Yaguchi Saori, Yaguchi Shigeo, Yagi-Yaguchi Yukari, Kozawa Tadahiko, Bissen-Miyajima Hiroko
Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.
Kozawa Eye Hospital and Diabetes Center, Mito, Japan.
PLoS One. 2017 Apr 20;12(4):e0176169. doi: 10.1371/journal.pone.0176169. eCollection 2017.
To quantify zonular weakness based on lens movement at the start of continuous curvilinear capsulorhexis (CCC) and establish a classification system for it.
Kozawa Eye Hospital and Diabetes Center, Mito, Japan.
Retrospective interventional case series.
We examined 402 consecutive eyes of 316 patients who underwent CCC, phacoemulsification and aspiration (PEA), and intraocular lens (IOL) implantation. The movement of the lens capsule was measured using images from video recordings of the CCC procedure. Zonular weakness was classified based on the shifted distance: Grade I, less than 0.20 mm; Grade II, 0.20-0.39 mm; and Grade III, greater than 0.40 mm. For each of these grades, we examined the use of the capsule stabilization device during PEA, the surgical procedure for lens removal, and IOL fixation.
We classified 276 eyes (68.6%) as Grade I, 102 eyes (25.4%) as Grade II, and 24 eyes (6.0%) as Grade III. As the grade increased, the use of the capsule stabilization device in PEA and scleral suture fixation of IOL increased.
Zonular weakness was quantified by measuring the movement of the lens capsule. An objective classification of zonular weakness based on lens movement may be useful for selecting the appropriate device and procedure during cataract surgery.
基于连续环形撕囊（CCC）开始时晶状体的移动来量化悬韧带薄弱程度，并建立相关分类系统。
日本水户小泽眼科医院及糖尿病中心。
回顾性干预性病例系列研究。
我们检查了316例接受CCC、超声乳化吸除术（PEA）及人工晶状体（IOL）植入术患者的402只连续眼。使用CCC手术视频记录中的图像测量晶状体囊膜的移动。根据移位距离对悬韧带薄弱程度进行分类：I级，小于0.20毫米；II级，0.20 - 0.39毫米；III级，大于0.40毫米。对于每个级别，我们检查了PEA期间囊膜稳定装置的使用情况、晶状体摘除的手术过程以及IOL固定情况。
我们将276只眼（68.6%）分类为I级，102只眼（25.4%）分类为II级，24只眼（6.0%）分类为III级。随着级别增加，PEA中囊膜稳定装置的使用以及IOL的巩膜缝线固定增加。
通过测量晶状体囊膜的移动来量化悬韧带薄弱程度。基于晶状体移动对悬韧带薄弱程度进行客观分类可能有助于在白内障手术中选择合适的装置和手术方法。
