晚期囊袋阻滞综合征与后发性液化性白内障

Late capsular block syndrome （CBS） and liquefied after-cataract

目的探讨晚期囊袋阻滞综合征（CBS）与后发性液化性白内障的区别、联系及有效地治疗方法。方法对2012年9月至2013年5月在邢台市眼科医院观察白内障超声乳化联合人工晶状体植入术后5—11年，发生囊袋阻滞的5例患者，手术前后视力、屈光度、眼部表现等的改变，评价手术治疗的临床疗效。结果4例通过手术方法治疗。术中扩大前囊口，彻底清除囊袋内混浊物，抛光后囊膜。术后视力恢复至0．8～1．0，前房加深，人工晶状体位置居中。观察3~6个月，视力保持稳定，后囊膜未见混浊。1例因对视力影响轻，患者未治疗，随访3个月未发生明显改变。结论晚期CBS是白内障手术中连续环形撕囊孔的并发症之一，早期表现为后发性液化性白内障。通过手术治疗可将混浊液体彻底清除到眼外，同时避免后囊膜的损伤，扩大前囊口彻底解除晚期囊袋阻滞综合征再次发生的可能，是晚期CBS安全有效地治疗方法。

Objective To discuss the relationship of late CBS and liquefied after-cataract, and to assess the effect of surgery treatment. Methods A retrospective study. Clinical manifestation, vision, dioptric situation were observed before and after surgery on 5 patients who had experienced phaco- emulsification and IOL implantation 5-11 years before, the clinical effect of surgery treatment was as- sessed. Results There were 4 patients received operation. Continuous curvilinear anterior capsular hole was expanded, the milky substance was aspirated, and the capsule was polished. The visual acu- ity increased to 0.8-1.0, anterior chamber deepened, IOL relocated, the posterior capsule was clear, adjacent to the IOL. Follow-up time was 3-6 months, the vision was remained stable. One patient had not treated because the impacted light of vision, no obvious changes after 3 months observation. Conclusions Late CBS is one of complication of smaller continuous curvilinear anterior capsu- lorhexis in the process of phacoemulsification, clinical manifestation as liquid after-cataract in early stage. The operation of enlarge the anterior capsular hole is safe, reliable, and can instantly resolve the CBS and induce myopic shift, prevent the possible of recurrence, aspirate the milky substance and keep the posterior capsule intact effective prevent eye complication, vitreous opacity, ocular fundus pathology and so on.