Anand N, Tole D M, Morrell A J
St James's University Hospital, Leeds, UK.
Eye (Lond). 1996;10 ( Pt 4):509-13. doi: 10.1038/eye.1996.111.
Neodymium-YAG laser posterior capsulotomy is associated in some cases with an acute rise in the intraocular pressure (IOP), possibly caused by blockage of the trabecular meshwork by debris. To test the hypothesis that the IOP rise is preventable if fixation of the intraocular lens (IOL) in the capsular bag is ensured, we conducted a study comparing IOP changes at 1, 2, 3 and 24 hours after Nd:YAG capsulotomy between eyes with capsular bag-fixated, one haptic in the bag (haptic in/out) and cillary sulcus-fixated IOLs. Analysis of variance for repeated measures showed that after capsulotomy there were significant increases in IOP from baseline (p < 0.05) in both the sulcus-fixated (1, 2 and 3 hours) and haptic in/out groups (2 and 3 hours), while IOPs in the bag-fixated group did not show any significant increase. The increases in IOP in the sulcus-fixated group at 1, 2 and 3 hours after capsulotomy were significantly higher than the IOP changes at the corresponding periods in the other two groups (Kruskal-Wallis test, p < 0.01). The mean maximum IOP rise in the sulcus-fixated group (11.33 +/- 7.85 mmHg) was significantly higher than that in the haptic in/out group (3.89 +/- 7.14 mmHg) and the bag-fixated group (1.10 +/- 2.71 mmHg), while there was no difference between the latter two groups. In 57.5% of the sulcus-fixated group, 5% of the haptic in/out group and none of the eyes of the bag-fixated group the IOP rise was more than 10 mmHg. A significantly larger proportion of sulcus-fixated eyes had anterior chamber cells and capsular debris after capsulotomy (chi 2 test, p < 0.001). In the haptic in/out group significant correlation (-0.56, p = 0.009) between IOP rise at 1 hour and the percentage enclosure of the IOL by the anterior capsule was demonstrated. There was no significant difference in maximum IOP rise between glaucomatous and non-glaucomatous eyes (Mann-Whitney U-test, p = 0.49).
钕钇铝石榴石激光后囊切开术在某些情况下与眼内压（IOP）急性升高有关，这可能是由碎屑阻塞小梁网所致。为了验证如果确保人工晶状体（IOL）固定在囊袋内，IOP升高是可以预防的这一假设，我们进行了一项研究，比较了囊袋固定、一个襻在囊袋内（襻在囊袋内/外）和睫状沟固定IOL的眼睛在钕:钇铝石榴石后囊切开术后1、2、3和24小时的IOP变化。重复测量方差分析显示，后囊切开术后，睫状沟固定组（1、2和3小时）和襻在囊袋内/外组（2和3小时）的IOP均较基线水平显著升高（p < 0.05），而囊袋固定组的IOP未显示任何显著升高。后囊切开术后1、2和3小时，睫状沟固定组的IOP升高显著高于其他两组相应时间段的IOP变化（Kruskal-Wallis检验，p < 0.01）。睫状沟固定组的平均最大IOP升高（11.33±7.85 mmHg）显著高于襻在囊袋内/外组（3.89±7.14 mmHg）和囊袋固定组（1.10±2.71 mmHg），而后两组之间无差异。睫状沟固定组中57.5%的眼睛、襻在囊袋内/外组中5%的眼睛以及囊袋固定组的眼睛均未出现IOP升高超过10 mmHg的情况。后囊切开术后，睫状沟固定的眼睛前房细胞和囊膜碎屑明显更多（卡方检验，p < 0.001）。在襻在囊袋内/外组中，1小时时IOP升高与前囊膜包绕IOL的百分比之间存在显著相关性（-0.56，p = 0.009）。青光眼患者和非青光眼患者的最大IOP升高无显著差异（Mann-Whitney U检验，p = 0.49）。
