CAJ | 학술논문

目的：观察 Nd：YAG激光治疗高危因素白内障患者术后前囊膜收缩的临床效果。方法对2010年12月至2012年11月收集的120例高危因素白内障患者分为试验组（术后3 d行激光前囊膜松懈术）和对照组。分别在激光术后立刻（基础值）、1、3、6个月用 EAS-1000系统进行前囊膜开口面积测量，同时计算开口面积下降率。并且评价激光术后人工晶体偏移、倾斜、后囊膜混浊及其他并发症。结果在观察的120例患者中，假性囊膜剥脱综合征40例、原发性房角关闭40例、糖尿病视网膜病变40例，激光术后前囊膜开口面积基础值，试验组与对照组比较差异均无统计学意义（P＞0．05）。激光术后1、3、6个月原发性房角关闭患者，试验组前囊膜开口面积较对照组明显变大（P＜0．05），而且开口面积减少率明显小于对照组。而假性囊膜剥脱综合征和糖尿病视网膜病变患者，试验组前囊膜开口面积与对照组比较差异无统计学意义（P＞0．05），但开口面积下降率明显变小（P＜0．05）。而在人工晶体偏移、倾斜、后发障及其他并发症方面无明显差别。结论白内障术后早期，YAG激光治疗预防前囊膜收缩是安全有效的。
목적：관찰 Nd：YAG격광치료고위인소백내장환자술후전낭막수축적림상효과。방법대2010년12월지2012년11월수집적120례고위인소백내장환자분위시험조（술후3 d행격광전낭막송해술）화대조조。분별재격광술후립각（기출치）、1、3、6개월용 EAS-1000계통진행전낭막개구면적측량，동시계산개구면적하강솔。병차평개격광술후인공정체편이、경사、후낭막혼탁급기타병발증。결과재관찰적120례환자중，가성낭막박탈종합정40례、원발성방각관폐40례、당뇨병시망막병변40례，격광술후전낭막개구면적기출치，시험조여대조조비교차이균무통계학의의（P＞0．05）。격광술후1、3、6개월원발성방각관폐환자，시험조전낭막개구면적교대조조명현변대（P＜0．05），이차개구면적감소솔명현소우대조조。이가성낭막박탈종합정화당뇨병시망막병변환자，시험조전낭막개구면적여대조조비교차이무통계학의의（P＞0．05），단개구면적하강솔명현변소（P＜0．05）。이재인공정체편이、경사、후발장급기타병발증방면무명현차별。결론백내장술후조기，YAG격광치료예방전낭막수축시안전유효적。
Objective To observe the clinical effect of anterior capsule relaxing incisions with Nd:YAG laser in treating postop-erative anterior capsule contraction in high-risk cataract patients.Methods 120 high-risk cataract patients with postoperative ante-rior capsule contraction collected from December 2010 to November 2012 were divided into experimental group(performed the ante-rior capsule relaxing incisions on postoperative 3 d)and control group.The anterior capsule opening area was measured immediately after laser operation(baseline),in postoperative 1,3,6 months by using the Scheimpflug video photogeaphy system,and the descent rate of the opening area was simultaneously calculated.The decentration degree and tilt of intraocular lens(IOL),posterior capsule opacification and other complications were also assessed.Results Of the observed 120 cases,40 cases were pseudo posterior capsule stripping syndrome,40 cases were primary angle closure and 40 cases were diabetic retinopathy.There was no statistically signifi-cant difference in the baseline value of the opening area between the experimental group and the control group(P>0.05).In the ca-ses of primary angle closure 1,3,6 months after operation,the anterior capsule opening area in the experimental group was signifi-cantly increased compared with the control group(P<0.05)and the descent rate of the opening area was significantly diminished (P<0.05).In the cases of pseudo posterior capsule stripping syndrome or diabetic retinopathy,although there was no statistically significant difference in anterior capsule opening area between the experimental group and the control group(P>0.05),the descent rate of the opening area was significantly diminished(P<0.05).No significant differences were found in the aspects of IOL decen-tration and tilt,posterior capsule opacity,or other complications.Conclusion YAG laser anterior capsule relaxing incisions in the early period after cataract surgery is safe and effective in preventing anterior capsule contraction in high-risk patients.