A Comparison Study On The Cataract Phacoemulsification By Two Different Kinds Of Incisions

Objective To evaluate the different effective of two kinds of incisions- Transparent cornea incision and Sclera corneascleral modified incision in cataract ultrasonic emulsification operations.Investigating the different of the influenced degree and the recovery time of the function of tear film between the two kinds of surgery incision after phacoemulsifications.Methods 81 eyes (75patients) were randomly divided into GroupA (40eyes), GroupB(41eyes),which were performed the phacoemulsification with implantation of a IOL through a transparent cornea incision or a sclera corneascleral modified incision, respectively.Postoperatively,the vision acuity ,corneal astigmatism , complication, tear film break-up time,Schirmer'sâ… test without topical anesthesia,corneal fluorescein staining, conjunctival impression cytology(CIC) were observed at one day ,one week ,one month and three months .Result: 1.One day, 1 week ,1 month, 3 month after operation, the uncorrected acuity in the B group was better than in the A group.The acuity in two groups increased with time,The difference of uncorrected acuity between two groups decreased gradually.2.The corneal astigmatism in the B group was lower than in the A group at one day,1 week,1 month,3months after operation.Postoperative astigmatism was highter than the preoperative in every stage in two groups.The astigmatism reached the largest on the first day after operation,and gradually decreased.The difference of corneal astigmatism between two groups decreased gradually too.3.There was no significant difference in the complications between two groups.4.The function of tear film of two groups fell down obviously: At 1 day, 1 week postoperatively, the mean tear film , break-up time reduced greatly, and returned to the preoperative value at 1 month postoperatively. Corneal fluorescein staining score increased at 1 day and l week postoperatively ,returned to the preoperative value at 1 month postoperatively. The value of Schirmer's I test increased greatly at l day postoperatively, reduced to the preoperative one at 1 week postoperatively.Postoperatively,the conjunctival goblet cell density returned to their preoperative values at 1 week.There isn't obvious disparity in the recovery of tear film function after phacoemusification between Group A and Group B.Every indexes(BUT, Schirmer's I test ,fluorescein staining, CIC) tell no disparity at each time period postoperatively.Conclusion: 1.The effect of sclera corneascleral modified is better than that of transparent cornea incision.2.There was no significant difference in the safety between two groups. 3. The function of tear film of ocular surface falls down after phacoemulsification. The function decreases obviously at 1 day, 1 week postoperatively and returns to the preoperative level at 1 month postoperatively.4.The damage extent of phacoemulsification on tear film is identical nomatter which incision is used, clear corneal incision or sclerotic tunnel incision.