Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea.
Ophthalmology. 2010 Dec;117(12):2278-86. doi: 10.1016/j.ophtha.2010.03.053. Epub 2010 Jun 18.
To evaluate the amount of intraocular lens (IOL) decentration and refractive changes after cataract surgery using posterior continuous curvilinear capsulorrhexis (PCCC).
Prospective comparative case series.
We included 86 eyes of 77 patients who had cataract surgery using PCCC (the PCCC group), and 79 eyes of 68 patients treated without PCCC (the control group).
Foldable IOLs with polymethylmethacrylate haptics (VA-60BB, Hoya Corporation, Tokyo, Japan) were implanted in both groups. The best-corrected visual acuity (BCVA) was assessed. Automated refractokeratometry, Scheimpflug imaging (Pentacam; Oculus, Wetzlar, Germany), and slit-lamp photography with retroillumination were performed at each follow-up visit over 6 months. The axial shift of each IOL was measured as the distance between the corneal endothelium and the anterior surface of the IOL on Scheimpflug images. The horizontal shift was assessed as the distance between the geometric center of the IOL and the centers of the pupil and the limbus.
Best-corrected visual acuity, horizontal and axial shift of the IOL, and automated refraction.
There was no difference between the 2 groups in the mean BCVA before surgery and at any postoperative follow-up. The mean horizontal shift of the IOL after 6 months was 0.25 ± 0.14 mm for the pupil and 0.31 ± 0.17 mm for the limbus in the PCCC group (P = 0.315), and 0.26 ± 0.09 mm and 0.31 ± 0.13 mm, respectively, in the control group (P = 0.115). These were not different from the measurement on the postoperative day 1 (P = 0.515, P = 0.263, P = 0.421, and P = 0.875, respectively). At each follow-up visit over 6 months, there was no difference in the horizontal shift between the 2 groups (P > 0.05). The IOL shifted insignificantly in the PCCC group (-0.08 ± 0.24 mm anterior shift), but the shift was significant in the control group (-0.42 ± 0.27 mm anterior shift; P = 0.009). The mean postoperative refractive shift 6 months after surgery compared with refraction on the first day after surgery was -0.16 ± 0.67 diopter (D) in the PCCC group and -0.60 ± 0.70 D in the control group (P = 0.042).
During cataract surgery, PCCC is useful to stabilize and minimize postoperative refractive changes. The IOL displacement attributable to capsular contraction is less when cataract surgery involves PCCC.
评估后房型连续环形撕囊（PCCC）在白内障手术后眼内人工晶状体（IOL）偏心和屈光变化的程度。
前瞻性对照病例系列。
我们纳入了 86 只眼（77 例患者）接受 PCCC 白内障手术（PCCC 组），以及 79 只眼（68 例患者）未行 PCCC 治疗（对照组）。
两组均植入聚甲基丙烯酸甲酯襻的折叠式 IOL（VA-60BB，HOYA 公司，东京，日本）。评估最佳矫正视力（BCVA）。在术后 6 个月的每次随访中，使用自动屈光角膜计、Scheimpflug 成像（Pentacam；Oculus，威茨拉尔，德国）和带有后照照明的裂隙灯照相进行检查。在 Scheimpflug 图像上，通过测量角膜内皮和 IOL 前表面之间的距离来测量每个 IOL 的轴向移位。水平移位评估为 IOL 几何中心与瞳孔和角膜缘中心之间的距离。
BCVA、IOL 的水平和轴向移位以及自动折射。
两组患者术前和术后任何时间点的平均 BCVA 均无差异。PCCC 组术后 6 个月时瞳孔的平均 IOL 水平移位为 0.25 ± 0.14mm，角膜缘为 0.31 ± 0.17mm（P = 0.315），对照组分别为 0.26 ± 0.09mm 和 0.31 ± 0.13mm（P = 0.115）。与术后第 1 天相比，这些差异无统计学意义（P = 0.515，P = 0.263，P = 0.421 和 P = 0.875）。在术后 6 个月的每次随访中，两组之间的水平移位均无差异（P > 0.05）。在 PCCC 组，IOL 仅轻微向前移位（-0.08 ± 0.24mm），而对照组明显向前移位（-0.42 ± 0.27mm；P = 0.009）。与术后第 1 天的折射相比，术后 6 个月的平均术后折射移位在 PCCC 组为-0.16 ± 0.67 屈光度（D），在对照组为-0.60 ± 0.70D（P = 0.042）。
在白内障手术中，PCCC 有助于稳定和最小化术后屈光变化。当白内障手术涉及 PCCC 时，IOL 移位是由囊袋收缩引起的，这种移位更小。
