Raina Usha K, Gupta Vinita, Arora Ritu, Mehta D K
Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.
J Pediatr Ophthalmol Strabismus. 2002 Sep-Oct;39(5):278-87. doi: 10.3928/0191-3913-20020901-08.
To evaluate the efficacy of posterior continuous curvilinear capsulorhexis (PCCC) with optic capture of the posterior chamber intraocular lens (PC IOL) in the absence of vitrectomy in preventing secondary opacification of the visual axis following pediatric cataract surgery.
Thirty-four eyes of 28 children with congenital or developmental cataract, aged 1.5 to 12 years (mean, 6.39 years), were included in this prospective, randomized study. Anterior continuous curvilinear capsulorhexis (ACCC) with PCCC without optic capture of the PC IOL was performed in group A (18 eyes) and ACCC with PCCC with optic capture of the PC IOL was performed in group B (16 eyes). None of the eyes underwent anterior vitrectomy. Secondary opacification of the visual axis, visual acuity, and possible complications were observed and analyzed.
The follow-up period ranged from 8 to 28 months (mean, 17.5 months). All 16 eyes (100%) in group B had a clear visual axis at the end of follow-up. Eight eyes (44.4%) in group A had significant opacification of the visual axis. The difference between the two groups was statistically significant (P = .0011). No eye in group B required secondary intervention, whereas all 8 eyes in group A with significant secondary opacification required secondary intervention. There was no statistically significant difference in other complications such as anterior chamber reaction, fibrin formation, lenticular precipitates, and posterior synechiae. The final best-corrected visual acuity at the end of follow-up was comparable in the two groups (P > .05).
PCCC with optic capture of the PC IOL prevents secondary opacification of the visual axis even in the absence of vitrectomy.
评估在不进行玻璃体切割术的情况下,采用后囊连续环形撕囊(PCCC)并光学捕获后房型人工晶状体(PC IOL)预防小儿白内障手术后视轴继发性混浊的疗效。
本前瞻性随机研究纳入了28例患有先天性或发育性白内障的儿童的34只眼,年龄为1.5至12岁(平均6.39岁)。A组(18只眼)进行了前囊连续环形撕囊(ACCC)及PCCC,但未光学捕获PC IOL;B组(16只眼)进行了ACCC及PCCC并光学捕获PC IOL。所有眼睛均未行前部玻璃体切割术。观察并分析视轴继发性混浊、视力及可能的并发症。
随访期为8至28个月(平均17.5个月)。随访结束时,B组所有16只眼(100%)视轴清晰。A组8只眼(44.4%)视轴有明显混浊。两组之间差异有统计学意义(P = .0011)。B组无眼需要二次干预,而A组所有8只视轴有明显继发性混浊的眼均需要二次干预。在前房反应、纤维蛋白形成、晶状体沉着物及虹膜后粘连等其他并发症方面,两组差异无统计学意义。随访结束时两组最终最佳矫正视力相当(P > .05)。
即使不进行玻璃体切割术,采用PCCC并光学捕获PC IOL也可预防视轴继发性混浊。