Iladevi Cataract and IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India.
Eye (Lond). 2009 Aug;23(8):1702-6. doi: 10.1038/eye.2008.355. Epub 2008 Dec 12.
To evaluate the effect of anterior capsule polishing on the development of anterior capsule opacification (ACO) in patients undergoing cataract surgery.
This prospective randomized observational double-masked clinical trial comprised 120 eyes of 60 consecutive patients with bilateral age-related cataract who underwent phacoemulsification. The patients were randomly assigned to one of the two groups: One eye received a 360 degree anterior capsule polishing (group 1 (cases)) and the fellow eye was without anterior capsule polishing (group 2 (controls)) The primary observation was to observe the development of ACO between the 2 groups, whereas the secondary observation was to measure uveal inflammation. ACO was evaluated at 1 week, 1 month, and 6 months.
At the 1-week follow-up, there was no significant difference in the development of ACO between the two groups. At 1 month, 54 (90%) eyes developed ACO in controls and 26 (43.3%) eyes in cases (P<0.001). However, at 6 months, there was no significant difference in the development of ACO between controls and cases (P=0.500). The odds of having cells and flare were significantly more in cases compared with controls at first postoperative day (cells: OR, 39.27; 95% CI, 13.49-114.26 and flare: OR, 48.0; 95% CI, 15.57-147.97).
ACO was significantly lower at 1 month in cases compared with controls. However, the difference in ACO between the two groups was insignificant at 6 months. A significant difference in anterior segment inflammation was documented in cases on the first postoperative day. There was no detectable benefit of performing scraping on the anterior capsule to avoid opacification after phacoemulsification.E
评估白内障手术后前囊抛光对前囊混浊（ACO）发展的影响。
本前瞻性随机观察性双盲临床试验纳入了 60 例连续双侧年龄相关性白内障患者的 120 只眼，这些患者均接受了超声乳化白内障吸除术。患者被随机分为两组：一组眼接受 360 度前囊抛光（病例组 1（病例）），另一眼未行前囊抛光（对照组 2（对照））。主要观察指标为两组间 ACO 的发展情况，次要观察指标为测量葡萄膜炎症。ACO 在术后 1 周、1 个月和 6 个月进行评估。
在术后 1 周时，两组间 ACO 的发展无显著差异。在术后 1 个月时，对照组 54 只（90%）眼发生 ACO，而病例组 26 只（43.3%）眼发生 ACO（P<0.001）。然而，在术后 6 个月时，对照组和病例组间 ACO 的发展无显著差异（P=0.500）。与对照组相比，病例组在术后第 1 天细胞和炎症反应的发生率明显更高（细胞：OR，39.27；95%CI，13.49-114.26 和炎症反应：OR，48.0；95%CI，15.57-147.97）。
与对照组相比，病例组在术后 1 个月时 ACO 明显更低。然而，两组间 ACO 的差异在术后 6 个月时并不显著。病例组在术后第 1 天的前节炎症有显著差异。在超声乳化白内障吸除术后进行前囊刮除以避免混浊，并没有发现明显的获益。
