Gamidov A A, Averkina E A, Bolshunov A V, Fedorov A A
Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021.
Vestn Oftalmol. 2017;133(6):45-49. doi: 10.17116/oftalma2017133645-49.
Progressive metaplastic fibrosis of the anterior capsulorhexis opening is a frequent complication of the postoperative period. There is a widely practiced method of anterior capsular contraction syndrome (ACCS) correction through radial anterior laser capsulotomy. Despite many advantages, it can be complicated by unpredictable anterior capsule tearing and intraocular lens (IOL) dislocation into the vitreous Body, which justifies the search for new technical solutions.
to develop a safe technique of combined laser anterior capsulotomy (LAC) in patients with ACCS.
The study included 19 patients (20 eyes) with ACCS. The suggested LAC technique involved two differently directed YAG-laser cuts that could be regarded as a combination of radial anterior capsulotomy and anterior peripheral linear capsulotomy. With the cuts located perpendicularly to each other, the distal end of each radial cut was connected to the middle of each longitudinal cut.
The suggested technique allows an increase in the anterior capsulorhexis diameter up to more than twice the pre-laser size. The difference between the average pre- and post-laser capsulorhexis diameters was statistically significant (р<0.0001). Neither case developed an unpredictable anterior capsule tear.
The safety of the new technique is ensured by preliminary longitudinal cuts that create a barrier against unpredictable radial tears in the capsular bag during radial capsulotomy.
前囊撕开开口处的进行性化生纤维化是术后常见的并发症。有一种广泛应用的通过放射状前部激光囊切开术矫正前囊收缩综合征(ACCS)的方法。尽管有许多优点,但它可能会并发不可预测的前囊撕裂和人工晶状体(IOL)脱位至玻璃体,这使得人们寻求新的技术解决方案成为必要。
开发一种用于ACCS患者的联合激光前部囊切开术(LAC)的安全技术。
该研究纳入了19例(20只眼)ACCS患者。所建议的LAC技术包括两条不同方向的YAG激光切口,可视为放射状前部囊切开术和前部周边线性囊切开术的结合。两条切口相互垂直,每条放射状切口的远端与每条纵向切口的中部相连。
所建议的技术可使前囊撕开直径增加至激光术前大小的两倍以上。激光术前和术后前囊撕开直径的平均值差异具有统计学意义(р<0.0001)。无一例发生不可预测的前囊撕裂。
新技术的安全性通过预先进行的纵向切口得以确保,这些切口在放射状囊切开术期间为囊袋中不可预测的放射状撕裂形成了一道屏障。