| Objective To observe the curative effect,reliability and security of intraocular lens implantation combined with coreoplasty in patients with mydriasis as well as aphakia.Methods This study used a retrospective as well as self-controlled method.A total of 16 patients(16 eyes,including aphakic and intraocular lens eyes)with iris rupture and pupil abnormalities were included in our hospital from October 2017 to December 2019,with 12 males and 4 females included,and were aged from 25 to 68 years,with an average of(43.75±12.27)years.All patients were performed the operation of intraocular lens implantation combined with coreoplasty.After operation,the patients were followed up.The differences before and after operation in visual acuity(converted to LogMAR),pupil diameter,intraocular pressure,central retinal thickness and subfoveal choroidal thickness and visual function questionnaire scores were compared.Meanwhile,observe the complications during and after surgery.Statistical analysis was carried out by using SPSS25.0 software.Paired sample t-test was used for comparative observation of various indexes before and after operation,and analysis of variance and pairwise comparison of single factor repeated measurement were used at different time after operation.P<0.05 was considered statistically significant.Results The mean uncorrected visual acuity(UCVA)had been improved to different levels after operation.The mean UCVA was 1.82±0.84 before operation,and 0.68±0.17,0.63±0.21,0.53±0.19,0.49±0.19,0.48±0.19 at 3 days,1 week,1 month,3 months as well as 6 months after operation,compared with preoperative level one by one,the difference was statistically significant(P<0.05).The difference between UCVA at different time points after operation was statistically significant(F=26.67,P<0.05),and there was significant difference in UCVA between 1 week and 1 month after operation(P<0.05).The best corrected visual acuity(BCVA)was mean 0.39±0.23 at time before surgery,and 0.61±0.20,0.54±0.23,0.43±0.19,0.41±0.20,0.38±0.18 at 3 days,1 week,1 month,3 month as well as 6 months after operation;The difference between BCVA before operation and 3 days as well as 1 week after operation was statistically significant(P<0.05),while compared with BCVA at 1 month,3 months and 6 months after operation,the difference was not statistically significant(P>0.05).The BCVA had recovered with the increase of postoperative time,and the difference in BCVA between 1 week and 1 month after operation was statistically significant(P<0.05).The preoperative mean intraocular pressure was(15.19±2.92)mmHg,and(16.02±3.89)mm Hg,(15.80±4.91)mm Hg,(14.38±2.02)mmHg,(14.26±2.10)mmHg,(14.29±1.85)mmHg,at 3 days,1 week,1 month,3 months as well as 6 months after operation;compared with the level before operation,no significant difference was found(P > 0.05).The mean pupil diameter measured before operation was(6.52±0.62)mm,and(3.63±0.32)mm after operation,the difference between the two measurement results was statistically significant(P<0.05);The mean difference between the longest and shortest pupil diameter before operation was(1.45±1.55)mm,and(0.67±0.47)mm after operation,the difference between the two results had statistical significance(P<0.05);The postoperative pupil of the patient was near-round,and the diameter was smaller than the optical area of intraocular lens.The mean central retinal thickness(CRT)before operation was(241.00±39.30)?m,and(250.94±47.74)?m,(267.94±53.36)?m,(257.06±48.66)?m,(252.69±47.38)?m at 1 week,1 month,3 months as well as 6 months after operation;CRT after operation was measured thicker than the result before operation,the difference was statistically significant(P<0.05).The mean subfoveal choroidal thickness(SFCT)before operation was(287.56±62.38)?m,and(302.75±59.98)?m,(305.81±61.89)?m,(304.75±62.13)?m,(302.69±61.37)?m,at 1 week,1 month,3 months as well as 6 months after operation;SFCT after operation was measured thicker than the result before operation,the difference was statistically significant(P<0.05).The symptom of photophobia and shame had relieved after operation.The visual quality of the patients was investigated.Except for the score comparison before and after surgery in eye discomfort and color vision was not statistically significant(P>0.05),scores of the remaining subscales after operation were higher than before,and the difference was statistically significant(P<0.05).About the complications: A small amount of hyphema occurred in 1 case during the operation,and the bleeding stopped after hemostatic operation;The number of people with high intraocular pressure after operation was 3,all had recovered after drug treatment or clinical observation;And slight deviation of intraocular lens was observed in 1 case.Conclusions The treatment of intraocular lens implantation combined with coreoplasty is a safe and effective method,it can not only make the visual acuity of patients improved,but also maximize the restoration of the shape of the anterior segment,eliminate symptoms such as photophobia and glare,and satisfy the patients' pursuit of improving visual quality. |
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