Aslan Lokman, Aksoy Adnan, Aslankurt Murat, Ozdemir Murat
Ophthalmology Department, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaraş, Turkey.
Clin Ophthalmol. 2013;7:511-4. doi: 10.2147/OPTH.S42758. Epub 2013 Mar 9.
This study aimed to compare lens capsule-related problems in mature versus non-mature senile cataracts in patients undergoing phacoemulsification surgery.
A total of 295 patients with senile cataract were divided into two groups according to lens maturation: 105 patients with mature senile cataract comprised Group 1 (study group) and the remaining 190 with non-mature senile cataract comprised Group 2 (control group). Prior to surgery, ophthalmological examination was undertaken. Patients' best-corrected visual acuity and intraocular pressure were measured and a slit-lamp examination and funduscopy performed. All examination data were recorded and any capsule-related problems during surgery were also recorded. Patient files were reviewed retrospectively and compared between groups. Fisher's exact test was used in the statistical analysis.
In Group 1, the capsule-related problems found were: inability to complete capsulorhexis (seven eyes [6.6%]), posterior capsular perforation (three eyes [2.8%]), and conversion to extracapsular surgery (one eye [0.9%]). A posterior capsular perforation was seen in one eye (1%) in the control group. An intraocular lens was inserted into the sulcus in six eyes (5.7%) and one anterior chamber (0.9%) in Group 1 and into the sulcus in one eye (0.5%) of Group 2. The lens was inserted into the capsular bag in all other patients.
Delaying surgery in patients with cataracts creates a high risk for capsule-related surgical complications. Although capsule dyes make capsulorhexis easier, capsulorhexis is the most problematic phase of phacoemulsification in mature cataracts.
本研究旨在比较接受超声乳化手术的成熟与未成熟老年性白内障患者晶状体囊膜相关问题。
295例老年性白内障患者根据晶状体成熟度分为两组：105例成熟老年性白内障患者为第1组（研究组），其余190例未成熟老年性白内障患者为第2组（对照组）。手术前进行眼科检查。测量患者的最佳矫正视力和眼压，并进行裂隙灯检查和眼底检查。记录所有检查数据，同时记录手术期间任何与囊膜相关的问题。回顾性查阅患者病历并在组间进行比较。统计分析采用Fisher精确检验。
在第1组中，发现的与囊膜相关的问题有：无法完成连续环形撕囊（7只眼[6.6%]）、后囊膜穿孔（3只眼[2.8%]）以及转为囊外手术（1只眼[0.9%]）。对照组有1只眼（1%）出现后囊膜穿孔。第1组有6只眼（5.7%）和1只眼（0.9%）将人工晶状体植入睫状沟，第2组有1只眼（0.5%）将人工晶状体植入睫状沟。所有其他患者的人工晶状体均植入囊袋内。
白内障患者延迟手术会产生与囊膜相关的手术并发症的高风险。尽管囊膜染料使连续环形撕囊更容易，但连续环形撕囊是成熟白内障超声乳化手术中最具问题的阶段。
