Hayashi Ken, Yoshida Motoaki, Nakao Fuminori, Hayashi Hideyuki
Hayashi Eye Hospital, 4-23-35 Hakataeki-mae, Hakata-Ku, Fukuoka, Japan.
Am J Ophthalmol. 2008 Jul;146(1):23-30. doi: 10.1016/j.ajo.2008.02.015. Epub 2008 Apr 11.
To examine the effect of two or three neodymium:yttrium-aluminum-garnet (Nd:YAG) laser relaxing incisions made in the anterior capsular rim on prevention of anterior capsule contraction after cataract surgery.
Randomized clinical trials.
One hundred patients scheduled for bilateral cataract surgery were randomized to one of two groups: two or three relaxing incisions in the left eye and no incisions in the right eye, and relaxing incisions in the right eye and no incisions in the left eye. The anterior capsule opening area was measured using Scheimpflug photography immediately after capsulotomy and at one, three, and six months after capsulotomy, and the percentage reduction was calculated. The degree of intraocular lens (IOL) decentration and tilt and of posterior capsule opacification (PCO) also were examined.
There was no significant difference in the anterior capsule opening area between fellow eyes at baseline (P > or = .1770). In patients who underwent two incisions, no significant difference was found between fellow eyes in the opening area (P > or = .4098) or in the percentage of reduction (P > or = .8730) throughout follow-up. In patients who underwent three incisions, the opening area in eyes with capsulotomy was significantly greater than that in eyes without capsulotomy (P < or = .0154), and the percentage reduction was significantly smaller in eyes with capsulotomy than in eyes without capsulotomy (P < or = .0016). No significant differences were found in the IOL decentration and tilt, or in PCO.
Three relaxing incisions made in the anterior capsule decrease the anterior capsule contraction, whereas two incisions do not.
探讨在白内障手术中,在前囊边缘制作两或三个钕:钇铝石榴石(Nd:YAG)激光松解切口对预防前囊收缩的效果。
随机临床试验。
计划行双侧白内障手术的100例患者被随机分为两组:左眼制作两或三个松解切口,右眼不做切口;右眼制作松解切口,左眼不做切口。在囊切开术后即刻以及囊切开术后1个月、3个月和6个月,使用Scheimpflug摄影测量前囊开口面积,并计算面积减少的百分比。还检查了人工晶状体(IOL)的偏心和倾斜程度以及后囊混浊(PCO)情况。
基线时,两眼的前囊开口面积无显著差异(P≥0.1770)。在制作两个切口的患者中,整个随访期间,两眼的开口面积(P≥0.4098)或面积减少百分比(P≥0.8730)均无显著差异。在制作三个切口的患者中,行囊切开术的眼的开口面积显著大于未行囊切开术的眼(P≤0.0154),且行囊切开术的眼的面积减少百分比显著小于未行囊切开术的眼(P≤0.0016)。IOL的偏心和倾斜以及PCO方面均未发现显著差异。
在前囊制作三个松解切口可减少前囊收缩,而两个切口则不能。