不同设计人工晶状体植入术后3年后囊膜混浊的研究

Posterior capsule opacification and lens epithelial cell growth patterns with different types of intraocular lenses: A comparative study with a 3-year follow-up

目的研究不同材料和不同设计的人工晶状体植入术后3年的后囊膜混浊(posterior capsular opacification,PCO)发生率及PCO形态。方法回顾性研究132眼老年性白内障患者,由同一医生进行超声乳化联合人工晶状体(in-traocular lens,IOL)植入术,根据IOL的不同分为4组:Storz Hydroview H60M组(33眼),Silicone折叠式硅胶IOL组(29眼),AcrySof三片式IOL组(36眼)和聚甲基丙稀酸甲酯(poly-methyl methacrylate,PMMA)组(34眼)。术后3年随访患眼的最佳矫正视力(best corrected visual acuity,BCVA),扩瞳后采集PCO数码图像,分析不同IOL组PCO的形态及PCO发生率。结果各种IOL的PCO形态各异,H60M组和AcrySof组分别有10眼和15眼后囊形成皱折,而Silicone和PMMA组为片状混浊。虽然各组BCVA和BCVA下降率差异没有显著性(P>0.05),但PCO发生率差异有非常显著性,分别是AcySof组5.6%,Silicone组30.3%,H60M组31%和PMMA组55.9%。结论AcrySof疏水丙烯酸酯三片式折叠IOL,有直角边缘设计,术后3年能明显降低PCO的发生。

Objective To compare the incidence of posterior capsule opacifcation （PCO） and lens epithelial cell （LEC） growth patterms on posterior surface of different intrnocular lenses （IOLs） 3 years after implantation.Methods A retrospective study comprised of 132 eyes that had undergone cataract extraction and insertion of an IOL in the. capsular hag was performed by a single surgeon using a standardized phacoemlsification technique. The eyes were divided into 4 groups based on the type of IOL implanted： iStozz Hydroview H60M （33 eyes）, Silicone foldable silicon IOL （29 eyes）, AcrySof acrylic （36 eyes） and PMMA IOL （34 eyes）. The changes in best corrected visual acuity （BCVA）, and the developmeat of PCO and LEC growth pattems on the posterior capsule were analyzed after 3 years. Results Each type of IOL had special LEC growth patterns. Ten patients in the H60M group and 15 in the AcrySof group had linear PCO; no patient in the silicone or PMMA group had posterior capsule folds at 3 years. Although there was no significent difference （P 〉 0.05） for BCVA and a decrease in BCVA among the different IOL types, there was a significant difference in the incidence of PCO at 3 years （P〈0.01）. AcrySof IOLs were associated with a lower incidence of PCO （5.6%） than with silicone （30.3%）, H60M （31%） or PMMA IOLB（55.9%）.Conclusion The AcrySof IOL, which has a squared-edge design, had a significanfly lower incidence of PCO 3 years postoperatively.