Behrendt S, Wetzel W
Klinik für Ophthalmologie der Universität Kiel.
Ophthalmologe. 1994 Aug;91(4):526-8.
The capsulorhexis technique has become established as procedure of choice for anterior capsular opening in cataract surgery. With the spread of the method even relatively rare complications are gaining in importance.
In a patient with cataract and multifocal chorioretinitis, phacoemulsification with implantation of a one-piece PMMA posterior chamber IOL through a capsulorhexis opening was performed without complications. Within a period of 3 months, shrinking of the anterior capsule led to complete occlusion of the anterior aperture. To our knowledge, no comparably severe finding has been reported. The anterior capsule was successfully opened by by means of Nd:YAG laser capsulotomy. However, improvement in visual acuity was limited by cystoid macular edema due to the basic condition.
No relations with other systemic or eye diseases have yet been demonstrated. As another case report describes a similar--though less severe--combination of progressive constriction of the anterior capsule and inflammatory eye disease, the opening of the anterior capsule in such cases should be sufficiently large. If anterior capsular shrinkage has developed, Nd:YAG-laser capsulotomy is a low-risk method of therapy.
连续环形撕囊技术已成为白内障手术中前囊开口的首选方法。随着该方法的推广,即使是相对罕见的并发症也日益受到重视。
一名患有白内障和多灶性脉络膜视网膜炎的患者,通过连续环形撕囊开口进行了超声乳化白内障吸除术,并植入了一体式聚甲基丙烯酸甲酯后房型人工晶状体,手术无并发症。在3个月内,前囊收缩导致前房开口完全闭塞。据我们所知,尚未有如此严重的类似报道。通过钕:钇铝石榴石激光晶状体囊切开术成功打开了前囊。然而,由于基础疾病,视力的改善受到黄斑囊样水肿的限制。
尚未发现与其他全身或眼部疾病有关。正如另一例病例报告所述,存在前囊渐进性收缩与炎性眼病的类似——尽管不太严重——组合,在此类病例中前囊开口应足够大。如果已经出现前囊收缩,钕:钇铝石榴石激光晶状体囊切开术是一种低风险的治疗方法。