CAJ | 학술논문

目的对白内障超声乳化术后囊袋收缩综合征的患者行Nd∶YAG激光前囊膜切开及表麻下囊袋松解术治疗,观察二者的临床疗效,为囊袋收缩综合征治疗方法的选择提供安全有效的依据.方法对23例(23只眼)白内障超声乳化及人工晶状体植入术后囊袋收缩综合征的患者进行临床观察并分类.囊袋收缩综合征多发生于直径较小的连续环形撕囊眼,可分为初发型、进展型和重度型三型,对各型选择相应治疗方法,治疗后随访1～3个月,观察撕囊口直径,人工晶状体的位置,前房反应,最佳矫正视力,角膜内皮细胞密度及眼压的变化,判断治疗效果.结果 Nd∶YAG激光前囊膜切开术适用于初发型和进展型囊袋收缩征.表麻下囊袋松解术适用于重度型囊袋收缩征.术后23只眼囊袋收缩未再继续进展,无严重并发症发生,治疗前、后的视力改变具有统计学意义,(P＜0.05),最佳矫正视力较治疗前有显著提高.角膜内皮细胞密度治疗后无明显减少,较治疗前差异无统计学意义(P＞0.05).治疗后1个月、3个月的眼压较治疗前无明显升高,统计学差异无统计学意义(P＞0.05),治疗后1个月与3个月相比亦差异无统计学意义(P＞0.05).结论 Nd∶YAG激光前囊膜切开及囊袋松解术是治疗白内障超声乳化术后囊袋收缩综合征安全有效的方法.预防囊袋收缩综合征发生的关键在于合适大小的前囊膜连续环形撕囊口,以直径5～6mm最为适宜,术中可用角膜标记环钻指导撕囊口的大小.
목적 대백내장초성유화술후낭대수축종합정적환자행Nd∶YAG격광전낭막절개급표마하낭대송해술치료,관찰이자적림상료효,위낭대수축종합정치료방법적선택제공안전유효적의거.방법 대23례(23지안)백내장초성유화급인공정상체식입술후낭대수축종합정적환자진행림상관찰병분류.낭대수축종합정다발생우직경교소적련속배형시낭안,가분위초발형、진전형화중도형삼형,대각형선택상응치료방법,치료후수방1～3개월,관찰시낭구직경,인공정상체적위치,전방반응,최가교정시력,각막내피세포밀도급안압적변화,판단치료효과.결과 Nd∶YAG격광전낭막절개술괄용우초발형화진전형낭대수축정.표마하낭대송해술괄용우중도형낭대수축정.술후23지안낭대수축미재계속진전,무엄중병발증발생,치료전、후적시력개변구유통계학의의,(P＜0.05),최가교정시력교치료전유현저제고.각막내피세포밀도치료후무명현감소,교치료전차이무통계학의의(P＞0.05).치료후1개월、3개월적안압교치료전무명현승고,통계학차이무통계학의의(P＞0.05),치료후1개월여3개월상비역차이무통계학의의(P＞0.05).결론 Nd∶YAG격광전낭막절개급낭대송해술시치료백내장초성유화술후낭대수축종합정안전유효적방법.예방낭대수축종합정발생적관건재우합괄대소적전낭막련속배형시낭구,이직경5～6mm최위괄의,술중가용각막표기배찬지도시낭구적대소.
Objective To observe the effect of Nd∶YAG Laser and the operation of anterior capsule tearing on the treatment of capsule contraction syndrome after cataract phacoemulsification and intraocular lens implantation. Aim to provide safe and effective basis of treatment options. Methods Twenty-three patients (23 eyes ) with capsule contraction syndrome after cataract phacoemulsification and intraocular lens implantation were divided into three types: the initial type, the progressive type and the severe type. Each type represented one group. Select the appropriate treatment for various types of capsule contraction syndrome. Measure numerical values of intraocular pressure, best corrected visual acuity, corneal endothelial cell density. Observe the anterior chamber reaction, the change of anterior capsule diameter and the position of intraocular lens. The values pre-operation and post-operation one month, three months were analyzed. Results The development of capsule contraction was stopped. No severe complication was observed. Best corrected visual acuity changes with a statistically significant difference before and after treatment (P ＜0.05). It improved significantly after treatment compared with best corrected visual acuity before therapy. There was no significant difference in corneal endothelial cell density before and after treatment (P ＞0.05). Intraocular pressure had no significant increase after treatment (P ＞0.05). There were no significant differences in intraocular pressure between 1 month the operation of anterior capsulotomy tearing are safe and effective to treat the capsule contraction syndrome.The key of preventing is the suitable diameter of anterior capsule mouth. The most appropriate diameter is 5 to 6 millimeters. The most effective means of prevention in capsule contraction syndrome is to use a positioning ring on central cornea to fix a position to guide the size of anterior capsule mouth during the operation.