开窗术治疗白内障术后连续环形撕囊口纤维膜闭

Fenestration with Membranectomy to Open the Fibrous Membrane Closure of Continuious Curvilinear Capsulorrhexis after Cataract Surgery

目的:探讨白内障术后连续环形撕囊(CCC)开口纤维膜闭行开窗术处理的初步临床效果。方法:回顾性系列病例研究。对2011年9月至2018年9月在台州市眼科医院就诊的白内障术后前囊膜CCC开口完全纤维膜闭的患者15例(15眼)行纤维膜开窗切除手术,并对其纤维膜闭形成原因、手术方式和效果进行了探讨。结果:所有术眼术后视力均较术前明显提高。术后次日,裸眼视力(UCVA)为0.2~0.3者4眼,0.4~0.5者8眼,0.6~0.7者3眼。前囊膜开窗口内透明,开窗范围大小合适,约4.5 mm×5.0 mm。人工晶状体位正无移位,光学部平展。所有患者均无术眼眩光主诉。结论:白内障术后前囊膜CCC开口纤维膜闭可能与晶状体上皮细胞及成纤维细胞等的增殖迁徙有关。开窗术可有效解除纤维膜闭并明显提高视力。

Objective:To study the primary clinical effects that occur with fenestration membranectomy to produce an opening through the fibrous membrane closure of the continuous curvilinear capsulorrhexis(CCC)after cataract surgery.Methods:This was a restrospective study.Fifteen patients(15 eyes)had surgical CCC openings that were completely closed by a fibrous membrane after cataract surgery.They underwent fenestration with membranectomy in the Taizhou Eye Hospital between September 2011 and September 2018.The causes of fibrous membrane closure,surgical methodology and its effectiveness are also discussed.Results:Visual acuity improved significantly postoperative.Among them the uncorrected visual acuity(UCVA)was 0.2-0.3 in 4 eyes,0.4-0.5 in 8 eyes and 0.6-0.7 in 3 eyes the next day after operation.The interior of the fenestration opening of the anterior capsule was transparent,the size of the fenestration opening was about 4.5 mm×5.0 mm,the intraocular lens(IOL)position was normal without displacement,and the optical part of IOL was flattened in all eyes postoperatively.None of the patients had major complaints about glare.Conclusions:The causes of fibrous membrane closure of the CCC opening may be related to the proliferation and migration of lens epithelial cells and fibroblasts after cataract surgery.The fibrous membrane closure of the CCC opening can be effectively solved by fenestration of the membrane and can significantly improve visual acuity.