放射状前囊剪开对预防白内障术后囊袋收缩综合征发生的临床研究

Radial capsule cut in preventing capsular contraction syndrome

目的：探讨放射状前囊剪开对预防白内障术后囊袋综合征发生的作用。方法选取我院2013年12月至2014年10月期间被确诊为年龄相关性白内障，并行超声乳化联合人工晶状体植入的患者78例（82只眼），随机分为前囊剪开组38例（41只眼）和对照组40例（41只眼），所有患者均植入AcrySof IQ（SN60WF）人工晶状体，术中记录撕囊直径大小，晶状体植入囊袋后，沿前囊口边缘各象限均匀做八处放射状剪开，延伸度约1 mm。术后3个月观察囊口直径、囊口的形态以及人工晶状体的位置。结果剪开组26只眼（63．4％），对照组22只眼（53.7％），囊口缩小1-2 mm人工晶状体无偏位剪开组12只眼（29．3％），对照组11只眼（26．8％），囊口明显机化增厚人工晶状体轻度偏位剪开组3只眼（7．3％），对照组有6只眼（14．6％），对照组2只眼（4．9％）出现人工晶状体夹持，前囊剪开组未出现。两组总有效率比较有统计学意义（ P ＜0．05）。结论白内障术中行一期放射状前囊剪开，可以在一定程度上减轻前囊收缩程度，有效降低囊袋收缩综合征的发生率。

Objective To explore the effects of radial capsule cut open on prevention of capsule contraction syn-drome.Methods Seventy-eight age-related cataract patients （82 eyes） were included in this study.Patients were divided into radial cut open group （38 patients, 41 eyes） and control group （40 patients, 41 eyes）.The radial cuts were uniformly made at 8 places along the capsule edges in each quadrant and extended to 1 mm.Both groups of patients received phacoe-mulsification and were implanted with AcrySof IQ （ SN60WF） IOL.The capsulorhexis size was recorded.Follow up period was 3 months.Capsule shape, diameter, and IOL position were compared between the two groups.Results The rate of mild anterior capsular fibrosis was 63.4% in patients received radial capsule cut compared to 43.9% in control group. Capsular contraction with reduced opening diameter （1-3 mm） occurred in 29.3%of the patients with radial cut and in 39%of the patients in control group.Fibrosis and IOL mild dislocation were found in 7.3%of the patients with radial cut but 12.2%in control group.Conclusion Radial capsule cut was effective in delaying the occurrence of anterior capsular contraction and preventing capsule contraction syndrome.