No Viscoelastic Agent Study With Phacoemulsification And Intraocular Lens Implantation

Objective:To explore and evaluate the use of phacoemulsification cataract surgery and intraocular lens implantation in the anterior chamber maintainer (ACM) and viscoelastic (OVD), and postoperative visual acuity, intraocular pressure changes and the impact of the cornea.Methods:79 patients,90 patients with senile cataract (excluding related eye disease) were randomly divided into three groups (n= 30), phacoemulsification and intraocular lens implantation. A group (study group): surgery using ACM, no OVD; group B (control group), operation and use of ACM OVD; group C (control group):surgery using OVD. Respectively in preoperative and postoperative 3d,7d,30d,90d observe changes in their vision, intraocular pressure, central corneal thickness, corneal endothelial cell count, corneal endothelial cell density, corneal astigmatism and other indicators, the data were compared, and and postoperative complications were recorded.Results:Three groups of patients uncorrected visual acuity> 0.5 persons, A group 46.6%(after 3d),53.3%(after 7d),63.3%(after 30d),80%(after 90d), group B 43.3%(after 3d),46.6%(after 7d),33.3%(after 30d),66.6%(after 90d)；group C 43.3%(after 3d),66.6%(after 7d),83.3%(after 30d),86.6% (after 90d),after the three groups at different times were significantly improved vision,and basically stabilized visual acuity in each group after 90d；IOP,A,B, C three groups of patients after 3 d,7d,30d,90d intraocular pressure were within normal range(≤21 mmHg)；corneal endothelial cell loss rate, postoperative 3d,7d,30d,90d,respectively,A group 10.84%,11.30%,10.81%, 12.69%;group B 7.21%,10.35%,13.80%,15.85%；group C 12.19%,11.88%, 11.30%,13.09%,there was no significant difference among the three groups at different times after surgery(P>0.05)；corneal endothelial cell density(cell/ mm2),after 3d,7d,30d,90d,respectively, group(2085.70±422.56), (2003.89±383.09),(1997.91±365.03),(1978.21±324.15),B group(2037.28 ±339.53),(1976.07±342.92),(1921.94±298.51),(1839.09土342.73),group C(2008.74±399.09),(1969.35±465.76),(1846.85±470.69),(1885.22± 459.11)and there was no significant difference(P>0.05)among the three groups at different times；corneal endothelial cell area coefficient of variation, after 3d,7d,30d,90d,respectively,A group(40.74±6.52)%,(40.05±8.77)%, (38.56±9.25)%,(36.86±8.95)%,group B(41.90±6.91)%,(41.08±7.29)%, (37.69±7.41)%,(36.67±8.62)%,C group(38.50±6.34)%,(40.30±7.14)%, (38.82±5.13)%,(38.66±6.36)%,there was no significant difference among the three groups at different times(P>0.05)；corneal endothelium the proportion of hexagonal cells,after 3d,7d,30d,90d,respectively；A group(43.00±8.12)%, (46.63±9.51)%,(47.07±9.04)%,(49.73±9.69)%,group B(40.20±8.04%, (42.93±7.20)%,(43.13±9.72)%,(45.33Q8.34)%,group C(42.40±7.73)%, (44.63±11.40)%,(44.93±7.20)%,(49.30±9.40)%,there was no significant difference(P>0.05)among the three groups at different times；central corneal thickness (μm), after 3d,7d,30d,90d, A group (553.40±36.70), (532.33± 42.59), (522.53±37.80), (518.03±35.08), group B (536.10±46.94), (530.47± 38.74), (517.20±34.94), (508.20±33.75), group C (534.10±34.65), (519.67 ±31.97), (508.03±26.99), (496.70±27.67), no statistically significant difference between the groups (P> 0.05); corneal astigmatism, postoperative 3d, 7d,30d,90d, A group (1.74±0.85) D, (1.36±0.69) D, (1.23±0.57) D, (0.99± 0.46) D, group B (1.55±0.78) D, (1.30±0.60) D, (1.10±0.47) D, (1.01±0.48) D, C group (1.65±0.55) D, (1.03±0.71) D, (1.16±0.47) D, between (0.99± 0.47) D, each group at different times the difference was not statistically significant (P> 0.05). Complications, B group, one case of intraoperative posterior capsule rupture occurs.Conclusion:phacoemulsification cataract surgery and intraocular lens implantation using only ACM no worse corneal edema, corneal endothelial cell injury and increased corneal astigmatism, instructions before phacoemulsification cataract surgery used throughout Room maintainer is safe and feasible.