| The first part Comparative study on the closure of microincision cataraet surgeryObjective:To Compare corneal incision closure between 3.0mm and 2.2mm incision in phacomulsification.Methods:Firstly, 67 age-related cataract patients with 71 eyes,were divided into two groups randomly. Secondly, 35 eyes were treated with 3.0mm incision and 36 eyes with 2.2mm incision. Finally, the author used AS-OCT to observe and compare the corneal thickness, corneal tunnel gaping, corneal endothelial gaping and descemet membrane detachment of each surgical incision at one day, one week, two weeks and one month after the surgery respectively.Results:1 There were no differences of two surgical incisions in uncorrected log MAR visual acuity and best corrected log MAR visual acuity at one day, one week, two weeks and one month after the surgery.2 Comparison of the AS-OCT index of two groups at different times2.1 The corneal incisional thickness: The mean corneal incisional thickness of 3.0mm incision and 2.2mmincision were 822.40±77.10μm and 862.53±68.01μm at one week, respectively. That is, the corneal incisional thickness of 2.2mm incision was thicker than the 3.0mm incision, and there was statistically significant difference between the 2 follow-up visits(P=0.023). The mean corneal incisional thickness of 3.0mm incision was 871.86±88.65μm at one day, 810.00±70.00μm at two weeks and 804.00±53.00μm at one month, respectively. The mean corneal incisional thickness of 2.2mm incision was 870±96.00μm at one day, 800.69±76.68μm at two weeks and 780.69±68.61μm at one month, respectively; there was no statistically significant difference between the 2 follow-up visits(P=0.796;P=0.747;P=0.411).2.2 The corneal tunnel gaping: Thecorneal tunnel gaping area of 3.0mm incisions was 8050.00(14800.00)μm2, and the 2.2mm incision was 5963.75(12137.00)μm2 at one day; there was no statistically significant difference between the 2 follow-up visits(P=0.295). The corneal tunnel gaping area of 3.0mm incision and 2.2mm incision was 4600.00(9435.00)μm2 and 6256.50(8712.00)μm2 at one week, respectively; there was no statistically significant difference between the 2 follow-up visits(P=0.284). The corneal tunnel gaping area of 3.0mm incision was 3507.50(13900.00)μm2, and the 2.2mm incision was 0.00(4154.00)μm2 at two weeks; there was 0.00(4485.00)μm2 and 0.00(4154.00)μm2 corresponded respectively to the 3.0mm’s corneal tunnel gaping area and the 2.2mm’s at one month; they are not significantly different(P=0.538).2.3 Difference comparisons of the incidence of corneal endothelial gaping and of the healing rates: The incidence of corneal endothelial gaping of the 3.0mm incision was 71.4%, the incidence of corneal endothelial gaping of the 2.2mm incision was 58.3% at one day; there was no statistically significant difference between the 2 follow-up visits(P=0.248). The corneal endothelial gaping incidence of the 3.0mm incision was 77.1% and the incidence of the 2.2mm incision was 63.9% at one week; there was no statistically significant difference between the 2 follow-up visits(P=0.221). At two weeks, the 3.00 mm’s incidence was 57.1% and the same index of the 2.2mm incision was 33.3%.Apparently, the incidence of the 3.0mm was higher than the 2.2mm’s. They are significant difference(P=0.044).The healing rate of the 3.0mm’s corneal endothelial gaping was 65.7%, meanwhile the healing rate of the 2.2mm incision was 69.4%, they are not significantly different(P=0.737).2.4 Difference comparisons of the corneal descemet membrane detachments and of the healing rates: There were 12 cases of the corneal descemet membrane detachment in 3.0mm surgery group at one day. Accordingly, there were 13 cases in 2.2mm surgery group. At one month, there were 11 cases had healed up in group 3.0mm incision, while there were 7 cases of 2.2mm incision. The healing rates were 91.7% and 53.8%, respectively. The healing rates of the group 3.0mm was higher than that in the 2.2mm group, there was statistically significant difference between the 2 follow-up visits at one month(P=0.035).Conclusion:The 2.2mm incision and the 3.0mm incision have similar closure in phacomulsification. The second part Comparative study on the visual quality assessment of microincision cataraet surgeryObjective: To Compare the difference on visual quality with 3.0mm and 2.2mmcataract surgeryincision.Methods: Firstly, the author collected 31 simple age-related cataract patients whose refractive astigmatism were less than 1.0D and crystal degree were between 18.0D and 24.0D and who were received and cured by our hospital from February to October in 2014 with 33 eyes. Then we divided them into two groups. There were 19 eyes with 3.0mm incision, named team I, and there were 14 eyes with 2.2mm incision, named team II. Lastly, we compared patients’ best corrected visual acuity, wave-front aberrations’ higher-order aberration, overall aberration, coma aberration and trefoil aberration at one day, one week, and one month after surgery.Results:1 The best corrected log MAR visual acuity: They are not significantly different at one month(P=0.788).2 Difference comparison of two groups’ wave-front aberrations index2.1 Astigmatism of wave-front aberration: The astigmatism of wave-front aberration of team I was 0.533±0.307μm, the same index of team II was 0.631±0.159μm, and there was no statistically significant difference between the 2 follow-up visits at one month(P=0.245).2.2 Coma aberration: The coma aberration which was 0.150±0.083μm of 3.0mm incision was higher than that which was 0.092±0.062μm of 2.2mm surgical incision, and there was statistically significant difference between the 2 follow-up visits at one month(P=0.037).2.3 Trefoil aberration: Trefoil aberration of team I was 0.315±0.131μm, trefoil aberration of team II was 0.276±0.112μm, and there was no statistically significant difference between the 2 follow-up visits at one month(P=0.367).2.4 Total aberration root mean square(RMS): The total aberration RMS of the group of 3.0mm incision was 0.930±0.354μm, the same index of 2.2mm incision was 0.874±0.196μm, and there was no statistically significant difference between them at one month(P=0.595).2.5 High order aberration RMS: The high order aberration RMS of the group of 3.0mm incision was 0.429±0.155μm, the same index of the another group was 0.319±0.208μm, and there was no statistically difference between them at one month(P=0.913).Conclusion:The coma aberration of 2.2mm incision was less than that of 3.0mm incision in phacomulsification. |
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