Nd∶YAG激光治疗白内障术后囊袋收缩综合征

doi:10.3760/cma.j.cn115909-20190831-00238

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摘要目的：探讨白内障超声乳化术后囊袋收缩综合征（CCS）患者临床特征及实施Nd∶YAG激光治疗的临床疗效，为白内障术后并发症的预防和治疗提供参考。方法：回顾性病例对照研究。选择2017年1 月至2019年6月温州医科大学附属苍南医院眼科门诊收治的23例（25眼）白内障超声乳化术后有症状的CCS患者行Nd∶YAG激光治疗，并收集相关临床资料，总结患者出现CCS的临床特征、影响因素并探究Nd∶YAG激光治疗效果。所有病例均随访6个月及以上。数据采用配对设计符号秩和检验。结果：23例CCS患者均主诉视力较出院时明显下降，裂隙灯显微镜下环行撕囊口不同程度地缩小而且偏心，前囊增生明显，环形增生纤维环宽度>2 mm。散瞳后见IOL偏中心者19眼，IOL倾斜者3眼， IOL囊袋内夹持者1眼。13眼发生在白内障超声乳化术后3～5周，占52%。患者的基础疾病情况是并发CCS重要的影响因素。除3例IOL倾斜者（2例视网膜色素变性和1例高龄患者因悬韧带松弛导致的脱位）和1例夹持患者激光前囊切开后视力提高不明显外，所有患者视力均提高。治疗前主诉伴眩光或单眼复视者，治疗后上述主观症状消失。Nd∶YAG激光前囊切开术后前囊口收缩环均被打开，囊袋收缩缓解，随访期内无人工晶状体偏移及脱位，无严重并发症。结论：Nd∶YAG激光治疗CCS 疗效可靠，简便安全。

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关键词 ：囊袋收缩综合征, Nd∶YAG激光, 白内障, 超声乳化术

Abstract：Objective: To explore the clinical characteristics of patients with capsular contraction syndrome (CCS) after cataract phacoemulsification, and the clinical efficacy of Nd∶YAG laser treatment; to provide a reference for the prevention and treatment of post-cataract complications. Methods: In this retrospective case-control study, the relevant clinical data from 23 patients (25 eyes) with symptomatic CCS after cataract phacoemulsification were collected in patients who were admitted to the Department of Ophthalmology, Cangnan Hospital Affiliated to Wenzhou Medical University from January 2017 to June 2019 and who were treated with Nd∶YAG laser. The clinical characteristics and influencing factors of patients with capsular contraction syndrome were summarized and the effect of Nd∶YAG laser treatment was studied.All cases were followed up for 6 months or more, and the data were tested by a paired design symbol rank sum test. Results: All 23 patients with CCS complained that their visual acuity decreased than discharge. Their circular capsulorhexis was reduced and eccentric. Anterior capsule hyperplasia was evident, and the width of the annular hyperplasia fiber ring was >2 mm. After mydriasis, 19 eyes had an IOL decentration, 3 eyes had IOL tilt, and 1 eye had an IOL held in the capsular sac. These conditions occurred in 13 eyes 3 to 5 weeks after phacoemulsification, accounting for 52%. The patients' underlying disease was an important influencing factor for concurrent CCS. Visual acuity did not improve in 3 patients with a tilted IOL (2 patients with retinitis pigmentosa and 1 elderly patient with dislocation due to lax ligament relaxation) and 1 patient with an IOL holder. Subjective symptoms disappeared after treatment in those patients who complained of glare or monocular diplopia before treatment. After Nd∶YAG laser anterior capsulotomy, the anterior capsular contraction ring was opened, and the capsular contraction was relieved. There was no intraocular lens deviation or dislocation during the follow-up period, and no serious complications. Conclusions: Nd∶YAG laser treatment of CCS is reliable, simple and safe.

Key words： capsular contraction syndrome Nd∶YAG lasers cataract phacoemulsification

收稿日期: 2019-08-31

通讯作者: 华峰（ORCID：0000-0002-3865-4152），Email：huaf766@126.com

引用本文:

陈吉孟李正义陈宝伟苏婷婷华峰. Nd∶YAG激光治疗白内障术后囊袋收缩综合征[J]. 中华眼视光学与视觉科学杂志, 2020, 22(7): 536-539. Jimeng Chen, Zhengyi Li, Baowei Chen, Tingting Su, Feng Hua. Effect of Nd∶YAG Laser in the Treatment of Capsular Contractile Syndrome after Cataract Surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(7): 536-539. DOI: 10.3760/cma.j.cn115909-20190831-00238

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20190831-00238 或 https://www.cjoovs.com/CN/Y2020/V22/I7/536

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