[关键词]
[摘要]
目的:比较合并不同病情的白内障患者与普通白内障患者行白内障超声乳化人工晶状体植入术后前囊口生物学变化之间是否存在差异。
方法:选择普通白内障、合并高度近视、合并原发性闭角型青光眼、合并糖尿病的白内障患者4组,各25例,行Phaco+IOL术,均植入同型亲水型一片式人工晶状体,手术顺利,手术均由经验5 000例以上的医生完成。撕囊口面积经Image-pro plus 6.0图像分析软件测量在23mm2以上,术后1wk; 1,3,6mo分别充分散瞳后行眼前节裂隙灯照相并软件测量前囊口面积,观察各组患者术后前囊口面积改变。
结果:四组患者在术后1wk时平均前囊口面积值两两相比无统计学差异(P>0.05); 普通组及合并高度近视组:术后各随访期的囊口面积值与术后1wk时相比无统计学差异(P>0.05); 合并原发性闭角型青光眼组:术后3mo始出现囊袋收缩,其平均面积值与术后1wk时相比有统计学差异(P<0.05); 合并糖尿病组:术后6mo出现囊袋收缩,平均前囊口面积与术后1wk时相比有统计学差异(P<0.05)。
结论:合并原发性闭角型青光眼及合并糖尿病组的患者为可能发生囊膜收缩的高危人群,囊口改变最早可在术后1mo内发生。对于高危人群需进一步延长随访时间、充实前囊口生物改变的观察数据,为合理干预提供临床依据。
[Key word]
[Abstract]
AIM: To compare changes of anterior capsular opening size between complicated and simple cataract patients who underwent phacoemulsification and foldable IOL implantation.
METHODS:Patients complicated with high myopia, primary angle-closure glaucoma(PACG), diabetic cataract and simple cataract(control group)were selected, 25 case in each group. All patients accepted phacoemulsification by the doctor with operation experience of more than 5 000 cases, and the same 1-piece hydrophilic acrylic IOL was implanted without any complicated happened. The measured value about anterior capsular area by Image-pro plus 6.0 was greater than 23mm2. Every patient was checked regularly through dilated pupil, take photos by slit-lamp camera and area was measured after operation 1 week, 1 month, 3 and 6 months, then to record the biological changes about anterior capsular in 4 groups.
RESULTS: The average anterior capsular area in 4 groups 1 week after operation had no difference(P>0.05); No difference was found between simple and complicated high myopia group 6 months after operation(P>0.05). Capsule contraction was observed in complicated POAG group 3 months after operation and in diabetes mellitus group 6 months postoperatively, the average anterior capsular area become smaller than 1 week postoperatively(P<0.05).
CONCLUSION: Cataract patients who complicated PACG or diabetes mellitus maybe the high-risk groups, capsule contraction will be happened 1 month after operation. For high-risk groups, we should prolong the follow-up time, enrich the observation data, and provide the clinical basis for reasonable and preventive intervention.
[中图分类号]
[基金项目]
中国上海市卫生局科研课题资助项目(No.20124135)