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。

25G posterior capsulotomy with anterior vitrectomy for posterior capsule opacification

AIM: To evaluate the efficacy and complications of 25G posterior capsulotomy with anterior vitrectomy for posterior capsule opacification(PCO).

METHODS: The 25G transconjunctival sutureless vitrectomy technique was performed in 48 cases(68 eyes)of PCO eyes. The mean follow-up was 24mo. Best-corrected visual acuity(BCVA), intraocular pressure, anterior chamber reaction and complications during and after the operation were observed.

RESULTS: 4mm diameter round holes were obtained at the center of the posterior capsule in all eyes. At 1d postoperative, uncorrected visual acuity(UCVA)was 0.70±0.12(0.5-1.0), and BCVA was 0.73±0.10(0.6-1.0). At 3mo postoperative, UCVA was 0.72±0.12(0.5-1.0), and BCVA was 0.74±0.10(0.6-1.0). It was statistical significance between preoperative and postoperative UCVA(t=-45.902, P=0.000). There were no complications during the postoperative follow-up period, such as dislocation or damage of the IOL, corneal edema, endoophthalmitis, pupil vitreous hernia, vitreous prolapse, retina detachment, intraocular hypertension and reocclusion of the visual axis, etc.

CONCLUSION: The 25G transconjunctival sutureless vitrectomy technique to remove PCO is a safe and effective procedure with less complications, which can be an alternative treatment for PCO.