Clinical Observation Of Using Anterior Chamber Assisted Perfusion In Phacoemulsification In Vitrectomized Eyes

OBJECTIVE:To evaluate the safety of using anterior chamber maintainer(ACM)in phacoemulsification in postvitrectomy cataract.METHODS:All the 22 cases of postvitrectomy cataract in the First Affiliated Hospital of Guangxi Medical University from June 2016 to October2018 underwent phacoemulsification and intraocular lens implantation by using anterior chamber maintainer(ACM).Preoperative best correction vision acuity(BCVA),postoperative best correction vision acuity,preoperative corneal endothelial cell count,corneal endothelial cell count in 1 week postoperative and corneal endothelial cell density at 1 month postoperative were collected.Intraoperative and postoperative findings and complications were recorded to analyse the safety of the operation using ACM application in postvitrectomy cataract.RESULTS:The best corrected visual acuity(BCVA)postoperatively(in 1month after operations)was significantly improved compared with BCVA preoperatively(0.89±0.49 logMAR vs 0.42±0.37 logMAR).There was no significant change in intraocular pressure preoperatively(14.73±3.84 mmHg)and intraocular pressure(15.32±4.03 mmHg)on the first postoperative day(P=0.38).No complications such as posterior capsule rupture,iris damage,vitreous loss,zonular dialysis and dropped lens fragment.The postoperative complications within 3 months after operation were 3 cases(14%)of transient corneal edema occurred after operation,4 cases(18%)of posterior capsule opacity,1 case(5%)of macular edema in 1 month after operation,and 1 case(5%)of recurrent retinal detachment after 3 months.The corneal endothelial cell density in 1 week and 1 month were lower than that before surgery,the difference was statistically significant(P<0.05),they were 2589.5±279.0cells/mm~2 before operation,2424.0±287.6 cells/mm~2 at 1 week,and2401.6±297.2 cells/mm~2 at 1 month after surgery,but there was no significant difference in the density between 1 week and 1 month(P=0.06).The corneal endothelial cell loss rate was 6.1%(±4.1)in 1 week after surgery and 6.7%(±4.1)in 1 month after surgery.In the operation,there were 2 cases(9%)of anterior chamber deepening and 1 case(5%)of pupil dilation.CONCLUSINONS:The application of anterior chamber maintainer for phacoemulsification in postvitrectomy cataract is safe,it can maintain the stability of anterior chamber and is beneficial to the operation,and cause no additional damage to corneal endothelial function.