从视野角度来探讨4mm直径Nd:YAG激光后囊膜切开术

目的 :从视野角度来探讨 4mm直径后囊膜切开的适用性。方法 :2 0例后囊膜Ⅱ级混浊患者行Nd :YAG激光4mm直径后囊膜切开术 ,术后 1个半月计算机静态视野检查 ,与行同样白内障术后后囊膜透明组 2 1例检查视野进行比较。结果 :4mm后囊膜组中心 30°及周边 6 0°视野结果 (均数±标准差 ) ,MD(- 4 0 8± 2 73)、PSD(3 0 5± 2 13)、周边 6 0°总光敏感度 (94 5 95± 2 4 4 74 )dB、后囊膜透明组 :MD(- 2 93± 3 10 )、PSD(2 38± 1 4 6 )、周边 6 0°总光敏感度 (992 0 0± 2 5 6 0 5 )dB。经单因素方差分析两组的MD、PSD及周边 6 0°总光敏感度比较 ,差异无显著性意义 (P >0 0 5 )。结论 :4mm切开孔从视野角度来说是个可选用的后囊膜切开直径。     

2mm直径Nd:YAG激光后囊膜切开术的视野变化

目的观察2mm直径后囊膜切开术后的视野变化并分析其相关因素。方法20例后囊膜Ⅱ级混浊患者行NdYAG激光2mm直径后囊膜切开术,术后90d计算机静态视野检查,行同样白内障术后后囊膜透明组21例检查视野。结果2mm后囊膜组中心30°及周边60°视野结果,平均偏差(MD)(-8.65±3.96)、模式标准差PSD(5.71±2.60)、中心10°总光敏感度(289.30±43.63)dB、周边60°总光敏感度(558.20±197.27)dB、后囊膜透明组MD(-2.93±3.10)、PSD(2.38±1.46)、中心10°总光敏感度(341.55±42.90)dB、周边60°总光敏感度(992.00±256.05)dB。经单因素方差分析两组的MD、PSD、中心10°及周边60°总光敏感度差异有显著性意义(P<0.01)。结论2mm直径后囊膜切开孔会引起视网膜平均光敏感度的下降,并伴视岛的部分明显压陷。     

Q开关Nd：YAG激光治疗后发性白内障临床观察

目的　探讨 Q开关 Nd:YAG激光后囊膜切开术治疗后发性白内障的疗效及安全性。方法　回顾性分析行 Q开关 Nd:YAG激光后囊膜切开术后发性白内障患者 16 5例 193眼 ,记录手术前后视力、眼压及并发症 ,并进行统计学分析。结果　 (1)后囊膜一次性切开成功率为 10 0 % ,所用激光脉冲数平均 2 4± 2 1.7次 ,激光总能量平均 5 9.3± 6 6 .2 m J;(2 ) 91.2 % (176眼 )视力较术前提高 ;(3) 5 9.6 % (115眼 )出现一过性眼压升高 ;手术前后眼压变化与是否植入人工晶状体、所用激光脉冲数以及白内障手术与后囊膜切开术间隔时间有关 ;(4) 19.3% (32眼 )出现人工晶状体损伤。结论　 Q开关 Nd:YAG激光后囊膜切开术治疗后发性白内障安全、有效 ,但应严格掌握手术适应证 ,并合理选择激光参数。     

人工晶状体袢的角度与后发性白内障相关性研究

目的　探讨后发性白内障与人工晶状体袢角度之间的关系。方法　 9只科研兔随机分为 3组 ,每组 6眼。麻醉后 ,行透明晶状体囊外摘出术 ,并分别植入袢角度不同的PMMA人工晶状体 ,第 1组植入 0°袢人工晶状体 ,第 2组植入 5°袢人工晶状体 ,第 3组植入 10°袢人工晶状体。术后 6个月 ,裂隙灯下观察晶状体后囊混浊情况并分级 ,取出晶状体后囊 ,行光镜及透射电镜检查 ,并采用免疫组化法对晶状体后囊染色 ,然后采用医用多功能图像分析软件对晶状体后囊表面及赤道部的增殖细胞核抗原 (proliferatingcellnucle arantigen ,PCNA)进行定量检测 ,用SPSS统计软件分析结果。结果　裂隙灯下可见术后随着人工晶状体袢角度的增加 ,发生后发性白内障的例数及等级均呈下降趋势。光镜及透射电镜扫描可见发生后发性白内障的晶状体后囊表面有一层或多层晶状体上皮细胞生长 ,未发生后发性白内障的晶状体后囊表面无晶状体上皮细胞生长 ,赤道部均可见多层晶状体上皮细胞生长。PCNA定量结果 :植入 0°袢人工晶状体组与植入 5°袢人工晶状体组之间后囊表面及赤道部PCNA阳性率 (分别为 10 .5 0 0±2 2 5 8,9.16 7± 2 .2 2 9)无明显差异 (P >0 .0 5 ) ,而植入 10°袢人工晶状体组 (4.5 0 0± 1.871)与植入 0°袢人工晶状体组及植入     

25G后囊膜切开联合前段玻璃体切除术治疗后发性白内障

目的：探讨25G后囊膜切开联合前段玻璃体切除手术治疗后发性白内障的疗效及并发症。

方法：对48例68眼后发性白内障患者以TSV 25G玻璃体手术系统经扁平部行后囊膜切开联合前段玻璃体切除手术。术后平均随访24mo,观察视力、眼压、前房反应和并发症的发生情况。

结果：所有术眼晶状体后囊膜中央均形成直径约4mm的圆形透明区,术中前房稳定,人工晶状体无损伤。术后第1d,裸眼视力(uncorrected visual acuity,UCVA)为0.70±0.12(0.5～1.0),最佳矫正视力(best corrected visual acuity,BCVA)为0.73±0.10(0.6～1.0)。术后3mo,UCVA为0.72±0.12(0.5～1.0),BCVA为0.74±0.10(0.6～1.0)。术后3mo UCVA与术前UCVA比较,差异有统计学意义(t=-45.902,P=0.000)。随访期间无切口渗漏、角膜水肿、眼内炎、瞳孔区玻璃体疝、人工晶状体损伤、视网膜脱离、高眼压及晶状体后囊膜切开区再次混浊等并发症。

结论：25G后囊膜切开联合前段玻璃体切除手术去除后囊膜混浊效果稳定、眼底并发症少,可以作为治疗后发性白内障的一种选择。     

肝素缓释系统抑制后发性白内障的实验研究

目的　探讨肝素缓释系统抑制后发性白内障发生的可行性和有效性。方法　将 30只(30只眼 )超声乳化透明晶状体吸除术后新西兰大白兔随机均分为A组 (术后生理盐水滴眼 )、B组(术中后房内植入空白缓释系统 )及C组 (术中后房内植入肝素缓释系统 )。术后 12周对 3个组兔眼进行裂隙灯显微镜、组织病理学及电镜检查 ,并检测血、房水肝素浓度和晶状体后囊膜的湿重。结果(1)术后 12周A、B及C组发生晶状体后囊膜混浊的眼数分别为 10、10及 4只眼 ,差异有非常显著意义(χ2 =14 0 9,P =0 0 0 1)。 (2 )术后 12周A、B及C组晶状体后囊膜的平均湿重分别为 (15 8± 5 )、(16 0± 9)及(2 0± 3)mg,差异有非常显著意义 (F =116 8 99,P =0 0 0 0 )。 (3)C组房水中的平均肝素浓度为 (2 6± 12 )mg/L。 (4)光镜和电镜下C组兔眼晶状体后囊膜细胞增殖不活跃 ,未发现眼内毒性反应。 (5 )术中和术后无眼内出血现象。结论　后房内植入肝素缓释系统 ,可明显提高并长期维持房水中的肝素浓度 ,有效抑制后发性白内障的发生 ;该方法毒副作用小 ,是一种安全、有效的给药方式。     

不同类型人工晶状体植入后远期效果观察

目的　分析透明角膜切口植入不同类型后房型人工晶状体 ,2 4月后结果是否存在差异。方法　对A、B、C 3组共96眼白内障行超声乳化并植入不同类型后房型人工晶状体。A组 3 2眼采用STAAR/Chiron硅胶折叠人工晶状体 ;B组 43眼采用法马西亚 92 0硅胶折叠人工晶状体 ;C组 2 1眼采用法马西亚或Upiohn 80 9CPMMA单片晶状体。 3组手术切口分别为3 2mm ,3 7mm ,5 0mm。结果　术后非矫正视力 :A组为 0 7± 0 2 ,B组为 0 65± 0 2 ,C组为 0 6+± 0 2 ;术后矫正视力 :A组为0 8± 0 2 ,B组为 0 8± 0 2 5 ,C组为 0 8± 0 3。术后眼压均在正常范围。结论　 3组之间仅有轻度屈光和角膜地形图的改变 ,差异无显著意义。     

非球面人工晶状体与球面人工晶状体临床应用的对比研究

目的比较前表面光学改良的非球面人工晶状体与传统球面人工晶状体对超声乳化白内障吸除人工晶状体植入眼球差和视觉功能的影响。方法将169例（169只眼）拟行超声乳化白内障吸除人工晶状体植入术的老年性白内障患者随机分为2组,分别植入非球面人工晶状体（试验组）和传统球面人工晶状体（对照组）。术后检测人工晶状体眼的球差、矫正远视力、矫正远视力后的近视力、对比敏感度、眩光敏感度和表观调节力;随访时间为3个月。结果术后3个月,瞳孔直径5mm情况下人工晶状体眼的总球差试验组为（0．024±0．076）μm,对照组为（0．217±0．137）μm,差异有统计学意义（P〈0．05）,而两组角膜球差的差异无统计学意义（P〉0．05）。4．0°和2．5°视角的对比敏感度试验组分别为39．18±11．94和28．30±12．07,对照组分别为33．28±11．84和24．50±8．20,差异有统计学意义（P〈0．05）;6．3°、4．0°、2．5°和1．6° 视角的眩光敏感度试验组分别为30．90±9．21、27．09±8．45、19．20±8．71和12．08±4．44,对照组分别为27．08±8．24、23．30±6．24、15．53±4．37和10．04±4．20,差异有统计学意义（P〈0．05）;两组的矫正远视力、矫正远视力后近视力、表观调节力比较,差异均无统计学意义（P〉0．05）。结论与传统球面人工晶状体比较,非球面人工品状体可以减少人工晶状体眼的球差,提高视觉对比度,改善白内障患者术后的视觉质母。     

应用新一代AS-OCT观察高度近视白内障术后人工晶状体与后囊膜贴附的研究

目的：利用新一代眼前节OCT(AS-OCT)定量检测和分析高度近视长眼轴患者白内障术后人工晶状体与后囊膜贴附情况。

方法：采用回顾性病例观察研究设计。纳入2019-10/12于深圳市眼科医院接受晶状体囊外摘除,经超声乳化吸出联合人工晶状体植入术的白内障患者60例60眼,根据眼轴长度(axial length,AL)分为两组：高度近视长眼轴组(AL>26.00mm)和正常眼轴组(AL：22.00～24.5mm)各30例30眼。分别于术后1、7、30d用AS-OCT测量两组白内障术后人工晶状体光学面与后囊膜之间围成的空间平面面积(AREAP)和未贴附残留后囊膜的边长。采用Kaplan-Meier生存分析法分析两组术后不同时间点的人工晶状体与后囊膜贴附率,Log-Rank检验法比较贴附率。

结果：正常眼轴组术后1、7、30d的AREAP分别为0.81±0.37、0.33±0.19、0.14±0.06mm²,未贴附后囊膜边长分别为7.93±3.03、3.95±2.44、1.26±0.08mm,人工晶状体光学面与后囊膜贴附率分别为33%、67%、83%; 高度近视长眼轴组术后1、7、30d的AREAP分别为3.29±0.43、1.54±0.66、0.62±0.28mm²,未贴附后囊膜的边长分别为13.56±4.02、8.13±3.90、3.78±2.51mm,人工晶状体光学面与后囊膜贴附率分别为0、7%、23%。两组术后各时间点AREAP、未贴附后囊膜边长、人工晶状体光学面与后囊膜贴附率均有差异(P<0.05)。

结论：高度近视长眼轴患者白内障术后人工晶状体与后囊膜之间残留更大的空间,贴附需要更长时间。新一代AS-OCT可以清晰地显示晶状体后囊膜的影像,有望成为研究晶状体相关疾病的有效检查设备。     

透明角膜切口白内障超声乳化手术临床观察

目的　探讨透明角膜切口白内障超声乳化吸除及丙烯酸可折叠人工晶状体植入术后的临床效果。方法　采用上方 3.2 mm阶梯状透明角膜切口 ,对 80例 (89只眼 )老年性、并发性和外伤性白内障行超声乳化吸除 ,并植入丙烯酸可折叠人工晶状体。结果　术后第 1天裸眼或球镜矫正视力≥ 0 .5者占 88.77% ;术后 1周、1个月和3个月裸眼或球镜矫正视力≥ 0 .5者分别占 95 .5 1 %、97.75 %和 98.88%。术后 1周平均散光为 (0 .96± 0 .82 ) D,比术前增加 0 .1 2 D,(P >0 .0 5 )。术后 1个月和 3个月平均散光为 (0 .89± 0 .5 6 ) D和 (0 .85± 0 .6 9) D,与术前无统计学差异 (P >0 .0 5 )。术后后囊膜混浊发生率为 1 .1 2 %。结论　透明角膜切口白内障超声乳化吸除和折叠式人工晶状体植入术具有早期恢复视力、散光稳定快和后囊混浊发生率低的优点 ,是值得推广的手术     

Association between intensity of posterior capsule opacification and visual acuity

PURPOSE: To investigate the correlation between the change in visual acuity and the difference in objective posterior capsule opacification (PCO) scores before and after neodymium:YAG (Nd:YAG) laser capsulotomy. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Forty pseudophakic eyes of 35 patients with PCO of varying intensity were examined before and after Nd:YAG laser capsulotomy. Visual acuity was determined using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart at 4 m and the Holladay reading chart at 40 cm. The pupil diameter under reading conditions was measured each time. Digital retroillumination images of the posterior capsule were taken, and the corresponding area inside the pupil was evaluated using the Automated Quantification of After-Cataract (AQUA) automated PCO analysis program. The change in visual acuity and difference between PCO scores before and after Nd:YAG laser capsulotomy were calculated for all eyes. RESULTS: The mean AQUA score (scale 0 to 10) was 3.56 before and 0.13 after Nd:YAG laser capsulotomy. The mean ETDRS visual acuity score (logMAR scale) was 0.28 and -0.07, respectively. The correlation coefficient between the differences in PCO score and distance visual acuity was 0.61 and near visual acuity, 0.62. CONCLUSIONS: The objective PCO score obtained by an automated image-analysis program correlates well with the PCO-induced decrease in visual acuity when the central area (inside the pupillary aperture) of the posterior lens capsule was evaluated. Objective PCO assessment by automated image-analysis systems is, therefore, a valuable and clinically relevant method for clinical studies of the development and prevention of PCO.     

Effect of posterior capsular opacification removal on automated perimetry

PURPOSE: Although posterior capsular opacification (PCO) is a common phenomenon in a considerable number of ophthalmologic patients, no prospective controlled trials assessing its influence on automated perimetry exist. This technique continues as a standard in the diagnosis of glaucoma and neuro-ophthalmological diseases. The aim of the present report is to investigate the effect of PCO on automated visual field examination. METHODS: A total of 26 PCO affected eyes of 26 patients had Humphrey SITA standard (program 24-2) immediately before, and between 1 and 8 weeks after Neodymium : YAG capsulotomy. The effect of learning associated with repeated testing was controlled with automated perimetry before enrollment and visual fields of the fellow eye. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and global perimetric pre- and post-laser indices were compared using the Student's t-test for paired samples. Correlation and linear regression analyses were also performed. RESULTS: BCVA and mean deviation (MD) improved following capsulotomy. Pattern standard deviation (PSD), an indicator of localized defects in the field, also improved significantly when PCO was solved. Moreover, a strong association among BCVA, MD, and PSD was shown both prior to and after capsulotomy. CONCLUSION: PCO is a heterogeneous mean opacity. This polymorphism may alter visual field results, and may even simulate the perimetric behaviour of other pathologies such as glaucoma. Consequently, the presence of PCO should be considered in the interpretation of any automated perimetry in pseudophakic patients. In addition, the values obtained before capsulotomy may partially predict the values obtained after capsulotomy.     

Changes of retinal light sensitivity after YAG-laser capsulotomy

BACKGROUND: The aim of this prospective study was firstly to investigate the changes of retinal light sensitivity of the central visual field in patients with posterior capsule opacification (PCO) after YAG-laser capsulotomy and secondly to determine the correlation between changes in retinal light sensitivity and patient's age and the diameter of posterior laser capsulotomy. PATIENTS AND METHODS: Our study includes 25 eyes (25 patients) with PCO after phacoemulsification and intraocular lens implantation. In all patients YAG-laser capsulotomy was performed. In all patients, a threshold visual field analysis was carried out with the C 30 - 2 programme of the automated Humphrey Field Analyzer before and one month after the procedure. RESULTS: In all patients a significant improvement of visual acuity was observed one month after capsulotomy (p = 0,00003). One month after YAG-laser treatment, a significant improvement of retinal light sensitivity in the central visual field was also observed. The average MD (mean deviation) before the procedure was - 6.05 db (+/- 3.2, max. - 11.7, min. + 2.17) and after the procedure - 3.61 db (+/- 3.7, max. - 10.87, min. + 0.71). Before laser capsulotomy obvious areas of reduced retinal sensitivity in 19 of 25 eyes (76 %) were found with MD p values of less than 5 %. One month after the procedure the MD p values were less than 5 % only in 8 eyes (32 %). The improvement in MD was statistically significant (p = 0,0002). No correlation was established between the improvement of retinal light sensitivity and patient's age or the size of the capsulotomy. CONCLUSIONS: Our study shows that the improvement of retinal light sensitivity is significant after YAG-laser capsulotomy and not depends on patient age or capsulotomy size.     

白内障术后晶状体后囊膜混浊及远期视力下降影响因素分析

目的探讨白内障术后晶状体后囊膜混浊(posterior capsular opacification,PCO)发生及术后远期视力下降的影响因素。方法收集行白内障超声乳化摘出联合人工晶状体植入术的年龄相关性白内障患者37例(47眼),记录患者术前、术后的眼部检查情况及是否行后囊膜抛光处理等术中情况,于术后2a对PCO进行分级评价。结果 47眼中,有25眼在术后2a发生了PCO,其中18眼混浊已累及中心3mm区,4眼已行YAG激光后囊膜切开术,后囊膜切开率8.5%。统计分析显示,PCO和混浊累及中心3mm区的发生率在是否行后囊膜抛光眼之间的差异均有统计学意义(均为P<0.05)。在各因素中,行后囊膜抛光是发生PCO以及混浊累及中心3mm区仅有的保护性因素。累及中心3mm区的PCO、眼底疾病和黄斑病变与术后2a视力变化之间的关联均有统计学意义(均为P<0.05)。结论白内障术后发生累及中心3mm区的PCO可导致术后远期视力下降;术中行后囊膜抛光处理可显著降低PCO的发生率和严重程度。     

Effect of posterior capsule opacification on macular sensitivity

PURPOSE: To evaluate the effect of posterior capsule opacification (PCO) on macular sensitivity. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Macular sensitivity, best corrected visual acuity (BCVA), and PCO intensity were evaluated before and after neodymium:YAG (Nd:YAG) laser capsulotomy in pseudophakic eyes with clinically significant PCO that had a healthy macula or dry age-related macular degeneration (ARMD). Macular sensitivity was determined using the fundus-related Microperimeter 1 (Nidek) in a central field of 10 degrees. The intensity of the PCO was assessed objectively in the central 3.0 mm area (score 0 to 10) using quantification software. RESULTS: After Nd:YAG capsulotomy, both groups had a significant improvement in BCVA and mean macular sensitivity; the change in the mean logMAR value was -0.26 in the healthy macula group and -0.23 in the dry ARMD group and the change in mean macular sensitivity, 2.5 dB and 2.0 dB, respectively. Before Nd:YAG capsulotomy, significant correlations were observed between PCO values, BCVA, and macular sensitivity in the healthy macula group only (P<.01). CONCLUSIONS: Neodymium:YAG laser capsulotomy improved BCVA and macular sensitivity. The PCO scores correlated well with the PCO-induced decrease in BCVA and with PCO-induced loss of macular sensitivity. Functional macular mapping indicated an overall loss of macular sensitivity in patients with dry ARMD. There was no significant association between PCO values and macular sensitivity in eyes with dry ARMD.     

基于超声生物显微镜图像分型的先天性白内障摘出术后后发性白内障的手术设计及疗效观察

目的　基于超声生物显微镜（ultrasound biomicroscope，UBM）对先天性白内障摘出术后后发性白内障（posterior capsular opacification，PCO）图像特征的影像学分类，探讨PCO类型与手术方式选择的关系。方法　对在广州市妇女儿童医疗中心行先天性白内障摘出术，术后采用水囊式UBM成像技术进行检查，并确诊为PCO的27例（40眼）患儿的UBM检查结果进行分析。根据UBM图像特征将PCO分为3组，并根据分型实施不同的手术方式:膜性纤维化型组采用Nd:YAG激光晶状体后囊膜切开术，皮质再生型组采用前段玻璃体切割术，混合型组采用前段玻璃体切割联合电子撕囊术。术后定期随访并复查UBM。结果　全部术眼术中视轴区混浊均被清除，晶状体后囊膜中央切口均为直径3.0~4.0 mm的圆形透明区，PCO手术的成功率为100%。术后随访6~30个月，膜性纤维化型组20眼中2眼发生虹膜粘连、瞳孔膜样闭锁，再次手术，采用虹膜后粘连分离联合前段玻璃体切割术治疗，术后未再次复发；皮质再生型组14眼和混合型组6眼术后视轴区均未再次出现混浊。PCO术后总复发率为5.0%。结论　对先天性白内障摘出术后PCO的UBM图像进行分型，有助于最佳手术方式的选择，可达到更好的治疗效果。     

人工晶状体眼后发性白内障的手术

目的探讨巩膜隧道切口插管灌注经睫状体平坦部后囊切开术治疗人工晶状体眼后发性白内障的效果。方法32例(34眼)人工晶状体植入术后后发性白内障行巩膜隧道切口插管灌注经睫状体平坦部后囊切开术。平均随访18个月。结果全部术眼晶状体后囊中央均形成直径3.5~4mm的圆形透明区,后发性白内障切开术的成功率为100%;术中前房稳定,人工晶状体无损伤。术后能配合视力检查的患者最佳矫正视力均恢复至后发性白内障发生前的最佳水平;随访期间无切口渗漏、角膜水肿、瞳孔区玻璃体疝、人工晶状体损伤、视网膜脱离、高眼压或晶状体后囊膜切开区再次浑浊等并发症。结论巩膜隧道切口插管灌注经睫状体平坦部后囊切除术治疗人工晶状体植入术后的后发性白内障安全、有效。     

Correlation between posterior capsule opacification and visual function before and after Neodymium: YAG laser posterior capsulotomy

PURPOSE: To investigate the correlation between visual acuity, contrast sensitivity, and contrast sensitivity with glare source (glare sensitivity), and the degree of posterior capsule opacification (PCO) before and after neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy. DESIGN: Prospective interventional case series. METHODS: Eighty-four patients (90 pseudophakic eyes) scheduled to undergo Nd:YAG laser capsulotomy were recruited. Visual acuity and contrast sensitivity with and without the presence of a circular glare source (using the contrast glare tester) were measured before and after Nd:YAG laser capsulotomy. The PCO density value was measured using a Scheimpflug videophotography system. The visual functions were statistically correlated with the PCO value. RESULTS: Before Nd:YAG laser capsulotomy, strong correlation existed between the PCO value and visual acuity (r = 0.728). Contrast sensitivity and glare sensitivity were also weakly correlated with the PCO value, but the correlation coefficients were smaller than that of visual acuity. After Nd:YAG laser capsulotomy, mean visual acuity, contrast sensitivity, and glare sensitivity at all visual angles improved significantly (P <.0001). After capsulotomy, no significant correlation was found between visual acuity, contrast sensitivity, or glare sensitivity and the PCO value. CONCLUSIONS: Before Nd:YAG laser capsulotomy, visual functions correlated significantly with the degree of PCO. Specifically, visual acuity has a stronger association with PCO than does contrast sensitivity or glare sensitivity and therefore should be considered to reflect most accurately the degree of PCO. After capsulotomy, these visual functions improve markedly and no longer have a significant correlation with PCO.     

掺钕钇铝石榴石激光后囊膜混浊切开对人工晶状体眼波前像差的影响

目的研究掺钕钇铝石榴石(Nd:YAG)激光后囊膜混浊切开对人工晶状体(IOL)眼波前像差的影响。方法对57例(68眼)白内障超声乳化吸除加IOL植入术后后囊膜混浊(PCO)患者行Nd:YAG激光后囊膜切开,激光前后应用NidekOPDScanⅠ角膜地形图/波前像差仪测量瞳孔直径为5.0mm时IOL眼的总像差、总高阶像差、球差、彗差和三叶草像差的均方根值(RMS),比较Nd:YAG激光前后波前像差的变化。Nd:YAG激光后囊膜切开采用环形切开向后翻转法,切开后囊膜瓣直径为5.0mm。结果激光术后最佳矫正视力较术前提高,差异有统计学意义(P<0.05)。激光术后总像差、总高阶像差、球差、彗差和三叶草像差的RMS分别为1.849±0.763、0.605±0.247、0.238±0.146、0.166±0.112及0.322±0.132,均较术前下降,差异有统计学意义(P<0.05)。结论 Nd:YAG激光后囊膜混浊切开直径5.0mm可以明显降低IOL眼的波前像差,改善视觉质量。     

In vivo quantitative measurement of posterior capsule opacification after extracapsular cataract surgery

Purpose: To introduce a new in vivo quantitative measurement of posterior capsule opacification (PCO) after extracapsular cataract surgery and also to analyze the correlation between opacification density and the patient’s visual acuity.Methods: Prospectively, the opacification density value in the central 3-mm portion of the posterior capsule was quantitated by means of an area densitometry with the Scheimpflug photography system (EAS-1000). The EAS-1000 examination was performed on 40 eyes with clinically significant PCO both before and after undergoing Nd:YAG laser posterior capsulotomy, and on 10 eyes without PCO. The correlation between the opacification density value and the visual acuity was analyzed with a linear regression analysis.Results: The mean opacification density values ± SD were 48.8 ± 29.5 computer-compatible tapes (CCT) steps in the PCO group before capsulotomy, 15.5 ± 7.8 CCT steps in the PCO group after capsulotomy, and 12.9 ± 4.9 CCT steps in the non-PCO group. The mean opacification density value in the PCO group before capsulotomy was significantly greater than that in the PCO group after capsulotomy or than that of the non-PCO group. A linear regression analysis determined that the opacification density value also correlated well with the visual acuity (R² = .808).Conclusions: We have established a new in vivo quantitative measurement of PCO. Because the opacification density value obtained by this measurement correlated well with the patient’s visual acuity, we consider this measurement to be useful in both the research and clinical management of PCO.