晶状体囊抛光及透明质酸酶预防囊的浑浊

目的探讨晶状体囊抛光并囊袋内注射透明质酸酶预防囊的浑浊和后发性白内障的作用及安全性.方法年龄相关性白内障70例80眼,按常规进行超声乳化吸出人工晶状体植入术.治疗组40眼水分离时用含透明质酸酶1000 IU的必施（BSS）进行,乳化吸出晶状体核和皮质后在黏弹剂的保护下,囊袋内注入含透明质酸酶500IU的BSS,2分钟后用抛光针尖进行晶状体囊抛光,然后注吸清除上皮细胞碎屑,囊袋内植入人工晶状体.对照组40眼则用同等量BSS进行水分离,仅行后囊抛光.术后18月随访,进行角膜内皮、眼底及视网膜电图等检查,并对前、后囊浑浊的情况进行分级.结果术后18月治疗组前、后囊膜浑浊的发生率与对照组相比,差异有统计学意义.角膜内皮损失率与对照组相比,差异无统计学意义.两组眼底检查和视网膜电图检查显示视网膜功能正常.结论晶状体囊袋内注射透明质酸酶联合晶状体囊抛光可以预防囊的浑浊和后发性白内障发生,且眼内应用安全.

Prevention of posterior capsule opacification: Combining intralens-bag injection of hyaluronidase with lens epithelium polishing

Objective To assess whether hyaluronidase injection with posterior capsule polishing can reduce anterior capsule opacification(ACO) and posterior capsule opacification(PCO) without causing ocular toxicity. Methods Eighty eyes of 70 cataract patients received operation(phacoemulsification and intraocular lens implantation)were randomized into two groups.The control group received BSS only.The experimental group,BSS with hyaluronidase was injected into the capsular bag while hydrodissection and polishing during endocapsular phacoemulsification.Eighteen month after surgery,anterior capsule opacification,posterior capsule opacification and cornea,iris,pupil,IOL and retina were observed by slitlamp,ophthalmoscope,corneal specular microscope and electroretinogram. Results The experimental group in human eyes had clear capsules and minor ACO and PCO.The control group developed more severe ACO and PCO.The difference between the two groups was statistically significant(P<0.05). Conclusions Our results suggest that the application of hyaluronidase during hydrodissection and polishing effectively reduce ACO and PCO in patient eyes.