Mootha V Vinod, Tesser Rachel, Qualls Clifford
Division of Ophthalmology, Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA.
J Cataract Refract Surg. 2004 Nov;30(11):2354-8. doi: 10.1016/j.jcrs.2004.03.038.
To evaluate the incidence of and determine the risk factors for residual posterior capsule opacification (PCO).
University of New Mexico Health Sciences Center and the Veterans Administration Medical Center, Albuquerque, New Mexico, USA.
This study evaluated 194 uneventful cataract surgeries. Immature cataracts were graded for nuclear sclerosis (NS), posterior subcapsular cataract (PSC), and anterior cortical spokes on a 1 to 4 scale. Preoperative Snellen best corrected visual acuity was converted to the logMAR scale. The posterior capsule was examined after polishing and was classified as clear or as having residual opacity. Those with residual capsule opacity were evaluated 6 weeks postoperatively for the presence of visually significant PCO.
The incidence of residual capsule opacity was 23% (44 eyes). Seven (54%) of 13 eyes with white mature cataract had residual capsule opacity. In contrast, 37 (20%) of 181 eyes with immature cataract had residual capsule opacity (P = .01). In eyes with immature cataract, the mean preoperative logMAR acuity was +1.14 +/- 0.60 (SD) in the residual capsule opacity group and +0.73 +/- 0.46 in the clear group (P<.001). In eyes with immature cataract, the adjusted odds ratio for each increasing grade of NS was 2.3 and of PSC, 1.8 (P = .002 and P<.001, respectively). Eleven percent (5 eyes) of residual capsule opacities resulted in visually significant PCO 6 weeks postoperatively. All 5 opacities were centrally located at surgery.
Results indicate that aggressive polishing of peripheral or adherent residual capsule opacities is not advisable as only 5 eyes with central residual capsule opacities developed visually significant PCO.
评估后囊膜混浊（PCO）残留的发生率并确定其危险因素。
美国新墨西哥州阿尔伯克基市新墨西哥大学健康科学中心和退伍军人管理局医疗中心。
本研究评估了194例无并发症的白内障手术。对未成熟白内障的核硬化（NS）、后囊下白内障（PSC）和前皮质辐轮状混浊按1至4级进行分级。术前Snellen最佳矫正视力转换为logMAR视力表。在抛光后检查后囊膜，并将其分类为清晰或有残留混浊。对有残留囊膜混浊的患者在术后6周评估是否存在具有视觉意义的PCO。
残留囊膜混浊的发生率为23%（44只眼）。13只白色成熟白内障眼中有7只（54%）存在残留囊膜混浊。相比之下，181只未成熟白内障眼中有37只（20%）存在残留囊膜混浊（P = 0.01）。在未成熟白内障眼中，残留囊膜混浊组术前平均logMAR视力为+1.14±0.60（标准差），清晰组为+0.73±0.46（P<0.001）。在未成熟白内障眼中，NS每增加一级的调整优势比为2.3，PSC每增加一级的调整优势比为1.8（分别为P = 0.002和P<0.001）。11%（5只眼）的残留囊膜混浊在术后6周导致具有视觉意义的PCO。所有5只眼的混浊在手术时均位于中央。
结果表明，对于周边或附着的残留囊膜混浊进行积极抛光并不可取，因为只有5只中央残留囊膜混浊的眼睛出现了具有视觉意义的PCO。
