玻璃体视网膜疾病并发白内障患者行玻璃体切割术联合超声乳化白内障摘除术,即前后节联合手术,是高效的手术方式,而后囊膜破裂(posterior capsular rupture,PCR)是超声乳化白内障摘除术的术中并发症之一,能够及时、有效地处理PCR,稳定、安全地植入人工晶状体(intraocular lens,IOL),对于顺利完成后段手术,减少术后并发症十分重要。本文将对前后段联合手术中后囊膜破裂的术中处理、以及IOL光学部夹持固定法植入IOL的手术技术要点进行总结。
Combined surgery of pars plana vitrectomy (PPV) and phacoemulsification is an effective and safe way for management of retinal diseases complicated with cataract. Posterior capsular rupture (PCR) is one of the common intraoperative complications of phacoemulsification, and it is thus very important to deal with it promptly and efficiently, and ensure the subsequent procedures of intraocular lens (IOL) implantation as well as PPV. We will summarize the key points of the surgical technique for management of PCR and capture of IOL optic during combined surgery.
该文报道了一例40岁女性患者,因“双眼渐进性视物模糊3个月”就诊。患者既往于2005年因高度近视行双眼准分子激光原位角膜磨镶术 (LASIK)。最佳矫正视力OD:0.2 (–11.00 DS/ –1.25 DC×170 °),OS:0.7 (–4.00 DS/ –0.75 DC×25 °)。双眼角膜透明,前房中深,晶状体混浊,豹纹状眼底伴后巩膜葡萄肿。诊断为双眼并发性白内障,并行右眼白内障超声乳化联合人工晶状体 (IOL) 植入术,术中植入+14.0 D IOL一枚,目标屈光度为–0.5 D。术后1周裸眼视力0.3,验光结果示右眼屈光度+2.75 DS,最佳矫正视力0.7。术后2周行右眼IOL置换术,由+14.0 D置换为+17.0 D。右眼术后1周裸眼视力0.8,验光结果示右眼屈光度–0.75 DC×15 °。
It is reported in this article that a 40-year-old female patient presented with "progressive blurred vision of both eyes for 3 months". The patient underwent bilateral laser in situ keratomileusis (LASIK) because of high myopia in 2005. It was recorded that her best corrected visual acuity was 0.2 (–11.00 DS/ –1.25 DC×170 °) in the right eye and 0.7 (–4.00 DS/ –0.75 DC×25 °) in the left, and clear cornea, normal anterior chamber, cloudy lens, tessellated fundus with posterior staphyloma in both eyes. The patient was diagnosed with bilateral complicated cataract. Phacoemulsification combined with intraocular lens (IOL, +14.0 diopter (D)) implantation was performed on the right eye, with the target –0.5D refractive diopter . One week after surgery, it was recorded that the uncorrected visual acuity of the right eye was 0.3, and the best corrected visual acuity was 0.7 (+2.75 DS). IOL replacement of the right eye was performed two weeks after surgery, the +14.0 D IOL was replaced by +17.0 D IOL. One week after surgery, the uncorrected visual acuity of the right eye was 0.8 (–0.75 DC×15 °).
目的:通过对改良“Z”形无线结经巩膜缝线固定人工晶状体手术和传统有线结巩膜缝线固定人工晶状体手术治疗先天性晶状体脱位的比较来评价改良术式的临床疗效。方法:回顾性病例研究。纳入2018年1月—2021年3月期间于中山大学中山眼科中心行手术治疗的先天性晶状体脱位患者73例73眼,按手术方式不同将患者分为无线结组36例36眼和有线结组37例37眼。比较两组患者术前和术后1年的球镜度(DS)、柱镜度(DC)、等效球镜(SE)、最佳矫正视力(BCVA)、眼压(IOP)、眼轴长度(AL)、角膜内皮细胞计数和术后并发症的发生率。结果:两组患者术前各项观察指标组间比较差异无统计学意义(均P>0.05)。两组患者术后1年 BCVA 均较术前提高(均P<0.05),SE均较术前降低(均P<0.05)。两组患者术后1年 BCVA 、DS、DC、SE、IOP、AL、角膜内皮细胞丢失率组间比较差异均无统计学意义(均P>0.05)。术后1年,有线结组有5例(13.5%)出现缝线暴露,无线结组未出现缝线暴露,组间比较差异有统计学意义(P<0.05)。结论:改良无线结 IOL 巩膜缝线固定手术可改善CEL患者的最佳矫正视力和屈光不正,有效减少缝线暴露及相关并发症。
Objective: To evaluate the clinical efficacy of modified “Z”-shaped knotless transscleral suture fixation intraocular lens (IOL) and traditional knotted transscleral suture fixation IOL in congenital ectopia lentis. Methods: A retrospective case study. A total of 73 eyes of 73 patients with congenital ectopia lentis who underwent surgical treatment in our hospital from January 2018 to March 2021 were included. According to different surgical methods, the patients were divided into the knotless group (36 eyes) and knotted group (37 eyes). Preoperative and postoperative of 1-year diopter sphere (DS), diopter cylinder (DC), spherical equivalent (SE), best corrected visual acuity (BCVA), intraocular pressure (IOP), and axial length (AL), corneal endothelial cell counts and the occurrence of postoperative complications rate were analyzed among two groups. Results: There was no significant difference in preoperative outcome measures between the two groups (P>0.05). BCVA at 1-year postoperative was significantly better (P<0.05), and SE at 1-year postoperative was significantly lower (P<0.05). There was no significant difference in BCVA, DS, DC, SE, IOP, AL, and corneal endothelial cell loss rate between the two groups at 1-year after operation (P>0.05). One year after the operation, there were 5 cases of suture exposure (13.5%) in the knotted group and no suture exposure in the knotless group, and the difference was statistically significant (P<0.05). Conclusions: The modified knotless IOL transscleral suture fixation can improve the best corrected visual acuity and alleviate ametropia of CEL patients, and reduce suture exposure and related complications effectively.
目的:在硅油取出联合白内障手术患者中,使用扫频源光学相干断层扫描生物测量仪OA-2000进行生物测量,比较10种人工晶状体(IOL)屈光力计算公式的准确性。方法:回顾性分析2021年3月—7月于中山大学中山眼科中心接受硅油取出联合白内障手术的患者共62例(62眼),所有患者均使用扫频源光学相干断层扫描生物测量仪OA-2000进行生物学参数测量。计算并比较新公式[Barrett Universal II (BUII)、Emmetropia Verifying Optical(EVO) 2.0、Hill-Radial Basis Function (Hill-RBF) 3.0、Hoffer QST、Kane、Pearl-DGS]及传统公式(Haigis、Hoffer Q、Holladay 1、SRK/T)的预测准确性,主要评价指标为绝对预测误差中位数(MedAE)及平均绝对预测误差(MAE)。按眼轴长度≤23 mm(组1),>23 mm且≤26 mm(组2)与>26 mm(组3)进行亚组分析。结果:6个新公式、Haigis、SRK/T公式均出现近视漂移(-0.47 ~-0.27 D,P<0.05),而HofferQ及Holladay 1公式无系统误差(P>0.05)。Kane公式的MedAE(0.55 D)及MAE(0.81 D)最小,但公式间比较差异无统计学意义(P>0.05)。组1中所有公式均出现近视漂移(-1.46~ -1.25 D,P<0.05),而其他亚组比较差异无统计学意义(-0.32 ~ 0.41 D,P>0.05)。在组1中,Pearl-DGS公式的MedAE(0.97 D)及MAE(1.26 D)最小,且优于Hill-RBF 3.0(P=0.01)及SRK/T公式(P=0.02);组2中,Kane公式具有最小的MedAE(0.44 D)及MAE(0.66 D);组3各个公式屈光预测准确性比较差异无统计学意义(P>0.05)。结论:在使用OA-2000进行术前生物测量时,Kane公式在接受硅油取出联合白内障手术患者中的预测准确性较高;而眼轴长度≤23 mm时,Pearl-DGS公式可能更为准确。
Objective: To compare the accuracy of 10 intraocular lens (IOL) power calculation formulas in patients undergoing combined silicone oil removal and cataract surgery, biometry is performed using the swept-source optical coherence tomography biometer OA-2000. Methods: A retrospective analysis. A total of 62 patients (62 eyes) who underwent combined silicone oil removal and cataract surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from March to July in 2021 were enrolled. Preoperative biometry was performed by OA-2000 in all patients. New-generation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO] 2.0, Hill-Radial Basis Function [Hill-RBF] 3.0, Hoffer QST, Kane and Pearl-DGS) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) were evaluated. The median absolute prediction error (MedAE) and mean absolute prediction error (MAE) were the main parameters used to assess accuracy. Subgroup analyses were performed based on the axial length of 23 mm and 26 mm. Results: Six new-generation formulas, Haigis, and SRK/T showed myopic shift (-0.47 ~ -0.27 D, P<0.05), while no systematic bias was found in Hoffer Q and Holladay 1 displayed (P>0.05). The smallest MedAE (0.55 D) and MAE (0.81 D) were found in Kane formula, but there was no statistically significant difference compared with other formulas (P>0.05). The myopic shift (-1.46 ~ -1.25 D, P<0.05) in eyes shorter than 23 mm were found in all formulas, while there was no significant systematic bias (-0.32 ~ 0.41 D, P>0.05) in other subgroups. In axial length shorter than 23 mm, the Pearl-DGS formula stated the smallest MedAE (0.97 D) and MAE (1.26 D), and was significantly more accurate than Hill-RBF 3.0 (P=0.01) and SRK/T (P=0.02). In eyes with an axial length between 23 mm and 26 mm, the Kane formula had the lowest MedAE (0.44 D) and MAE (0.66 D). No significant difference was found in eyes longer than 26 mm. Conclusion: The Kane formula showed the highest accuracy in patients undergoing combined silicone oil removal and cataract surgery measured by OA-2000, whereas the Pearl-DGS formula could be more accurate in eyes with an axial length shorter than 23 mm.
目的:探讨超声乳化晶状体吸除联合囊袋上经巩膜缝线固定人工晶状体(intraocular lens,IOL)植入术治疗球形晶状体(microspherophakia,MSP)的有效性和安全性。方法:采用回顾性分析,选取2019年1月至 2020年6月期间在复旦大学附属眼耳鼻喉科医院进行治疗的MSP患者37例(37眼),随机分为两组,纳入行超声乳化晶状体吸除联合囊袋上巩膜缝线固定IOL植入术(supra-capsular and scleral-fixated intraocular lens implantation,SCSF-IOL)的MSP患者20例(20眼)和行超声乳化晶状体吸除联合改良型囊袋张力环植入术(transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation,MCTR-IOL)的MSP患者17例(17眼),观察两组术后最佳矫正视力及并发症等情况。结果:两组术后最佳矫正视力比术前均有改善(P<0.001),而组间比较差异无统计学意义(P=0.326)。两组的IOL倾斜度相当(P=0.216)。预防性Nd:YAG激光后囊膜切开术在SCSFIOL术后1周至1个月进行。在SCSF-IOL组,2眼(10.00%)需要重复激光治疗,1眼(5.00%)出现囊口偏心。后囊膜混浊是MCTR组最常见并发症(6眼,35.29%)。随访期间两组均未出现IOL脱位、继发性青光眼和视网膜脱离。结论:SCSF-IOL是治疗球形晶状体的简单易行的手术方式,疗效与MCTR-IOL相当。Nd:YAG激光后囊膜切开术是预防SCSF-IOL术后囊袋并发症的必要手段。
Objective: To investigate the efficacy and safety of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens (IOL) implantation in the treatment of microspherophakia (MSP). Methods: by retrospective analysis, 37 MSP patients (37 eyes) who were treated in our hospital from January 2019 to June 2020 were randomly divided into two groups, including 20 MSP patients (20 eyes) who treated by SCSF-IOL and 17 MSP patients (17 eyes) who treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL). The best corrected vision and complications were observed. Results: the best corrected vision was significantly improved in both groups (P < 0.001), but there was no remarkable difference between the two groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd: YAG laser posterior capsulotomy was performed from 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment, and one eye (5.00%) had a decentered capsule opening. Posterior capsular opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up. Conclusions: SCSF-IOL is a simple and viable surgical option for managing MSP and is comparable with the MCTR-IOL. Nd: YAG laser posterior capsulotomy is a necessary mean to prevent residual capsule complications after the SCSF-IOL procedure.
目的:探讨压核进钩劈核技术在白内障超声乳化摘除手术培训中的应用效果。方法:采用回顾性研究。选取2019年1月—2023年12月在广东省中医院珠海医院眼科学习超声乳化白内障吸除术的30名学员为研究对象,所有对象培训周期均为3个月,分为乳化劈核教学组和压核进钩劈核教学组,统计学员第一次完成劈核前的猪眼手术量、第一次完成全部手术步骤前的猪眼手术量、一次性完整完成二分核的次数,培训结束时对学员进行猪眼手术操作考核并记录评分,采用问卷调查对两种教学方式进行评价。结果:压核进钩劈核教学组第一次完成劈核前的平均猪眼手术量为36.69(19,50)个,低于乳化劈核教学组的49.86(29,66)个(U=-3.08,P<0.05);压核进钩劈核教学组第一次完成全部手术步骤前的平均猪眼手术量为58.13(31,79)个,低于乳化劈核教学组73.14(50,90)个(U=-2.66,P<0.05);压核进钩劈核教学组一次性完整完成二分核的次数为14.75(9,22)次,高于乳化劈核教学组6.79(3,14)(U=4.02,P<0.05);压核进钩劈核教学组学员动物眼手术碎核步骤平均分为4.50(3,5),高于乳化劈核教学组的3.71(2,5)次(U=2.23,P<0.05);完整手术考核总分平均分为29.00(23,33)分,高于乳化劈核教学组的23.07(19,28)分(U=3.98,P<0.05)。培训结束时,压核进钩劈核教学组学员评价教学效果调查问卷总评分平均为18.31(15,20)分,高于乳化劈核教学组15.07(12,18)(U=3.69,P<0.05)。结论:核进钩劈核技术有助于学员更快地掌握碎核技术,缩短白内障超声乳化摘除手术的学习曲线,增强学习白内障手术的信心,提高超声乳化白内障吸除术的教学效果和满意度。
Objective:To investigate the effect of the press-and-chop technique in cataract phacoemulsification training. Methods:From January 2019 to December 2023, 30 trainees who studied cataract phacoemulsification surgery in the ophthalmology department of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai were selected as the research subjects. The training period for all subjects was 3 months, and they were divided into two groups: phaco-chop teaching group and press-and-chop teaching group. The quantity of porcine eye surgeries performed by each trainee before completing the first nuclear chopping, the quantity of porcine eye surgeries performed before completing all surgical steps for the first time, and the number of times of complete nuclear chopping in one attempt were recorded. At the end of the training, the trainees were assessed on their ability to perform porcine eye surgeries and their scores were recorded. A questionnaire survey was conducted to valuate the two teaching methods. Results:The average number of porcine eye surgeries performed by the press-and-chop teaching group before completing the first nuclear chopping was 36.69 (19,50), which was lower than the phaco chop teaching group's 49.86 (29,66);The average number of porcine eye surgeries performed by the press-and-chop teaching group before before the first completion of all surgical steps was 58.13 (31, 79), which was lower than the phaco chop teaching group's 73.14 (50, 90).The average number of complete nuclear chopping in one attempt in the press-and-chop teaching group was 14.75 (9,22), which was higher than the phaco chop teaching group's 6.79 (3,14);The average score of the chopping step of porcine eye surgery for the press-and-chop teaching group was 4.50 (3,5), which was higher than the phaco chop teaching group's 3.71 (2,5);The average score for the press-and-chop teaching group of the complete surgery examination was 29.00 (23, 33), which was higher than the phaco chop teaching group's 23.07 (19, 28).At the end of the training, the average score of the survey questionnaire on the evaluation of teaching effectiveness by the press-and-chop teaching group was 18.31 (15, 20), which was higher than that of the phaco chop, which was 15.07 (12, 18). Conclusions:The press-and-chop technique helps trainees to master the chopping technique faster, shorten the learning curve of cataract phacoemulsification surgery, enhance confidence in learning cataract surgery, and improve the teaching effectiveness and satisfaction of cataract phacoemulsification surgery.
目的:评估内界膜翻瓣术联合空气填充在黄斑裂孔手术应用中的有效性。方法:回顾性分析中山眼科中心2016—2019年入院,因黄斑裂孔行内界膜翻瓣术联合空气填充术治疗的患者71例71眼,术后俯卧位1~3 d且随访达6个月以上。通过OCT判断患者黄斑裂孔闭合率,比较患者术前及术后最佳矫正视力(best corrected visual acuity, BCVA),通过MAIA微视野计检查评估术前与术后黄斑平均光敏度、黄斑完整指数、固视稳定性P1及P2等指标。结果:在总的71只眼中,有91.5%达到了黄斑裂孔的完全闭合。患者术前及术后BCVA提升(P<0.001),黄斑平均光敏度增加(P<0.000 1)、黄斑完整指数降低(P<0.000 1)、固视稳定性P1(P<0.000 1)及P2(P<0.001)均提升。结论:内界膜翻瓣术联合空气填充是治疗黄斑裂孔有效的手术方式,空气填充可有效地辅助黄斑裂孔愈合,可作为优先考虑的术中填充物,减轻患者因长时间保持面向下体位带来的痛苦。微视野计参数可用作评估黄斑结构及功能恢复的良好指标。
Objective: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (P < 0.001), average macular sensitivity significantly increased (P < 0.000 1), macular integrity index significantly decreased (P < 0.000 1), and fixation stability P1 (P < 0.000 1) and P2 (P < 0.001) both significantly improved. Conclusions: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.
二氧化碳(carbon dioxide, CO2)激光通过气体混合物激发产生红外光,组织水分高度吸收后引发汽化和局部热效应,能够精确封闭小血管和淋巴管。这些特性使得CO2激光在组织切割过程中能够最大限度地减少出血,提高术中视野的清晰度,缩短手术时间,并减轻术后肿胀、瘀斑及疼痛。在眼整形外科,特别是处理眼周复杂病例方面,CO2激光展现了显著的优势。文章对CO2激光在眼整形外科中的应用进行综述,包括眼睑肿物切除、泪小管炎治疗、瘢痕治疗、皮肤松弛治疗以及眼袋去除等,旨在为临床医生和研究人员提供关于CO2激光在眼整形外科中的全面参考,帮助其了解该项技术的优势、效果及术后并发症,以更有效地应用于实践并探索未来发展。
The carbon dioxide (CO2) laser generates infrared light through the excitation of a gaseous mixture. When this infrared light is highly absorbed by tissue water, it triggers vaporization and localized thermal effects, enabling precise sealing of small blood vessels and lymphatic vessels. These properties allow the CO2 laser to minimize bleeding during tissue dissection, enhance intraoperative visual field clarity, reduce operative time, and alleviate postoperative swelling, ecchymosis, and pain. The CO2 laser has demonstrated significant advantages in oculoplastic surgery, particularly in the management of complex periorbital cases. This article reviews the applications of the CO2 laser in oculoplastic surgery, including eyelid tumor excision, treatment of canaliculitis, scar management, skin laxity treatment, and removal of eye bags. It aims to provide clinicians and researchers with a comprehensive reference on the use of the CO2 laser in oculoplastic surgery, helping them understand the advantages, effects, and postoperative complications of this technology, in order to more effectively apply it in practice and explore future developments.
Background: Different visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.Methods: We used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.Results: When all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by –0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P>0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P<0.05).Conclusions: Both the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.
Background: Different visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.Methods: We used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.Results: When all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by –0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P>0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P<0.05).Conclusions: Both the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.
Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens (IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by iTrace wavefront aberrometer (Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square (RMS) values of Z(3, -3), Z(3, 3), Z(3, -1), Z(3, 1), and Z(4, 0) and total high order aberration (HOA) were evaluated.Results: The uncorrected and corrected visual acuities improve significantly (P<0.001). No significant postoperative changes were observed in spherical aberration (P=0.652). Significant changes in vertical coma and vertical trefoil (0.005±0.214 vs. -0.049±0.242, P=0.037; -0.141±0.222 vs. -0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery (0.567±0.161 vs. 0.688±0.343, P<0.001).Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8 mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.
Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens (IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by iTrace wavefront aberrometer (Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square (RMS) values of Z(3, -3), Z(3, 3), Z(3, -1), Z(3, 1), and Z(4, 0) and total high order aberration (HOA) were evaluated.Results: The uncorrected and corrected visual acuities improve significantly (P<0.001). No significant postoperative changes were observed in spherical aberration (P=0.652). Significant changes in vertical coma and vertical trefoil (0.005±0.214 vs. -0.049±0.242, P=0.037; -0.141±0.222 vs. -0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery (0.567±0.161 vs. 0.688±0.343, P<0.001).Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8 mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.