Joshi Rajesh Subhash
Department of Ophthalmology, Vasatrao Naik Government Medical College, Yavatmal, India.
Clin Ophthalmol. 2013;7:1605-8. doi: 10.2147/OPTH.S49396. Epub 2013 Aug 8.
To find out the incidence of primary posterior capsular opacification (PCO) in rural patients with a hypermature senile cataract undergoing cataract surgery.
Tertiary eye care center in central India.
Prospective, observational, noncomparative study.
Two-hundred eyes of 200 patients presenting with a hypermature cataract underwent manual small incision cataract surgery. A single surgeon performed all surgeries under peribulbar anesthesia. After cortical clean-up, the capsular bag was inflated with viscoelastic. The presence or absence of opacity on the posterior lens capsule and location was noted. Postoperative follow-up was done for visual acuity and need for neodymium-doped yttrium aluminum garnet (ND:YAG) laser capsulotomy.
Primary PCO occurred in 76 eyes (incidence of 38%). It was peripheral in 58 eyes (76.3%) and central in 18 eyes (23.7%). At 6 weeks postoperatively, best corrected visual acuity for eyes with central primary PCO (n = 18) was 0.2-0.3 logMAR and 0-0.2 logMAR for eyes with peripheral primary PCO (n = 58). Best corrected visual acuity at the 6- and 12-month follow-up was 0-0.2 logMAR in both groups. Fibrotic primary PCO was seen in four patients. No predilection for the development of primary PCO to a particular quadrant of posterior capsule was observed. At 1 year postoperatively, eleven (14.5%) patients required ND:YAG laser capsulotomy, six (7.90%) of whom underwent ND:YAG laser capsulotomy at the 6-month follow-up. Seven patients with central primary PCO and four patients with peripheral primary PCO required ND:YAG laser capsulotomy.
A high incidence of primary PCO was noted in rural patients with a hypermature senile cataract undergoing cataract surgery. No serious intraoperative complications were noted. Visual outcome at 1-year follow-up was satisfactory. Need for early ND:YAG laser posterior capsulotomy should be explained to these patients before cataract surgery. No post ND:YAG capsulotomy complications were noted in any patient.
了解农村地区超熟期老年性白内障患者白内障手术后原发性后囊膜混浊（PCO）的发生率。
印度中部的三级眼科护理中心。
前瞻性、观察性、非对照研究。
200例患有超熟期白内障的患者的200只眼睛接受了手法小切口白内障手术。所有手术均由一名外科医生在球周麻醉下进行。清除皮质后，用粘弹剂充盈囊袋。记录晶状体后囊膜上有无混浊及位置。术后随访视力以及是否需要钕掺杂钇铝石榴石（ND:YAG）激光囊膜切开术。
原发性PCO发生在76只眼中（发生率为38%）。其中58只眼（76.3%）为周边型，18只眼（23.7%）为中央型。术后6周，中央型原发性PCO患者（n = 18）的最佳矫正视力为0.2 - 0.3 logMAR，周边型原发性PCO患者（n = 58）的最佳矫正视力为0 - 0.2 logMAR。在6个月和12个月随访时，两组的最佳矫正视力均为0 - 0.2 logMAR。4例患者出现纤维化原发性PCO。未观察到原发性PCO在晶状体后囊膜特定象限的发生偏好。术后1年，11例（14.5%）患者需要进行ND:YAG激光囊膜切开术，其中6例（7.90%）在6个月随访时接受了ND:YAG激光囊膜切开术。7例中央型原发性PCO患者和4例周边型原发性PCO患者需要进行ND:YAG激光囊膜切开术。
农村地区接受白内障手术的超熟期老年性白内障患者原发性PCO发生率较高。未观察到严重的术中并发症。1年随访时的视力结果令人满意。在白内障手术前应向这些患者解释早期进行ND:YAG激光后囊膜切开术的必要性。未观察到任何患者发生ND:YAG激光囊膜切开术后并发症。
