光学材料与晶状体前后囊混浊及撕囊收缩量的关系

Relationship of optic materials with anterior and posterior capsule opacification as well as capculorhexis contraction of lenses

背景:囊袋混浊是人工晶体植入后最常见的远期并发症,研究者们一直在探寻理想的人工晶体以减少囊袋混浊的发生。目的:观察3种具有锐利光学边缘的人工晶状体光学材料对晶状体前后囊膜混浊和撕囊收缩的影响。设计、时间及地点:随机分组对照观察,于2005-05/2006-12在承德医学院附属医院眼科完成。对象:随机选取年龄相关性白内障患者135例(148眼),其中男73例(80眼),女62例(68眼);年龄52～81(71.44±6.83)岁。方法:均行超声乳化白内障摘除联合人工晶状体植入术,术中植入具有锐利光学边缘的折叠式人工晶状体。随机分3组:疏水材料组43例(49眼)植入疏水丙烯酸材料直角边缘人工晶状体;亲水材料组42例(46眼)植入亲水丙烯酸材料直角边缘人工晶状体,亲水疏水一体式材料组50例(53眼)植入亲水疏水一体式丙烯酸材料直角边缘人工晶状体。主要观察指标:术后1年扩瞳观察前囊膜混浊、后囊混浊及撕囊收缩情况并进行量化评估。结果:疏水材料组、亲水材料组、亲水疏水一体式材料组术后1年后囊混浊发生率分别为:8.3%,26.7%,15.3%,差异有显著性意义(P<0.05);而前囊膜混浊的发生率及撕囊收缩量3组比较,差异无显著性意义(P>005)。结论:具有锐利光学边缘的人工晶状体的光学材料对前囊膜混浊及撕囊收缩量均无影响,但影响后囊混浊的形成,其中疏水丙烯酸材料可减少后囊混浊的发生。

BACKGROUND： Capsule opacification is a common complication following implantation of intraocular lenses for a long period. Scholars are looking for an ideal intraocular lens so as to reduce the incidence of capsule opacification. OBJECTIVE： To study the effects of three intraocular optic materials with sharp optic edge on anterior and posterior capsule opacification as well as capsulorrhexis contraction. DESIGN, TIME AND SETTING： A randomized controlled study was performed at the Department of Ophthalmology, Affiliated Hospital of Chengde Medical College from May 2005 to December 2006. PARTICIPANTS： A total of 135 patients （148 eyes） with age-related cataract, including 73 males （80 eyes） and 62 females （68 eyes） and aging 52 81 years with the mean age of （71.44 ±6.83） years, were collected in this study. METHODS： All patients were performed with phacoemulsification combining with implantation of foldable intraocular lenses which were characterized by sharp optic edges. Thereafter, they were randomly divided into three groups： lyophobic material group （n=43, 49 eyes）, who were implanted with lyophobic acrylic acid intraocular lens; hydrophilic material group （n=42, 46 eyes）, who were implanted with hydrophilic acrylic acid intraocular lens; lyophobic/hydrophilic material group （n=50, 53 eyes）, who were implanted with lyophobic/hydrophilic acrylic acid intraocular lens. MAIN OUTCOME MEASURES： Anterior and posterior capsule opacification as well as capculorhexis contraction were quantitatively evaluated 1 year postoperatively. RESULTS： At one year postoperatively, incidences of posterior capsule opacification were 8.3% in the lyophobic material group, 26.7% in the hydrophilic material group, and 15.3% in the lyophobic/hydrophilic material group, respectively, and there was significant difference （P 〈 0.05）; however, there were no significant differences in anterior capsule opacification and capculorhexis contraction among the three groups （P 〉 0.05）. CONCLUSION： The optic intraocular lens of sharp optic edge does not have any effects on anterior capsule opacification or capsulorrhexis contraction, but has effects on formation of posterior capsule opacification; in particular, lyophobic acrylic acid can reduce the incidence to posterior capsule opacification.