晶体前囊膜弹性的研究

目的研究前囊膜弹性。方法对２２只牛眼行连续环形撕囊术（ｃｏｎｔｉｎｕｏｕｓｃｉｒｃｕｌａｒｃａｐｓｕｌｏｒｈｅｘｉｓ，ＣＣＣ），截囊及娩核后，缓慢张大两脚规至前囊膜开口撕开后测定前囊膜的弹性。将撕裂时的周长与原切口周长之比作为前囊膜弹性指标。结果完整的ＣＣＣ切口在造成放射状撕裂之前比原切口周长扩大６１％，扩大的囊膜切口面积显著大于原切口面积及核倾斜３０°时的横断面面积。结论前囊膜具有一定的弹性，适当大小的ＣＣＣ切口可保证晶体物质的安全娩出及人工晶体的植人而不产生放射状撕裂。     

选择性后房型人工晶状体植入前的后环形撕囊术

目的：探讨后囊膜增殖钙化的白内障摘出术后的后囊膜处理技术。方法：对42例(49只眼)后囊膜增殖钙化的白内障患者，于摘除白内障后在后囊膜旁中心处用破囊针头划出起始瓣，沿起始瓣边缘撕开一直径约3～4mm的类圆孔，再植入人工晶状体。结果：全部术眼后囊膜中央均有一透明类圆孔，术后无人工晶状体偏位或眼底异常改变。结论：后房型人工晶状体植入前的后环形撕囊术可使后囊膜增殖钙化的白内障获得视轴透明区，是安全有效地处置后囊膜混浊方法之一。     

青年人眼晶状体的显微研究及其临床意义

目的 通过对正常成人尸眼晶状体的显微解剖研究,推动白内障摘出及人工晶状体（IOL）植入术的改进。方法 测量53人共102只成年尸眼（年龄19－41a)的晶状体直径（LD）及无韧带区直径（ZFZ）等有关正常值。结果 正常成年人LD平均为9．61mm,ZFZ为7．73mm,ZFZ与LD呈直线正相关关系;晶状体核直径（ND）平均为7．68mm,核厚度（NT）为2．9mm,同一人的LD、ND、NT呈直线正相关关系;晶状体囊袋直径（CBD）平均为10．15mm,与LD比较有显著差异。结论 成年人白内障摘出术中连续环形撕前囊应在5－6mm之间。     

Role of the posterior capsule in the prevention of postoperative bacterial endophthalmitis: experimental primate studies and clinical implications.

The posterior capsule has an important effect on the risk of postoperative bacterial endophthalmitis. In order to investigate whether the posterior capsule inhibited the spread of infection into the vitreous we performed extracapsular cataract extraction in both eyes of 10 primates. In one eye of each primate the posterior capsule was left intact and in the other eye a large posterior capsulectomy was performed. When the anterior chambers were challenged with equivalent inocula of Staphylococcus aureus, one of 10 eyes with an intact posterior capsule developed culture-positive vitreous infection. In contrast, nine of 10 eyes with a large posterior capsulectomy developed culture-positive vitreous infection. In a second experiment we investigated the effect of an intraocular lens on the barrier effect. Ten primates received extracapsular cataract extraction in both eyes and pseudophakic implantation. In one eye of each primate the posterior capsule was left intact and a J-loop monoplanar lens was implanted in the ciliary sulcus. In the other eye of each primate a large posterior capsulectomy was followed by implantation of a monoplanar, non-vaulted pseudophakos into the anterior chamber. None of the 10 eyes with a posterior capsule intact and a posterior chamber lens in place developed positive vitreous cultures or histopathological evidence of vitreous infection. Thus the presence of a posterior chamber lens did not appreciably compromise the barrier effect of the intact posterior capsule. 40% of the eyes with a large posterior capsulectomy and a non-vaulted pseudophakos in the anterior chamber developed culture-positive vitreous infection, and 60% of the eyes showed histopathological evidence of vitreous infection.     

晶状体囊袋内旋转切削超声乳化白内障吸除术的临床观察

目的 观察超声乳化白内障吸除手术中囊袋内旋转切削晶状体核方法的临床效果。方法 对不同硬度晶状体核白内障患者１６９例（２１５只眼）行连续环形撕囊、充分水分离,以晶状体核囊袋内旋转切削方法完成超声乳化白内障吸除人工晶状体植入手术要超声乳化旋转转切削平均周数：２～４周;平均超声能量及时间：Ⅱ级晶状体核６．２％,９ｓ;Ⅲ级晶状体核２０．９％,７３ｓ;Ⅳ级晶状体核３０．７％,１３４ｓ。术后第７天角膜内眼细胞     

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３７例（３９眼）后房人工晶状体植入术后后浑浊行后囊切开术。结果 激光截囊前后视力有显著差异,而激光截囊后与后发障发生前视力针差异,儿童组复发率达５８．３％。人工晶状体损伤９例（１０眼）占２５．６％,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本损伤和最高后囊爆破,从而大幅度减少     

Comparison of function and fixation of small incision circular and oval poly(methyl methacrylate) intraocular lenses.

A prospective study of function and fixation was done on 40 patients implanted with small incision poly(methyl methacrylate), single piece, biconvex intraocular lenses after in situ phacoemulsification cataract extraction via a continuous curvilinear capsulorhexis. A 5.0 mm circular optic (Pharmacia 740 P), 14 mm length lens was compared with an oval 5.0 x 6.0 mm optic (IntraOptics SP18UB), 12.75 mm lens. Twenty patients were implanted with each design and were surveyed three months postsurgery. Satisfactory visual acuity and absence of motor vehicle headlight glare was found in all 40 patients. One glare disability of 35% occurred in a patient with an off-center capsulorhexis that formed a Soemmering's ring partially posterior to a circular optic lens. Fixation was clinically central in all patients. A space between optic and posterior capsule persisted in seven eyes with an oval optic lens and in eight eyes with a circular optic lens. Therefore both designs were associated with a "no space, no cells" situation that should decrease eventual pearl formation. Total Soemmering's rings formed posterior to 9 of 20 circular optic lenses if the capsulorhexis was 5 mm or larger in diameter (only one oval optic lens formed a Soemmering's ring). Compression of the posterior capsule occurred in seven of the nine patients with circular optic lenses and total Soemmering's rings. I conclude that the circular optic design was best implanted via a 5 mm or slightly larger central capsulorhexis to promote both Soemmering's ring formation and posterior capsule compression. Both designs provided satisfactory clinical results.     

Effect of intraocular lens and anterior capsule opening type on posterior capsule opacification.

PURPOSE: To determine the effect of intraocular lens (IOL) type and anterior capsulectomy technique on the incidence of posterior capsule opacification. SETTING: Department of Ophthalmology, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey. METHODS: Three hundred two eyes of 294 patients were examined retrospectively after IOL implantation in the capsular bag performed between February 1991 and November 1996. Patients were divided into 3 groups according to IOL type: poly(methyl methacrylate) (PMMA); heparin-surface-modified PMMA (HSM PMMA); plate-haptic silicone. Envelope capsulectomy or continuous curvilinear capsulorhexis (CCC) was used. Mean follow-up was 27 months (range 12 to 33 months). RESULTS: Posterior capsule opacification developed in 47 cases (15.6%): 21.7% in the PMMA lens group after planned extracapsular cataract extraction (ECCE), 17.4% in the HSM PMMA lens group after planned ECCE, and 7.7% in the plate-haptic silicone lens group after phacoemulsification. Posterior capsule opacification occurred less in patients who had anterior capsulectomy using the CCC technique (11.5%) than in those having an envelope capsulectomy (24.5%) (P < .05). Posterior capsule opacification was significantly less in eyes with a capsular-bag-fixated plate-haptic silicone lens than in those with a PMMA or HSM PMMA IOL (P < .05). CONCLUSION: This study demonstrated that the anterior capsulectomy technique and the IOL type influence the incidence of PCO.     

Staining of zonules during posterior chamber lens implantation in a cadaver eye model.

A cadaver eye model was used to study the effects of extracapsular lens removal and implantation on the zonules and capsule. Five staining solutions were instilled in the posterior and anterior chambers of human cadaver eyes and washed out three to five minutes later. Gomori's chrom hematoxylin-eosin most clearly revealed the zonules. Three eyes stained in this way had lens removal (including the continuous circular capsulorhexis technique for anterior capsulectomy) and intraocular lens implantation. The effects of the surgery on the zonules and capsule were clearly visualized and appeared quite satisfactory. This staining technique may prove useful in other cadaver eye models.     

Anterior capsular phimosis in eyes with a capsular tension ring.

A 64-year-old woman with zonular weakness in the left eye and a 79-year-old man with bilateral pseudoexfoliation and intraoperative zonular dehiscence had phacoemulsification with in-the-bag implantation of a single-piece poly(methyl methacrylate) intraocular lens (IOL) and a capsular tension ring. Ten to 12 weeks postoperatively, all 3 eyes developed significant visual loss secondary to capsule shrinkage and occlusion of the capsulorhexis opening. All eyes had a neodymium:YAG laser radial anterior capsulotomy, anterior capsulectomy, or both. Visual acuity was restored in all eyes despite slight IOL decentration.