Clinical Study Of Decompression Capsulorhexis Versus Routine Capsulorhexis In Phacoemulsification For Hypermature Cataracts

Objective: To investigate the clinical efficacy of decompression capsulorhexis versus routine capsulorhexis in phacoemulsification for hypermature cataracts.Methods: A retrospective analysis was conducted on the clinical data of 68 patients(76 eyes)with hypermature cataracts who underwent phacoemulsification with intraocular lens implantation in the Haiyang City Hospital of Traditional Chinese Medicine from June 2011 to June 2016.They were divided into the experimental group and the control group according to the difference in capsulorhexis.Those who intraoperatively received routine capsulorhexis in phacoemulsification with intraocular lens implantation from June 2011 to June 2013 were assigned to the control group(n = 34,40 eyes),while those who received decompression capsulorhexis in the same procedure from June 2013 to June 2016 were assigned to the experimental group(n = 34,36 eyes).All patients were treated with hacoemulsification for cataracts with intraocular lens implantation.The experimental group used the decompression capsulorhexis,while the control group used the routine capsulorhexis.For both groups of patients,comparisons were made of the intraoperative integrity of the anterior lens capsule,the extent of the intraoperative corneal edema,the deviation rate of intraocular lens,the postoperative uncorrected visual acuity(UCVA),the best corrected visual acuity(BCVA),counts of endothelial cells,as well as the intraocular pressure and the fundus condition.Results: There was no significant difference in major general information,including gender,age,lens nucleus hardness,visual acuity and physical condition,between the experimental group and the control group(P>0.05),and both groups were comparable.In the experimental group,34 eyes(94.44%)successfully completed continuous curvilinear capsulorhexis,compared with 29 eyes(72.5%)in the control group,and the difference was statistically significant between both groups(P≤0.05).From Day 1 to Month 6 postoperatively,numbers of affected eyes with UCVA/BCVA >0.5 increased in both groups.At 1 and 7 days postoperatively,numbers of affected eyes with UCVA/BCVA >0.5 increased markedly in the experimental group compared with those in the control group,but the difference was not statistically significant between both groups(P>0.05);at 1 and 6 months postoperatively,numbers of affected eyes with UCVA/BCVA >0.5 increased markedly in the experimental group compared with those in the control group,and the difference was statistically significant between both groups(P≤0.05).At 1 and 7 days,1,3 and 6 months postoperatively,there was no significant difference in deviation rate of intraocular lens between both groups(P>0.05).Counts of corneal endothelial cells at 1 and 7 days,1,3 and 6 months postoperatively in both groups decreased markedly compared with those preoperatively;the experimental group had a higher counts of corneal endothelial cell than the control group,but the difference was not statistically significant between both groups(P>0.05).At 1 day postoperatively,the number of eyes without corneal edema was markedly higher in the experimental group than in the control group,and the difference was statistically significant between both groups(P≤0.05);for numbers of eyes with grade I/III/IV corneal edema,the experimental group were inferior to the control group,but the difference was not statistically significant between both groups(P>0.05);the experimental group had significantly less eyes with grade II edema than the control group,and the difference was statistically significant(P≤0.05).At two weeks postoperatively,corneal edema subsided in both groups,and the difference was not statistically significant(P>0.05).Conclusion: Application of decompression capsulorhexis in phacoemulsification for hypermature cataracts can improve surgical safety and reduce damage to corneal endothelial cells.