Clinical research of topography-guided phacoemulsmcation surgery for diabetic cataract patients

Abstract

Objective To observe the symptom of ocular surface,corneal thickness,tear film stability and astigmatism of diabetic cataract patients after phacoemulsification surgery guided by corneal topography and implantation IOL. Methods tn a prospective randomized sample controlled clinical study.Sixty diabetic cataract patients (60 right eyes) were randomly divided into two groups:(group A) traditional superior comeal incision phacoemulsification surgery and IOL implantation,(group B) corneal topography guiding incision phacoemulsification surgery and IOL implantation.The vision,the symptom of ocular surface,Ocular Surface Disease Index (OSDI),tear film function and topography tests were performed at 1 week,1 month and 3 months postoperatively. Results There were no significant difference for corneal astigmatism,the symptom of ocular surface,OSDI and tear film function were found between two groups preoperatively (tastigmatism=0.642,tsymptom=0.342,tOSDI=0.667,tBUT=0.437,theight of tear meniscus=0.732,tST=0.151,tFL=-0.847,P＞0.05),and no statistically significance of pachymetry (including the center and the eight midperipheral locations) at preoperative day 1 and postoperative month 1 in both groups (P＞0.05).Corneal topography indicated that no significant difference for corneal vertical J0 and horizon astigmatism P were found between two groups preoperatively (FJ0=0.46,FP=0.64,P ＞0.05).There were statistically significance for corneal vertical J0,horizon astigmatism P,symptom eyes,OSDI,break up time (BUT),Schirmer Ⅰ test (ST),the height of tear meniscus and fluorescein staining (FL) at preoperative compared the postoperative week 1 in group A (FAJ0=18.372, FAP=14.648, tAsymptom=17.823, tAOSDI =12.326, tABUT=10.646, tAheight of tear meniscus=9.383, tAST =7.623,tAFL=-6.057; FBJ0=5.78,FBP=6.84; tBsymptom=10.662,tBOSDI=11.761,tBBUT=9.167,tBheight of tear meniscus=8.165,tBST=6.323,tBFL =-5.798; P ＜0.05),whereas no statistically significance at preoperative compared the postoperative month 3 in both groups (FAJ0=4.38,FAP=5.45, tAsymptom=1.664,tAOSDI =0.834,tABUT=0.622, tAheight of tear meniscus=0.674, tAST=1.223, tAFL =-1.024; FBJ0=6.34,FBP=5.52, tBsymptom=1.459,tBOSDI=0.798,tBBUT=0.688,tBheight of tear meniscus=0.562,tBST=1.114,tBFL=-0.886; P ＞0.05).There were statistically significance for symptom eyes,OSDI,BUT and FL at postoperative week 1 in both groups (tsymptom=16.605,tOSDI=13.581,tBUT=20.569,tFL =-8.632,P ＜0.05),whereas no statistically significance at preoperative compared the postoperative month 3 in both groups (tsymptom=1.132,tOSDI=0.843,tBUT=0.367,theigh,of tear meniscus=0.564,tST=1.143,tFL =-0.846,P＞0.05). Conclusions Topography-guided phacoemulsification surgery and IOL implantation is a more favorable solution for diabetic cataract patients,which can correct the corneal astigmatism,stabilize the tear film,mitigate the symptom of ocular surface and therefore improve the visual quality. Key words: Corneal topography ; Phacoemulsification surgery ; Astigmatism ; Tear film ; Diabetic cataract ;