Konyagoz Eye Hospital, Sancak Mah. Unluer Sok. No: 13, Selcuklu, Konya, Turkey.
Int Ophthalmol. 2022 Oct;42(10):3089-3095. doi: 10.1007/s10792-022-02295-5. Epub 2022 Apr 4.
To retrospectively evaluate the effectiveness of the capsular vacuuming technique in reducing posterior capsule opacification (PCO).
Group 1 of the study consisted of 2752 eyes of 2752 patients with a cataract who had undergone phacoemulsification and IOL implantation surgery with anterior, equatorial, and posterior capsular polishing between January 2010 and December 2014. Group 2 consisted of 2761 eyes of 2761 patients with a cataract who had undergone phacoemulsification and IOL implantation surgery with anterior, equatorial, and posterior capsular polishing as well as posterior capsular vacuuming between January 2010 and December 2014.
The mean patient age was 63.45 ± 12.23 years (range, 43-89) in Group 1 and 64.02 ± 13.36 years (range, 40-91) in Group 2. The two groups did not significantly differ with respect to age, sex, preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) measurements (p > 0.05). At the 5-year follow-up, 253 eyes (9.19%) in Group 1 developed PCO requiring Nd:YAG laser capsulotomy, whereas 24 eyes (0.86%) in Group 2 developed PCO requiring Nd:YAG laser capsulotomy (p < 0.001). During capsular vacuuming, posterior capsule rupture was observed in the shape of a hole in only 2 eyes in Group 2. But the IOLs were implanted in the capsular bag in all eyes in both groups.
PCO is the most common complication of cataract surgery; therefore, surgical technique is important in preventing PCO formation. We recommend posterior capsular vacuuming together with anterior, equatorial, and posterior capsular polishing, as this method significantly reduced the PCO rate.
回顾性评估囊袋抽空技术在减少后发性白内障(PCO)中的效果。
研究组 1 包括 2010 年 1 月至 2014 年 12 月期间行白内障超声乳化吸除术联合人工晶状体植入术的 2752 例(2752 只眼)患者,术中行前囊、赤道部及后囊抛光。研究组 2 包括 2010 年 1 月至 2014 年 12 月期间行白内障超声乳化吸除术联合人工晶状体植入术的 2761 例(2761 只眼)患者,术中除了行前囊、赤道部及后囊抛光外,还进行了后囊袋抽空。
研究组 1 患者的平均年龄为 63.45±12.23 岁(范围 43-89 岁),研究组 2 患者的平均年龄为 64.02±13.36 岁(范围 40-91 岁)。两组患者在年龄、性别、术前和术后未矫正视力(UCVA)、最佳矫正视力(BCVA)和眼内压(IOP)测量值方面均无显著差异(p>0.05)。在 5 年随访时,研究组 1 中有 253 只眼(9.19%)发生需要行 Nd:YAG 激光后囊切开术的 PCO,而研究组 2 中有 24 只眼(0.86%)发生需要行 Nd:YAG 激光后囊切开术的 PCO(p<0.001)。在囊袋抽空过程中,研究组 2 中有 2 只眼后囊仅出现孔状破裂,但两组所有眼的人工晶状体均植入囊袋内。
PCO 是白内障手术后最常见的并发症,因此手术技术对于预防 PCO 形成很重要。我们建议采用后囊袋抽空联合前囊、赤道部及后囊抛光,因为这种方法能显著降低 PCO 发生率。