手术治疗晚期囊袋阻滞综合征疗效分析  

Clinical analysis of late capsular block syndrome after surgical treatment

作　　者：黄扬[1] 叶子[1] 马天驹[1] 李朝辉[1] 

机构地区：[1]解放军总医院眼科,北京100853

出　　处：《中国实用眼科杂志》2017年第3期326-330,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨晚期囊袋阻滞综合征（CBS）的临床表现、发生机制及治疗方法。方法 回顾性分析解放军总医院2012年6月至2016年6月，收治的白内障超声乳化吸除联合人工晶状体植入术后晚期CBS患者7例（7只眼），均采用前囊膜松解及囊袋内液体吸除术治疗，囊袋内＂牛奶状＂液体成分运用Western blot检测。结果 7例发病时间为术后1~6年，平均术后3.7年，均表现为近视漂移、前囊口缩小、人工晶状体前移位及后囊扩张。7例囊袋内均有＂牛奶状＂混浊液体积聚。术后最佳矫正视力不同程度提高。Western blot证实囊袋内液体含有大量αB及βB晶状体蛋白，但肿瘤坏死因子-α（TNF-α）及白细胞介素-1β（IL-1β）未见表达。结论 囊袋内混浊液体来源于晶状体上皮细胞，炎症反应可能不参与CBS病变过程。前囊膜松解及囊袋内液体吸除术治疗晚期CBS安全有效。Objective To investigate the clinical manifestation, pathogenesis and therapy of late capsular block syndrome（CBS）.Methods Seven patients（7 eyes） admitted to our hospital from June 2012 to June 2016 were retrospectively analyzed, all of them took the treatment with anterior capsule release and transparent liquid material aspiration. The milky-like liquid material was investigated with Western blot.Results Seven eyes of late postoperative CBS all had myopia shift, anterior capsular opening block, intraocular lens（IOL） moving forward and posterior capsule expansion, which occurred in 1 year to 6 years（average 3.7 years） after phacoemulsification with IOL implantation. All eyes were filled with milky-like liquid material in the capsule, best corrected visual acuity（BCVA） improved in all patients after treatment. Western blot confirmed that milky-like liquid contains αB and βB crystalline, instead of tumor necrosis factor-α（TNF-α） and interleukin-1β（IL-1β）.Conclusions Transparent liquid material is derived from human lens epithelial cells, inflammation isn’t involved in pathogenesis of late postoperative CBS. Capsule release and milky-like liquid aspiration isone of the effective treatment for late postoperative CBS.

关 键 词：囊袋阻滞综合征 前囊膜松解术 晶状体蛋白 炎症 

分 类 号：R776.1[医药卫生—眼科]