Clinical Comparison Of Three Different Incision Cataract Surgery

Purpose：By comparing and observing the result of oculyzer (volumeof corneal, corneal thickness, astigmatism) at preoperative andpostoperative of three different length incision cataractphacoemulsification surgery, the corneal endothelial, accommodation inpseudophakic eyes, in order to find an optimum method of cataractsurgery.Methods：This prospective randomized study comprised patientswho had phacoemulsification and IOL implantation in May2011toFebruary2012at the First Hospital of Jilin University, a total of110people (114eyes). Patients were divided into three groups (a total of110)based on personal voluntary choice of IOL types.1.8mm group forimplantation of Bausch&Lomb MI60IOL (52),3.2mm group forimplantation of Bausch&Lomb Akreos AO IOL (32),5.5mm group forimplantation of Alcon TYPE05IOL (30). Compare the test results ofpreoperative and postoperative3days,1week,1month,3months, includeuncorrected visual acuity, oculyzer（volume of corneal, corneal thickness,astigmatism）, corneal endothelial cell. Postoperative3days,1week,1month，3months record accommodation in pseudophakic eyes. Recordultrasound time and ultrasound energy. Examination and surgical methods:All the examination (Oculyzer) is completed by one operator, and repeated3times. The corneal endothelial were repeated three times too, and choosethe best result. Refraction and visual acuity: Use TOPCON automaticcomputer measure patients’ visual status (uncorrected distance, near visionand corrected visual) and record result. Determination of the near point ofthe eye was seized with Slataper as the standard method (the subjective test) to adjust the force. All procedures were done with a surgeon using theBausch&Lomb Stellaris phacoemulsification instrument. UsingSPSS13.0statistical analysis software for data analysis, to take rank sumtest and the chi-square test was used for statistics, data as mean±standarddeviation (x±s), P <0.05difference was statistically significant.Results： There were no statistically significant differences ineffective phacoemulsification time and intraoperative ultrasound energy(P>0.05). Oculyzer: There were no statistically significant differences incorneal astigmatism, corneal volume and central corneal thickness beforesurgery.Corneal astigmatism: The three groups of corneal astigmatismdifference was statistically significant (P <0.05) after3days, week, month,the smaller the incision smaller astigmatism. The surgical astigmatism ingroup1.8mm was less than that of3.2mm group and5.5mm group in earlytime (P<0.05), nearly three months with the time advantage is graduallyreduced. At3months there were no statistically significant differencesbetween1.8mm and3.2mm group (P>0.05), compare with5.5mm groupthere is statistically significant differences. Corneal volume: In the threegroups, corneal volume increases, but with time, can be gradually restored,1.8mm group is minimum change3days and1week after surgery (P<0.05), but the3.2mm and5.5mm group difference was not statisticallysignificant (P>0.05). To1month after surgery1.8mm and5.5mmsignificant difference (P <0.05), the difference was not statisticallysignificant (P>0.05) between the other groups. After3months, thedifference between the three groups was not statistically significant (P>0.05). Central corneal thickness: In the three groups, central cornealthickness increases, but with time, can be gradually restored,1.8mm groupis minimum change1week after surgery (P <0.05), there are nostatistically significant difference between the the3.2mm group with 5.5mm group (P>0.05).1month and3months after surgery, among thethree groups was no significant difference (P>0.05). The visual acuitynaked eyes were better in1.8mm group than in3.2mm group and5.5mmgroup in the earlier days after operation (P<0.05). There were nostatistically significant differences in corneal endothelial cell. In the1.8mm group and3.2mm group, the accommodation in pseudophakic eyesis higher than the5.5mm group in every time point (P＜0.05).Conclusion：Oculyzer anterior segment data including volume ofcornea, corneal thickness, astigmatism, crystal position, and its changesproduce accurate quantitative easier to sum up, observe the curativeeffect.Phacoemulsification through1.8mm coaxial micro incision canrapidly restore visual acuity earlier, reduce corneal astigmatism, increaseaccommodation in pseudophakic eyes, and less corneal injury.