高度近视眼白内障术中Ⅰ期后囊膜连续环形撕除术

Effect of posterior continuous curvilinear capsulorhexis on preventing posterior capsular opacification in cataract with high myopia

目的 探讨I期后囊膜连续环形撕除术（Posterior continuous curvilinear capsulorhexis,PCCC）对高度近视眼白内障术后后发障的预防作用.方法 对203例（211只眼）高度近视眼白内障行白内障超声乳化及人工晶状体植入术,其中70只眼术中行连续环形撕除后囊（A组）,植入普通聚甲基丙烯酸甲酯（PMMA）人工晶状体;非PCCC组138只眼进一步分为普通PMMA人工晶状体组（B组）73只眼,光学部边缘直角设计的折叠人工晶状体组（C组）68只眼.B组和C组单纯行白内障超声乳化及人工晶状体植入术,保留完整后囊膜.所有患眼术后随访2年以上,观察术后后发障、视网膜脱离等并发症情况. 结果 A组2只眼（2.86%）发生了后发障,B组为18只眼（24.66%）,C组8只眼（11.76%）,两两对比差异显著具有统计学意义（P＜0.05）;A组和C组无视网膜脱离发生,B组仅1只眼发生视网膜脱离. 结论 I期后囊膜连续环形撕除术安全有效,明显减少了高度近视眼白内障术后后发障的发生.

Objective To explore the effect of posterior continuous curvilinear capsularhexis （PCCC） on preventing posterior capsular opacification （PCO） in cataract with high myopia operation. Methods Of 203 cases （211 eyes） with cataract and high myopia were randomized to be divided into three groups. Group A received phacoemulsification and intraocular lens implantation combined with posterior continuous curvilinear capsulorhexis （n=70 eyes, RS-55B, Ophthalmic Innovations International, Inc.）,group B （n=73 eyes, RS-55B, Ophthalmic Innovations International, Inc.） and group C （68 eyes, Sensar AR40e, Advanced Medical Optic, Inc.） only received phacoemulsification and intraocular lens implantation, maintaining the integrity of the posterior capsule. After operation, the degree of opacification of posterior capsule was observed. The follow-up period was more than 2 years. Results Posterior capsular opacification occurred in 2 eyes （2.86%） of group A, 18 eyes （24.66%） in group B and 8 eyes （11.76%） in group C. There were statistically significant differences among three groups （P 〈0.05）. Retinal detachment occurred in 1 eye of group B and none in group A and group C. Conclusions PCCC is a safe and effective method for preventing posterior capsule opacification in cataract patients with high myopia operation.