Phacoemulsification In Patients Research Articles

First-Generation iStent Bypass Implantation versus ab Externo Canaloplasty Combined with Phacoemulsification in Patients with Primary Open Angle Glaucoma-12-Month Follow-Up.

This prospective, non-randomized, interventional clinical study evaluated the efficacy and safety profile of first-generation iStent bypass implantation versus ab externo canaloplasty, both combined with phacoemulsification, in patients with primary open-angle glaucoma (POAG) after 12-month follow-up. A total of 138 patients with POAG and their 138 eyes (69 phaco-iStent and 69 phacocanaloplasty) were included. Postoperatively at 12 months, the mean intraocular pressure (IOP) decreased from 18.44 ± 3.88 to 15.51 ± 2.50 mmHg and from 17.20 ± 4.04 to 14.97 ± 2.37 mmHg in the phaco-iStent (PiS) and phacocanaloplasty (PC) groups, respectively (p = 0.480). In both groups, 35.7% achieved >20% IOP reduction from baseline. A total of 86% and 71.4% of the eyes were medication-free at 12 months in the PiS and PC groups, respectively. In both groups, all eyes showed improvement in best-corrected visual acuity compared with baseline and demonstrated similar safety profiles throughout the 12-month follow-up period. This study showed equal hypotensive effects of PiS and PC. Both procedures significantly reduced the IOP and the requirement for IOP-lowering medications for at least 12 months postoperatively, with no significant differences between the groups.

Evaluation of Endothelial Cell Density after Torsional Phaco-Emulsification in Patients with Pseudo-Exfoliation

Background The corneal endothelium is a single layer of hexagonal cells that do not have the ability to regenerate. The normal density of corneal endothelial cells in adults is approximately 2500 cells/mm² and it is reduced by about 0.6% a year. The endothelium performs an essential function of maintaining the hydration of the cornea. When the endothelial cells density is reduced to approximately 800cells/mm², it may lead to corneal decompensation causing corneal edema and loss of corneal transparency which disrupts vision. Aim of the Work The aim of this study is to compare pre-operative corneal thickness between normal subjects and subjects with pseudo-exfoliation and to determine the effects of phaco-emulsification surgery on corneal endothelial cell density in cataract patients with pseudo-exfoliation syndrome. Patients and Methods The type of study was case controlled study, at department of Ophthalmology at Ain Shams University hospitals. This study included 66 patients divided to two equal groups (33 each): study group: 33 patients with pseudo-exfoliation, control group: 33 patients with senile cataract without pseudo-exfoliation. Results We found that ECD loss was 11.42% in the study group and 8.11% in the Control group 4 weeks after surgery. Phaco time and used BSS values were significantly higher in patients with PXS but had no significant influence on endothelial cell loss. They also suggested that the corneal endothelium in PXS be vulnerable to cataract surgery. Conclusion Torsional mode phacoemulsification and IOL implantation provided a safe and favorable surgical outcome in patients with/without PXS. Torsional phacoemulsification led to significantly higher ECD loss in the PXS than that in the control group during the whole follow up period.

Phacoemulsification Complicated Subluxation of the Crystalline Lens, Anterior Megalophthalmos, Central Cloudy Corneal Dystrophy of Francois and High Myopia

A case is described of a 47-old man with anterior megalophthalmos, high myopia (>31.0 mm) and who underwent bilateral consecutive phacoemulsification. In addition a bilateral dislike corneal opacity was present which was classified as central cloudy corneal dystrophy of Francois. Special attention must be paid to both surgical technique and IOL selection. In the first eye a single-piece foldable IOL was implanted into a capsule bag, in the second eye three-piece foldable IOL were sutured fixed to the iris. In the meantime, phacoemulsification in patients with dystrophy of Francois safe and does not lead to progression. We calculated the IOL power for our case with the Haigis and Barret II Universal formula retrospectively.

Endothelial Cell Density before and after Phacoemulsification in patients with Diabetes Mellitus

Introduction: Cataract is the leading cause of treatable blindness worldwide. Phacoemulsification with intraocular lens (IOL) implantation is the most common surgical procedure performed for the treatment of cataract. The diabetic cornea has decreased corneal endothelial cell density (CED) due to cell dysfunction and malfunctioning repair systems. Objective: To compare the mean endothelial cell density before and after phacoemulsification in patients with diabetes mellitus. Material and Methods: A total number of 30 patients who presented for cataract extraction were included. Data regarding patients age, gender, duration of diabetes mellitus and side of cataract was collected. One day before surgery, CED was measured in all patients using Specular Microscope. After 2 weeks of surgery, CED was measured again. Results: Mean age of patients included in this study was 48.70±8.39 years. Mean duration of diabetes mellitus was 5.03±2.85 years. There were 16 (53.33%) males and 14 (46.67%) female patients. There were 15 (50.00%) patients with right eye and also 15 (50.00%) with left eye. On comparison of mean ECD between the Groups, the mean pre-operative ECD was 2753.05±126.91 Cells/mm2 and post-operative ECD was 2451.16±160.93 Cells/mm2, this difference was statistically significant with p value <0.0001. Conclusion: Phacoemulsification is associated with significant decrease in endothelial cell density in diabetic patients presenting with cataract. The benefit of this study is that it adds to the existing body of literature on impact of phacoemulsification on endothelial cell density in diabetic patients which can help in the development of advanced surgical techniques and better post operative management in such patients. Keywords: Endothelial cell density, phacoemulsification, diabetes mellitus.

Effect of Phacoemulsification on Intraocular Pressure in Eyes with Functioning Tube Shunts.

To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in eyes with functioning tube shunts. This was a retrospective chart review of primary open-angle glaucoma (POAG) patients with a functioning tube who underwent phacoemulsification and had 24 months of follow-up. The primary end point was defined as surgical failure (IOP 21 mmHg) at month 24, progression to no light perception (NLP) vision, glaucoma reoperation, or implant removal. Surgical failure defined as IOP 18 and 15 mmHg, changes in visual acuity (VA), IOP, and number of medications were assessed. Twenty-seven eyes of 27 patients with moderate or severe POAG were included. The mean age of the patients was 64.2 10.8 years. The interval between the tube shunt and phacoemulsification was 28.8 25.0 months. At the end of the study, four (14.8%) eyes met the failure criteria; the average time to failure was 9.3 3.8 months. The causes of failure were high IOP in two (50.0%) and glaucoma reoperation in two (50.0%) eyes; however, no eyes progressed to NLP vision. Surgical failure defined as IOP 18 and 15 mmHg showed an increasing failure rate (18.5% and 48.5%, respectively).Themean IOP and medications number remained stable at month 24 compared to baseline (P = 0.131 and P = 0.302, respectively). Initially, VA showed improvement, with the greatest improvement at 6 months (P = 0.001), but at 24 months the improvement was no longer significant (P = 0.430). Phacoemulsification in patients with functioning tubes did not change the mean IOP in most of the patients (86.2%); the number of medications also did not increase.

Результаты смешанной цилиокапсулярной фиксации трехчастной ИОЛ при факоэмульсификации у пациентов с несостоятельностью связочного аппарата хрусталика

Purpose. To evaluate clinical results of mixed ciliary-capsular fixation of a three-piece IOL in combination with the intracapsular ring's implantation during phacoemulsification in patients' zonular weakness caused by pseudoexfoliative (PEX) syndrome. Material and methods. This study included 78 patients (86 eyes) with complicated cataract and PEX syndrome associated with zonular weakness and natural lens instability. The average age of the patients was 74.3±9.3 years. Phacoemulsification was performed in a standard technique and followed by ciliary-capsular fixation of a three- piece IOL in all cases. Preoperative and postoperative follow up period lasted from 1st day until 10 months postop. It included biomicroscopy, visual acuity measurement, keratometry, tonometry, ultrasonic biomicroscopy, optical coherence tomography of the posterior segment of the eye. Results. At the 2nd day postop (86 cases) UCVA and BCVA were 0.46±0.29 and 0.58±0.27 respectively, IOP was 16.48±2.81 mm Hg; at 10 months postop (38 cases) UCVA and BCVA – 0.54±0.31 and 0.79±0.28, IOP – 15.34±3.71 mm Hg. The average deviation of the predicted refraction at the 2 days after surgery was –0.29±0.77 D with no significant change after 10 months. Efficiency ratio at 10 months postop was 193, the safety factor was 285. This type of IOL fixation didn't lead to an increase in IOP, development of chronic inflammation such as iridocyclitis or any other comorbidity. All IOLs were stable position regardless of the status of the zonular fibers. Conclusion. As a result of a preliminary study, it was found that mixed ciliary-capsular fixation of a three-piece IOL provides its stable position, high clinical and functional results in the early and late postoperative period after phacoemulsification in patients with pseudoexfoliative syndrome and failure of the lenticular ligamentous-capsular system. Key words: pseudoexfoliative syndrome, zonular weakness, intraocular lens, ciliary-capsular fixation, lens subluxation, myopic shift

A PROSPECTIVE COMPARATIVE STUDY ON ENDOTHELIAL CORNEAL CELL AFTER CATARACT SURGERY USING TORSIONAL VS LONGITUDINAL PHACOEMULSIFICATION

Objectives: Our aim was to compare endothelial corneal cell changes after cataract surgery performed with Torsional and Longitudinal phacoemulsification in patient with senile cataract. Methods: In this prospective study, the patients were divided into two groups, 24 eyes underwent cataract surgery using Torsional (OZil Infiniti Vision System, Alcon) and 23 eyes using Longitudinal phacoemulsification (Stelaris, Bausch & Lomb). Preoperative, 1 day, and 1-week post-operative examinations on endothelial corneal cells were performed using specular microscope. Cataracts were subdivided according to the LOCS III grading of nucleus. Intraoperative parameters using phacoemulsification time were evaluated. Results: On the results of CCT at 1 day and 1-week post-operative, there were significant changes in group Torsional and Longitudinal 601±68.67; 562.22±45.48 (p=0.033) and 561,71±36,37; 519.52±79.93 (p = 0.015). However, there were no significant changes of CD, CV, HEX 1 day and 1 week post operatively between two groups. The phacoemulsification time was lower in group Torsional 17.11±15.86 seconds than group Longitudinal 18.53±15.46 seconds (p=0.595) but not significantly different. Conclusions: Torsional phacoemulsification outperforms the Longitudinal with a lower phacoemulsification time on soft and medium cataracts, but the differences were not significant. Torsional caused more corneal edema at 1 day and 1 week postoperative significantly and more endothelial cell losses but insignificantly.

Long-Term Endothelial Safety Profile With iStent Inject in Patients With Open-Angle Glaucoma

To report 5-year postoperative safety data of iStent inject, including overall stability, endothelial cell density (ECD), and endothelial cell loss (ECL) in patients with mild-to-moderate primary open-angle glaucoma (POAG). 5-year follow-up safety study of the prospective, randomized, single-masked, concurrently controlled, multicenter iStentinject pivotal trial. In this 5-year follow-up safety study of the 2-year iStent inject pivotal randomized controlled trial, patients receiving iStent inject placement and phacoemulsification or phacoemulsification alone were studied for the incidence of clinically relevant complications associated with iStent inject placement and stability. Corneal endothelial endpoints were mean change in ECD from screening and proportion of patients with >30% ECL from screening, from analysis of central specular endothelial images by a central image analysis reading center at several time points through 60 months postoperatively. Of the 505 original randomized patients, 227 elected to participate (iStent inject and phacoemulsification group, n=178; phacoemulsification-alone control group, n=49). No specific device-related adverse events or complications were reported through month 60. No significant differences were observed in mean ECD, mean percentage change in ECD, or proportion of eyes with >30% ECL between the iStent inject and control groups at any time point; mean percentage decrease in ECD at 60 months was 14.3% ± 13.4% in the iStent inject group and 14.8% ± 10.3% in the control group (P=.8112). The annualized rate of ECD change from 3 to 60 months was neither clinically nor statistically significant between groups. Implantation of iStent inject during phacoemulsification in patients with mild-to-moderate POAG did not produce any device-related complications or ECD safety concerns compared to phacoemulsification alone through 60 months.

Modern clinical, functional, and ophthalmo-ergonomic features of phacoemulsification in patients with visual-intense labor with bilateral cataract: a systematic review

A systematic review was performed using databases of RSCI and PubMed, and the following keywords were used for the literature search: Cataract, Phacoemulsification, PEC, Visual-stress work, VSW, Anisometropia, and Quality of life. Articles were selected based on the criteria for prospective or retrospective studies. A total of 684 sources were analyzed, further using systematic review filters and authors knowledge of the topic. The retrospective analysis covered the period from 2016 to 2022. Data indicate that the current state of the problem of PEK in patients with VSW with bilateral cataracts during traditional sequential (on different days) surgery (especially if the interval between operations increased by more than 710 days) is accompanied by the emergence of clinical, functional (pain syndrome, anisometropia, diplopia, and impaired stereoscopic vision), and ophthalmo-ergonomic (insufficient level of visual performance) adverse manifestations after the first surgery. To eliminate them, sequential bilateral cataract surgery received increasing attention (both operations within the same day), characterized by fewer hospital visits for the patient, faster recovery of vision, and lower healthcare costs. Thus, the stated provisions in the dispensary observation of patients with VSW with bilateral cataracts must be considered.

Phacoemulsification in patients after previous implantation of a complete intrastromal ring into a corneal transplant

BACKGROUND: The MyoRing implantation into a corneal transplant can significantly compensate for irregular post-keratoplastic astigmatism. However, the cataract that occurs in this category of patients and the lack of information in the literature on its phacoemulsification and the calculation of a toric intraocular lens (tIOL) power in them determines the relevance of our study.
 AIM: The aim of the study is to conduct a clinical and functional analysis of phacoemulsification in patients after previously performed implantation of a MyoRing into a corneal transplant.
 MATERIALS AND METHODS: We operated on 21 patients (21 eyes) who had previously undergone the MyoRing implantation into a corneal transplant. According to keratotopography, all patients were diagnosed with a regular form of corneal astigmatism. All patients underwent phacoemulsification with tIOL implantation. When calculating the tIOL power, its diopter value was corrected depending on the average value of the corneal transplant keratometry according to the keratotopogram data. The observation period duration was 6 months.
 RESULTS: One month after the procedure, there was an increase in uncorrected visual acuity by 0.2 0.9 LogMAR, best corrected visual acuity by 0.3 1.0 LogMAR, the spherical component of refraction up to 0.4 0.44 D, the cylindrical component of refraction up to 0.62 0.18 D, all of which did not change later on.
 CONCLUSIONS: Phacoemulsification with tIOL implantation, with its power calculated taking into account an additional correction for its diopter value, is an effective, predictable and safe method of treating patients after previously performed MyoRing implantation into a penetrating corneal transplant.

Safety and Efficacy of Rapid Primary Phacoemulsification on Acute Primary Angle Closure with and without Preoperative IOP-Lowering Medication.

This study aimed to investigate the safety and efficacy of rapid primary phacoemulsification in patients with acute primary angle closure (APAC) (n = 41), with or without preoperative IOP-lowering medication. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of corneal endothelial cells (CECs), and number of IOP-lowering medications at the preoperative examination (Pre), postoperative day 1 (1d), week 1 (1w), and month 1 (1m) were used as indicators and compared. BCVA significantly improved at 1d, 1w, and 1m compared with Pre (p < 0.05) and significantly improved at 1m compared to 1d (p < 0.05) for all eyes. IOP significantly decreased at 1d, 1w, and 1m compared with Pre (p < 0.05). CECs were not significantly different between Pre and 1m; the number of IOP-lowering medications decreased significantly from Pre to 1m (p < 0.05). BCVA and IOP were not significantly different between the two groups for all periods. CECs were not significantly different between the two groups at Pre and 1m. Rapid primary phacoemulsification improved visual acuity due to improvement of corneal edema without central visual field defects and good IOP control without reoperation or IOP-lowering medication and maintained the number of corneal endothelial cells with or without preoperative IOP-lowering medication in patients with APAC.

Efficacy and Safety of ab Externo Phaco-Canaloplasty versus First-Generation iStent Bypass Implantation Combined with Phacoemulsification in Patients with Primary Open Angle Glaucoma-Early Results.

This study evaluated the early outcomes of the hypotensive efficacy and safety profile of ab externo phaco-canaloplasty versus first-generation iStent bypass implantation combined with phacoemulsification in patients with primary open-angle glaucoma (POAG). In total, 82 patients with POAG comprising 92 eyes were divided into phaco-canaloplasty (Group PC, (n = 47) or iStent combined with phacoemulsification (Group PiS, n = 45) groups. Primary outcome measures were intraocular pressure (IOP) reduction and number of glaucoma medications. Secondary outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (EECD), changes in anterior chamber depth (ACD), and complication rate. The follow-up period was approximately 6 months. Preoperative IOPs were 17.30 (15.00; 19.85) mmHg and 17.50 (15.10; 20.90) mmHg in the PC and PiS groups, respectively (p = 0.876). At the end of the follow-up, IOP decreased to 15.00 (13.00; 16.00) mmHg and 15.00 (14.00; 17.00) mmHg in the PC and PiS groups, respectively (p = 0.438). Medication usage decreased from 2.08 to 0.12 and 1.40 to 0.04 in PC and PiS eyes, respectively. Most patients in both groups were medication-free at 6 months follow-up. After 6 months of observation, EECD in PC and PiS groups decreased from 2309.50 (2032.00; 2533.00) to 1966.50 (1262.00; 2353.50) and 2160.00 (1958.50; 2372.50), to1231.00 (1089.00; 2050.00), respectively (p = 0.037). Pre-surgery BCVA was 0.80 (0.50; 1.00) and 0.60 (0.40; 1.00) in PC and PiS eyes, respectively (p = 0.456). Follow-up BCVA was 0.95 (0.60; 1.00) for PC and 1.00 (1.00; 1.00) for PiS. Hyphema and corneal oedema were noted on the first day post-surgery in both groups. Subsequent complications included a transient increase in IOP in the PC group. Phaco-canaloplasty and iStent bypass implantation combined with phacoemulsification significantly lowered IOP and decreased medication burden. All eyes in both groups maintained or exhibited improved BCVA relative to baseline. Both surgeries had low postoperative complication rates and exhibited comparable safety profiles over 6-month follow-up in patients with POAG.

Efficacy and safety of the eight-chop technique in phacoemulsification for patients with cataract.

The aim of this study was to estimate the efficacy of the 8-chop technique in phacoemulsification surgeries of patients with cataract. Sato Eye Clinic, Chiba-ken, Japan. Prospective study. Patients were classified into 3 groups (Grade II, Grade III, and Grade IV; n = 50 each) according to the firmness of their lens nuclei. The Eight-chopper I was used for Grade II, Eight-chopper II for Grade III, and Lance-chopper for Grade IV. The best-corrected visual acuity, intraocular pressure (IOP), and endothelial cell density were evaluated at 7 and 19 weeks postoperatively. The primary outcome measures were the mean operative time, mean phaco time, cumulative dissipated energy (CDE), and volume of fluid used. 150 cataract surgeries were performed. The operative time (minutes), phaco time (seconds), CDE, and volume of fluid used (milliliters) differed significantly among the 3 groups, increasing in the following order: Grade II, Grade III, and Grade IV ( P < .01). The corneal endothelial cell density did not decrease significantly in the 3 groups at 19 weeks postoperatively ( P = .09). The rate of endothelial cell loss was 0.9% ± 5.9%, 1.0% ± 10.3%, and 5.3% ± 11.1% in the Grade II, III, and IV groups at 19 weeks postoperatively, respectively. There were significant reductions in the IOP at 7 and 19 weeks postoperatively compared with the preoperative IOP in the 3 groups ( P < .01). The 8-chop technique was effective and safe in phacoemulsification for patients with cataracts with lens nuclei of varying hardness.

Trabecular microbypass stent combined with phacoemulsification in patients with open-angle glaucoma, 1-year outcome in a Taiwanese population

Trabecular microbypass stent combined with phacoemulsification in patients with open-angle glaucoma, 1-year outcome in a Taiwanese population

Impact of minimally invasive glaucoma surgery on the ocular surface and quality of life in patients with glaucoma.

Minimally invasive glaucoma procedures are emerging as clinically effective and safe glaucoma management approaches; however, evidence regarding quality-of-life outcomes is limited. To explore the impact of minimally invasive glaucoma surgery (MIGS) combined with phacoemulsification on patient-reported outcomes and clinical parameters related to ocular surface disease in people with glaucoma. Retrospective observational study. Fifty-seven consecutive patients were examined prior to undergoing iStent combined with phacoemulsification with or without adjunctive endocyclophotocoagulation and at 4-month follow-up. At follow-up, on average patients returned statistically significantly improved scores on glaucoma-specific (GQL-15, p < 0.001; GSS, p < 0.001), general health (EQ-5D, p = 0.02) and ocular surface PROMs (OSDI, p = 0.001). Patients were using fewer eye drops on average after MIGS compared with before surgery (1.1 ± 0.9 versus 1.8 ± 0.8; p < 0.001). Undergoing MIGS was associated with improved tear film break-up time (p < 0.001) and reduced corneal fluorescein staining (p < 0.001). This retrospective audit shows quality of life and clinical parameters related to the ocular surface are improved following MIGS combined with phacoemulsification in patients previously treated with anti-glaucoma therapy.

Incidence of refractive surprise after phacoemulsification in patients of cataract with primary pterygium.

The purpose of this study was to find the incidence of refractive surprise in patients of cataract with primary pterygium and compare it with patients of cataract without pterygium after phacoemulsification surgery. The present observational study included 30 patients who had cataract with pterygium and 30 patients of cataract without pterygium. A detailed ophthalmic examination was done in all the cases. Horizontal corneal encroachment of pterygium from the limbus was measured. Keratometry and biometric measurements were performed preoperatively to determine the target refraction which was kept between - 0.50D and + 0.50D. The achieved spherical equivalent (SE) and prediction error were calculated postoperatively. A difference of >± 1.00D SE from the targeted postoperative refraction was considered a refractive surprise. The mean age of patients was 61 ± 8.32 years. The mean extension of pterygium on the cornea was 2.3 ± 0.91 mm. Refractive surprise was seen in 16.7% of cases of cataract with pterygium and 10% of cases of cataract without pterygium. Only cataract surgery can be performed in patient having cataract with primary pterygium of up to 2.3 ± 0.91 mm horizontal corneal length, and the incidence of refractive surprise in these cases is comparable to that in patients of cataract without pterygium.

Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study

Central Corneal Thickness and Endothelial Cell Changes after Phacoemulsification in Patients with Diabetes Mellitus: A Prospective Study

Assessment of Iridotrabecular Contact and Its Association With Intraocular Pressure After Phacoemulsification in Primary Angle Closure

To investigate the association between the quantitative assessment of iridotrabecular contact (ITC), measured by swept-source anterior segment optical coherence tomography (SS AS-OCT), and intraocular pressure (IOP) control after phacoemulsification in patients with primary angle closure disease (PACD). Retrospective, clinical cohort study. Preoperative and postoperative anterior chamber angle parameters were measured using SS AS-OCT. IOP was measured preoperatively and until 6 months postoperatively. Percent IOP reduction and fluctuation after surgery were calculated, and their relationships with SS AS-OCT parameters were assessed by correlation analyses and locally weighted scatterplot smoothing (LOWESS) regression with change-point analysis. A total of 51 eyes of 51 PACD patients were included. Preoperative ITC index and area (r=0.626, r=0.551), as well as changes in ITC index and area (r=0.632, r=0.543) after surgery, were significantly correlated with postoperative IOP reduction, after adjusting for age and gender (all P <.001). Higher postoperative ITC index (r=0.405, P=.005) and ITC area (r=0.460, P=0.001) were associated with greater postoperative IOP fluctuations. Change points on LOWESS curves were observed for preoperative ITC index (33.0%) and change in ITC index (27.0%) and percent IOP reductions were significantly correlated with them above (β=0.386, β=0.664, all P < .001) but not below the change points. Quantitative assessment of circumferential ITC can predict postoperative IOP control after phacoemulsification, and thus it may be used as a reference for determining lens extraction in PACD eyes.

Surgical Outcome of Combined MicroPulse Transscleral Laser Therapy with Phaco Emulsification in Patients with Cataract and Glaucoma

Purpose: To determine the effectiveness and safety of combined MicroPulse transscleral laser therapy (TLT) and phacoemulsification in patients with co-existing cataracts and glaucoma. Methods: A retrospective consecutive case series of 22 eyes of 19 patients with co-existing cataract and glaucoma. The patients underwent MicroPulse TLT, phacoemulsification, and intraocular lens implantation during the same setting. A comparison of baseline data with the data at 18 months follow-up was made to determine the variation in best-corrected visual acuity (BCVA), intraocular pressure (IOP), and changes in the number of anti-glaucoma drugs. Results: Twenty-two eyes of 19 patients (57.9% were female) underwent combined MicroPulse TLT and phacoemulsification. The mean age was 60.5±9.3 years (range: 39.0 to 76.0). Nine eyes (40.9%) had primary open-angle glaucoma, nine eyes (40.9%) had chronic angle-closure glaucoma, and four eyes (18.2%) had pseudoexfoliation glaucoma. The mean baseline IOP was 26.3±4.7, which was significantly reduced to 15.3±2.4 mmHg (43.9%±10.2%) at 18 months (p&lt;0.001). The median number of glaucoma medications was 4 (2 to 5) at baseline and 2 (0 to 4) at 18 months (p=0.002). The mean BCVA was 0.84±0.31 LogMAR (Snellen: 20/138) at baseline and 0.28±0.23 LogMAR (Snellen:20/38) at 18 months (p&lt;0.001). The mean follow-up period was 15.8±3.0 months (range 12 to 18). Conclusions: Combined MicroPulse TLT and phacoemulsification was a safe and effective procedure that achieved reduction in both IOP and glaucoma medications for up to 18 months, with no associated vision-threatening complications.

The effect of sodium hyaluronate on tear film stability in patients with dry eye syndrome after cataract surgery.

This study aimed to observe the changes in the ocular surface after phacoemulsification in patients with age-related cataracts with respect to the addition of varying concentrations of hyaluronate. Patients with dry eye syndrome were treated with 0.3% and 0.1% sodium hyaluronate eye drops to evaluate the clinical improvement in each treatment group. A total of 73 patients (91 eyes) with age-related cataracts suffering from dry eye syndrome after phacoemulsification were divided into treatment group A (30 eyes), undergoing conventional therapy and treatment with 0.3% sodium hyaluronate; treatment group B (31 eyes), undergoing conventional therapy and treatment with 0.1% sodium hyaluronate; and the control group (group C; 30 eyes), undergoing conventional therapy only. Two groups were given different concentrations of sodium hyaluronate eye drops four times a day (should be completed between 8 AM and 8 PM), one drop at a time. Seven days, 2weeks, 1month, and 2months postoperatively, there were significant differences in the Schirmer I test (SIt), first noninvasive tear film break-up time (NIBUTf), average noninvasive tear film break-up time (NIBUTav), tear meniscus height (TMH), and irregularity (when the refractive force of different parts of different meridians on the same meridian is different. The main manifestation is that the two meridians on the anterior surface of the cornea do not show a 90-degree vertical distribution, which cannot be corrected by conventional astigmatism lenses) between the three groups (p < 0.05). When compared with group C, there were significant differences in the SIt, NIBUTf, NIBUTav, TMH, and irregularity of group A and group B (p < 0.05). When compared with group B, there were significant improvements in the SIt, NIBUTf, NIBUTav, and TMH in group A (p < 0.05). In the early stage after phacoemulsification, the stability of the tear film is reduced. Adding sodium hyaluronate eye drops can restore tear film structure and improve corneal surface regularity, and a 0.3% solution of sodium hyaluronate eye drops is more effective than a 0.1% solution.