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| Effects of Corneal Incision in Different Directions on Tear Film Stability and Corneal Nerve Repair after Cataract Surgery |
| Xi Zou, Zhinan Liu, Dong Zhou, Jun Zhang, Yi Jiang, Guohua Deng |
| The Third People's Hospital of Changzhou, Changzhou 213000, China |
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Abstract Objective: To investigate the effects of transparent corneal incision in different directions on tear film stability and corneal nerve injury repair in patients with age-related cataract (ARC) and diabetic cataract (DC). Method: In this prospective clinical study, 67 patients (80 eyes) of cataract underwent phacoemulsification combined with intraocular lens (IOL) implantation from September 2021 to December 2021 in the Third People's Hospital of Changzhou. Thirty-five patients (40 eyes) of ARC were randomly divided into groups Ⅰ , Ⅱ ; 18 patients (20 eyes) of ARC in group Ⅰ were treated with upper transparent corneal incision; 17 patients (20 eyes) in group Ⅱ were treated with temporal transparent corneal incision. Thirty-two patients (40 eyes) of DC were randomly divided into groups Ⅲ , Ⅳ ; 16 patients (Twenty eyes) of DC in group Ⅲ were treated with upper transparent corneal incision; 16 patients (20 eyes) of DC in group Ⅳ were treated with temporal transparent corneal incision. Tear film break-up time (BUT), tear meniscus height (TMH) and Schirmer I test (S Ⅰ T) were examined before operation, 1 week, 1 month and 3 months after operation; anterior segment optical coherence tomography (AS-OCT) was performed at 1 week, 1 month and 3 months after operation; corneal confocal microscopy (CCM) was performed at 1 and 3 months after operation. The t-test was used to test BUT, TMH and S Ⅰ T in each group after and before operation. One-way ANOVA was used to compare differences between age, corneal nerve fiber density (CNFD) and corneal nerve branch density (CNBD) of each group. Nonparametric Mann-Whitney test was used to compare corneal nerve fiber length (CNFL) and cornenl nerve fiber width (CNFW). Results: There were significant differences in BUT, TMH and S Ⅰ T at 1 week and 1 month after operation compare with before operation (P<0.05); The values of BUT, TMH and S Ⅰ T in group I were higher than those in group III, group II than those in group IV one week after operation (P<0.05), but the difference disappeared 1 month after operation. One month after operation, there were few integral long nerve fibers in all patients. Three months after operation, integral long nerve fibers and nerve fiber branch connection were seen in all four groups. Compared with 1 month after operation, CNFL, CNFD and CNBD increased in the four groups at 3 months after operation (P<0.05). One month after operation, CNFL, CNFD and CNBD in group IV were lower than those in group III (P<0.05). One month and three months after operation, the value of CNFL, CNFD and CNBD in group I were higher than those in group III, group II was higher than those in group IV, and the difference was significant (P<0.05). Conclusion: During cataract surgery, the corneal nerve injury of the upper corneal incision in DC patients was lighter than those of the temporal incision. The repair of tear film injury and corneal nerve injury in DC patients was slower than those in ARC patients.
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Received: 28 February 2022
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| Fund:Young Scientific and Technological Talents Promotion Project of Changzhou "Longcheng Medical Star" Health; Science and Technology planning Project Foudation of Changzhou (CJ20220097) |
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Corresponding Authors:
Guohua Deng, the Third People's Hospital of Changzhou, Changzhou 213000,China (Email: 13584379133@163.com)
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