Comparison Of The Safety And Visual Quality Of Two Kinds Of Polishing Methods

Objective To study and compare the efficacy and safety of two kinds of capsule polishing methods to remove the residual cortical fibers and epithelial cells in the cataract phacoemulsification combined with intraocular lens implantation,and to compare the visual quality,so as to provide the a new choice for improving the surgical skills and reducing the incidence of posterior capsule opacificationMethods The data of the patients who had cataract surgery in our hospital from January 2019 to January 2020 were collected.Patients were randomly divided into A and B group.Group A was single I/A polishing capsule group:conventional cataract phacoemulsification technology,I/A polishing lens before,after and equatorial capsule.Group B:hydropolish combined with water polishing capsule group:conventional phacoemulsification,I/A was used to polish the anterior capsule,hydropolish involved of the posterior and equatorial capsule after I/A polishing.The best corrected visual acuity(BCVA),internal high order aberrations(internal HOA),trefoil,coma,endothelial cell density(ECD),central corneal thickness were observed,CCT,CDE and intraoperative complications were analyzed by SPSS 26.0.The data were expressed in the form of mean±SD.Before and after treatment,paired sample t test was used in each group,and independent sample t test was used between the two groups.P<0.05 was statistically significant.Results 60 eyes were included in this study,32 eyes in group A and 28 eyes in group B.(1)BCVA of the patients in the two groups was significantly improved after operation.The BCVA of group B was better than that of group A at each time point in the follow-up period(P<0.05),but there was no statistical significance between the two groups at 1 and 3 months after operation(P>0.05).(2)The RMS values of internal HOA,trefoil and coma in group B were significantly lower than those in group A(P<0.05).(3)There was no significant difference in CDE between the two groups(P>0.05),while the amount of intraoperative fluid used(EDU)in group B was significantly less than that in group A(P<0.05).(4)The CCT of group A was significantly higher than that of group B on the first day after operation(P<0.05).(5)The postoperative ECD of the two groups decreased significantly.The ECD of the two groups was still significantly lower than that of the group before operation in 3 months after operation(P<0.05).During the follow-up period,one month and three months after operation,group A was significantly lower than that of group B,the difference was statistically significant(P<0.05).(6)During the follow-up of 60 patients,intraocular lenses were all in the pouch,and no complications such as IOL deviation,pouch shrinkage and corneal endothelial decompensation were found.In 2 cases of single eye I/A polishing capsule,posterior capsule rupture occurred during operation,and the data results were not included in this study.Conclusion The whole capsule polishing can effectively remove the remaining cortex fibers and epithelial cells in the capsule,improve the postoperative vision,prevent the occurrence of posterior capsule opacification,and improve the postoperative visual quality of the patients.Water polishing is a fast,non-contact,safe and effective polishing technique for phacoemulsification.This technique does not need special surgical instruments,and is easy to operate.Compared with conventional I/A polishing,it can remove the residual cortex and epithelial cells more safely,The postoperative visual acuity improved significantly,and greatly reduced the risk of corneal endothelial injury and posterior capsule rupture.