术中预防性囊口松解对视功能及囊袋收缩的影响

摘要

Abtsr act Objective:To explore the effect of preventative capsule edge release in preventing anterior capsular contraction and imtraoc -uler lens ( IOL) dislocation .Methods:The phacoemulsification and IOL implantation was performed on 84 eyes of 60 age-related cataract patients from March 2012 to December 2012 at our center with follow up in 3 and 6 months after the operation .The capsulorhexis size was recorded during operation .The postoperative monocular best -corrected visual acuity was equal to or more than 0.5 in long-distance.84 eyes were randomly divided into two groups:edge cutting group ( n=44 ) and none edge cutting group ( n=40 ) .The CSF and GFS was measured with OPTEC 6500 under distance vision conditions (with spatial frequencies of1.5c /d,3.0 c/d,6.0 c/d,12.0 c/d,18.0c/d). In addition, the morpha of anterior capsular ,capsule orifice diameter and location of IOL are also observed in the current study .Differ-ences and characteristics among groups were compared and analyzed .Results:In the day time without glare ,there was a significant differ-ence in CSF between edge cutting group and none edge cutting group at 1.5c/d、2.0c/d(all P<0.05).While in the day time with glare, a significant difference in CSF was also found between the two groups at 1.5cd/、 18c/d(all P<0.05).There was no significant difference at all other spatial frequency between the two groups .Conclusion:Preventative capsule edge release was found to be effective in limiting the degree of anterior capsular contraction , and keeping the IOL in location much longer , and improving contrast sensitivity function .%目的：研究白内障术中对前囊口采用预防性松解技术对术后囊袋收缩以及人工晶状体偏中心的影响。方法：选取年龄相关性白内障患者60例（84眼），记录术中撕囊直径。其中施行前囊口松解者44只眼（n＝44），未松解者40只眼（n＝40）。术后3个月、6个月复查裸眼视力、矫正视力、对比敏感度及眩光对比敏感度，测量前囊口直径、记录前囊形态，观察人工晶状体偏位及后囊混浊程度等。结果：术后3个月未松解组有4眼前囊口明显机化，囊口直径缩小1 mm。未松解组3眼前囊机化但无囊口缩小。2组人工晶状体均无明显偏位。昼无眩光状态下，在1．5c/d、12．0 c/d 2组之间CSF值差异有统计学意义（P＜0．05）。昼有眩光状态下，在1．5c/d、18．0c/d 2组之间CSF值差异有统计学意义（P＜0．05）。其余白天各空间频率及夜间所有空间频率2组CSF值差异均无统计学意义（ P＞0．05）。术后6个月未松解组有9眼前囊口明显机化，囊口缩小≥1 mm。松解组7眼前囊口明显机化但无囊口缩小。结论：术中预防性囊口松解技术可以减轻前囊收缩的程度，更久的维持人工晶状体的正位，提高昼无眩光状态下1．5c/d、12．0c/d，昼伴眩光状态下1．5c/d、18．0c/d空间频率的对比敏感度，改善术后视功能。