The Effect Of Anterior Capsule Polishing On The Changes Of Anterior Capsule And The Position Of Intraocular Lens After Femtosecond Laser-assisted Cataract Surgery

Objective:To study the effect of lens anterior capsule polishing on anterior capsule contraction and intraocular lens position after femtosecond laser-assisted cataract surgery.Methods:A prospective case study.The study included 36 cataract patients aged 55-75 years.All patients were treated with femtosecond laser-assisted cataract surgery,and a capsulorhexis diameter of 5.2 mm was set during the surgery.According to the principle of randomized control,they were divided into two groups,18 cataract patients(18 eyes)were in the polished group,in which 360° anterior capsule polishing was performed with the capsule polisher during the surgery,and 18 cataract patients(18 eyes)were in the non-polished group,without the anterior capsule polishing during the surgery.At the end of the surgery,the anterior capsule images of all the observation subjects were taken.At 1,3 and 6 months after the surgery,the patients in both groups were examined by optometry,post-mydriatic slit lamp photography,3D anterior segment analysis of Pentacam,and the anterior capsule opacification was graded under slit lamp.The postoperative diopter and anterior chamber depth were recorded.At the same time,the area of the anterior capsule opening,the horizontal diameter of the anterior capsule opening,the vertical diameter of the anterior capsule opening,and the decentration and tilt of the intraocular lens were measured by image proplus 6.0 image analysis software.Results:There was no significant difference in baseline data such as age,gender,predictive diopter,cataract nuclear color score,eye axis,anterior chamber depth and the anterior capsule opening area,horizontal diameter,vertical diameter at the end of the surgery between the polished and non-polished groups.The anterior capsule opening area and horizontal diameter gradually decreased with time.The difference between the two groups was statistically significant at three time points after surgery.The vertical diameter of the anterior capsule opening slowly decreases slowly with time.Comparison within the group:in the polished group,there was a statistical difference in the vertical diameter of the anterior capsule opening only between 1 month and 6 months after the surgery;in the non-polished group,there was a statistical difference in the vertical diameter of the anterior capsule opening between 1 month and 3 months,1 month and 6 months after the surgery.Comparison between groups:there was no significant difference in the vertical diameter of the anterior capsule opening between the polished group and the non-polished group at 1 month,but there were significant differences in the vertical diameter of the anterior capsule opening between the two groups at 3 and 6 months.The intraocular lens decentration of the two groups increased slowly with time,but all of them were less than 0.4mm.Comparison within the group:in the polished group,there was no statistical difference in the intraocular lens decentration at three time points after surgery;in the non-polished group,there were statistical differences in the intraocular lens decentration between 1 month and 6 months,3 months and 6 months after surgery.Comparison between groups:there was statistical difference in the intraocular lens decentration between polished group and non-polished group only at 6 months after surgery.The intraocular lens tilt increased slowly with time,but all of them were less than 3 degree.Comparison within the group:there were statistical differences in the intraocular lens tilt of polished group between 1 month and 6 months,3 months and 6 months;there were statistical differences in the intraocular lens tilt of non-polished group between 1 month and 3 months,1 and 6 months.Comparison between groups:there was no statistical difference between the two groups in the intraocular lens tilt at 1 month after surgery,but there were statistical differences between the two groups at 3 and 6 months after surgery.In the polished and non-polished groups,the anterior chamber depth and diopter did not vary statistically with time,and there was no statistical difference between the two groups.In the polished and non-polished groups,the anterior capsule became opaque slowly with time.There was a significant difference in the degree of anterior capsule opacification between the two groups at three time points after surgery,the time difference between one month and three months after surgery was extremely significant,and the difference decreased at six months after surgery.Conclusion:The anterior capsule contracted and opaqued in different degrees after femtosecond laser-assisted cataract surgery,and the intraocular lens may become decentral and tilted,but the decentration and tilt are small,and the diopter is stable after sugery.Anterior capsule polishing can reduce the anterior capsule shrinkage,reduce the degree of opacification of the anterior capsule,and reduce the intraocular lens decentration and tilt,but it has no significant effect on the postoperative diopter.