囊袋收缩综合征Nd：YAG激光前囊切开术的疗效观察

The clinical effect of Nd： YAG laser anterior capsulotomy for the treatment of capsular bag contraction syndrome

目的观察Nd：YAG激光前囊切开术治疗人工晶状体植入术后囊袋收缩综合征的临床效果。方法85例（85只眼）白内障超声乳化联合人工晶状体植入术后囊袋收缩综合征，行Nd：YAG激光前囊切开术。记录激光术前1d和术后1周最佳矫正视力，最小囊口直径，角膜内皮细胞计数和眼压。并随访6个月。结果85例（85只眼）Nd：YAG激光前囊切开术术后前囊口收缩环均被打开，囊袋收缩缓解，无严重并发症。术后1周，最佳矫正视力≥0．3者由术前的43只眼增至52只眼；术后最小囊口直径较术前显著增加，由（1．91±1．52）mm增至（4．33±1．92）mm（t=7．45，P=0．00）；角膜内皮细胞密度与术前比较无明显改变，术前（2304±202）个／mm2，术后（2281±234）个／mm2（t=1．03，P=0．15），术后1周的眼压与术前比较无明显改变；术前（15．53±4．34）mmHg，术后（15．76±4．49）mrnHg（1mmHg=0．133kPa），（t=0．62，P=0．27）。随访6个月，无人工晶状体移位。结论Nd：YAG激光前囊切开术是治疗囊袋收缩综合征的有效方法，早期手术未发现严重并发症。

Objective To observe the clinical effect of Nd：YAG laser anterior capsulotomy for the treatment of capsular bag contraction syndrome （CCS） after intraocular lens implantation. Methods Eighty- five eyes of 85 cases of CCS were treated with Nd ： YAG laser anterior capsulotomy. The minimum diameter of the anterior capsule opening, best corrected visual acuity（BCVA） , corneal endothelial count and intraocular pressure （IOP） were observed 1 day preoperation and 1 week postoperation. The follow-up time was 6 months. Results The contractile ring of anterior capsule opening was opened and the contraction of capsule bag was released after Nd：YAG laser anterior capsulotomy. No serious complication was observed. The number of the eyes with BCVA≥0.3 was increased from preoperative 43 eyes to postoperative 52 eyes. The minimum diameter of the anterior capsule opening increased significantly, form （ 1.91± 1.52） mm to （4.33 ± 1.92） mm （ t = 7.45, P = 0.00 ）. No significant change in corneal endothelial cell counts after treatment was observed, （2304±202）/mm2 vs （2281 ±234）/mm2 （t = 1.03,P = 0. 15）. IOP did not change significantly 1 week postoperation compared to 1 day preoperation, （ 15.53 ± 4.34） mmHg vs （ 15.76 ± 4.49 ） mmHg （t = 0. 62,P = 0.27）. No IOL shift was observed during 6 months follow-up. Conclusion Nd： YAG laser anterior capsulotomy is an effective treatment for CCS. No serious complication was observed after early surgical treatment.