两种Nd:YAG激光后囊切开方式对不同材料人工晶状体损伤的观察

Observe on damage of different material intraocular lens by two methods of Nd:YAG laser capsulotomy

目的观察Nd:YAG激光后囊膜切开方式对不同材料的人工晶体(IOL)损伤的情况。方法对86例(124只眼)IOL眼晶状体后囊膜混浊(posterior capsule opacity,PCO)患者随机分为两组行Nd:YAG激光后囊膜切开术。A组64眼采用环行切开后推膜瓣法,人工晶体包括:PMMA23眼、疏水性丙烯酸26眼、硅凝胶15眼。B组60眼行十字形切开法,人工晶体包括:PMMA21眼、疏水性丙烯酸25眼、硅凝胶14眼。术前术后常规眼前段检查、测视力、眼压。结果截囊成功率100%。发生IOL损伤16眼,其中A组6眼(9.38%),B组10眼(16.67%),两种方式对相同材料的人工晶体损伤的机率相似(均p>0.05),不同材料的耐受强弱依次为PMMA、疏水性丙烯酸、硅凝胶,均为轻度损伤。结论两种方式对不同材料损伤的机率依次为硅凝胶、疏水性丙烯酸、PMMA,但环行切开后推膜瓣法可以减少Nd:YAG激光后囊膜切开术IOL损伤机率。

Objetive To observe and compare the situation of damage of different material intraocular lens（IOL） in two methods of Nd：YAG laser posterior capsulotomy. Methods 124 eyes of 86 cases with posterior capsular opacity（PCO） after IOL implant surgery were divided into two groups according to the methods of laser surgery. 64 eyes with the method of Nd：YAG laser surgery which was posterior capsular circular incision and push down of the capsular ship were as Group A, 60 eyes as Group B with cruciate posterior capsulotomy. Routine eye examination,vision,eye tesion were recorded, Results Successful rate of capsulotomy was 100%.The damage of IOL was occurred in 16 eyes. Among 6 eyes in Group A（9.38%）,10 eyes in Group B（16.67%）.The sequence of damage was silicone, acrylic and then PMMA in two groups for IOL material. Conclusion The rate of damage inthe same material IOLs is similar or in different material IOLs is different in the two methods of Nd：YAG laser surgery, But the method of posterior capsular circular incision and push down of the capsular ship can effectively reduce damage of IOLs.