Cataract extraction combined with posterior chamber intraocular lens implantation and minimally invasive vitrectomy for the treatment of senile cataract with posterior vitreous detachment

Objective To observe the clinical effect of phacoemulsification combined with posterior chamber intraocular lens implantation and minimally invasive vitrectomy in the treatment of senile cataract with posterior vitreous detachment (PVD). Methods From June 2016 to June 2017, the clinical data of 30 hospitalized patients (30 eyes) with senile cataract combined with PVD were diagnosed in two families of cataract in the ophthalmology hospital of Chinese Academy of traditional Chinese medicine (Chinese Academy of Chinese Medicine). Among them, there were 12 males (12 eyes) and 18 females (18 eyes). The age were 50~66 years old with an average age of (56±5.1)years. According to the vitrectomy, it was divided into the exposure group [10 cases(10 eyes), the vitrectomy combined with cataract surgery)] and the non exposure group [(20 cases(20 eyes) with cataract surgery]. The operation time, postoperative visual acuity, postoperative bad visual symptoms, operation and disease and patient satisfaction were observed respectively. All the data in this study were tested by K-S and showed normal distribution. Mean square deviation(±s)was used to describe them. Independent samples t-test was used in comparison. The best corrected visual acuity of two groups was compared before and after 1 day, 1 week and 3 months by two factor repeated analysis of variance. Results All cases were followed up to 3 months after the operation. The average operation time of the exposed group was (22.4±4.5)min, the average operation time of the non exposed group was (10.5±2.8)min, and the difference was statistically significant (t=-8.99, P 0.05). The results of intra group comparison showed that the visual acuity of the exposed group was higher than that before the operation, and the difference was statistically significant (the exposure group (t= 4.71, -8.51, -9.56; P<0.05); the visual acuity of the non exposed group was also higher than that before the operation. The difference was statistically significant (t=7.13, -10.71, -11.99; P<0.05). After 1 and 3 months after operation, compared with 1 day after operation, the visual acuity of the exposed group was higher than that before the operation (t=3.63, 4.31, P<0.05), and the visual acuity of the non exposed group was also higher than that before the operation. The difference was statistically significant (t=3.43, -3.75, P<0.05). 3 months after operation, the B-mode ultrasound showed that the PVD remission rate was 100%(10/10) and the vitreous turbidity remission rate was 80%(8/10) in the exposed group. The visual symptoms of 9 cases(9 eyes) in the exposure group disappeared, only 1 case(1 eye) still felt the "black spot floating" in front of the eyes, which basically did not affect the normal life. Only 2 cases(2 eyes) in the non exposed group had no significant adverse visual symptoms, and 18 cases(18 eyes) had obvious bad visual symptoms such as "black shadow fluttering" and "flying mosquito" , of which 15 cases(15 eyes) all complained of normal life. The symptoms of 4 cases(4 eyes) were more severe than those before the operation. The satisfaction rate of the exposed group was 100%(10/10), while that of the non exposed group was 75%(15/20). Conclusion Phacoemulsification combined with posterior chamber intraocular lens implantation and minimally invasive vitrectomy can improve the adverse visual symptoms of senile cataract with PVD, and should be used for reference. Key words: Vitreous Detachment; Vitrectomy; Treatment Outcome