超声乳化术中前囊膜抛光预防后囊膜混浊的临床研究

Effect of polishing the anterior lens capsule during phacoemulsification in preventing the occurrence of posterior capsular opacification——a clinical study

目的 :探讨在白内障超声乳化术中行前囊膜抛光处理减少后发障发生的有效性和安全性。方法 :178例 (2 35只眼 )白内障患者在施行白内障超声乳化吸除及人工晶状体植入术中进行前囊膜抛光 ,术后对其视力、眼前节反应及后囊膜情况进行临床观察 ,随访 1个月～ 1年 ,选择同期未行前囊膜抛光者 2 2 0例 (2 30只眼 ) ,作为对照组进行比较。结果 :(1)术中无并发症发生 ;(2 )术后视力恢复快而良好 ;(3)术后后囊膜混浊发生 8只眼 (3 5 % ) ,均为轻度纤维型混浊 ,对视力无显著影响 ,而对照组术后后囊膜混浊发生 2 3只眼 (10 2 % )。对照组显著高于抛光组 (P <0 0 5 )。结论 :白内障超声乳化术中行前囊膜抛光处理可以减少术后后囊膜混浊的发生。作用机制可能是 :前囊膜抛光可大幅度地减少残留于前囊下的晶状体上皮细胞数量 ,阻止了上皮细胞的增殖及化生的来源 。

Objective:To investigate the effect and safety of polishing the anterior lens capsular during phacoemulsification and IOL implantation in preventing occurrence of posterior capsular opacification (PCO).Methods:The anterior lens capsules of 178 patients (235 eyes) with cataract were polished during phacoemulsification and IOL implantation (as the polished group).Postoperative (1 month to 1 year) visual acuities,operative reactions in anterior segments and conditions of posterior lens capsules were observed and compared with those of the control group,220 patients (230 eyes) of cataract without polishing the anterior capsules during the same period.Results:In the polishing group:(1)no complications,(2)operated eyes recovered quickly and had good vision postoperatively,(3)postoperative PCO occurred in 8 eyes (3 5%).As the opacities were of mild fibrinous type,the postoperative visions were little affected,while in the control group,there were 23 eyes(10 2%)(P<0 05) had complicated PCO postoperatively.Conclusion:Poli shing the anterior lens capsule during phacoemulsification is safe and effective,as it may reduce the residual subcapsular lens epithelial cells,decreasing their multiplication,so prevent the occurrence of posterior capsular opacification.