影响后发障光切术后效果的临床观察

The factors affecting the effect of posterior capsulotomy

目的 :分析后发障光切术后并发症及视力不增的原因及研究预防措施。方法 :对白内障现代囊外摘除及人工晶体植入术后 8d～ 5年后发障的 115例、148眼行Nd :YAG激光后囊膜光切术 ,术后次日复诊 ,随诊 7d～ 3个月。结果 :接受该法治疗的 115例 ,除 1例玻切术后硅油充满前房的患者膜切开不成功外 ,余者均切膜成功 ,成功率为 99.32 %。视力提高 10 8眼 ( 72 .97% ) ,不变 4 0眼 ( 2 7.0 3% )。视力由治疗前的 0 .31±0 .2 6提高到治疗后的 0 .56± 0 .37。结论 :后发障光切术是白内障术后因后发障而再次致盲患者有效的、非介入性的手术治疗 ,安全 ,患者无痛苦 ,成功率高 ,视力提高显著。白内障术后视力不提高系治疗前原有眼部病变所致 ,与激光治疗本身无相关性 ,并发症的发生则与激光能量及膜质量成正相关。因此 ,早期治疗和分次治疗可减少和预防并发症的发生。对Ⅲ级膜后发障的分次治疗尤为重要 ,可避免一次性过高使用能量 ,给周围组织带来不必要的损伤。

Objective: To analyse the causes of the complications of laser posterior capsulotomy and unchanged vision. Methods: 115 cases with 148 eyes with after-cataract, who accepted extracapsular cataract extraction and intraocular lens implantation, were performed Nd: YAG laser capsulotomy. The follow-up periods ranged from 7ds to 3months. Results:Except that 1 case with silicone oil filled the anterior chamber failed in the treatment,all the others obtained success from the laser capsulotomy. The successful rate was 99.32%. Vision was improved in 108 eyes(72.97%),and remained unchanged in 40 eyes. The vision was improved from 0.31±0.26 to 0.56±0.37.Conclusion:Nd: YAG laser capsulotomy is an effective and non-traumatic surgical method for after-cataract. It can effectively improve the vision. In this study group, the causes for the unchanged vision are the primary eye diseases that existed before the treatment. The happeness of the complications is positive relative to the laser energy and the degree of the after-cataract. So early and seperatedly treatment can lessen the complications. For after-cataract of grade Ⅲ, it is especially important to treat in seperated times to prevent the destroy of the around tissue from high energy in one time.