白内障囊外摘除术后后囊混浊的原因分析及预防

The Cause and Prevention of Posterior Capsular Opacification after Extracapsular Cataract Extraction

目的:探讨白内障摘除术后晶体后囊膜混浊的原因及预防办法。方法:对72例(90眼)白内障囊外摘除术或后房型人工晶体植入术患者随访观察2年。结果:本组72例(90眼)术后发生后囊混浊24眼,总发生率为26．67％。单纯囊外摘除术18眼发生后囊混浊8眼,占44．44％;囊外摘除+人工晶体植入术72眼发生后囊混浊16眼,占22．22％,明显低于前组(P<0．05)。术后随访半年、1年和2年出现后囊混浊分别为10眼(11．11％)、20眼(22．22％)和24眼(26．67％)。发生后囊混浊患者的平均年龄为58．24岁;无后囊混浊患者的平均年龄为69．46岁,明显高于前者(P<0．05)。结论:后囊混浊是多因素作用的结果,与手术方式、患者年龄、白内障类型及随访时间等有关,但其形成的主要物质基础是晶体上皮细胞的残留与增殖。为预防后囊混浊的发生,术中应尽可能彻底清除晶状体皮质,改进手术方式,并进一步开展有关术后抑制增殖的药物研究。

Objective： To study the cause and prevention of posterior capsular opacification after extracapsular cataract extraction. Methods： Two years＇ follow-up survey of 72 cases （90 eyes） after extracapsular cataract extraction or posterior chamber intraocular lens implantation were analyzed. Results.. 24 eyes of posterior capsular opacifieation were found in all 72 patients （90 eyes）, the total incidence rate is 26. 67% （24/90）. Among 24 eyes of posterior capsular opacification, 8 eyes （44.44%） were found in 18 eyes after simp｜e extracapsu｜ar cataract extraction, 16 eyes （22. 22% ） were found in 72 eyes after extracapsular cataract extraction and intraocular lens implantation. The incidence rate of posterior capsular opacification in the latter group was obviously lower than the former group （P〈0.05）. In all 90 eyes, posterior capsular opacification were found in 10 eyes （11.11% ）, 20 eyes （22. 22% ） and 24 （26. 67%） respectively in 6 monthes, 1 year and 2years after operation. Mean age of the patients with posterior capsular opacification was 58. 24 years. Mean age of the cases without posterior capsular opacification was 69.46 years. The latter mean age was higher than the former （P〈0. 05）. Conclusion：Posterior capsular opacification after operaion resulted from multiple factors, including： operation mode, age of patients, eataracta type, follow-up period, and so on. The main material foundation leading to posterior capsular opacification was the remains or proliferation of crystalline lens epithelial cells. In order to prevent posterior capsular opacification, crystalloid corpuscle cortex should be removed thoroughly in the operation as far as possible, operation mode should be improved, and the further research on drugs of inhibition of proliferation should be developed.