Gobeka Hamidu Hamisi, Gülyeşil Furkan Fatih, Sabaner Mehmet Cem
Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Department of Ophthalmology, Siirt Training and Research Hospital, Siirt, Turkey.
Photobiomodul Photomed Laser Surg. 2023 Aug;41(8):429-434. doi: 10.1089/photob.2022.0151.
Capsular bag distension syndrome (CBDS) can be effectively treated using either Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy or surgery. Assessing anterior segment, particularly immediately after Nd:YAG laser capsulotomy, could provide clinically relevant information on ocular dynamics, refractive changes, and complication mechanisms, especially in late postoperative CBDS. To explore the acute effects of Nd:YAG laser posterior capsulotomy on anterior segment parameters in late postoperative CBDS. In this study, 20 patients underwent Nd:YAG laser posterior capsulotomy after cycloplegia, during which milky-white fluid material migrated into the anterior vitreous. Anterior segment parameters were assessed before and immediately after laser using Scheimpflug-Placido topographer. The main outcome measures were differences in best-corrected visual acuity (BCVA), aqueous depth (AqD), anterior chamber volume (ACV), iridocorneal angle (ICA), corneal volume (CV), and central corneal thickness (CCT) at the baseline versus at immediately after laser. The mean age and duration since surgery for CBDS presentation were 70.25 ± 6.21 and 6.15 ± 1.31 years, respectively. The AqD, ACV, ICA, and spherical equivalent increased significantly compared with baseline (4.18 vs. 4.02 mm, = 0.001; 177 vs. 173.55 mm, = 0.004; 51.15° vs. 50.15°, = 0.023; -1.00 vs. -2.00 D, = 0.003, respectively). These changes were also associated with significantly improved BCVA an hour after capsulotomy [0.2 (0.05-0.2)] relative to baseline [0.3 (0.2-0.5)], ( = 0.001). CCT and CV decreased nonsignificantly; horizontal AC diameter and K and K increased nonsignificantly ( > 0.05). Nd:YAG laser posterior capsulotomy appears to be an effective CBDS treatment for acutely improving vision, potentially due to immediate refractive changes caused by altered anterior segment parameters.
囊袋扩张综合征（CBDS）可通过钕掺杂钇铝石榴石（Nd:YAG）激光晶状体切开术或手术有效治疗。评估眼前节，尤其是在Nd:YAG激光晶状体切开术后立即评估，可为眼动力学、屈光变化和并发症机制提供临床相关信息，特别是在CBDS术后晚期。为了探究Nd:YAG激光后囊膜切开术对CBDS术后晚期眼前节参数的急性影响。在本研究中，20例患者在睫状肌麻痹后接受了Nd:YAG激光后囊膜切开术，在此过程中乳白色液体物质移入前玻璃体。使用Scheimpflug - Placido地形图仪在激光治疗前和治疗后立即评估眼前节参数。主要观察指标为基线时与激光治疗后立即测量的最佳矫正视力（BCVA）、房水深度（AqD）、前房容积（ACV）、虹膜角膜角（ICA）、角膜容积（CV）和中央角膜厚度（CCT）的差异。CBDS患者的平均年龄和出现CBDS症状距手术的时间分别为70.25±6.21岁和6.15±1.31年。与基线相比，AqD、ACV、ICA和等效球镜显著增加（分别为4.18 vs. 4.02mm，P = 0.001；177 vs. 173.55mm，P = 0.004；51.15° vs. 50.15°，P = 0.023；-1.00 vs. -2.00D，P = 0.003）。这些变化还与晶状体切开术后1小时BCVA相对于基线显著改善相关[0.2（0.05 - 0.2）]相对于[0.3（0.2 - 0.5）]，（P = 0.001）。CCT和CV无显著下降；水平AC直径以及K1和K2无显著增加（P＞0.05）。Nd:YAG激光后囊膜切开术似乎是一种有效治疗CBDS的方法，可急性改善视力，这可能是由于眼前节参数改变导致的即刻屈光变化。
