Wróblewska-Czajka Ewa, Wylegała Edward
Z Oddziatu Okulistyki Okregowego Szpitala Kolejowego Samodzielnego Publicznego Zakładu Opieki Zdrowotnej w Katowicach.
Klin Oczna. 2008;110(7-9):259-64.
Opacification of the posterior capsule remains the most frequent complication of cataract-intraocular lens surgery. Nd: YAG laser capsulotomy is actually the most common procedure performed to remove the posterior capsule opacification. YAG laser secondary posterior capsulotomy can be associated with significant complications. Possible problems include among others, corneal oedema. Our study has to determine whether the neodymium:yttrium-aluminium-garnet (Nd: YAG) capsulotomy performed in postoperative posterior capsule opacification, has an impact on corneal thickness measured by means of the optical coherence tomography.
55 patients (43 females and 12 males), who underwent Nd: YAG capsulotomy in posterior capsule opacification, were enrolled to the study. Mean age was 65.1 years (range 23-87). Patients were examined before and one day, week, month, three months and six months after Nd: YAG capsulotomy. Central corneal thickness was measured with use of OCT, anterior chamber depth with OCT, endothelial cell density was estimated with specular microscopy. Besides, slit lamp examination, including fundus examination, and intraocular pressure measurement were performed. Visual function was assessed in terms of best corrected distance visual acuity by means of EDTRS type charts. Median of the total laser power and single impact laser power and count of impacts were determined. In all cases medical history was taken and analyzed.
Statistically, significant changes of central corneal thickness at one day, week, month and three months after capsulotomy were observed. Highest relative percentage change at first day (1.9) was noted. Statistically significant correlation between central corneal thickness change and total laser power and single impact laser power was found in patients 1 month and 3 months after treatment.
(1) Only temporary central corneal thickness increase was observed as assessed by means of OCT. (2) Nd: YAG capsulotomy should be performed with the minimal possible energy delivered to the eye.
后囊膜混浊仍是白内障人工晶状体手术最常见的并发症。钕钇铝石榴石（Nd:YAG）激光囊膜切开术实际上是目前用于清除后囊膜混浊最常用的手术。YAG激光二期后囊膜切开术可能会引发严重并发症。其中可能出现的问题包括角膜水肿等。我们的研究旨在确定在术后后囊膜混浊时进行的钕钇铝石榴石（Nd:YAG）囊膜切开术，对通过光学相干断层扫描测量的角膜厚度是否有影响。
本研究纳入了55例（43例女性和12例男性）因后囊膜混浊接受Nd:YAG囊膜切开术的患者。平均年龄为65.1岁（范围23 - 87岁）。在Nd:YAG囊膜切开术前以及术后1天、1周、1个月、3个月和6个月对患者进行检查。使用光学相干断层扫描（OCT）测量中央角膜厚度，用OCT测量前房深度，通过镜面显微镜评估内皮细胞密度。此外，还进行了裂隙灯检查（包括眼底检查）和眼压测量。通过EDTRS型视力表，根据最佳矫正远视力评估视觉功能。确定了总激光能量、单次冲击激光能量的中位数以及冲击次数。所有病例均记录并分析了病史。
从统计学角度来看，观察到囊膜切开术后1天、1周、1个月和3个月时中央角膜厚度有显著变化。术后第1天观察到最高相对百分比变化（1.9）。在治疗后1个月和3个月的患者中，发现中央角膜厚度变化与总激光能量和单次冲击激光能量之间存在统计学显著相关性。
（1）通过光学相干断层扫描评估发现，仅观察到中央角膜厚度有短暂增加。（2）进行Nd:YAG囊膜切开术时应向眼内传递尽可能少的能量。
