后发性白内障Nd:YAG激光后囊切开尺寸对眼部生物学参数及屈光状态的影响

Influence of size of Nd:YAG capsulotomy on ocular biological parameters and refraction

摘要:

目的：评估不同切口尺寸的Nd：YAG激光后囊切开术对后发性白内障(posterior capsule opacification，PCO)患者最佳矫正视力(BCVA)、眼压(IOP)等眼部生物学参数及屈光状态的影响。

方法：选取2017-06/2017-12于上海市东方医院眼科行Nd：YAG激光后囊切开术治疗的PCO患者41例41眼的临床资料进行回顾性分析，根据后囊切开尺寸将患者分成2组，囊膜切口≤3.5mm为组1(20例20眼)，囊膜切口>3.5mm为组2(21例21眼)。分别于术前，术后1wk，1、3mo行BCVA、屈光度、IOP、ACD、黄斑厚度(MT)等检查。

结果：术后1wk，1、3mo，两组患者BCVA均较术前显著改善，差异均有统计学意义(P<0.001)，但两组之间差异均无统计学意义(P>0.05)。手术前后，两组患者屈光度(SE)比较，差异无统计学意义(P>0.05)。术后1wk，组2患者IOP高于组1，差异有统计学意义(t=-2.609，P=0.013)。术后1wk，两组患者ACD均较术前明显变浅，差异均有统计学意义(P<0.01)，但术后1、3mo两组患者ACD差异均无统计学意义(P>0.05)。术后1wk，两组患者MT均较术前轻度增加，但差异无统计学意义(P>0.05)，且术后1wk，1、3mo两组患者MT差异均无统计学意义(P>0.05)。

结论：后囊切开尺寸对Nd：YAG激光后囊切开术后IOP影响显著，对BCVA、ACD、SE、MT无明显影响。

Abstract:

AIM:To investigate the influences of Nd:YAG laser capsulotomy with different size on visual acuity(VA), intraocular pressure(IOP), refraction, anterior chamber depth(ACD), and macular thickness(MT)in patients with posterior capsular opacification(PCO).

METHODS: In this retrospective, constantly study, 41 eyes of 41 patients treated with Nd:YAG laser posterior capsulotomy for PCO were divided into 2 groups according to the different incision sizes of capsulotomy: the patients received capsulotomy with the incision diameter less than or equal to 3.5mm were enrolled into group 1, while those received operation with incision diameter more than 3.5mm went to group 2. All patients were followed up before Nd:YAG laser capsulotomy, 1wk, 1 and 3mo after Nd:YAG laser capsulotomy, and the best-corrected visual acuity(BCVA), refraction, IOP, ACD, and MT were compared between two groups.

RESULTS: In both groups, BCVA were significantly improved postoperatively compared with base line(P<0.001), but there was no significant difference between two groups(P>0.05). The diopter(SE)of the two groups were not significantly different before and after operation(P>0.05). Intraocular pressure in group 2 was higher than those in group1 at 1wk(t=-2.609, P=0.013). ACD decreased significantly at 1wk postoperatively(P<0.01), but with no significant difference at 1 and 3mo(P>0.05). Both groups had increased macular thickness lightly at 1wk postoperatively, but with no statistical significance(P>0.05), and there was no significant difference between the two groups at 1wk, 1 and 3mo postoperatively(P>0.05).

CONCLUSION: The increase in intraocular pressure is more pronounced when the size of posterior capsulotomy was larger. However, the changes of BCVA, ACD, refraction, MT are not related with the incision size of posterior capsulotomy.