Joshi Rajesh Subhash
Nepal J Ophthalmol. 2017 Jul;9(18):149-155. doi: 10.3126/nepjoph.v9i2.19259.
Preexisting posterior capsular opacification is commonly seen in the developing world due to late presentation of patients for cataract surgery. Patients are implanted with either hydrophilic or hydrophobic IOL. Effect of these IOLs on pre-existing posterior capsular opacification has not yet been reported.
To determine the incidence of peripheral preexisting posterior capsular opacity (PPPCO) in patients undergoing cataract surgery and the rate of posterior capsular opacification (PCO) following implantation of hydrophilic and hydrophobic intraocular lens (IOLs).
Prospective, observational case study Setting: Tertiary eye care center in central India.
1400 consecutive patients undergoing phacoemulsification of senile cataract between July 2009 and June 2010 discovered to have PPPCO were included in the analysis. Patients were either implanted with hydrophilic (n= 40) or hydrophobic IOL (n=40). Images of the posterior capsule immediately and 3-years postoperatively were compared. Patients were followed up for development of PCO, visual outcome at 3 years and neodymium: YAG laser posterior capsulotomy (NYLPC) rate.
Eighty patients were found to have PPPCO (incidence of 5.7%). 47.5% of PPPCOs were from mature senile cataracts (n = 38), 36.2% were from posterior subcapsular cataracts (n = 29) and 16.2% were from posterior polar cataracts (n = 13). NYLPC was performed in 9 patients receiving hydrophilic (22.5%) and 3 patients receiving hydrophobic IOLs (7.5%; p = 0.12). Average time to NYLPC was 18 months in the hydrophilic and 30 months in the hydrophobic group (p = 0.002). Visual outcome was satisfactory at 3-years of follow-up.
PPPCO is a frequent occurrence in mature cataract and there is a higher incidence of PCO in PPPCO patients implanted with hydrophilic IOL than with hydrophobic IOL. Therefore, hydrophobic IOL should be considered for patients discovered to have PPPCO during cataract removal.
由于患者白内障手术就诊较晚，在发展中国家，先前存在的后囊膜混浊较为常见。患者植入亲水性或疏水性人工晶状体。这些人工晶状体对先前存在的后囊膜混浊的影响尚未见报道。
确定白内障手术患者中周边先前存在的后囊膜混浊（PPPCO）的发生率以及植入亲水性和疏水性人工晶状体（IOL）后后囊膜混浊（PCO）的发生率。
前瞻性观察性病例研究
印度中部的三级眼科护理中心。
对2009年7月至2010年6月间连续1400例接受老年性白内障超声乳化手术且发现有PPPCO的患者进行分析。患者分别植入亲水性人工晶状体（n = 40）或疏水性人工晶状体（n = 40）。比较术后即刻及3年后后囊膜的图像。随访患者PCO的发生情况、3年时的视力结果及钕：钇铝石榴石激光后囊膜切开术（NYLPC）的发生率。
80例患者存在PPPCO（发生率为5.7%）。47.5%的PPPCO来自成熟老年性白内障（n = 38），36.2%来自后囊下白内障（n = 29），16.2%来自后极性白内障（n = 13）。9例接受亲水性人工晶状体的患者（22.5%）和3例接受疏水性人工晶状体的患者（7.5%；p = 0.12）接受了NYLPC。亲水性人工晶状体组NYLPC的平均时间为18个月，疏水性人工晶状体组为30个月（p = 0.002）。随访3年时视力结果令人满意。
PPPCO在成熟白内障中较为常见，植入亲水性人工晶状体的PPPCO患者发生PCO的发生率高于植入疏水性人工晶状体的患者。因此，对于白内障摘除术中发现有PPPCO的患者，应考虑植入疏水性人工晶状体。
