Phacoemulsification Intraocular Lens Implantation Research Articles

Changes in Anterior Chamber Angle and Choroidal Thickness in Patients with Primary Angle-Closure Glaucoma after Phaco-Goniosynechialysis.

We aimed to observe changes in angle width and choroidal thickness (CT) before and after phacoemulsification intraocular lens implantation (PEI) combined with goniosynechialysis (GSL) in patients with primary angle-closure glaucoma (PACG) complicated by cataracts. This prospective cohort study included 60 patients with PACG complicated by cataracts from the Department of Ophthalmology of Shaoxing People’s Hospital, China. Patients underwent PEI combined with GSL (PEI-GSL group) or laser peripheral iridotomy (LPI) followed by PEI (PEI group). Intraocular pressure (IOP) and endothelial counts were significantly decreased in both groups after surgery, while best-corrected visual acuity and central anterior chamber depth were significantly increased. However, there were no significant differences between the two groups. The opening degrees of room corners at 12, 3, 6, and 9 o’clock were recorded as AA12, AA3, AA6, and AA9, respectively. Anterior chamber depth was significantly increased postoperatively compared to preoperatively in both groups, with no significant between-group differences (all ps > 0.05). At 1, 3, and 6 months postoperatively, the width at AA12, AA3, and AA9 points was higher in the PEI-GSL group than in the PEI group (all ps < 0.05). Significant between-group differences at AA6 were observed preoperatively (p = 0.023) and at 1 (p = 0.027) and 3 (p = 0.033) months postoperatively but not at 6 months postoperatively (p = 0.055). CT was smaller postoperatively than preoperatively (all ps < 0.001). The present study suggests that patients with PACG who underwent PEI with or without GSL had reduced IOP and CT after surgery.

Intravitreal Injection of Conbercept Combined with Minimally Invasive Photocoagulation and Phacoemulsification Intraocular Lens Implantation in the Treatment of Neovascular Glaucoma Complicated with Cataract.

Neovascular glaucoma (NVG) is a complex refractory glaucoma with a high rate of blindness. Compaq is an anti-VEGF agent that has been used in clinical NVG therapy. This study aims to investigate the effect of intravitreal injection of conbercept combined with minimally invasive photocoagulation and phacoemulsification intraocular lens implantation in the treatment of NVG complicated with cataracts. A total of 84 patients with NVG complicated with cataracts who were admitted to our hospital from September 2019 to September 2021 were selected. According to the random number table method, they were divided into the study group and the control group, with 42 cases in each. The control group underwent minimally invasive photocoagulation combined with phacoemulsification and intraocular lens implantation. The study group was given an intravitreal injection of conbercept first, followed by minimally invasive photocoagulation combined with phacoemulsification and intraocular lens implantation 3 to 7 days after the injection. The intraocular pressure and visual acuity of the two groups before surgery, 1 week, 1 month, 3 months, and 6 months after the operation were compared. The levels of serum vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were compared between the two groups before the operation and 1 week after the operation. The incidence of postoperative complications in the two groups was statistically compared. At 1 week, 1 month, 3 months, and 6 months after the operation, the intraocular pressure of the study group was lower than that of the control group, and the visual acuity was better than that of the control group (P < 0.05); one week after the operation, the serum levels of VEGF and IL-6 in the study group were lower than those in the control group (P < 0.05); there was no significant difference in the incidence of complications between the two groups (P > 0.05). Intravitreal injection of conbercept combined with minimally invasive photocoagulation and phacoemulsification intraocular lens implantation in the treatment of NVG complicated with cataract can improve the levels of serum inflammatory factors and vasoactive substances, effectively reduce intraocular pressure, and improve visual acuity.

Management of secondary glaucoma in patients with nanophthalmos

Objective To investigate the management of secondary glaucoma in patients with nanophthalmos. Methods The data of 16 eyes of 9 cases of nanophthalmos with secondary glaucoma from Dec.2013 to May 2018 were analyzed retrospectively.All cases received different treatment according to their clinical characters. Results Their treatment methods included laser peripheral iridotomy, trabeculectomy combined with anterior chamber angioplasty, and phacoemulsification intraocular lens implantation combined with anterior chamber angle separation or trabeculectomy. After surgery some cases received local drug therapy or reoperation according to different conditions. IOP were controlled. Conclusion Laser peripheral iridotomy, phacoemulsification and intraocular lens implantation combined with anterior chamber angle separation are effective in the early stage of secondary glaucoma in patients with nanophthalmos. Trabeculectomy and other external filtration are not recommended. After surgery, the intraocular pressure is controlled by drugs and cyclophotocoagulation if the intraocular pressure is still difficult to be controlled. Key words: Nanophthalmos; Glaucoma, secondary; Treatment

Comparison on the efficacy of two kinds of surgery for the treatment of phacomorphic glaucoma

Objective To compare the efficacy of phacoemulsification intraocular lens implantation combined with trabeculectomy or goniosynechialysis for the treatment of phacomorphic glaucoma. Methods The data of 126 eyes of 126 cases of secondary glaucoma with intumescent cataract were collected and analyzed retrospectively. Group A, 63 eyes of 63 patients, underwent phacoemulsification and intraocular lens implantation combined with trabeculectomy; group B, 63 eyes of 63 patients, underwent phacoemulicfication and intraocular lens implantation combined with goniosynechialysis. The efficacy and safety between two groups were compared and analyzed. The follow-up period was 4-12 months. Results The postoperative IOP in both groups were well controlled. The difference was statistically significant between before and after surgery (P 0.05). The central anterior chamber (CAC) after surgery were deeped in two groups. The increase of CAC in group B was higher than that in group A, the difference was statistically significant (P<0.01). The complications after surgery were inflammation, corneal edema, shallow anterior chamber and conjunctival bleb leakage. The incidence of complications in group A was significantly higher than that of group B. Conclusion Phacoemulicfication and intraocular lens implantation combined with goniosynechialysis or trabeculectomy for the treatment of phacomorphic glaucoma are effective surgical approach. However, the combined surgery goniosynechialysis is safer and with less complications. Key words: Cataract, intumescent; Glaucoma, secondary; Phacoemulsification; Goniosynechialysis; Trabeculectomy