超声乳化术后晶状体前囊膜混浊临床分析  

Clinical analysis of anterior capsular opacification after phacoemulsification

作　　者：古学军[1] 张旭[1] 喻理[1] 孙涛[1] 余学清[1] 程先华[1] 黄传华[1] 易敬林[1] 

机构地区：[1]南昌大学附属眼科医院白内障科,江西南昌330006

出　　处：《中国实用眼科杂志》2015年第5期493-497,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨白内障超声乳化术后前囊膜混浊（anteriorcapsularopacification，ACO）的临床表现、发病危险因素和影响因素，为预防术后ACO提供可靠有效的依据。方法采用回顾性分析研究。对2012年3月至2013年12月在南昌大学附属眼科医院施行白内障超声乳化联合人工晶状体植入术1056例（1325只眼），术后1周、1、3和6个月复查，观察前囊膜混浊情况、前囊口收缩程度和IOL位置等。结果术后共发生213例（225只眼）ACO，其中162例（170只眼）为1级ACO，39例（42只眼）为2级ACO，9例（9只眼）为3级ACO，3例（4只眼）为4级ACO。发生时间≤3个月占83．1％，撕囊口直径过小占61．3％，未进行前囊膜抛光占84．O％，植入亲水性丙烯酸酯IOL占75．1％，合并眼部和全身疾病占54．2％，术后有明显眼前节反应58．2％，严重ACO可出现远视漂移、视力下降等。结论超声乳化术撕囊口直径过小、晶状体上皮细胞残留是ACO发生的根本原因，合并眼部和全身疾病患者谨慎植入亲水性丙烯酸酯IOL，术后眼前节反应较重者应警惕发生ACO。Objective To investigate anterior capsule opacification （ACO） factors and their clini- cal manifestation, risk factors and influence after phacoemulsification, in order to provide a reliable basis for tile prevention of post operative ACO. Methods Retrospective analysis of hospital opera- rive records was analyzed from March 2012 to December 2013. During this time period, 1056 cases （1325 eyes）of phacoemulsification and intraocular lens implantation （IOL） were performed. Anterior capsule opacification were observed and analyzed 1 week, 1 month, 3 months and 6 months postop- eratively, and degree of anterior capsular contraction and IOL location were reviewed. Results Of 213 cases （225 eyes） with postoperative ACO, 162 cases （170 eyes） were of grade 1, 39 cases （42 eyes） grade 2, 9 cases （9 eyes） grade 3, 3 cases （4 eyes） grade 4. Cases with manifestation time less than three months accounted for 83.1%; these with capsulorhexis opening diameter too small ac- counted for 61.3%, without anterior capsule polishing accounted for 84.0%, implanted hydrophilic acrylic IOL accounted 75.1%; with ocular and systemic diseases accounted 54.2%; significant postop- erative reaction of ocular anterior segment 58.2%; severe ACO occurred the eyesight decline and hy- peropic shift. Conclusions Phacoemulsification capsulorhexis opening diameter too small and the re- sidual lens epithelial cells is the fundamental reason for the occurrence of ACO, additional risk fac- tors for ACO include the presence of ocular and systemic diseases, implantation of hydrophilic acryl- ic IOL and demonstration of postoperative reaction of the ocular anterior segment. These factors com- bined would warrant communication of higher level of alert for possibility of ACO occurrence.

关 键 词：前囊膜混浊 连续环形撕囊 白内障超声乳化术 

分 类 号：R776.1[医药卫生—眼科]