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Objective: To evaluate the efficacy of intraocular lens (IOL) cushion plate technology in reducing corneal endothelial cell loss during hard-core cataract surgery compared with conventional ultrasonic emulsification. Methods: Seventy-six patients with hard-core cataracts who underwent surgery at our institution from April 2019 to June 2022 were included. The patients were divided into an observation group (IOL cushion plate technology, 38 patients) and a control group (conventional ultrasonic emulsification, 38 patients). Surgical outcomes, including the corneal endothelial cell loss rate, best corrected visual acuity (BCVA), and central corneal thickness (CCTc), were compared between the two groups. Results: Preoperative patient characteristics were similar between the groups. Postoperatively, both groups demonstrated similar BCVA and CCTc values on days 7 and 30. However, compared with the observation group, the control group presented a significantly greater rate of corneal endothelial cell loss on postoperative days 7 and 30 (p < 0.05). Intraoperative complications and postoperative complications were notably greater in the control group (p < 0.05). The observation group had reduced ultramilk time and total energy consumption (p < 0.05). Conclusion: IOL cushion plate technology offers advantages in preserving corneal endothelial cells during hard-core cataract surgery, potentially improving surgical safety and efficacy.
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AIM: To compare the surgical outcomes of glaucoma drainage device implantation (GDI) and trans-scleral neodymium:YAG cyclophotocoagulation (CPC) in the management of refractory glaucoma after Descemet-stripping automated endothelial keratoplasty (DSAEK). METHODS: This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery (15 with GDI and 14 with CPC). The main outcome measures were intraocular pressure (IOP), glaucoma surgery success rate (defined as IOP of 6-21 mm Hg without additional anti-glaucoma operation), number of glaucoma medications, endothelial graft status, and best-corrected visual acuity (BCVA). RESULTS: The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries, both for the GDI and CPC groups. Both groups showed significant IOP reduction after glaucoma surgery. The GDI group presented a significantly higher success rate in IOP control than the CPC group (60% vs 21.4%, P=0.03). Both procedures significantly decreased the number of glaucoma medications (P=0.03). Forty percent and 57% of cases in the GDI and the CPC group, respectively, experienced endothelial graft failure during follow-up (P=0.36). Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI group. CONCLUSION: Both GDI and CPC significantly decrease IOP in eyes with glaucoma after DSAEK. GDI is preferable to CPC in refractory glaucoma cases after DSAEK, as it manifests a significantly higher success rate for IOP control, similar endothelial graft failure rate, and relatively preserves BCVA than CPC.
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AIM: To detect the relationship between infusion pressure and postoperative ganglion cells function. METHODS: This prospective observational cohort study included sixty-one eyes that underwent uncomplicated cataract surgery. Patients were divided into two groups according to infusion time (IT) recorded using surgery equipment [Group A: IT>ITmean (27 eyes); Group B: IT