Comparison of posterior capsule opacification at 360-degree square edge hydrophilic and sharp edge hydrophobic acrylic intraocular lens in diabetic patients

·AIM: To compare posterior capsule opacification(PCO)degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens(IOL)(570C C-flex, Rayner) and sharp edge hydrophobic acrylic IOL(Sensar AR40 e,AMO) in diabetic patients.· METHODS: Sixty diabetic patients underwent uneventful phacoemulsification and randomly implanted one of the two IOLs. The PCO value was measured by retroillumination photographs and Evaluation of Posterior Capsule Opacification(EPCO) 2000 image-analysis software at 1, 6, 12, and 24 mo after surgery. Visual acuity, and contrast sensitivity in photopic and mesopic conditions were also examined at each follow up time point. The incidence of eye that required Nd:YAG laser posterior capsulotomy were also compared.·RESULTS: There was not any statistically significant difference in PCO scores between Rayner C-flex 570 C group and Sensar AR40 e group at each follow up time point. Visual acuity, Nd:YAG capsulotomy incidence and contrast sensitivity also had no significant difference during the 24 mo follow-up.·CONCLUSION: For diabetic patients, Rayner 570 C Cflex and Sensar AR40 e IOLs are same effective for prevent PCO. The 360-degree square edge design maybe is a good alternative technique to improve PCO prevention.

Considerations in the management of single-piece intraocular lenses outside the capsular bag

AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.

Effect of four different intraocular lenses on posterior capsule opacification

AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.

Primary Posterior Chamber Intraocular Lens Implantation in Traumatic Cataract With Posterior Capsule Breaks

Background:In patients with incomplete posterior capsule support,posterior chamber intraocular lenses(PC-IOLs)were implanted with both haptics transs-cleral fixation.This causes more damage to the eye and may result in more com-plications,In patients with small posterior breaks,non-fixation or single haptic fixation may be adequate.Methods:Thiry-two consecutive patients of traumatic cataract with posterior capsule breaks caused by penetrating eye trauma were retospected.Posterior chamber intraocular lenses were implanted in all these patients with three tech-niques,ie,without fixation,with single haptic fixation and with both haptics fixation .The selection of the technique was based on the position and size of the posterior capsule.The follow-up period was 21days to 28months(mean,15.2months).Results:Intra-operative problems included ciliary body bleeding(Two patents,6.25%)and enlargement of posterior capsule breaks(2patients,6.25).Postoperative visual acuity was0.5or better(Corrected)in28case(87.5%)and 0.1-0.4in four patients(12.5%),Postoperative complications included hyphema(6eyes,18.8%),transient intraocular pressure elevation(6eyes,18.8%),transient hypotention(7eyes,21.8%).Postoperative IOL position were good except one case of IOL tilt.No pupillary capture or endophthalmitis was found.Conclusions:Not all PC-IOLs have to be fixed by two haptics.In patients with small posterior capsule breaks,PC-IOLmay not be fixed or fixed by only one haptics.Eye Science1995;11:140-142.

Trocar opening: silicone oil removal with phacoemulsification and intraocular lens implantation

AIM: To evaluate the efficacy and safety of a modified technique [trocar opening(TO)] for silicone oil removal(SOR) in combination with phacoemulsification and intraocular lens(IOL) implantation.METHODS: A total of 60 eyes of 60 patients with cataract and silicone oil-filled eyes were enrolled in this study. The patients were divided into two groups: the patients in the control group underwent 23-gauge pars plana active SOR surgery with phacoemulsification and IOL implantation, while the patients in the TO group underwent TO methods during surgery. Best corrected visual acuity(BCVA), surgery time, intraocular pressure, and operative complications were observed 6 mo after surgery.RESULTS: There was no significant difference between the two groups in terms of age, gender, preoperative, intraocular pressure, or time of silicone oil stay. Prior to surgery, the mean BCVA for the control and TO groups was 1.34±0.44 and 1.36±0.42. At 6 mo following surgery, the mean BCVA improved to 0.74±0.36 and 0.77±0.32, respectively(P<0.001). There was no significant difference between the two groups. The mean SOR time was 6.9±2.3 min and 4.8±1.2 min in the control and TO groups(P=0.008). The total operation time was 28.2±8.5 min and 24.6±6.4 min, respectively(P=0.035). Posterior capsule rupture occurred in four eyes of control and none of TO group(P<0.01). Late recurrent retinal detachment occurred in one eye in the control group(2 mo after surgery) and in one eye in the TO group(4 mo after surgery). CONCLUSION: TO is a simple, effective, time-saving, and safe method for SOR combined with phacoemulsification and IOL implantation.

Intraocular lens implantation performed first to protect the posterior capsule in Morgagnian cataracts during phacoemulsification

This study evaluated the safety of a modified method to implant an intraocular lens (IOL) into the capsular bag immediately after capsulorhexis with a whole or partial nucleus to protect the posterior capsule (PC) during phacoemulsification in a series of 12 Morgagnian cataracts. For 3 cases of hypermature cataracts with smaller and rigid nuclei, after a complete capsulorhexis, an IOL was directly inserted into the capsular bag, which protected the PC during the subsequent phacoemulsification process in the iris plate. For the other 9 cases with larger and softer nuclei, after the nucleus was partially emulsified, the IOL was inserted into the bag. Even with an obvious surge for some cases, the surgeries were uneventful in all 12 cases, with no PC rent or vitreous loss. IOL implantation into the capsular bag with a whole or partial nucleus can provide effective protection for the PC for hypermature cataract during phacoemulsification.

AB083.Intraocular lens biocompatibility:a novel,objective approach

Background:Understanding factors that contribute to posterior capsular opacification(PCO)development is a significant public concern as treatment can lead to complications.In order to prevent PCO,a better understanding of intraocular lens(IOL)characteristics,including design and material,and patient interaction is required.Herein,we performed a retrospective multivariable analysis to determine which factors(IOL and patient based)were least likely to result in PCO.Methods:One hundred eighty post-mortem eyes with implanted IOLs were collected from the Minnesota Eye Bank,along with clinical history,including date of cataract surgery and IOL model number.The capsular bag(CB)with the IOL implant was removed from all eyes to obtain digital images.PCO outcome was quantified on CB images using an objective,automated custom image analyzer(Medical Parachute Automated Detector Opacification Software).The software measured intensity and area of the opacification within the IOL optic edge,intra-optic edge(IOE=intensity/area),and in Soemmering’s ring(SR=intensity/area).Epidemiologic analysis assessed which IOL characteristics and patient-related factors correlated with PCO.IOL factors included material,edge design,lens filter,company,IOL model,decentration and time from cataract surgery to death.Patient factors included sex,age and diabetes,among others.Results:Multivariate analyses showed non-diabetic patients had less PCO(P=0.05).Individuals 50-80 years old compared to 80+had lower SR PCO(P=0.04).Non-blue light filter IOLs had lower SR and IOE PCO compared to filter IOLs(P=0.03,0.001).Square and frosted optic edge design had lower SR and IOE PCO rates compared to OptiEdge and round optic edge design(P=0.002,0.02).The IOL model that had the least PCO was the ZA9003 model,but this was only significant for SR and not IOE PCO(P=0.04).Adjusting for patient-factors,IOL lens model was no longer a confounding factor for PCO.Patients with an IOL implanted for<7 years had lower SR PCO,whereas lower IOE PCO was only seen in implants<4 years old(P=0.0001,0.04).Conclusions:In order to generate a lens that does not develop PCO,it is critical to understand the IOL-and patient-related factors that lead to PCO development.Based on our data,the most susceptible patients are elderly and diabetic,and it may be preferable to implant a square and frosted edge lens without blue-light filtering in this cohort.

Corneal astigmatism correction with scleral flaps in trans-scleral suture-fixed posterior chamber lens implantation:a preliminary clinical observation

AIM: To study the impact of scleral flap position, under which the posterior chamber intraocular lenses (PC-IOL) were sulcus-fixed by trans-scleral suture, on cornea astigmatism. METHODS: Twenty-six aphakic or cataract eyes were comprised in this prospective noncomparative case series study. Eleven eyes had traumatic cataract removed without sufficient capsular support, 3 had blunt trauma with subluxated traumatic cataract, 8 had undergone vitreoretinal surgery and 4 had congenital cataract removed. The average age was 54 years (range 21-74 years), with 17 men and 7 women. The foldable PC-IOL was fixed in sulcus by trans-scleral suture. The incision for IOL implantation was made 1mm posterior to limbus along the steepest meridian of cornea, while scleral flaps to bury the knots of trans-scleral suture were made along the flattest meridian. All the surgeries were performed by a single doctor (Ma L), and the follow up was at least 13 months (range 13-28 months). The preoperative, 3 months and 1 year postoperative corneal curvature along the steepest and flattest cornea meridian and overall cornea astigmatism were compared. RESULTS: The curvature along the steepest meridian changed from 44.25 +/- 2.22D preoperatively to 44.08 +/- 2.16D at 3 months postoperatively, and 43.65 +/- 5.23D at 1 year postoperatively (P>0.05); the curvature along the flattest meridian changed from 41.24 +/- 2.21D preoperatively to 43.15 +/- 3.94D at 3 months postoperatively, and 42.85 +/- 5.17D at 1 year postoperatively (P<0.05); and the surgery induced astigmatism (SIA) on cornea was calculated by vector analysis, which was 2.42 +/- 2.13D at 3 months postoperatively, and 2.18 +/- 3.42D at 1 year postoperatively, the difference was statistically significant (P<0.05). CONCLUSION: The scleral flap made along the flattest meridian, under which the posterior chamber intraocular lenses (PCIOL) were sulcus-fixed by trans-scleral suture, can steepen the cornea in varying degrees, thus reducing preexisting corneal astigmatism.

Clinical effect of peripheral capsule preservation in eyes with silicone oil tamponade

BACKGROUND At present,silicone oil has been widely used in vitrectomy to deal with complex fundus diseases.Usually,cataract extraction is combined with vitrectomy.However,reducing the complications of silicone oil tamponade and facilitating the secondary implantation of intraocular lens(IOL)are still an urgent problem.AIM To evaluate the clinical effect of vitrectomy combined with peripheral capsule preservation(PCP)in eyes with silicone oil tamponade.METHODS This single-center retrospective analysis included 70 patients(73 eyes)who underwent vitrectomy and silicone oil tamponade combined with cataract surgery(stage I)between January 2015 and July 2019.All patients underwent selective reoperation for silicone oil extraction and IOL implantation(stage II)more than 3 mo after stage I.These patients were divided into three groups according to the different lens capsule preservation methods:28 patients(31 eyes)in a whole capsule preserved(WCP)group,17(17 eyes)in a capsule absent(CA)group,and 25(25 eyes)in a peripheral capsule preserved(PCP)group.Intraocular pressure(IOP),best-corrected visual acuity,surgery time,and other complications were recorded at each time point(1 d,1 wk,and 1 mo after stages I and II).RESULTS The IOP values were 14.9±8.2 mmHg in the WCP group,20.3±13.0 mmHg in the CA group,and 14.2±9.7 mmHg in the PCP group(P<0.05)at 1 mo after stage I operation.Five eyes had IOP higher than 30 mmHg,and one eye in the WCP group appeared to have silicone oil entering the anterior chamber.There was no significant difference in IOP among the three groups at any other time point(P>0.05).With IOL implantation,visual acuity improved significantly compared to stage I.The incidence rate of posterior capsule opacity was higher in the WCP group than in the other groups(P<0.001).In the CA group,IOL deviation due to suture relaxation occurred in one case.There was no significant difference in the surgery time among the three groups in stage I(P=0.618).In stage II,the surgery time of the PCP group and WCP group was significantly shorter than that of the AC group(P=0.031).CONCLUSION Preservation of the peripheral capsule in vitrectomy combined with lens removal is a better option.This method has significant advantages in reducing intraoperative and postoperative complications.

囊袋张力环对高度近视患者Barrett universalⅡIOL计算公式准确性的影响

目的:评估囊袋张力环(CTR)对Barrett universalⅡ人工晶状体(IOL)计算公式在高度近视合并白内障患者术后屈光状态的稳定性与准确性的影响。方法:本研究为前瞻性研究。选取2022-01/06于我院就诊的高度近视白内障患者40例80眼。采用随机数字表法分为CTR组和空白组,每组40眼,所有患者均用IOL Master测量,并按照Barrett universalⅡ公式计算实际植入IOL屈光度及预测术后屈光度。记录患者术后6 mo的裸眼视力(UCVA)、最佳矫正视力(BCVA),比较术后6 mo两组平均绝对屈光误差(MAE),评估术后屈光状态的稳定性及预测术后屈光度与CTR的关系。结果:术后6 mo两组患者UCVA、BCVA均较术前改善(P>0.05),不同时间点两组UCVA、BCVA比较无差异(均P>0.05);80眼按照Barrett universalⅡ公式植入IOL后,CTR组预计术后屈光度为-2.01±0.71 D,术后实际屈光度为-1.64±0.88 D,MAE为0.37±0.98 D;空白组预计术后屈光度为-2.12±0.64 D,术后实际屈光度为-1.54±0.88 D,MAE为0.58±0.31 D,组间比较有差异(P<0.05)。根据眼轴长度进行分组,对于任意眼轴长度CTR的植入均能有效地减少屈光误差(P>0.05)。随着眼轴的增长,MAE的值越大,眼轴≥30 mm的患者术后MAE值比较两组间有差异(P<0.05)。CTR组、空白组中出现远视漂移的比例分别是18%(7/40)、30%(12/40),组间比较有差异(P<0.05)。结论:对高度近视合并白内障患者,Barrett universalⅡ公式在预测术后屈光度方面具有较高的准确性,术中植入CTR既能够保持囊袋的形态,有效防止术中晶状体悬韧带断裂,使IOL居中性更佳,又能有利于白内障患者术后屈光度的早期稳定,并提供更加稳定的屈光结果,减少屈光漂移。对于术中考虑植入CTR的近视患者,建议术前增加-0.50 D的预留屈光度,以达到理想屈光状态。

人工晶状体作为药物递送系统的研究进展

人工晶状体(intraocular lenses)作为一种给药装置,具有在白内障术后替代常规滴眼液等治疗的应用前景,从而可能用于术后眼部感染、眼内炎症和后囊浑浊等的预防和治疗。载药人工晶状体(drug-loaded intraocular lenses)的优点是能确保药物的持续输送,不受患者依从性的影响,且手术植入后无需采取任何其他措施。本综述总结了以人工晶状体作为药物递送系统的研究进展,分析了载药人工晶状体的载药策略、负载药物类型、以及临床研究现状,有助于更深入理解该领域的最新进展,并为一些眼部疾病如眼内炎和白内障术后并发症等的治疗提供策略和依据。

冲洗针头液流抛光技术治疗白内障超声乳化术后PCO的疗效观察

目的 观察冲洗针头液流抛光与传统注吸头机械抛光对白内障超声乳化术后晶状体后囊膜混浊(PCO)的疗效和安全性。方法 纳入2020年6月—2020年12月咸阳市第一人民医院眼科诊断为年龄相关性白内障患者100例(200只眼),随机分为对照组和观察组,最终纳入对照组47例(94只眼),观察组48例(96只眼)。2组患者均行常规白内障超声乳化吸除术后,对照组术中采用注吸头进行后囊膜抛光,再植入人工晶体。观察组植入人工晶体并在囊袋内旋转360°,采用冲洗针头液流抛光后囊膜。记录术前、术后1 d、7 d、1年的最佳矫正视力(BCVA),术后1年PCO评分和后囊膜激光切开率。结果 (1)BCVA:观察组术后各时间点BCVA均较术前改善,差异均有统计学意义(t1 d=36.759、t7 d=40.101、t1年=47.629,均P=0.000);对照组术后各时间点BCVA均较术前改善,差异均有统计学意义(t1 d=52.429、t7 d=56.829、t1年=62.487,均P=0.000)。2组间术后1 d和7 d BCVA比较,差异均无统计学意义(P>0.05),观察组术后1年BCVA优于对照组,差异有统计学意义(t=2.709,P=0.007)。(2)PCO评分:观察组PCO分值为(0.13±0.07)分,低于对照组的(0.25±0.15)分,差异有统计学意义(t=7.090,P=0.000)。(3)后囊激光切开率:2组后囊激光切开率比较,差异无统计学意义(P>0.05)。2组术中和术后均未发生并发症。结论 冲洗针头液流抛光技术可预防白内障术后PCO的发生,操作简单、经济实用、安全可靠,可降低白内障术后PCO发生率,具有一定推广价值。

金钗石斛总生物碱对大鼠后发性白内障的影响

探讨了金钗石斛总生物碱(DNLA)对SD大鼠后发性白内障的影响。取40只健康SD大鼠随机分为空白组、模型组和3个模型组+DNLA(高/中/低)处理组。建模后连续灌胃给药30d。采用裂隙灯生物显微镜检查大鼠晶状体混浊度,HE染色观察大鼠晶状体组织病理变化,免疫荧光检测大鼠晶状体上皮细胞中α-平滑肌肌动蛋白(α-SMA)的表达。结果表明,在裂隙灯下晶状体后囊膜混浊程度为模型组>低剂量组>中剂量组>高剂量组。给药后SD大鼠眼球晶状体组织晶状体上皮增生、炎性细胞浸润和纤维组织增生等病变有明显缓减,晶状体上皮细胞中α-SMA蛋白表达量明显减弱。金钗石斛总生物碱对大鼠后发性白内障晶状体上皮细胞的异常增生及纤维化具有明显抑制效果。

白内障撕囊直径不同对后发性白内障影响的临床研究

目的：观察连续环形撕囊口完全覆盖人工晶状体光学面与连续环形撕囊口完全不覆盖人工晶状体光学面的人工晶状体植入术后后囊膜混浊（posterior capsular opacification, PCO）的情况.方法：随访近5a来施行超声乳化吸出白内障联合人工晶状体植入手术的老年性白内障患者164例196眼,术后观察视力、撕囊口与人工晶状体光学面的关系及PCO等情况,随访12~26（平均16.3）mo.根据Sellman等的PCO分级标准进行分级：I级为没有PCO或极轻微PCO不减少红光反射,也没有珍珠样小体或IOL边缘也没有发现珍珠样小体;Ⅱ级为轻度PCO减少了红光反射,IOL边缘也没有发现珍珠样小体;Ⅲ级为在IOL区域内发现中度纤维化或珍珠样小体,但视轴（中心3mm）是透明的;Ⅳ级为重度纤维化或珍珠样小体并扩展到视轴区,并且严重减少红光反射.术后后囊膜出现Ⅱ,Ⅲ及Ⅳ级统计为临床出现后发性白内障的并发症病例.结果：后发性白内障是现代白内障摘除手术后晚期常见的并发症之一,连续环形撕囊口完全覆盖人工晶状体光学面组120眼中,发生后发性白内障42眼（35.0%）.连续环形撕囊口完全不覆盖人工晶状体光学面组76眼中,发生后发性白内障41眼（53.9%）.两组病例术后在临床后发性白内障发生率上有统计意义（P＜0.05）.结论：连续环形撕囊口大小与术后后囊膜的混浊有关.撕囊口完全覆盖人工晶状体光学面能减少后发性白内障发生的几率.

不同生物材料人工晶体与后囊混浊相互关系的meta分析

目的 :对不同生物材料人工晶体与后囊混浊的关系进行系统评价。方法 :通过计算机和手工检索 ,获得 1990年 1月至 2 0 0 2年 12月发表的人工晶体与后囊混浊的相关文献。按照入选标准选取合适的随机对照临床研究进行 m eta分析。对纳入文献的相关资料进行提取摘录 ,并根据 meta分析的统计学方法进行合并分析。以相对危险度 (RR)判定对后囊混浊的预防效果 ,并根据异质性分析选择固定效应模型或随机效应模型计算总的治疗效应。 结果 :有 9篇论文的 10 2 1例白内障患者纳入 m eta分析。聚丙烯酸、硅凝胶、水凝胶与聚甲基丙烯酸甲酯 (polymethylmethacrylate,PMMA)的 RR分别为 0 .12 (95 % CI[0 .0 5 ,0 .2 6 ])、0 .4 4 (95 % CI[0 .30 ,0 .6 4 ])、1.96 (95 % CI[0 .6 5 ,5 .91]) ,硅凝胶、水凝胶与聚丙烯酸的 RR分别为 1.34(95 %CI[0 .6 2 ,2 .89])、3.89(95 % CI[1.70 ,8.90 ]) ,水凝胶与硅凝胶的 RR为 4 .73(95 % CI[1.5 7,14 .32 ])。结论 :硅凝胶和聚丙烯酸人工晶体具有良好的囊膜组织相容性、很强的粘连趋势、良好的光学设计 。

后房型人工晶状体移位或脱位的相关因素分析及预防处理

目的:探讨白内障摘除联合后房型人工晶状体植入术后人工晶状体移位或脱位的影响因素、相关预防及处理措施。方法:对2009-02/2010-05因IOL移位或脱位收入我院的病例进行回顾性分析。主要记录原发白内障病情、人工晶状体移位或脱位发现时间、症状及体征、处理方法以及处理前后视力。结果:晶状体移位或脱位患者27例27眼,其中合并其他眼部疾病的并发性白内障17眼。移位或脱位发现时间为术后1d～14a。后囊不同程度破裂12眼;前囊情况:前囊撕裂5眼,撕囊较大3眼,前囊环形撕囊较小囊膜机化收缩混浊1眼;术后有眼部外伤史6眼。27例均通过再次手术得到治疗。术后随访10.23±2.10(3～16)mo。术后裸眼视力优于术前,差异有统计学意义(T=-0.327,P=0.001);最佳矫正视力术后与术前相比差异无统计学意义(T=-0.611,P=0.541)。结论:眼部病情复杂、后囊破裂、前囊撕囊欠佳、术后眼部外伤是影响人工晶状体移位或脱位的重要因素。熟练的手术技术和正确处理术中并发症是预防人工晶状体移位或脱位的关键。人工晶状体调位术或人工晶状体悬吊术是处理人工晶状体移位或脱位的有效方法。

人工晶状体的设计对后囊膜混浊的影响

后囊膜混浊是白内障囊外摘除术后最主要的并发症之一。后囊膜混浊的发生是多因素参与的结果,手术方式的改进、人工晶状体的改良、术后炎症反应的控制都可以减少后囊膜混浊的发生。本文就人工晶状体的设计对后囊膜混浊的影响作一综述。

超高度近视眼白内障超声乳化术后囊袋变化及人工晶状体稳定性研究

目的研究超高度近视眼白内障行超声乳化吸除并人工晶状体（IOL）植入术后晶状体前囊膜直径、面积及IOL偏心量、倾斜角的改变。方法选择超高度近视白内障患者62例（90眼,眼轴〉27mm）为超高度近视组,正常眼轴白内障患者55例（90眼,22mm≤眼轴≤24mm）为正常眼轴组,均行超声乳化并人工晶状体植入术,于术后1~3、3~6和6~12个月时（每个阶段均30眼）散瞳后拍摄眼前节彩照,使用Pentacam三维眼前节成像系统采集Scheimpflug图像,通过Image J图像分析软件测量各前囊口直径、面积及IOL的偏心量、倾斜角和术后房水深度（PAD）。比较两组患者各时间段前囊口形态和IOL稳定性。结果 （1）与正常眼轴组比较,超高度近视组患者术后1~3个月PAD加深,IOL倾斜角加大（t=3.544、2.380,P〈0.01或0.05）;术后3~6个月PAD加深、IOL倾斜角加大,晶状体前囊口面积缩小、平均直径缩短（t=3.390、2.107、-2.186、-2.009,P〈0.01或0.05）;术后6~12个月PAD变浅,但差异无统计学意义（P〉0.05）,而超高度近视组患者前囊口面积进一步缩小、水平径及平均直径缩短,IOL倾斜角变化减小（t=-2.652、-2.989、-2.628、0.463,P〈0.01或0.05）。（2）术后组内不同时间段比较,正常眼轴组前囊口形态及IOL稳定性改变的差异均无统计学意义（均P〉0.05）;超高度近视组患者术后6~12个月时的IOL倾斜角较术后1~3及3~6个月明显增加（均P〈0.01）。结论超高度近视合并白内障患者术后前囊口更容易发生收缩,且水平方向收缩程度更加明显,容易引起IOL倾斜角及PAD的改变。

Nd:YAG激光治疗人工晶状体后发障的临床探讨

目的 探讨Nd :YAG激光治疗人工晶状体植入术后后囊浑浊的疗效和方法。方法 应用Nd :YAG激光仪 ,对 3 7例 ( 3 9眼 )后房型人工晶状体植入术后后囊浑浊行后囊切开术。结果 激光截囊前后视力有显著差异 (P <0 0 1) ,而激光截囊后与后发障发生前视力无差异 (P >0 0 5 )。儿童组复发率达 5 8 3 %。人工晶状体损伤 9例 ( 10眼 )占 2 5 6% ,但不影响视力。结论 选择最佳激光能量与后退距离 ,可产生最低人工晶状体损伤和最高后囊爆破 ,从而大幅度减少并发症。

后发性白内障的研究进展

后发性白内障(posterior capsule opacification,PCO)是由于白内障术后残留的晶状体上皮细胞增殖、迁移、化生而形成的,严重影响术后视力的恢复,是现代白内障囊外摘出术后主要的并发症之一。因此,如何防治PCO一直是眼科研究的热点之一。本文就临床及实验室药物防治PCO两方面进行综述。