after the coaxial micro incision 2. 2mm and 2. 8mm in the phacoemulsification. METHODS:Eighty-six patients ( One hundred and six eyes ) from 2014/06 to 2016/01 in our hospital were enrolled. The patients were randomly divided into two groups. Forty-four patients ( Fifty-three eyes) in group A: coaxial 2. 2mm micro- incision phacoemulsification cataract extraction and intraocular lens(IOL) implantation;Forty-two patients ( Fifty-three eyes ) in group B: the conventional coaxial 2. 8mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time ( BUT) , dry eye symptom ( DES) score, Schirmer's I test ( SⅠt ) and lid-wiper epitheliopathy ( LWE ) score were assessed preoperatively and postoperatively. RESULTS:At 1wk, 1 and 2mo postoperatively, the BUT in two groups decreased after operations, and the BUT of group B was significantly lower than those of group A, the differences were statistically significant ( t = 3. 098, 4.512, 4.329; all P 0. 05). The BUT, DES score, SⅠt and LWE score in group B showed statistically significant differences (t=-4. 063, 7. 306, 3. 621, 4. 208;all P<0. 05).CONCLUSION:Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.2mm microincision phacoemulsification, compared with the conventional coaxial 2. 8mm incision phacoemulsification surgery.
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AIM:To explore and compare effect of coaxial micro-incision phacoemulsification and standard coaxial phacoemulsification in the treatment of cataract. METHODS:A total of 88 patients(88 eyes) with senile cataract who underwent selective cataract ultrasonic emulsification resorption combined with intraocular lens implantation in the hospital from Aug. 2013 and Aug. 2015 were selected, they were divided randomly into the control group ( 44 cases, 38 cases completed, 6 cases dropped out ) and the observation group ( 44 cases, 40 cases completed, 4 cases dropped out ) . The control group received standard coaxial 3. 0mm small incision phacoemulsification, the observation group received coaxial 1. 8mm micro-incision phacoemulsification. All patients were combined with intraocular lens implantation. Intraoperative effective ultrasonic time, cumulative release energy, best corrected visual acuity before and after surgery in the two groups were recorded, corneal endothelium cell population, incision corneal thickness, percentage of cornea hexagon cell, corneal astigmatism changes before the operation, 1d, 7d, 30d after the operation were compared. RESULTS: There was no significant difference in intraoperative effective ultrasonic time, cumulative release energy in the two groups(P>0. 05). There was no significant difference in postoperative best corrected visual acuity between the two groups(P>0. 05). Corneal endothelium cell population, percentage of cornea hexagon cell 1d, 7d, 30d after the operation in the two groups were significantly decreased compared with those before the treatment ( P 0. 05 ). Incision corneal thickness 30d after the operation in the observation group was significantly lower than the control group(PCONCLUSION: Coaxial micro - incision phacoemulsification and standard coaxial phacoemulsification can improve visual acuity of cataract patients, but the former can reduce degree of corneal astigmatism.
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AlM: To evaluate the clinical efficacy and safety of capsular tension ring ( CTR) combined with iris hooks in eyes with large traumatic zonular dialysis or weakness that underwent micro -incision coaxial phacoemulsification with posterior chamber ( PC ) intraocular lens ( lOL) implantation.METHODS: This prospective study was carried on 21 patients ( 21 eyes ) with traumatic cataract and traumaticzonular dialysis (0. 8 in 5 eyes. lOPs were in normal range too. The lOLs in 20 eyes remained the required position to the final follow- up examination except one eye in which the PC lOL was dislocated into vitreous cavity due to a postoperative spontaneity PCR, and in which vitrectomy and lOL suture fixation was performed.CONCLUSlON: ln cases of cataract associated with traumatic zonular dialysis (<180.) , by setting the rational parameters of phacoemulsification, the CTR and iris hooks are found to be efficient in preventing lOL decentration and reducing operation complication. ln our cases, the CTR combined with iris hooks is relatively safe application.
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AIM:To compare the operation effect of 2. 2mm micro incision and 3. 0mm incision coaxial phacoemulsification. METHODS: Patients with age - related cataract ( 90 cases, 90 eyes) were enrolled in the study from January 2012 to June 2013 in our hospital, and they were randomly divided into 2 groups:2. 2mm incision group (45 eyes of 45 cases), 3.0mm incision group (45 eyes of 45 cases). Corneal tunnel incision coaxial phacoemulsification was performed. At 1d, 1wk, 1, 3mo after operation, the visual acuity, corneal endothelial cell count, central corneal thickness, operation astigmatism were recorded. RESULTS:One day after operation, the visual acuity of 2. 2mm incision group were significantly improved, the difference was statistically significant ( P0. 05). Operation source astigmatism had statistically significant difference at 1d, 1wk, 1, 3mo after operation ( PCONCLUSION: The 2. 2mm small incision coaxial phacoemulsification with postoperative visual acuity improved more significantly, can significantly reduce the operation astigmatism.
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Objective To explore the clinical curative effect of combined liposuction and direction areolar incision on gynecomastia. Methods Fourty-three patients,aged 14-36 years,were involved in this study,including fat type (n=15) and mixed fat and gland type (n =28).The hypertrophic mammary tissues were incised through a small incision (1.0-1.5 cm) after the tumescent liposuction.And tumescent liposuction technique was used again to make sure of the transition-layer more smooth.The incision was in compression bandage after surgery area and stitches taken out after 7 days.Results All the patients with gynecomastia were treated.The nipple-areola complex were all alive.The scar of incision was not obvious.Follow-up was done for 3 years,showing that configuration of the breasts was good.Conclusions The surgical procedure is simply,less haemorrhage and quick recovery,with good aesthetic effects,which deserves wide application.
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Objective To investigate the surgical treatment of male gynecomastia. Methods The clinical data of 116 cases(156 sites) of male gynecomastia were treated by using micro incision of areola with tumescent anesthesia in the past 4 years were reviewed. Results In this series, 50 to 150 grams mammary gland tissue were resected from the breast. There were no severe postoperative complications,such as nipple or areola necrosis and apparent scar . Follow up was done for 12 to 36 months, the scars were obscure, and the configuration of the breasts were good. Conclusions The operation for male hynecomastia via micro incision of areola with tumescent anesthesia is a good, reliable and convenient technique. It is easily performed with milder injury,less bleeding, and quick recovery.