| Purposes:1.This study may know the relations between inflammatory factors and traumatic cataracts through testing the expression of interleukin-6 (IL-6), transforming growth factor-β (TGF-P), fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) in the aqueous humor of patients with traumatic cataract. 2.The clinical data of traumatic cataract patients who were treated in our hospital were analyzed in the study, to know the value of ocular trauma scoring system (OTS) in predicting postoperative vision of ocular trauma patients. To compare the results between primary and secondary artificial lens implantation. We reported a surgery that 2-point scleral fixation of intraocular lens for the treatment of the aphakic eye after traumatic cataract operation.Methods:Part 1:21 patients(group A) who has traumatic cataract by closed globe injuries (10.90±1.41) days after traumatic,20 age relative cataract cases(group B) and 20(group C) high myopia cases who were operated by posterior scleral reinforcement and puncture of anterior chamber were collected in this study. The enzyme linked immunosorbent assay (ELISA) was used to test the expression of IL-6, TGF-β,FGF and VEGF in the aqueous humor of the three groups. By comparing three data sets, we figured out change of inflammatory factors in the aqueous humor of those with traumatic cataract.Part 2:In the retrospective cohort study, clinical data of 104 people who had traumatic cataracts and received treatment and surgery in our hospital from October 2008 to December 2013 were collected. Analyze the etiology of these patients. Ocular trauma scoring system (OTS) was introduced to evaluating the accuracy of prognosis by comparing their prognosis vision before treatment and actual vision after treatment. The 104 patients who adopted a primary intraocular lens implantation were divided into group A and the patients who adopted a secondary intraocular lens implantation were divided into group B. Comparisons were made about vision and complication after treatment between these two groups. We picked out 16 people after cataract operation which have not enough capsule to support. A one-piece, foldable posterior chamber lens was implanted into the eye by 2-point scleral fixation. The vision, spherical equivalent (SE) and corneal endothelial cells count (ECC) were recorded and the lens location was checked by using ultrasound biomicroscopy (UBM) three days, one week, one month, six month and twenty four month after treatment.Results:Part 1:The expression of IL-6 in group A was statistically higher than that in the group B and group C. The expression of TGF-β in group A was statistically higher than that in the group B and group C. FGF in group A was statically the same as that in the group B and C. The expression of VEGF in group A was statistically higher than that in the group B and group C.Part 2:When the vision index was below 0.1 or above 0.5, the OTS’s prognosis accuracy was 100%; When the index was 0.1～0.5, the OTS’s accuracy was 91.9% and its specificity 100%.The vision after a primary IOL implantation was statistically different from a secondary IOL implantation. There was no statistically difference between the two groups in comparison of complication. The best corrected vision after IOL being fixated with suturing was statistically higher than before. The SE and ECC almost kept the same before and after the surgery. There were no complications like infection, lens displacement, suture exposure, retinal detachment, endophthalmitis and so on, except for two cases of macular edema (12.5%)Conclusion:IL-6、TGF-β、VEGF levels in the aqueous humor of traumatic cataract after closed globe were higher than normal, when the level of FGF have no significant change. OTS shows a good vision prognosis for traumatic cataract. The vision after the surgery of traumatic cataract after a primary IOL implantation was different from a secondary IOL implantation, but there was no difference in complications after surgery. It is safe and effective to treat aphakic after postoperative of traumatic cataract which have not enough capsule by the method of scleral-fixation technique for foldable intraocular lenses with four hollow haptics. |
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