Om Parkash Rohit, Mahajan Shruti, Biala Vinod, Om Parkash Tushya, Tasneem Alhaj F
Department of Cataract Surgery.
Department of Cataract and Refractive Surgery, Dr Om Parkash Eye Institute, Amritsar.
Clin Ophthalmol. 2017 Aug 8;11:1445-1451. doi: 10.2147/OPTH.S136532. eCollection 2017.
To describe various types of anterior capsular tears and an early diagnostic, flap motility, as a sign of posterior capsular rupture following posterior extension of radial tears.
This was a prospective study carried out in 4,331 eyes that underwent phacoemulsification in a private practice setting from April 2015 to February 2016. Twenty six consecutive cases of anterior capsular tears were included. Morphological features of anterior capsular tears and resultant complications were evaluated. Parameters studied were surgical step during which the tear occurred, shape of tear, its extension in relation to the equator, and flap nature and motility in tear extending up to equator.
The main outcome measures were motility and nature of flaps in anterior capsular radial tears and the relation to posterior capsule rupture.
Based on shape, extent, and angulation, anterior capsular tears were categorized into 5 types: Type I, pre-equatorial radial tear (26.92%); Type II, post-equatorial radial tear (3.85%); Type III, Argentinean flag sign pre-equatorial tear (57.69%); Type IV, Argentinean flag sign post-equatorial tear (7.69%), and Type V, mini punch (3.85%). Flaps were either seen to be everted and fluttering or inverted and non-fluttering. In all cases with everted fluttering flaps no posterior capsular rupture (PCR) was observed, while in cases with inverted non-fluttering flaps a PCR was observed (<0.05).
Everted and fluttering flaps of the anterior capsular tears indicate pre-equatorial tear, while inverted and non-fluttering flaps indicate posterior capsule rupture following tear extension beyond the equator.
描述各种类型的前囊撕裂以及一种早期诊断方法——瓣的活动度，作为放射状撕裂向后延伸导致后囊破裂的征象。
这是一项前瞻性研究，对2015年4月至2016年2月在私人诊所接受白内障超声乳化手术的4331只眼睛进行了研究。纳入了连续26例前囊撕裂病例。评估了前囊撕裂的形态特征及由此产生的并发症。研究的参数包括撕裂发生时的手术步骤、撕裂的形状、其相对于赤道的延伸情况，以及延伸至赤道的撕裂中瓣的性质和活动度。
主要观察指标是前囊放射状撕裂中瓣的活动度和性质以及与后囊破裂的关系。
根据形状、范围和角度，前囊撕裂分为5种类型：I型，赤道前放射状撕裂（26.92%）；II型，赤道后放射状撕裂（3.85%）；III型，赤道前阿根廷国旗征撕裂（57.69%）；IV型，赤道后阿根廷国旗征撕裂（7.69%），以及V型，微小穿孔（3.85%）。瓣要么外翻飘动，要么内翻不飘动。在所有外翻飘动瓣的病例中均未观察到后囊破裂（PCR），而在内翻不飘动瓣的病例中观察到了后囊破裂（P<0.05）。
前囊撕裂的外翻飘动瓣提示赤道前撕裂，而内翻不飘动瓣提示撕裂延伸至赤道后导致的后囊破裂。
