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“倒U法”钕:钇铝石榴石激光后囊切开术对白内障玻璃体切除术后患者眼前节参数、人工晶状体偏心和倾斜的影响。

Influence of the "Inverted U Method" Nd: YAG Laser Posterior Capsulotomy on Anterior Segment Parameters, Decentration and Tilt of Intraocular Lens in Patients after Phaco-vitrectomy.

作者信息

Lu Bo, Xu Haoyan, Wang Chunxia, Yan Qichang, Wang Xinling

机构信息

Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, Liaoning Province China.

出版信息

Semin Ophthalmol. 2021 Apr 3;36(3):88-93. doi: 10.1080/08820538.2021.1884267. Epub 2021 Mar 18.

Abstract

PURPOSE

To investigate the effects of the "inverted U method" Nd:YAG laser posterior capsulotomy on anterior segment parameters, decentration and tilt of intraocular lens (IOLs) and visual acuity in posterior capsular opacification (PCO) patients after combined phaco-vitrectomy.

METHODS

Seventy-six patients (76 eyes) were enrolled in this study, who were diagnosed as PCO and underwent "inverted U method" Nd:YAG laser posterior capsulotomy. All patients had undergone previous combined phaco-vitrectomy for rhegmatogenous retinal detachment. The parameters including IOL decentration, angle of IOL tilt, anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber volume (ACV), central corneal thickness (CCT), keratometry, pupil size, axial length (AL), intraocular pressure (IOP), refractive status, corrected distance visual acuity (CDVA), objective scattering index (OSI) and Chinese version of Visual Function 14 (VF-14) index were obtained before and 3 months after capsulotomy.

RESULTS

After capsulotomy, the tilt angle and decentration of the IOLs at both vertical (tilt: = .004, decentration: = .029) and horizontal meridian (tilt: = .001, decentration: = .017) were significantly decreased, ACA increased ( = .015), CDVA (.000), VF-14 score (.000) and OSI ( = .000) were significantly improved. There were a significant decrease in cylindrical error ( = .001) and a myopic shift in spherical error ( = .001) after the capsulotomy. No significant differences in ACD, ACV, CCT, keratometry, pupil size, AL and IOP were detected ( > .05 for all).

CONCLUSION

The "inverted U method" Nd: YAG laser posterior capsulotomy decreases tilt and decentration of the IOL, increases ACA and causes no change in ACD, ACV, CCT and IOP in patients after phaco-vitrectomy. These changes make a decrease in cylindrical error and a myopic shift in spherical error. Laser capsulotomy significantly improves visual acuity.

摘要

目的

探讨“倒U形法”钕:钇铝石榴石激光后囊切开术对白内障超声乳化联合玻璃体切除术后后囊膜混浊(PCO)患者眼前节参数、人工晶状体(IOL)偏心和倾斜以及视力的影响。

方法

本研究纳入76例(76只眼)诊断为PCO并接受“倒U形法”钕:钇铝石榴石激光后囊切开术的患者。所有患者此前均因孔源性视网膜脱离接受过白内障超声乳化联合玻璃体切除术。在囊切开术前及术后3个月获取以下参数:IOL偏心度、IOL倾斜角度、前房角(ACA)、前房深度(ACD)、前房容积(ACV)、中央角膜厚度(CCT)、角膜曲率、瞳孔大小、眼轴长度(AL)、眼压(IOP)、屈光状态、矫正远视力(CDVA)、客观散射指数(OSI)以及中文版视觉功能14(VF-14)指数。

结果

囊切开术后,IOL在垂直子午线(倾斜:=0.004,偏心:=0.029)和水平子午线(倾斜:=0.001,偏心:=0.017)的倾斜角度和偏心度均显著降低,ACA增大(=0.015),CDVA(=0.000)、VF-14评分(=0.000)和OSI(=0.000)显著改善。囊切开术后柱镜误差显著降低(=0.001),球镜误差出现近视性偏移(=0.001)。未检测到ACD、ACV、CCT、角膜曲率、瞳孔大小、AL和IOP有显著差异(所有均>0.05)。

结论

“倒U形法”钕:钇铝石榴石激光后囊切开术可降低白内障超声乳化联合玻璃体切除术后患者IOL的倾斜和偏心度,增大ACA,且ACD、ACV、CCT和IOP无变化。这些变化使柱镜误差降低,球镜误差出现近视性偏移。激光囊切开术显著提高视力。

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