| Background And ObjectivesCurrently, the cataract phacoemulsification and foldable intraocular lens (IOL) implantation has become a preferred surgery and common treatment of age-related cataract (ARC). But in the long term follow-up, the eyes of some patients after cataract surgery are likely to myopia. In some extent, There were some differences between the results and the expect, which can affect the patients’ visual quality. With the development of economy and society, the surgery technology of eyes is continue to improving, patients are increasingly concerned about the visual quality. The cataract surgery has from the surgery of restoring vision to refractive surgery. For patients, to obtain a good visual acuity after surgery, you need to take a variety of factors into account which may affect postoperative refraction of eyes, when you calculate the diopter of different types of intraocular lens before the surgery, such as: axial length, corneal curvature, refractive constant, intraocular lens material and thickness, haptics angle of intraocular lens and anterior chamber depth (ACD) and so on. This study investigates the correlation between the type of intraocular lens and the ACD changes, the refraction changes after cataract phacoemulsification and foldable intraocular lens implantation. It may provide a reference to choose different types and diopters of intraocular lens.Methods1.40cases (46eyes) of senile cataract were divided into two group having phacoemulsification and IOL implantation in bags from the Second Affiliated Hospital of Zhengzhou University. There were22males (24eyes) and18females (eyes) in them, age between60.0and79.0years old, an average age was68.5±2.5years old, except glaucoma, corneal opacity, retinal detachment and other eye diseases and high blood pressure, diabetes and other systemic diseases in their eyes. One-piece group (62.0～79.0old of age):10males and8females, the average age was70.3±3.8years old,23eyes implanted with one-piece intraocular lens (AMO Tecnis ZCB00, A constant is118.8, the material of optical and haptic are hydrophobic acrylic, haptic angular magnitude is0°); three-piece group (60.0-79.0old of age):12males and10females, average age was71.3±2.7years old,23eyes implanted with three-piece intraocular lens (AMO Tecnis ZA9003, A constant is119.1, the material of optical is hydrophobic acrylate, the material of haptic is polymethyl methacrylate (PMMA), haptic angular magnitude is5°).2. Patients had phacoemulsification and IOL implantation in bags capsular bag implantation with three-plane corneal incision, on the operating table, with continuous curvilinear capsulorhexis diameter of5mm-5.5mm. phacoemulsificated and implanted with intraocular lens, then adjusted the lens position. All intraocular lens were implanted in the capsular bag. All operations were performed by the same operator.3. The1st month, the3rd month, the6th month after surgery, measured the visual acuity, intraocular pressure (IOP), best corrected visual acuity, correction spherical degree, ACD was measured by ultrasound biomicroscopy (UBM). All checks operated by the same skilled doctors, ACD was measured three times and averaged.4. SPSS17.0statistical analysis software was used to analyze the clinical data. And a=0.05was used as the standard test.Results1. Complications:The1st month, the3rd month, the6th month after surgery, all the intraocular lens were in capsular bags. There were no glaucoma after cataract intraocular lens eccentric, dislocation, retinal detachment, corneal decompensation and other complications happened.2. Postoperative uncorrected distance visual acuity:Significant difference was found of the uncorrected distance visual acuity in one-piece group among the1month,the3months and6months after surgery (F=5.330, P=0.031<0.05). There was a significant difference of uncorrected distance visual acuity in one-piece group between that at1month and at6months after surgery (t=2.309, P=0.031<0.05). There was no significant difference of uncorrected distance visual acuity in one-piece group between that at1month and at3months and between that at3months and at6months after surgery (t=1.412, P=0.172>0.05; t=1.525, P=0.142>0.05); No significant difference was found of the uncorrected distance visual acuity in three-piece group among the1month,the3months and6months after surgery (F=2.026, P=0.169>0.05). There was no significant difference of correction spherical degree of postoperative distance visual acuity in these two group among the1month,the3months and6months after surgery (t=0.198, P=0.844>0.05; t=0.967, P=0.339>0.05; t=1.906, P=0.063>0.05).3. Postoperative near visual acuity:The significant difference was found of the near visual acuity in one-piece group among the1month,the3months and6months after surgery (F=5.184, P=0.033<0.05). There was a significant difference of near visual acuity in one-piece group between that at1month and at6months after surgery (t=2.784, P=0.011<0.05). There was no significant difference of near visual acuity in one-piece group between that at1month and at3months and between that at3months and at6months after surgery (t=2.046, P=0.053>0.05; t=1.683, P=0.106>0.05); No significant difference was found of the near visual acuity in three-piece group among the1month,the3months and6months after surgery (F=2.851, P=0.105>0.05).4. ACD of postoperative pseudophakic eye:Significant difference was found of ACD in one-piece group among the1month,the3months and6months after surgery (F=13.833, P=0.000<0.05). There was a significant difference of ACD in one-piece group between that at1month and at6months after surgery (t=4.576, P =0.000<0.05). There was no significant difference of ACD in one-piece group between that at1month and at3months and between that at3months and at6months after surgery (t=2.061, P=0.052>0.05; t=1.811,P=0.084>0.05); No significant difference was found of ACD in three-piece group among the1month, the3month and6months after surgery (F=1.867, P=0.179>0.05). ACD in one-piece group was less than that in three-piece group1month,the3months and6months after surgery (t=-2.082, P=0.043<0.05; t=-3.030, P=0.031<0.05; t=-3.508, P=0.020<0.05).5. Correction spherical degree of postoperative distance visual acuity:Significant difference was found of correction spherical degree in one-piece group among the1month,the3month and6months after surgery (F=3.900, P=0.036<0.05). There was a significant difference of correction spherical degree in one-piece group between that at1month and at6months after surgery (t=2.783, P=0.011<0.05). There was no significant difference of correction spherical degree in one-piece group between that at1month and at3months and between that at3months and at6months after surgery (t=1.859, P=0.076>0.05; t=1.947, P=0.064>0.05). No significant difference was found of correction spherical degree in three-piece group among the1month, the3months and6months after surgery (F=1.096,P=0.352>0.05).6. Correlation Analysis:The change of spherical degree had a positive correlated on the change of postoperative anterior chamber depth, compared1month with6months after surgery (r=0.672, P=0.000<0.05)Conclusions1. The diopter of pseudophakic eye is not only associated with the accuracy of intraocular lens power calculation, but also associated with the depth of the anterior chamber;2. In long term follow-up, the anterior chamber depth of the eye implanted with one-piece intraocular lens is shallower during the6months after surgery. The eyes with1-piece IOL are likely to cause myopia; The eyes implanted with3-piece IOL don’t have the changes of ACD and diopter;3. The ACD of1-piece IOL is shallower than that of3-piece IOL; 4. The change of spherical degree has a positive correlated on the change of postoperative anterior chamber depth after phacoemulsification;5. The ACD of intraocular lens with0°haptic angulation is shallower than that with5°haptic angulation. With the increasing of haption of IOL implanted, it showes a reducing in IOL moving forward. |
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