Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, MD 21287-9277, USA.
Eye (Lond). 2012 Nov;26(11):1459-64. doi: 10.1038/eye.2012.193. Epub 2012 Sep 28.
To compare the development of posterior capsule opacification (PCO) for idiopathic epi-retinal membrane cases between 20- and 23-gauge phacovitrectomy.
Cataract surgery of phacoemulsification with the SA60AT implantation and 20- or 23-gauge vitrectomy was performed for 20 patients in both groups. Cataract surgery alone was performed for 50 patients as the control. The PCO density values were measured using Scheimpflug video photography at 1 week, 1, 3, 6, 12, 18, and 24 months after surgery. The number of eyes that required Nd:YAG laser capsulotomy was also examined.
The mean PCO value in the 20-gauge phacovitrectomy group increased significantly with time (P<0.001), whereas those in the 23-gauge phacovitrectomy group and the cataract surgery group did not show any significant change. Furthermore, the PCO value in the 20-gauge phacovitrectomy group was significantly greater than that in the 23-gauge phacovitrectomy group at 6, 12, 18 (P<0.05), and 24 months (P<0.01) after surgery. The PCO value in the 23-gauge phacovitrectomy group was significantly greater than that in the cataract surgery group 24 months after surgery (P<0.05). The rate of capsulotomy in the 20-gauge phacovitrectomy group was significantly higher than that in the cataract surgery group (P=0.007), whereas there was no significant difference between the 23-gauge phacovitrectomy group and the cataract surgery group.
PCO rate in eyes with the 23-gauge phacovitrectomy was lower than in those with the 20-gauge phacovitrectomy, and PCO rate even in the 23-gauge phacovitrectomy was higher than in those with cataract surgery.
比较 20 号和 23 号针头经巩膜睫状体光凝切割术治疗特发性眼内膜视网膜前膜后后囊膜混浊(PCO)的发展情况。
对 20 例特发性眼内膜视网膜前膜患者分别采用 20 号和 23 号针头经巩膜睫状体光凝切割术联合超声乳化白内障吸除术(phacoemulsification with the SA60AT implantation)治疗,同期 50 例患者单纯行超声乳化白内障吸除术作为对照。术后 1 周、1、3、6、12、18 和 24 个月,采用 Scheimpflug 视频照相术测量 PCO 密度值。同时观察需要行 Nd:YAG 激光后囊膜切开术的眼数。
20 号针头经巩膜睫状体光凝切割术组的平均 PCO 值随时间推移显著增加(P<0.001),而 23 号针头经巩膜睫状体光凝切割术组和单纯超声乳化白内障吸除术组的 PCO 值无显著变化。此外,术后 6、12、18(P<0.05)和 24 个月(P<0.01),20 号针头经巩膜睫状体光凝切割术组的 PCO 值显著大于 23 号针头经巩膜睫状体光凝切割术组,术后 24 个月,23 号针头经巩膜睫状体光凝切割术组的 PCO 值显著大于单纯超声乳化白内障吸除术组(P<0.05)。20 号针头经巩膜睫状体光凝切割术组的后囊膜切开术率显著高于单纯超声乳化白内障吸除术组(P=0.007),而 23 号针头经巩膜睫状体光凝切割术组与单纯超声乳化白内障吸除术组之间无显著差异。
与 20 号针头经巩膜睫状体光凝切割术相比,23 号针头经巩膜睫状体光凝切割术的 PCO 发生率较低,即使是 23 号针头经巩膜睫状体光凝切割术,其 PCO 发生率也高于单纯超声乳化白内障吸除术。