Auffarth Gerd U, Brezin Antoine, Caporossi Aldo, Lafuma Antoine, Mendicute Javier, Berdeaux Gilles, Smith Andrew F
Department of Ophthalmology Ruprecht-Karls-University Heidelberg Germany.
Ophthalmic Epidemiol. 2004 Oct;11(4):319-29. doi: 10.1080/09286580490515116.
The aim of this study was to compare the incidence of Nd : YAG laser capsulotomy after cataract surgery according to the type of intra-ocular lens material (PMMA, silicone, hydrophilic acrylic, hydrophobic acrylic) implanted in four European countries (France, Italy, Germany, Spain).
A retrospective record review.
A review of 1525 patients (first operated eye), aged 50 to 80 years, operated on for cataract in 1996 or 1997 in 16 surgical centers (4 per country).
The study employed a retrospective cohort design. Charts were reviewed to collect information during at least a three-year period following cataract surgery to identify patients who underwent Nd : YAG laser capsulotomy postoperatively.
Data on the type of intra-ocular lens implanted was extracted from the patient notes, as was the date and outcome of the Nd : YAG laser intervention. Kaplan-Meier survival curve analysis with the time to Nd : YAG laser was performed on the data. RESULTS A total of 1525 patients (first operated eye) were available for the study (n = 294 for hydrophilic acrylic, n = 384 for PMMA, n = 421 for hydrophobic acrylic, n = 426 for silicone). There was a highly statistically significant difference between the IOL groups for the incidence of posterior capsule opacification (p < 0.001) and for Nd : YAG laser treatment (p < 0.001). The mean delay of Nd : YAG laser treatment from the date of cataract operation was 2.48 years (+/-1.70, ranging from 0 to 5.88 years). The rate of Nd : YAG laser capsulotomy over the follow-up period was lowest in the hydrophobic acrylic group (7.1%), followed by silicone (16.2%), PMMA (19.3%) and hydrophilic acrylic (31.1%), respectively.
A low incidence of posterior capsular opacification (PCO) and Nd : YAG laser treatment was detected in hydrophobic acrylic IOLs in comparison to three other types of IOLs implanted in a large cohort of persons with age-related cataract. Choice of IOL type may reduce the need for Nd : YAG laser treatment, although further research on the reasons for this is needed.
本研究旨在比较在四个欧洲国家（法国、意大利、德国、西班牙）植入不同类型人工晶状体材料（聚甲基丙烯酸甲酯、硅胶、亲水性丙烯酸酯、疏水性丙烯酸酯）后白内障手术中钕：钇铝石榴石激光晶状体囊切开术的发生率。
一项回顾性记录审查。
对1996年或1997年在16个手术中心（每个国家4个）接受白内障手术的1525例患者（首次手术眼）进行审查，患者年龄在50至80岁之间。
本研究采用回顾性队列设计。查阅病历以收集白内障手术后至少三年期间的信息，以确定术后接受钕：钇铝石榴石激光晶状体囊切开术的患者。
从患者病历中提取植入人工晶状体的类型数据以及钕：钇铝石榴石激光干预的日期和结果。对数据进行钕：钇铝石榴石激光治疗时间的Kaplan-Meier生存曲线分析。结果共有1525例患者（首次手术眼）可供研究（亲水性丙烯酸酯组294例，聚甲基丙烯酸甲酯组384例，疏水性丙烯酸酯组421例，硅胶组426例）。人工晶状体组在后囊膜混浊发生率（p<0.001）和钕：钇铝石榴石激光治疗（p<0.001）方面存在高度统计学显著差异。从白内障手术日期到钕：钇铝石榴石激光治疗的平均延迟时间为2.48年（±1.70，范围为0至5.88年）。随访期间钕：钇铝石榴石激光晶状体囊切开术的发生率在疏水性丙烯酸酯组最低（7.1%），其次是硅胶组（16.2%）、聚甲基丙烯酸甲酯组（19.3%）和亲水性丙烯酸酯组（31.1%）。
与一大群年龄相关性白内障患者植入的其他三种类型人工晶状体相比，疏水性丙烯酸酯人工晶状体后囊膜混浊（PCO）和钕：钇铝石榴石激光治疗的发生率较低。人工晶状体类型的选择可能会减少钕：钇铝石榴石激光治疗的需求，尽管对此原因还需要进一步研究。
