连续环形撕囊相关的囊袋收缩综合征

连续环形撕囊（CCC）是近年来白内障超声乳化吸除手术领域的最大进展之一。环行撕囊术的实施使囊袋内的超声乳化手术成为可能，提高了乳化效果，减少了对眼组织的损伤，最大限度地保持人工晶状体的囊袋内固定，同时也明显地减少了后囊混浊的发生率。但是，它也不可避免地引起了其它并发症。本综述了与连续环形撕囊相关的囊袋收缩综合征。主要包括：囊袋皱缩综合征，囊袋膨胀综合征，偏心囊袋收缩。     

术后早期囊袋膨胀综合征2例

囊袋收缩综合征包括囊袋皱缩综合征、囊袋膨胀综合征、偏心囊袋收缩，尚无统一的定义，与连续环形撕囊(CCC)相关，病因不清。发生于术后第1天至术后18个月甚至更晚，不同综合征的发病时间不同。本文报告2例2眼术后早期囊袋膨胀综合征的病程、转归，其中1眼术后8周出现偏心囊袋收缩。     

白内障术后囊袋收缩综合征

囊袋收缩综合征作为白内障手术连续环形撕囊所特有的并发症,可引起术后视力的严重下降。晶状体囊下上皮细胞的增生移行是其发病的主导因素。其前可通过术中的合理撕囊而预防其发生,对已经发生者,Nd：YAG激光治疗和松解囊袋手术均可不同程度地提高视力。     

连续环形撕囊相关的囊袋收缩综合征

连续环形撕囊 (CCC)是近年来白内障超声乳化吸除手术领域的最大进展之一。环行撕囊术的实施使囊袋内的超声乳化手术成为可能 ,提高了乳化效果 ,减少了对眼组织的损伤 ,最大限度地保持人工晶状体的囊袋内固定 ,同时也明显地减少了后囊混浊的发生率。但是 ,它也不可避免地引起了其它并发症。本文综述了与连续环形撕囊相关的囊袋收缩综合征。主要包括 :囊袋皱缩综合征、囊袋膨胀综合征、偏心囊袋收缩     

囊袋阻滞综合征

随着 8 0年代末期连续环形撕囊的兴起〔1〕,白内障超声乳化技术开始了突飞猛进的发展。连续环形撕囊的成功与否不仅直接影响超声乳化手术的进行 ,而且使囊袋内植入人工晶体 (IOL)更加符合生理特点又不易偏位〔2〕,80 %以上白内障医师在术中采用连续环形撕囊 ,但一些并发症也随之而来 ,如囊袋收缩、囊袋阻滞等〔2〕。 1990年 ,Davison〔3〕首次报道了术后囊袋阻滞 ,使白内障医师们开始注意这种与连续环形撕囊有关的并发症——囊袋阻滞综合征。一、囊袋阻滞综合征 (Capsular block SyndromeCBS)囊袋阻滞综合征 ,又称囊袋膨胀综合征 ,是指…     

囊袋收缩综合征的手术治疗

目的:探讨白内障连续环形撕囊术后囊袋收缩综合征的手术治疗效果。方法:对15例15眼白内障连续环形撕囊术后发生囊袋收缩综合征的患者进行手术治疗,观察患者术后视力、并发症情况。结果:手术治疗后视力均有不同程度的提高。无明显的并发症发生。结论:手术治疗增殖严重的囊袋收缩综合征是一种安全有效的方法。     

白内障超声乳化术后囊袋皱缩综合征病因分析

目的　探讨白内障超声乳化术后囊袋皱缩综合征的影响因素和危险因素、临床表现,为减少白内障术后囊袋皱缩综合征提供可靠有效的预防方法。方法　回顾性分析２０１４年１０月至２０１５年６月在我院收治的行白内障超声乳化联合人工晶状体植入术的白内障患者１０２８例（１２４２眼）,术后１周、１个月、３个月、６个月、１２个月复诊,观察患者视力、前囊口形态及直径、ＩＯＬ位置及形态。结果　１２４２眼中１９眼发生囊袋皱缩综合征,发生率１．５３％。１９眼中发生时间在术后３个月内者１５眼（７８．９５％）,术中未行前囊膜抛光１６眼（８４．２１％）,撕囊口直径过小（≤５ｍｍ）１６眼（８４．２１％）,植入亲水性丙烯酸酯人工晶状体１５眼（７８．９５％）,合并全身或眼部疾病１０眼（５２．６３％）,术后炎症反应重８眼（４２．１１％）。囊袋皱缩综合征可引起视力下降、远视漂移。结论　白内障术中撕囊口直径过小、前囊膜下晶状体上皮细胞残留是术后发生囊袋皱缩综合征的重要因素。人工晶状体的选择、合并全身或眼部疾病、术后炎症反应均是发生囊袋皱缩综合征的影响因素。术中大小适宜的环形撕囊、前囊膜下环周晶状体上皮细胞清除抛光可有效预防囊袋皱缩综合征的发生。     

囊袋收缩综合征的研究进展

囊袋收缩综合征为白内障手术连续环形撕囊特有的并发症,引起术后视力下降等症状,残留的晶状体上皮细胞在囊袋收缩的发病机制中具有主导作用.通过合适撕囊、选择合适的人工晶状体、后囊膜抛光、Nd:YAG激光、手术切开囊膜等方法能有效的防治囊袋收缩综合征的发生.     

晶状体囊袋阻滞综合征原因探讨

目的 探讨晶状体囊袋阻滞综合征的临床原因。方法 对术中，术后早期，术后晚期囊袋阻滞综合征的病因，临床表现，预防及处理等进行分析讨论。结论 连续环形撕囊术前囊孔直径小于人工晶状体光学部直径，不分离速度过快，术后黏弹剂未彻底清除是导致囊袋阻滞的主要因素。结论 晶状体核或人工晶状体光学部阻塞撕囊边缘是囊袋阻滞综合征的首先致病因素。     

超声乳化术后囊袋收缩综合征临床分析

目的：分析超声乳化白内障吸除术后囊袋收缩综合征发生的原因，观察其临床特点，探讨治疗及预防措施。方法：对218例(239只眼)术后1个月一3个月的超声乳化术后患者进行散瞳检查，观察前囊形态、撕囊口大小变化以及人工晶体的位置。结果：进行连续环形撕囊(CCC)的216只眼中有154只眼CCC边缘纤维化、增厚，其中37只眼CCC面积轻微缩小，3只眼明显缩小。27只眼人工晶体位置有不同程度偏位，其中74％发生在前囊机化收缩、CCC变小的患者。开罐式截囊的患者较少发生以上情况。结论：囊袋收缩是超声乳化术后常见的前囊形态变化，囊袋收缩综合征是连续环形撕囊所特有的一种临床表现。预防其发生可以提高和保持超声乳化术后长期良好视觉效果。     

Efficacy of haptic sutured in-the-bag intraocular lens for intraocular lens-capsule complex stability: a comparison of three insertion methods

AIM: To evaluate the efficacy and stability of haptic sutured in-the-bag intraocular lens (IOL) in eyes with zonular instability. METHODS: A total 60 eyes of 60 patients were included in this retrospective cohort study. Postoperative stability in three groups [haptic sutured IOL in the bag, IOL in the bag insertion with haptics oriented toward areas of zonulysis, IOL with capsular tension ring (CTR) in the bag insertion] were compared according to the IOL insertion methods. To evaluate the IOL stability, the changes of anterior chamber depth (ACD), refraction, contraction of anterior continuous curvilinear capsulotomy (CCC) area, and tilt of IOL were compared. RESULTS: There was no significant difference in change of ACD (-0.04±0.01 mm in group of haptic sutured IOL, -0.07±0.01 mm in group of CTR insertion) and refraction (0.05±0.05 D in group of haptic sutured IOL, 0.37±015 D in group of CTR insertion) between the group of haptic sutured IOL in the bag and CTR insertion group. But in comparison of CCC contraction and IOL tilt, CTR insertion group showed less contraction (1.00%±0.52%) and less IOL tilt (2.66°±0.11°) than the group of haptic sutured IOL in the bag (6.32%±1.36%, 3.47°±0.11°, respectively). The CTR insertion group showed the least CCC contraction and the least tilt. CONCLUSION: In eyes with zonular instability, the method of haptic sutured IOL in-the-bag shows comparable stability in ACD and refraction in comparison with IOL with CTR in the bag insertion. The method of IOL only in-the-bag insertion shows the largest contraction of CCC and the largest tilt of IOL.     

Photographic essay. Anterior segment optical coherence tomography findings of early capsular block syndrome

Capsular block syndrome (CBS) or capsular bag distension syndrome is characterized by distension of the capsular bag after uneventful phacoemulsification and endocapsular intraocular lens implantation. The syndrome has also been reported after extracapsular cataract extraction and intraocular lens placed in the sulcus. We report the anterior segment optical coherence tomographic findings in a case of early postoperative CBS. Anterior segment optical coherence tomographic aids in the diagnosis and management of CBS.     

Capsular block syndrome: A case series

Capsular block syndrome (CBS) or capsular bag distension syndrome has been described after cataract removal with in-the-bag placement of a posterior chamber intraocular lens in the presence of an anterior continuous curvilinear capsulorhexis. Features of CBS include shallowing of the anterior chamber and an unexpected myopic overrefraction; occasionally, there is a persistent uveitis. The patient may be mistakenly diagnosed with pupil block glaucoma or endophthalmitis. We report 9 cases of CBS and their initial diagnoses and management. In 1 case, the capsular bag distention and anterior chamber shallowing are illustrated by ultrasound biomicroscopy.     

Posterior chamber intraocular lens dislocation with the bag.

We report a rare case of a 46-year-old man presenting with a luxation of a posterior chamber intraocular lens (IOL) with the capsular bag after ocular contusion. Preoperative axial length was 36.58 mm. After trauma, pars plana extraction of the dislocated IOL inside the capsular bag was performed using a forceps. Capsular fibrosis had probably weakened the zonules, which were ruptured by the trauma. This observation confirms the necessity of a large continuous curvilinear capsulotomy and meticulous cleaning of the anterior and posterior capsules to minimize postsurgical fibrosis and capsule contraction.     

囊袋收缩综合征的研究现状

囊袋收缩综合征是白内障术后的一种并发症,以囊袋赤道部直径缩小为特征,造成眩光、复视、屈光不正、视功能障碍等一系列不良反应,影响了患者术后疗效。随着白内障囊外摘除术的普及,越来越多的患者接受超声乳化白内障吸除术,因此囊袋收缩综合征也成了人们关注的焦点,预防其发生和Nd:YAG激光治疗可以提高白内障患者术后的视觉效果。本文将对囊袋收缩综合征的临床特点、病因以及防治现状作一综述。     

Capsular bag distension syndrome after combined cataract and glaucoma surgery

PURPOSE: To report four cases of capsular bag distension syndrome (CBDS) after combined cataract and glaucoma surgery. METHODS: We describe the clinical features and evolution of each case after individual treatment. CASE REPORTS: We report four cases of CBDS after phacoemulsification, combined with trabeculectomy in two cases and with an Ahmed aqueous drainage device implantation in the other two cases. The space between the intraocular lens (IOL) and the posterior capsule was occupied by an optically clear liquid in two cases and by a turbid liquid in the other two cases, with posterior bowing of the capsule into the anterior vitreous. A myopic shift and anterior chamber shallowing occurred in three cases. After posterior Nd:YAG laser capsulotomy, the CBDS resolved in three cases. In case 1, a surgical posterior capsulotomy and anterior vitrectomy were necessary. DISCUSSION: Capsular bag distension syndrome should be included in the differential diagnosis of a shallow anterior chamber after combined cataract and glaucoma surgery.     

Late in-the-bag intraocular lens dislocation: incidence, prevention, and management

Dislocation of an intraocular lens (IOL) with the capsular bag is a late complication of cataract surgery, reported with increasing frequency in recent years. Pseudoexfoliation, uveitis, myopia, and other diseases associated with progressive zonular weakening and capsular contraction are the predisposing conditions. Capsular tension rings probably help but do not prevent this complication. Management includes IOL exchange, replacement with an anterior or a sutured posterior chamber IOL, or suturing the IOL through the bag to the iris or the sclera.     

Early decentration of plate-haptic silicone intraocular lenses

We report 4 eyes of a consecutive series of 1299 that developed early decentration of a 10.5 mm diameter plate-haptic silicone intraocular lens (IOL) after uneventful phacoemulsification. All eyes had an intact continuous curvilinear capsulorhexis (CCC) with the IOL placed in the capsular bag. After an initial period of good vision, patients noted the onset of glare or monocular diplopia between 1 and 5 weeks after surgery. On examination, there was no significant anterior capsule contraction; however, the edge of the IOL optic was visible in the undilated pupil. There was adhesion between the anterior and posterior capsules at the margin of the CCC that maintained the IOL decentration. Decentration recurred in 1 eye after the IOL was rotated 90 degrees and recentered. Symptoms resolved in 3 eyes after the IOL was removed and replaced with a rigid IOL with a larger diameter optic.     

半脱位晶状体张力环植入联合晶状体超声乳化的临床应用

目的评价半脱位晶状体超声乳化术中植入囊袋张力环(CTR)的应用价值。方法对11例(11眼)半脱位晶状体行白内障手术,术中连续环形撕囊后植入囊袋张力环,随后行白内障晶状体超声乳化术,囊袋内植入折叠式人工晶状体。结果术中所有手术都未出现张力环脱落及由于张力环张力过大而导致的晶状体囊袋撕裂现象。所有植入的人工晶状体基本位于正位。术后1周、1月、3月随访视力,观察人工晶状体位置,测量眼压,检测角膜内皮密度指标与常规超乳手术无明显差别。结论囊袋张力环是一种安全有效的辅助工具,它通过囊袋内植入,保持囊袋的位置和完整性,便于后房型人工晶状体的植入,防止术中由于晶状体核的坠落所产生的并发症及术后人工晶状体的偏位,提高了手术安全性,有利于术后视力恢复。