白内障现代囊外摘除人工晶状体植入术后发生后囊混浊相关手术因素分析  

The analysis of surgical-realated factors for PCO after extracapsular cataract extraction and intraocular lens transplantion

作　　者：冯晓津[1] 梁轩伟[1] 严灿荣[1] 宋洪妮[1] 郑彪[1] 

机构地区：[1]广东医学院附属医院眼科,湛江524001

出　　处：《临床眼科杂志》2005年第3期244-246,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨与白内障现代囊外摘除人工晶状体植入术(ECCE+IOL)有关的引起后囊混浊的因素,以减少因手术因素引起后囊混浊的发生。方法对78例(78只眼)行ECCE+IOL后发生后囊混浊的病例进行与手术有关的因素分析,如撕囊的方法、眼内操作的时间、皮质吸出的程度及后囊抛光等,并对结果进行统计学分析。结果在78例发生PCO组中行正中的连续环形撕囊(CCCC)有24只眼(30.77%),而NPCO组中则行CCCC有61只眼(78.21%),两组相比后囊混浊的发生率有明显差异(χ2=35.388,P<0.001);PCO组中眼内操作时间≥15min者53只眼(67.95%),而NPCO组中则为19只眼(24.36%),两组比较有明显差异(χ2=29.817,P<0.001);在PCO组中有7只眼(8.98%)进行了后囊抛光,NPCO组中则有35只眼(44.87%)进行了后囊抛光,两者比较有显著性差异(χ2=24.788,P<0.001)。结论后囊混浊的发生与手术中撕囊的方法、后囊膜抛光、残留皮质的吸出程度及眼内操作时间有关,因此为了减少后囊混浊的发生,手术中应尽量做到正中连续环行撕囊,充分吸出残留皮质、囊袋及后囊膜抛光。此外通过熟练的手术,缩短手术时间能够减少后囊混浊发生。Objective To investigate surgical factors relate to posterior capsularopacity(PCO) after extracapsular cataract extraction and intraocular lens transplantion ,aim to reduce the PCO incidence caused by operation. Methods To analyse the operative factors of 78 PCO cases after extracapsular cataract extraction and intraocular lens transplantion ,such as the form of capsule curvilinear capsulorhexis , and also intraovular operation time, the posterior capsule polishing .The results were analyzed statistically. Results Among 78 PCO cases ,there were 24 cases(30.77%) operated by center capsule curvilinear capsulorhexis (CCCC) ,while 61 cases(78.21%) of NPCO used this technique;53 cases(67.95%)operated more than 15 mins of PCO group occured PCO, compare with 19 cases(24.36%)of control group did;7 cases(8.98%) of PCO group polished the posterior capsule,while 35 cases(44.87%) polished the posterior capsule in NPCO group. Compare these three measures by chi-square test, there all have a statistics difference between two groups(χ2=35.388,29.817,24.788,P<0.001). Conclusion The occurance of PCO relates to the techniques of capsule curvilinear capsulorhexis, intraoccular operation time and the anterior capsules polish .Therefore, the technique of CCCC,clearing of cortices and capsules, polishing of the posterior capsules and reducing the intraoccular operative time can decrease the occurance of PCO.

关 键 词：现代囊外摘除 后囊混浊 因素分析 白内障 植入术后 人工晶状体植入术 ECCE+IOL 相关 后囊抛光 连续环形撕囊 连续环行撕囊 操作时间 统计学分析 显著性差异 PCO 手术因素 眼内操作 手术时间 手术中 后囊膜 皮质 发生率 

分 类 号：R779.66[医药卫生—眼科]