肝素表面修饰的亲水性丙烯酸酯人工晶状体在超声乳化联合小梁切除术中的应用

目的比较肝素表面修饰的亲水性丙烯酸酯人工晶状体和非肝素表面修饰的亲水性丙烯酸酯人工晶状体在晶状体超声乳化及人工晶状体植入联合小梁切除手术后的前房炎症反应。方法29例(29眼)施行晶状体超声乳化及后房型人工晶状体植入联合小梁切除手术者分为A组和B组:A组(15例)植入非肝素表面修饰的亲水性丙烯酸酯人工晶状体,B组(14例)植入肝素表面修饰的亲水性丙烯酸酯人工晶状体。于术后1d、7d、1月及3月随访观察。结果术后1d两组的房水闪光值和细胞计数均显著上升,术后7d下降明显,其后逐渐下降,术后3个月基本恢复至术前水平。两组间房水闪光值和细胞计数在术后1d和第7d差异有统计学意义(P<0.05),而术后第1月、3月两组间差异无统计学意义(P>0.05)。术后3个月,两组间最佳矫正视力及眼压的差异均无统计学意义(P>0.05)。结论肝素表面修饰的亲水性丙烯酸酯人工晶状体可改善人工晶状体的生物相容性,较非肝素表面修饰者更能减轻术后炎症反应,尤其有利于白内障联合青光眼术后早期阶段的视力康复。

The application of heparin surface modified hydrophilic acrylic intraocular lens in phacoemulsification combined with trabeculectomy

Objective To compare postoperative inflammatory reaction in anterior chamber between heparin surface modified (HSM) hydrophilic acrylic intraocular lens (IOLs) and non-HSM hydrophilic acrylic intraocular lens after phacoemulsification and intraocular lens implantation combined with trabeculectomy. Methods 29 patients (29 eyes) underwent phacoemulsification and posterior chamber intraocular lens implantation combined with trabeculectomy were divided into 2 groups, group A including 15 patients (15 eyes) and group B 14 patients (14 eyes). Group A were implanted with non-HSM hydrophilic acrylic intraocular lens, while group B implanted with heparin surface modified hydrophilic acrylic intraocular lens.Postoperative follow-up examinations took place at l d, 7 d, 1 m and 3 m.Primary efficacy assessments involved best corrected visual acuity, intraocular pressure, flare and cell values of anterior chamber. Results Flare and cell values of the two groups at 1 day postoperatively were both remarkably increased, rapidly decreased in the first week, and then decreased slowly to nearly normal values by 3 months. The difference of flare and cell values between the two groups were statistically significant at 1 day and 7 days (P<0.05),however there were no difference at 1 month and 3 month(P>0.05). At month 3, there was no statistically difference between the two groups in visual acuity or intraocular pressure. In both groups, all eyes had improved best corrected visual acuity compared to preoperatively and nopatients had complications such as malignant glaucoma,chorioidal detachment and posterior capsular opacity. Conclusions Heparin surface modified hydrophilic acrylic intraocular lens can improve the lens biocompatibility. It is more effective in reducing postoperative inflammation than non-HSM hydrophilic acrylic intraocular lens in phacoemulsification combined with trabeculectomy. It is beneficial for early postoperative vision recovery for those patients with cataract and glaucoma.