Gimbel H V, Van Westenbrugge J A, Sanders D R, Raanan M G
Gimbel Eye Centre, Calgary, Alberta, Canada.
Arch Ophthalmol. 1990 Aug;108(8):1126-9. doi: 10.1001/archopht.1990.01070100082039.
Neodymium-YAG capsulotomy for secondary cataracts can induce acute intraocular pressure rises, possibly by a blocking of the trabecular meshwork by debris. To test a hypothesis that bag-fixated intraocular lenses may act as a barrier to debris, thus reducing pressure rises after YAG capsulotomy, we conducted a study comparing pressures (at 1, 2, 3, 6, and 24 hours after YAG capsulotomy) between bag-fixated and sulcus-fixated cases. There were substantial and statistically significant intraocular pressure rises in the sulcus-fixated group starting at 1 and 2 hours after YAG capsulotomy, and peaking at 3 hours (mean rise, 7.83 mm Hg). There were no such peaks of intraocular pressure rise among bag-fixated cases (mean change, -0.32 mm Hg at 3 hours). There was a weak but significant (r = -.18) correlation between the change 1 hour after YAG capsulotomy in intraocular pressure and percent of enclosure of the intraocular lens optic among bag-fixated cases. Higher proportions (fourfold to fivefold) of cases with sulcus-fixated lenses had significant flare and particulate matter in the anterior chamber, compared with bag-fixated cases.
钕钇铝石榴石激光晶状体后囊切开术治疗继发性白内障可导致急性眼压升高，可能是由于碎屑阻塞小梁网所致。为了验证一个假设，即囊袋固定型人工晶状体可能作为碎屑的屏障，从而降低钕钇铝石榴石激光晶状体后囊切开术后的眼压升高，我们进行了一项研究，比较了囊袋固定型和睫状沟固定型病例在钕钇铝石榴石激光晶状体后囊切开术后1、2、3、6和24小时的眼压。睫状沟固定型组在钕钇铝石榴石激光晶状体后囊切开术后1小时和2小时开始出现显著且具有统计学意义的眼压升高，并在3小时达到峰值（平均升高7.83 mmHg）。囊袋固定型病例中没有出现这样的眼压升高峰值（3小时时平均变化为-0.32 mmHg）。在囊袋固定型病例中，钕钇铝石榴石激光晶状体后囊切开术后1小时眼压变化与人工晶状体光学部的包封率之间存在微弱但显著（r = -0.18）的相关性。与囊袋固定型病例相比，睫状沟固定型人工晶状体病例在前房出现明显闪光和颗粒物质的比例更高（四倍至五倍）。
