Nd:YAG激光后囊膜切开孔径大小对屈光度、眼压和黄斑厚度的影响

Effect of capsulotomy size on refraction,intraocular pressure,and macular thickness after Nd: YAG laser treatment

目的探讨Nd：YAG激光后囊膜切开孔径大小对后发性白内障患者术后屈光度、眼压和黄斑厚度的影响。方法回顾性分析Nd：YAG激光后囊膜切开术治疗后发性白内障患者76例（83只眼）,根据后囊膜切开孔径大小,将患者分为两组：A组3.5～4.5 mm,B组4.6～5.5 mm,观察术前以及术后1 d、1周、1个月患者最佳矫正视力（BCVA）、等效球镜（SE）、眼压和黄斑厚度的变化。结果 A组和B组术后BCVA均较术前明显提高（P〈0.05）,而两组间BCVA差异均无统计学意义（P〉0.05）。术后两组SE均较术前增加（P〈0.05）;术后1个月两组SE均高于术后1 d、1周（P〈0.05）,且B组患者SE大于A组（P〈0.05）。术后1 d两组眼压均较术前升高（P〈0.05）;而与术前相比,术后1周、1个月两组眼压差异无统计学意义（P〉0.05）;两组间眼压差异均无统计学意义（P〉0.05）。术后1 d、1周两组黄斑厚度均较术前增加（P〈0.05）;而术后1个月两组黄斑厚度与术前相比,差异无统计学意义（P〉0.05）;两组间黄斑厚度差异均无统计学意义（P〉0.05）。结论 Nd：YAG激光后囊膜切开孔径的大小与术后眼压、黄斑厚度的改变无关,但较大的切开孔径会引起更多的远视漂移。

Objective To evaluate the influence of Nd： YAG laser capsulotomy size on refraction,intraocular pressure and macular thickness in posterior capsule opacification（ PCO） patients. Methods We retrospectively evaluated83 eyes of 76 patients treated with Nd： YAG laser posterior capsulotomy for PCO. Patients were divided into two groups according to the size of capsulotomy,Group A（ 3. 5 ～ 4. 5 mm） and Group B（ 4. 6 ～ 5. 5mm）. Changes in best corrected visual acuity（ BCVA）,spherical equivalent（ SE）,intraocular pressure and macular thickness were examined preoperatively and 1 day,1 week,and 1 month after capsulotomy. Results Postoperative BCVA in both groups significantly improved after surgery（ P〈0. 05）,and there was no difference between the two groups. Postoperative SE were also significantly higher（ P〈0. 05）. SE at later（ 1 month） was higher than that at early time point（ 1 day or 1 week） after surgery. In addition,SE in Group B were significantly higher than that in Group A（ P〈0. 05）. Intraocular pressure at 1 day significantly increased in both groups,but returned to preoperative levels from 1 week. No significant difference was found between the two groups. Macular thickness at 1 day and 1 week were significantly higher（ P〈0. 05） but return to normal at 1 month. Conclusions The changes of intraocular pressure and macular thickness after Nd： YAG capsulotomy were independent to the size of capsulotomy,yet a larger capsulotomy induced a higher hyperopic shift.