不同人工晶状体行后囊后嵌顿术的实验研究

目的　对比３种不同人工晶状体植入术后对幼兔眼前节炎症反应、人工晶状体位置及后囊膜混浊的影响，为儿童后囊后人工晶状体嵌顿术选择合适的人工晶状体。方法　１月龄新西兰白兔３６只，随机分成Ａ、Ｂ、Ｃ３组，均行右眼晶状体吸出＋后囊膜连续环形撕囊联合人工晶状体后囊后嵌顿术，其中Ａ组植入硬片式人工晶状体；Ｂ组植入三片式软性人工晶状体；Ｃ组植入单片式软性人工晶状体。术后１ｄ、１周、１个月、３个月分别行术眼的裂隙灯、ＵＢＭ及眼前节照相检查。结果　术后１周时Ａ组的眼前节炎症反应较Ｂ组、Ｃ组重，差异均有统计学意义（Ｐ＝０. ０３、０．０３）。术后３个月时Ａ组有２眼人工晶状体夹持，１０眼正位；Ｂ组１１眼正位，１眼偏位；Ｃ组２眼正位，８眼偏位，２眼夹持；人工晶状体正位率Ａ组、Ｂ组之间差异无统计学意义（Ｐ＞０. ０５），但与Ｃ组间差异均有统计学意义（Ｐ＝０．０３、０．０１）。术后３个月时，Ａ组、Ｃ组均有２眼出现后囊膜混浊，余术眼后囊膜均保持清亮，后囊膜混浊发生率３组间差异无统计学意义。结论　襻为聚丙烯材料、光学部为丙烯酸酯（Ａｃｒｙｌｉｃ）的三片式人工晶状体更适合儿童后囊后嵌顿术，对维持人工晶状体正位有积极作用。

Experimental study on different intraocular lens in posterior capsular optic capture

Objective To compare the effects of three different intraocular lens ( IOL) on IOL position , anterior segment inflammation and posterior capsular opacification after surgery, and choose the appropriate IOL for the treated subjects underwent anterior and posterior capsulorrhexis combined with IOL implantation during the cataract surgery. Methods Thirty-six New Zealand rabbits were separated into three groups randomly. A1l rabbits were received posterior curvilinear capsulorhexis with optic capture of posterior chamber IOL . PMMA IOL was implanted in group A , three-pieces and Acrylic IOL in group B , sigie-piece Acrylic IOL in group C. A1l surgical arumals were checked with slit lamp, UBM and anterior photocamera at I day, I week, I month.3 months after the surgery. Results At postoperative I week. there were sigruficant differences in the eye anterior segment inflammation between group A and group B , C (P =0. 03 ,0. 03) . At postoperative 3 months . IOL were clamped in 2 eyes of group A, and 2 eyes in group C ;10 eyes were in positive position in group A,11 eyes in group B and 2 eyes in group C;I eye was found deflection in group B and 8 eyes in group C. There was no significant difference between group A and B (P > 0. 05 ) , but there were sigruficant differences between group A and C ( P = 0. 03 , 0. 01 ) . At postoperative 3 months ,2 eyes developed posterior capsular opacification in group A and B , other eyes remained clear . there was no significant difference in posterior capsular opacification among three groups. Conclusion The three-piece Acrylic IOL is more suitable to posterior capsular optic capture,which has the positive effect on maintaining the positive position of IOL.