Ravalico G, Tognetto D, Palomba M, Busatto P, Baccara F
Istituto di Clinica Oculistica, Università di Trieste, Ospedale Maggiore, Trieste, Italy.
J Cataract Refract Surg. 1996 Jan-Feb;22(1):98-103. doi: 10.1016/s0886-3350(96)80277-x.
Posterior capsule opacification (PCO) after intraocular lens (IOL) implantation has a multifactored pathogenesis. Capsulorhexis and capsular bag implantation of a one-piece, biconvex poly(methyl methacrylate) (PMMA) IOL are likely to reduce the PCO incidence. This study was performed to determine whether an ideal capsulorhexis size able to reduce PCO incidence exists.
A retrospective study of 107 patients who had extracapsular cataract extraction with capsulorhexis and capsular bag IOL implantation was carried out. The PCO site (central, paracentral, and peripheral) and degree (mild, moderate, and severe) were evaluated in relation to the capsulorhexis edge location relative to the IOL optic. Slitlamp biomicroscopy and photography and examination with a three-mirror Goldmann lens were performed. Patients were divided into three groups. Group 1: capsulorhexis free edge located on the IOL optic for 360 degrees; Group 2: capsulorhexis free edge located asymmetrically on and peripherally to the IOL optic; Group 3: capsulorhexis free edge located peripherally to IOL optic for 360 degrees. Each group was divided into two subgroups; one received polyHema IOLs and the second, PMMA IOLs.
In Groups 1 and 2, the capsular transparency was higher than in Group 3 (P < .04). Central opacification percentage was lower in Group 1 than in Groups 2 and 3 (P < .04). No statistically significant differences between the polyHema and the PMMA subgroups were seen.
Capsulorhexis with a slightly smaller diameter than the IOL optic appears to be better than a large-size capsulorhexis in reducing the incidence of PCO.
人工晶状体（IOL）植入术后后囊膜混浊（PCO）的发病机制是多因素的。连续环形撕囊及一体式双凸聚甲基丙烯酸甲酯（PMMA）人工晶状体囊袋内植入可能会降低PCO的发生率。本研究旨在确定是否存在能够降低PCO发生率的理想撕囊大小。
对107例行囊外白内障摘除联合连续环形撕囊及人工晶状体囊袋内植入术的患者进行回顾性研究。根据撕囊边缘相对于人工晶状体光学部的位置，评估PCO的部位（中央、旁中央和周边）和程度（轻度、中度和重度）。进行裂隙灯生物显微镜检查及摄影，并使用三面镜戈德曼透镜进行检查。患者分为三组。第1组：撕囊游离边缘在人工晶状体光学部上360度；第2组：撕囊游离边缘不对称地位于人工晶状体光学部上及周边；第3组：撕囊游离边缘在人工晶状体光学部周边360度。每组再分为两个亚组；一个亚组植入聚甲基丙烯酸羟乙酯人工晶状体，另一个亚组植入PMMA人工晶状体。
第1组和第2组的囊膜透明度高于第3组（P < 0.04）。第1组的中央混浊百分比低于第2组和第3组（P < 0.04）。聚甲基丙烯酸羟乙酯亚组和PMMA亚组之间未见统计学显著差异。
直径略小于人工晶状体光学部的连续环形撕囊在降低PCO发生率方面似乎优于大尺寸撕囊。
