肝素表面处理丙烯酸酯人工晶状体对白内障术后前房闪辉的影响

doi:DOI:10.3760/cma.j.issn.1674-845X.2017.02.002

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摘要

目的研究肝素表面处理丙烯酸酯人工晶状体（IOL）的临床疗效。方法前瞻性自身左右眼随机对照研究。选取双眼年龄相关性白内障硬度相似的患者20例（40眼），行双眼白内障超声乳化吸除手术，随机一眼植入肝素表面处理过的丙烯酸酯IOL为观察组，另一眼植入传统丙烯酸酯IOL为对照组。术前1 d，术后1 d、1周、1个月及3个月检查眼部情况，激光前房闪辉仪检测前房闪辉值。2组之间视力及前房闪辉值比较采用配对样本t检验，各时间段之间的差异采用重复测量方差分析。结果 2组间术前最佳矫正视力、眼压、眼轴及角膜曲率差异无统计学意义；术中超声乳化总能量差异无统计学意义。对照组和观察组的前房闪辉值在术前1 d分别为（6.6±2.7）ph/ms、（6.8±1.5）ph/ms（P＞0.05），术后1 d分别为（15.4±8.6）ph/ms、（10.1±5.8）ph/ms（P＜0.01），术后1周分别为（9.7±4.6）ph/ms、（7.6±1.8）ph/ms（P＜0.05），术后1个月分别为（7.9±2.3）ph/ms、（7.4±3.1）ph/ms（P＞0.05），术后3个月分别为（7.5±1.1）ph/ms、（7.2±1.5）ph/ms（P＞0.05）。与术前比较，对照组术后1 d、1周增高（P＜0.05），1个月及之后差异无统计学意义；观察组术后1 d增高（P＜0.05），1周及之后差异无统计学意义。结论与传统丙烯酸酯IOL相比，肝素表面处理的丙烯酸酯IOL能有效减轻白内障术后早期的前房炎症反应。

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	俞阿勇
	张翔翔
	王勤美
	朱双倩
	潘安鹏
	包芳军
	梁远波

关键词 ：肝素表面处理, 丙烯酸酯, 人工晶状体, 炎症, 前房闪辉

Abstract：

Objective To evaluate the clinical effect of a heparin surface-modified acrylate intraocular lens (IOL). Methods Prospective bilateral randomized controlled study. Twenty age-related cataract patients (40 eyes) with the same bilateral nuclear hardness were enrolled. After phacoemulsification, one eye from each patient was randomly chosen for implantation with a heparin surface-modified acrylate IOL, as the trial group, and the other eye for implantation with a traditional IOL as the control group. One day preoperatively and 1 day, 1 week, 1 month, and 3 months postoperatively, routine examinations were performed, and the flare value was measured by a laser flare meter. Paired t test was used to analyze the between-groups difference in visual acuity and flare. Repeated measures analysis of variance was performed to analyze the difference at each time point. Results The average patient age (means±standard deviation) was 67.9±8.3 years old. The differences in the preoperative best corrected visual acuity, intraocular pressure, axial length, and corneal curvature were not statistically significant between the two groups. There was no significant difference in total phacoemulsification power (t=-0.37, P＞0.05). At 1 day preoperatively, flare values in trial and control groups were not significant different (P＞0.05). At postoperative day 1, trial eye flare values were lower than the control eye (P＜0.01), and at Week 1, the trial eye flare value remained significantly lower than the control eye (P＜0.05). At postoperative months 1 and 3, the trial eye flare values were not significantly different from the corresponding control eye flare (P＞0.05 each). Compared with the baseline, the flare value in the trial group was increased at 1 day (P＜0.05), and recovered at 1 week. The flare value in control group was increased at 1 day and 1 week (P＜0.05), and recovered at 1 month. Conclusion Compared with the traditional acrylate IOL, heparin surface-modified acrylate IOL effectively reduced the short-term inflammation in the anterior chamber after cataract surgery.

Key words： Heparin surface-modified Acrylate Intraocular lens Inflammation Anterior chamber flare

收稿日期: 2016-04-05

通讯作者: 俞阿勇，Email：yaybetter@hotmail.com

引用本文:

俞阿勇,张翔翔,王勤美,朱双倩,潘安鹏,包芳军,梁远波. 肝素表面处理丙烯酸酯人工晶状体对白内障术后前房闪辉的影响[J]. 中华眼视光学与视觉科学杂志, 2017, 19(2): 71-75. YU Ayong, ZHANG Xiangxiang,WANG Qinmei,ZHU Shuangqian,PAN Anpeng,BAO Fangjun,LIANG Yuanbo. Effect of a heparin surface-modified acrylate intraocular lens onaqueous flare after cataract surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2017, 19(2): 71-75. DOI: DOI:10.3760/cma.j.issn.1674-845X.2017.02.002

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