AIM:To compare the outcomes of combined phacoemulsification and non-penetrating deep sclerectomy(P-DS)with combined phacoemulsification and trabeculectomy(P-T)in patients who have cataract and moderate-to-severe prima...AIM:To compare the outcomes of combined phacoemulsification and non-penetrating deep sclerectomy(P-DS)with combined phacoemulsification and trabeculectomy(P-T)in patients who have cataract and moderate-to-severe primary open angle glaucoma(POAG)or pseudoexfoliative glaucoma(PXG).METHODS:In this prospective randomized study 40 eyes of 40 patients with cataract and POAG or PXG were evaluated.Complete eye examination and glaucoma tests were performed in all patients.Combined P-DS and P-T were performed under local anesthesia in 20 eyes in each group.Visual acuity(VA),intraocular pressure(IOP)and number of glaucoma medications were all recorded preoperatively and postoperative on 10 d,1,3,6 and12 mo.Complications,laser goniopuncture in P-DS group and needling in P-T group were also recorded.RESULTS:The age(P-DS,66.3±11.0 and P-T,70.2±9.3y)and sex distribution(P-DS,7 female and 13 male,P-T,9 female and 11 male)were similar in both groups(P〈0.05).Number of POAG and PXG patients were 12 and 8,and 13 and 7 in P-DS and P-T groups,respectively(P〈0.05).There was no difference between groups in terms of preoperative VA(P-DS,0.69±0.22 and P-T,0.76±0.22 logMAR),IOP(P-DS,17.9±1.6 and P-T,18.1±1.9mm Hg)and number of medications(P-DS:2.7±0.7 and P-T:2.9±0.8),(P〈0.05).VA increased,IOP and number of medications decreased in both groups postoperatively(P〈0.01).Postoperative lOPs were 15.0±1.7 and 14.5±1.6 mm Hg in P-DS and P-T groups respectively(P=0.472).Postoperative number of medications were slightly better in P-T group(0.5±0.7)than in P-DS group(0.8±0.9)(P=0.307).There were no complications in both groups.Laser goniopuncture was applied in 7 eyes(once in 5 eyes and twice in 2 eyes)in P-DS group.Needling was performed in 1 eye in P-T group.CONCLUSION:In patients with coexisting cataract and glaucoma,both combined P-DS and P-T may be performed safely.Reliability and efficacy were similar in both groups.Follow-up of P-DS should be done cautiously and when necessary laser goniopuncture should be performed.展开更多
AIM:To report the effectiveness of intravitreal implantation of dexamethasone implant(Ozurdex)after phacoemulsification and intraocular lens implantation in refractory uveitis patients.METHODS:This single-center retro...AIM:To report the effectiveness of intravitreal implantation of dexamethasone implant(Ozurdex)after phacoemulsification and intraocular lens implantation in refractory uveitis patients.METHODS:This single-center retrospective study conducted for refractory pan-uveitis patients who underwent cataract surgery combined with intravitreal Ozurdex implantation.The main outcome measurements were bestcorrected visual acuity(BCVA),central retinal thickness(CRT),grade of anterior chamber cell(AAC),intraocular pressure(IOP),and systemic/ocular adverse events.RESULTS:Ten eyes of 7 patients were included.BCVA showed significant improvement at 1 mo(P=0.004),3 mo(P=0.0004),and 6 mo(P=0.001)post operation.There were no statistically significant differences in the postoperative CRT among follow-up groups(P>0.05).No significant differences were observed in the baseline IOP when compared to 1,3,and 6 mo(all P>0.05)post operation.One patient developed a transient elevated IOP post injection.Two eyes(20%)developed posterior capsular opacifications and underwent neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy.In six patients(8 eyes,71.4%),the systemic steroid usage was reduced to below 10 mg/d.The patients experienced a mean of 1.4±0.52 recurrences of inflammation in the 6 mo before operation and 0.7±0.48 in the 6 mon post operation.The mean recurrence time was 13±0.58 wk(range 12-14 wk)post operation.In five of seven patients(7 out of 10 eyes),inflammation relapse was developed postoperatively.Only one patient(2 eyes)needed increased amounts of oral corticosteroids.Intraocular inflammation recurrence in the remaining patients was controlled by topical steroids.CONCLUSION:Ozurdex is considered a safe and effective approach to control postoperative inflammation in cataract surgery for patients with refractory uveitis in our study.After the disappearance of Ozurdex’s antiinflammatory effects over time,in most cases the recurrent inflammation can be controlled by topical steroids.展开更多
文摘AIM:To compare the outcomes of combined phacoemulsification and non-penetrating deep sclerectomy(P-DS)with combined phacoemulsification and trabeculectomy(P-T)in patients who have cataract and moderate-to-severe primary open angle glaucoma(POAG)or pseudoexfoliative glaucoma(PXG).METHODS:In this prospective randomized study 40 eyes of 40 patients with cataract and POAG or PXG were evaluated.Complete eye examination and glaucoma tests were performed in all patients.Combined P-DS and P-T were performed under local anesthesia in 20 eyes in each group.Visual acuity(VA),intraocular pressure(IOP)and number of glaucoma medications were all recorded preoperatively and postoperative on 10 d,1,3,6 and12 mo.Complications,laser goniopuncture in P-DS group and needling in P-T group were also recorded.RESULTS:The age(P-DS,66.3±11.0 and P-T,70.2±9.3y)and sex distribution(P-DS,7 female and 13 male,P-T,9 female and 11 male)were similar in both groups(P〈0.05).Number of POAG and PXG patients were 12 and 8,and 13 and 7 in P-DS and P-T groups,respectively(P〈0.05).There was no difference between groups in terms of preoperative VA(P-DS,0.69±0.22 and P-T,0.76±0.22 logMAR),IOP(P-DS,17.9±1.6 and P-T,18.1±1.9mm Hg)and number of medications(P-DS:2.7±0.7 and P-T:2.9±0.8),(P〈0.05).VA increased,IOP and number of medications decreased in both groups postoperatively(P〈0.01).Postoperative lOPs were 15.0±1.7 and 14.5±1.6 mm Hg in P-DS and P-T groups respectively(P=0.472).Postoperative number of medications were slightly better in P-T group(0.5±0.7)than in P-DS group(0.8±0.9)(P=0.307).There were no complications in both groups.Laser goniopuncture was applied in 7 eyes(once in 5 eyes and twice in 2 eyes)in P-DS group.Needling was performed in 1 eye in P-T group.CONCLUSION:In patients with coexisting cataract and glaucoma,both combined P-DS and P-T may be performed safely.Reliability and efficacy were similar in both groups.Follow-up of P-DS should be done cautiously and when necessary laser goniopuncture should be performed.
基金Supported by National Natural Science Foundation of China(No.81870651No.81671642)。
文摘AIM:To report the effectiveness of intravitreal implantation of dexamethasone implant(Ozurdex)after phacoemulsification and intraocular lens implantation in refractory uveitis patients.METHODS:This single-center retrospective study conducted for refractory pan-uveitis patients who underwent cataract surgery combined with intravitreal Ozurdex implantation.The main outcome measurements were bestcorrected visual acuity(BCVA),central retinal thickness(CRT),grade of anterior chamber cell(AAC),intraocular pressure(IOP),and systemic/ocular adverse events.RESULTS:Ten eyes of 7 patients were included.BCVA showed significant improvement at 1 mo(P=0.004),3 mo(P=0.0004),and 6 mo(P=0.001)post operation.There were no statistically significant differences in the postoperative CRT among follow-up groups(P>0.05).No significant differences were observed in the baseline IOP when compared to 1,3,and 6 mo(all P>0.05)post operation.One patient developed a transient elevated IOP post injection.Two eyes(20%)developed posterior capsular opacifications and underwent neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy.In six patients(8 eyes,71.4%),the systemic steroid usage was reduced to below 10 mg/d.The patients experienced a mean of 1.4±0.52 recurrences of inflammation in the 6 mo before operation and 0.7±0.48 in the 6 mon post operation.The mean recurrence time was 13±0.58 wk(range 12-14 wk)post operation.In five of seven patients(7 out of 10 eyes),inflammation relapse was developed postoperatively.Only one patient(2 eyes)needed increased amounts of oral corticosteroids.Intraocular inflammation recurrence in the remaining patients was controlled by topical steroids.CONCLUSION:Ozurdex is considered a safe and effective approach to control postoperative inflammation in cataract surgery for patients with refractory uveitis in our study.After the disappearance of Ozurdex’s antiinflammatory effects over time,in most cases the recurrent inflammation can be controlled by topical steroids.
