【In Press】 The effect of cataract surgery on sleep quality: a systematic review and meta-analysis

AIM: To evaluate the effect of cataract surgery on sleep quality and to compare the difference between ultraviolet-blocking clear intraocular lens (UVB-IOL) and blue-filtering intraocular lens (BF-IOL) implantation. METHODS: Electronic search was performed of PubMed, MEDLINE, Embase and the Cochrane Library up to January 2016. Studies were eligible when it they evaluated the sleep quality before and after cataract surgery by Pittsburgh Sleep Quality Index (PSQI). A random /fixed-effects meta-analysis was used for the pooled estimate. Heterogeneity was assessed with the I2 test. RESULTS: Six studies were selected from 5623 references. Cataract surgery significantly reduced the PSQI scores at postoperative 0-3mo [mean difference (MD) =-0.62, 95%CI: -1.14 to -0.11, P=0.02, I2=66%] and 3-12mo (MD=-0.32, 95%CI:-0.62 to -0.02, P=0.04, I2=0), respectively. Considering different IOL implantations, relative post-operative PSQI reduction was found for both UVB-IOL and BF-IOL, but a significant reduction was detected only for UVB-IOL. No significant difference was found with the effect of BF-IOL vs UVB-IOL on sleep quality. CONCLUSION: This study found that cataract surgery significantly improved the PSQI score-derived subjective sleep quality irrespective of the intraocular lens type implanted. These findings highlight a substantial benefit of cataract surgery on systemic health with photoreceptive restoration in addition to visual acuity improvements.     

Comparison of visual outcomes with implantation of trifocal versus bifocal intraocular lens after phacoemulsification: a Meta-analysis

AIM: To compare a trifocal intraocular lens (IOL) and a bifocal IOL implantation in improving visual function after cataract surgery. METHODS: Eligible literatures were systematically searched through EMBASE and PubMed databases. The inclusion criteria were prospective comparative clinical trials on cataract surgery comparing trifocal IOL with bifocal IOL implantation that assessed visual acuity, contrast sensitivity and subjective vision quality. The effects were computed as standardized mean differences and pooled using fixed-effect or random-effect models. RESULTS: Four prospective randomized controlled trials (RCTs) and five cohorts provided data were included by a systematic review, comprising 265 eyes implanted with trifocal IOLs and 264 eyes implanted with bifocal IOLs. Monocular distance visual acuity (VA) showed a statistically significant but small difference that favored trifocal IOLs (MD=-0.06; 95%CI, -0.10 to -0.02; Z=2.90, P=0.004 for uncorrected distance VA, and MD= -0.02; 95%CI, -0.03 to -0.00; Z=2.02, P=0.04 for corrected distance VA), but the data did not suggest that the effect of trifocal IOL implantation would clinically outperform bifocal IOL implantation. There was no significant difference in monocular near VA (MD=-0.01; 95%CI, -0.07 to 0.04; Z=0.42, P=0.68 for distance-corrected near VA, and MD=-0.01; 95%CI, -0.06 to 0.03; Z=0.55, P=0.58 for corrected near VA) or refraction between two groups. Contrast sensitivity and subjective visual quality had no conclusive results. CONCLUSION: All results indicate that trifocal IOL and bifocal IOL had similar levels of monocular distance and near VA.     

【In Press】 Comparison of visual outcomes with implantation of trifocal versus bifocal intraocular lens after phacoemulsification: a Meta-analysis

AIM: To compare a trifocal intraocular lens (IOL) and a bifocal IOL implantation in improving visual function after cataract surgery. METHODS: Eligible literatures were systematically searched through EMBSE and PubMed databases. The inclusion criteria were prospective comparative clinical trials on cataract surgery comparing trifocal IOL with bifocal IOL implantation that assessed visual acuity, contrast sensitivity and subjective vision quality. The effects were computed as standardized mean differences and pooled using fixed-effect or random-effect models. RESULTS: Four prospective randomized controlled trials (RCTs) and five cohorts provided data and were included by a systematic review, comprising 265 eyes implanted with trifocal IOLs and 264 eyes implanted with bifocal IOLs. Monocular distance visual acuity (VA) showed a statistically significant but small difference that favored trifocal IOLs (MD=-0.06; 95%CI, -0.10 to -0.02; Z=2.90, P=0.004 for UDVA and MD=-0.02; 95%CI, -0.03 to -0.00; Z=2.02, P=0.04 for CDVA), but the data did not suggest that the effect of trifocal IOL implantation would clinically outperform bifocal IOL implantation. There was no significant difference in monocular near VA (MD=-0.01; 95% CI, -0.07 to 0.04; Z=0.42, P=0.68 for UNVA, and MD=-0.01; 95% CI, -0.06 to 0.03; Z=0.55, P=0.58 for DCNVA) or refraction between two groups. Contrast sensitivity and subjective visual quality had no conclusive results. CONCLUSION: All results indicate that trifocal IOL and bifocal IOL had similar levels of monocular distance and near visual acuities. Besides, contrast sensitivity and subjective visual quality have no conclusive results.     

Toric IOL植入术与PCRI联合传统IOL植入术矫正白内障患者角膜散光的Meta分析

目的：:系统评价Toric人工晶状体（Toric IOL）植入术与传统IOL植入联合角膜缘松解术（PCRI）在矫正年龄相关性白内障患者合并≤3 D角膜散光的有效性、安全性以及对视功能的影响。方法：:循证医学研究。采用Cochrane系统评价方法,计算机检索PubMed、EMBASE、Cochrane图书馆、Clinic...     

蓝光滤过型人工晶状体对青光眼白内障患者白内障术后睡眠质量的影响

目的　观察青光眼合并白内障患者行白内障超声乳化吸出联合蓝光滤过型人工晶状体植入术后睡眠质量的情况。方法　本研究为前瞻性研究,选取2017年1月至2018年1月于北京市回民医院眼科就诊的分别行双眼白内障超声乳化吸出联合蓝光滤过型人工晶状体植入术治疗的患者99例198眼,将所有患者分为两组:青光眼合并白内障组49例98眼,单纯白内障组50例100眼。使用匹兹堡睡眠质量指数（PSQI）量表对入组患者进行白内障术前及术后1个月、3个月的调查评分,并对结果进行统计学分析。结果　青光眼合并白内障组PSQI总分值术前为（7.00±1.09）分,术后1个月为（5.00±1.04）分,术后3个月为（5.00±1.03）分,术后1个月、3个月较术前均有改善,差异均有统计学意义(F=12.35、12.36,均为P=0.02)。单纯白内障组PSQI总分值术前为（7.00±1.02）分,术后1个月为（4.00±1.09）分,术后3个月为（4.00±1.06）分,术后1个月、3个月较术前均有改善,差异均有统计学意义(F=15.46、15.47,均为P=0.01)。青光眼合并白内障组与单纯白内障组术前PSQI 总分差异无统计学意义(t=0.09、P=0.80),术后1个月、3个月青光眼合并白内障组PSQI总分值高于单纯白内障组,差异均有统计学意义 (t=0.08、0.21,P=0.02、0.01)。结论　蓝光滤过型人工晶状体对青光眼白内障患者术后睡眠质量无负面影响,单纯白内障患者较青光眼合并白内障患者行白内障术后睡眠质量改善幅度更大。     

Effects of ultraviolet and blue-light filtering on sleep: a meta-analysis of controlled trials and studies on cataract patients

PurposeTwo types of intraocular lenses (IOLs), namely ultraviolet-filtering IOL (UVF-IOL) and blue-light-filtering IOL (BF-IOL), are used to replace the aging lens in cataract patients. This provides a clinical scenario to investigate the BF and UVF effects on circadian rhythm. We revisited this topic and conducted an updated meta-analysis investigating the effects of UVF-IOL and BF-IOL on sleep quality.MethodsA literature search was conducted using the PubMed, Embase, and Cochrane Library databases, and finally, four randomized controlled trials, one nonrandomized controlled study, and two cohort studies were included in this meta-analysis.ResultsThe fixed-effect model revealed a significantly larger sleep quality improvement in the UVF-IOL group than in the BF-IOL group (standard mean difference [SMD] = 0.10, 95% confidence interval [CI]: 0.00–0.21) at 3–8 weeks but not 7–12 months after IOL implantation (SMD = 0.03, 95% CI: −0.08 to 0.13). The random effects model revealed no difference between groups at 3–8 weeks (SMD = 0.16, 95% CI: −0.07 to 0.39) and 7–12 months (SMD = 0.03, 95% CI: −0.08 to 0.13) after IOL implantation.ConclusionsOur study found some weak evidence supporting that UVF-IOL implantation demonstrated a greater improvement in subjective sleep quality than the BF-IOL implantation only in a shorter period but not in a longer period. More trials should be conducted before further recommendations. Nevertheless, our study provides some insights into the effects of short wavelength electromagnetic radiation on the circadian rhythm. PROSPERO registration number: CRD42019128832.Subject terms: Quality of life, Perception     

Frequency doubling technology perimetry after clear and yellow intraocular lens implantation

PURPOSE: To evaluate the effect of intraocular lens (IOL) color on frequency doubling technology (FDT). DESIGN: Randomized clinical trial. METHODS: For 26 eyes of 26 patients, FDT perimetry (24-2-threshold test) was measured three months after cataract surgery. An acrylic IOL was randomly selected from clear (VA60BB, HOYA) and yellow-tinted lenses (YA60BB, HOYA), which only differed by color. As a control, a further 14 cataractous eyes with visual acuity > or =20/30 were examined. We analyzed mean deviation (MD) and pattern standard deviation (PSD) among the three groups. RESULTS: After cataract surgery, MD significantly improved (Fisher protected least significant difference (PLSD): P < .05), but PSD did not change (analysis of variance (ANOVA): P = .94) compared with control values. There was no significant difference between the two IOLs for either MD (Mann-Whitney test; P = .15) or PSD (Mann-Whitney test; P = .84). CONCLUSIONS: When interpreting the results of FDT, the effect of cataract should be considered but that of IOL color does not need consideration.     

Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens

AIM: To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens (IOL) and asymmetric refractive multifocal IOL. METHODS: The prospective nonrandom, comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs: AT LISA tri 839MP (30 eyes; Carl Zeiss Meditec, Germany) and LS-313 MF30 (30 eyes; Oculentis GmbH, Germany). Visual acuity, refractive outcome, contrast sensitivity, defocus curves, quality of vision, and optical phenomena were evaluated at 3mo postoperatively. RESULTS: There were no statistical differences between groups in uncorrected distance visual acuity (P=0.13) and uncorrected near visual acuity (P=0.54). In contrast, uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group (P=0.02). No significant statistical between-group difference was detected in cylinder (P=0.43). Compared to trifocal group, spherical refraction and spherical equivalent in refractive multi focal group were more myopic (P<0.01). Under photopic conditions, no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree (cpd). The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group (P=0.01, P=0.034, respectively). The questionnaires of quality of vision and optical phenomena showed no differences between groups. CONCLUSION: Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity. Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.     

白内障术后晶状体前囊膜收缩对人工晶状体偏心的影响

目的：评价白内障术后晶状体前囊膜收缩对人工晶状体偏心的影响。

方法：选取40例40眼年龄相关性白内障患者行白内障超声乳化吸除联合人工晶状体植入术,术后使用Photoshop软件测量术后3mo内的晶状体前囊膜口面积,使用iTrace视觉质量分析仪测量人工晶状体偏心距离,采用Pearson相关性分析晶状体前囊膜收缩对人工晶状体偏心的影响。

结果：术后1d,1、3mo,前囊膜口面积逐渐缩小(P<0.01); IOL偏心逐渐增大(P<0.01); 患者的裸眼视力逐渐下降(P<0.01)。前囊膜口面积变化量与IOL偏心量呈正相关(r=0.566,P<0.05),术后患者的裸眼视力与IOL偏心量无明显相关(r=-0.104,P>0.05),前囊膜口面积变化量与初始面积呈负相关(r=-0.476,P<0.05)。

结论：白内障术后晶状体前囊膜的收缩可导致IOL偏心。     

Ultrasound biomicroscopy examination of intraocular lens haptic position after phacoemulsification with continuous curvilinear capsulorhexis and extracapsular cataract extraction with linear capsulotomy.

PURPOSE: Intraocular lens (IOL) haptic position in 35 eyes that had undergone cataract surgery was examined with ultrasound biomicroscopy (UBM). METHODS: In a prospective randomized study the patients were operated by phacoemulsification using continuous curvilinear capsulorhexis (CCC) (group I) or by extracapsular cataract extraction (ECCE) using linear capsulotomy (group II). Ultrasound biomicroscopy was used to localize both haptics of the implanted intraocular lenses and to measure anterior chamber depth (ACD), iris thickness and anterior chamber angle. The inflammatory reaction in the anterior chamber was assessed with laser flare photometry. Slit lamp examination was performed. RESULTS: Both IOL haptics were found in the lens capsule in all 18 eyes in group I. In group II one of the haptics was located out of the capsule in 7 of 17 eyes (41%). The difference is statistically significant (p=0.01). Postoperatively mean ACD measured with the UBM was 4.06+/-0.30 mm in group I and 3.64+/-0.24 mm in group II (p=0.00025). CONCLUSION: The UBM examinations indicate that phacoemulsification with continuous curvilinear capsulorhexis is a more reliable technique than ECCE with linear capsulotomy to achieve implantation of the intraocular lens haptics in the capsular bag.     

Comparison of intravitreal aflibercept and dexamethasone implant in the treatment of macular edema associated with diabetic retinopathy or retinal vein occlusion: a Meta-analysis and systematic review

AIM: To compare the efficacy and safety of intravitreal aflibercept with dexamethasone implant in the treatment of macular edema (ME) associated with diabetic retinopathy (DR) or retinal vein occlusion (RVO). METHODS: A comprehensive search of studies comparing dexamethasone and aflibercept in patients with ME was conducted at PubMed, Embase, and Cochrane Central Register of Controlled Trials from the beginning of library to April 16, 2021. Extracting the data including best-corrected visual acuity (BCVA), central retinal thickness (CRT), number of injections and serious adverse events (SAEs) from the final qualified articles. RevMan 5.3 software was used for Meta-analysis of the included studies. RESULTS: Totally 7 studies with 369 eyes were included. The causes of ME in the final screening study included RVO and DR. Compared with the aflibercept treatment group, the BCVA of the dexamethasone implant treatment group showed no significant difference in the follow-up for 3mo [mean difference (MD): -0.05, 95% confidence interval (CI): -0.11, 0.02; P=0.17] and 12mo (MD: -0.01, 95%CI: -0.38, 0.37; P=0.98), but it was slightly worse than the aflibercept group at 6mo (MD: 0.12, 95%CI: 0.03, 0.21; P=0.008). In terms of CRT reduction, there was no significant difference between the two groups at 3mo (MD: -28.14, 95%CI: -79.95, 23.67; P=0.29), 6mo (MD: 27.67, 95%CI: -84.89, 140.24; P=0.63), and 12mo (MD: -59.00, 95%CI: -127.37,9.37; P=0.09). However, dexamethasone implant had fewer injections, but more adverse events such as elevated intraocular pressure (IOP) and cataract. CONCLUSION: Intravitreal injection of aflibercept and dexamethasone implant can both effectively increase BCVA and reduce CRT. Compared with aflibercept, dexamethasone implant is not inferior in improving vision and reducing CRT in the initial treatment period (3mo) and long-term treatment period (12mo). Besides, it has fewer injections and more likely to cause elevated IOP and cataract.     

Effect of cataract surgery with intraocular lens implant on frequency doubling perimetry

PURPOSE: To study the effect of cataract surgery with intraocular lens (IOL) on frequency doubling perimetry (FDP). METHODS: Patients aged 40 years or above seen at our outpatient clinic with no ocular pathology except for visually significant cataract and visual acuity 6/24 or better were eligible. They underwent FDP before and 4 to 6 weeks after cataract surgery with IOL. RESULTS: Screening test: Mean scores by three different scoring methods were 1.82 (3.21), 2.80 (5.54), 4.18 (9.18) before and 0.22 (0.51), 0.26 (0.63), 0.26 (0.69) after surgery (p = 0.002 0.001, < 0.0001). Threshold test: Mean deviation (MD) and pattern standard deviation (PSD) were -5.23 (3.08) and 5.15 (2.78) before and -2.94 [corrected] (2.49) (p < 0.0001) and 5.21 (1.780) (p = 0.63) after surgery. CONCLUSIONS: The screening test should be interpreted cautiously in the presence of cataract. On threshold testing, cataract surgery causes significant decrease in MD but no change in PSD.     

晶状体半脱位白内障术中两类折叠型IOL做悬吊术的疗效比较

目的:探讨囊内摘除联合两类人工晶状体(intraocular lens,IOL)做悬吊术治疗晶状体半脱位白内障的临床疗效。方法:晶状体半脱位患者21例23眼,行晶状体囊内摘除前部玻璃体切割联合IOL悬吊术,依植入IOL类别分为四个闭合襻IOL组和两个C襻IOL组,术后观察视力、眼压、综合验光、眼底,6mo时裂隙灯眼前节摄像系统拍照确定IOL偏心值,超声生物显微镜(ultrasound biomicroscopy,UBM)检查确定IOL的倾斜度检查。结果:所有患眼术后视力均有不同程度的提高。四襻组IOL平均偏心为0.57mm,两襻组平均偏心0.79mm;四襻组IOL平均倾斜度为6°,两襻组平均倾斜度11°,两组间差异均有统计学意义(P<0.05)。结论:晶状体半脱位术中四个闭合襻IOL做悬吊术后居中性更好,IOL倾斜度更小。     

三种手术方式治疗青光眼合并白内障疗效的比较

目的 探讨治疗青光眼合并白内障3种手术方式的适应证和临床疗效.方法 对青光眼合并白内障患者135例152只眼进行手术分组:其中30例36只眼先行抗青光眼手术,待白内障发展到一定程度再行白内障手术,即所谓的两阶段手术(A组);87例98只眼行-白联合手术-复合式小梁切除联合小切口白内障晶体吸除+人工晶状体植入术(B组);18例18只眼行单纯白内障手术+人工晶状体植入术(C组).比较不同适应证下3种手术方式的临床疗效,包括眼压控制情况、角膜内皮细胞、视力以及术后并发症等.随访时间(12±1)月.结果 均经统计学处理.结果 手术前后视力≥0.2的眼数3组比较,差异有统计学意义(x~2=16.00,P<0.01).A组与B组手术前后眼压有显著性差异(t_1=1.89,P_1=0.01:t_2=2.87,P_2=0.03),C组手术前后无显著性差异(t=0.43,P=0.78).术前术后角膜内皮细胞数量无显著性差异(P>0.05),3组均未见严重术中并发症,其个A组滤泡形成良好,眼压控制满意,B组术后角膜水肿17例,未特殊处理,1周后全部消退;有2只眼出现瞳孔区纤维膜,滤泡形成欠理想.C组术后视力均显著捉高,有2只眼轻度角膜水肿,有2只眼需加用药物控制眼压,其中1只眼最后接受抗青光眼手术.结论 青光眼合并白内障患者应根据具体情况选择适当的手术方式,以获得较好的视力和眼压控制.     

Predicting the refractive outcome after cataract surgery: the comparison of different IOLs and SRK-II v SRK-T

AIM: To determine any differences between the predictive abilities of the IOL calculation formulas of SRK-II and SRK-T and to compare these using two different IOL types. METHODS: A prospective, consecutive, single surgeon clinical trial was conducted on 400 consecutive patients who received routine, standardised phacoemulsification cataract surgery. 200 had cataract surgery and had the Alcon MZ30BD, a 5.5 mm one piece PMMA IOL, and another 200 cases used the Chiron C11UB, a silicone plate haptic IOL. The data used optimised A-constants. The measures were preoperative axial length and keratometry, IOL implanted, and refractive error at 4-6 weeks postoperatively. RESULTS: There was no significant difference between the predictive abilities of SRK-II or SRK-T. For the Alcon and Chiron lens respectively, prediction errors using SRK-II were <0.5 dioptres in 58% and 70% and for <1.0 dioptres in 84% and 92%. These differences were statistically significant (chi(2), p=0.02). CONCLUSION: There are differences in the predictability of refractive outcomes between intraocular lens styles.     

囊袋张力环维持人工晶状体稳定性效果的Meta分析

目的评价囊袋张力环(CTR)对维持常规白内障术后人工晶状体(IOL)稳定性的效果。 方法利用计算机检索中国知网及生物医学文献数据库、万方数据库、维普数据库、PubMed、Medline及Cochrane Library，搜集CTR应用于维持白内障术后IOL的相关文献。采用Cochrane系统评价的方法，由两位评价者独立进行文献检索、筛选、质量评价及数据提取。从选取的研究中提取术后IOL的旋转度、未矫正视力(UCVA)以及残余散光度。采用均数差(MD)及其95%置信区间(CI)表示计量资料的效应量。文献研究间的异质性评价，采用Q检验和I²检验。如P<0.05或I²>50%则认为异质性较大，采用随机效应模型进行分析；反之，采用固定效应模型进行分析。 结果在各数据库初步检索到文献1253篇。去除重复、内容不相符或者主要结局指标不完善、非随机对照试验(RCT)及数据不能提取的文献，最终纳入本研究文献4篇。其中，包括153只眼植入CTR与156只眼未植入CTR。经Meta分析，发现白内障常规手术植入CTR可降低IOL的术后旋转度，提高IOL的稳定性。经随机效应模型分析，两者比较的差异具有统计学意义(MD＝-0.81，95%CI：-1.46~-0.15，P<0.05)。白内障常规手术植入CTR与患者术后UCVA的比较，差异无统计学意义(MD＝0.02，95%CI：-0.01~0.05，P>0.05)；CTR植入与术后残余散光度的比较，差异无统计学意义(MD＝-0.14，95%CI：-0.33~0.05，P>0.05)。 结论白内障常规手术植入CTR可降低IOL的术后旋转度，增加其稳定性，但对术后UCVA以及残余散光度均无明显影响。应用CTR提高散光矫正型IOL的稳定性仍待商榷。     

Posterior chamber phakic intraocular lenses to correct high myopia: a comparative study between Staar and Adatomed models

PURPOSE: To determine the feasibility of using posterior chamber phakic intraocular lenses (PIOLs) to treat high myopia, comparing two different models, Staar and Adatomed. METHODS: Twenty-four eyes from 12 patients were studied prospectively. A phakic Staar IOL was implanted in one eye of each patient, and the other eye received a phakic Adatomed IOL. Patients with uveitis or ocular trauma prior to ocular surgery, diabetic retinopathy, or capsular pseudoexfoliation were excluded. The mean preoperative spherical equivalent refraction was -16.00 +/- 5.05 D for the Staar group and -15.39 +/- 2.83 D for the Adatomed group. Average follow-up was 32.4 months (range, 19 to 46 mo) for the Adatomed group and 18.3 months (range, 11 to 21 mo) for the Staar group and included evaluation of intraocular pressure, intraocular lens pigment deposits, lens decentration, anterior subcapsular cataract, and visual acuity. RESULTS: Spectacle-corrected and uncorrected visual acuity improved in all eyes in both groups. No statistically significant differences in visual acuity gain were observed with the two materials (Student t-test, P = .08 for the Staar group and P = .6 for the Adatomed group), although the gain in visual acuity was somewhat greater with the Staar PIOLs. The difference in mean intraocular pressure before surgery and at last follow-up was 1.5 mmHg for the Staar group and 2.3 mmHg for the Adatomed group (P = .36). The incidence of lens pigment deposits was the same in both groups (41.66%), with deposits in 5 of the 12 eyes in both groups. The incidence of lens decentration was higher in the Adatomed group (5/12; 41.66%) than in the Staar group (2/12; 16.7%). Anterior subcapsular cataract was higher in the Adatomed group (4/12; 33.3%) than in the Staar group (3/12; 25%). CONCLUSIONS: There was a higher incidence of lens decentration and anterior subcapsular cataract in the Adatomed group than in the Staar group.     

Intraoperative autorefraction for combined phakic intraocular lens explantation and cataract surgery

PURPOSE: To evaluate intraoperative autorefraction during combined phakic intraocular lens (PIOL) explantation and cataract surgery. METHODS: Phakic intraocular lens explantation was followed by crystalline lens emulsification and reformation of the anterior chamber with balanced salt solution. Autorefraction was performed intraoperatively with the Nikon Retinomax 2, and the IOL power was calculated using a formula for myopic eyes: IOL for emmetropia = 1.3 x aphakic spherical equivalent refraction + 1.45. RESULTS: Nineteen myopic eyes of 15 patients with anterior or posterior chamber PIOL (including 6 eyes that had undergone photorefractive keratectomy) were treated. Two months postoperatively, mean spherical equivalent refraction was -0.56+/-0.40 diopters (D) (range: 0 to -1.50 D). CONCLUSIONS: In myopic eyes, intraoperative auto-refraction provided a simple and reliable method to calculate IOL power in combined PIOL explantation and cataract surgery.     

高度近视散光的白内障复曲面(toric)人工晶状体及囊袋张力环植入术的效果观察

目的:观察有角膜散光的高度近视伴白内障患者进行超声乳化复曲面人工晶状体(toric IOL)及囊袋张力环植入术的临床效果及人工晶状体旋转稳定性。方法:回顾性研究。上海新视界眼科医院2016年11月至2020年3月角膜规则散光>1.50 D的高度近视伴白内障21例(31眼),行超声乳化toric IOL及囊袋张力环植入术...     

不同丙烯酸材料的人工晶状体应用于联合手术的对比性研究

目的:探讨两种不同丙烯酸材料的人工晶状体应用于白内障超声乳化摘除联合玻璃体切割及人工晶状体植入术(以下简称"联合手术")治疗玻璃体视网膜疾病合并白内障的临床疗效。方法:回顾性分析联合手术治疗玻璃体视网膜疾病合并白内障患者54例55眼,C-flex组26例26眼,SA60AT组28例29眼,术后定期随访,观察视力、IOL囊袋稳定性及后发性白内障等手术并发症。结果:术后随访9～15平均(11.8±2.0)mo。最佳矫正视力:C-flex组提高20眼(77%),SA60AT组提高24眼(83%),两组间差异无统计学意义(Z=-2.97,P>0.05);人工晶状体偏心量两组间差异无统计学意义(Z=-0.01,P>0.05);预防前囊膜混浊(ACO)C-flex组优于SA60AT组(Z=-2.03,P<0.05);预防后囊膜混浊(PCO)SA60AT组优于C-flex组(Z=-2.08,P<0.05);手术主要并发症两组间差异无统计学意义(P>0.05)。结论:两种人工晶状体应用于联合手术治疗玻璃体视网膜病变合并白内障安全、有效。预防ACO,C-flex略优于SA60AT,而预防PCO,SA60AT略优于C-flex,但其作用仍待于长期观察。