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目的 探讨Nd∶YAG激光十字形后囊切开治疗人工晶体眼后发性白内障的技术要点和并发症的预防方法。方法 对 5 8例接受Nd∶YAG激光十字形后囊切开术治疗的后发性白内障患者的临床资料进行回顾性分析。 5 8只患眼中包括不同类型 (纤维膜型、Elschnig珍珠型、混合型、伴部分皮质残存型 )和不同病情分级 (1、2和 3级 )的后发性白内障 ,术中根据后囊厚薄和机化程度的不同 ,以及人工晶体与后囊的距离等 ,选择能量和功率密度以及十字形切开的方法。结果 截囊成功率 10 0 %。术后矫正视力均明显提高 ,由术前均≤ 0 5 ,改变为均≥ 0 5 ,45只眼 (77 6 % )矫正视力达 0 7以上。主要并发症是玻璃体前界膜破裂 (2 7 6 % )和人工晶体点状损伤 (6 9% )。结论 十字形切开技术适用于各种类型后发性白内障的治疗 ,安全有效。精确聚焦、个体化的能量设定、适当的切开方法以及适时治疗是提高疗效、降低并发症的关键。
Objective To investigate the technical points and prevention methods of posterior capsule cataract extraction with Nd:YAG laser in the treatment of posterior chamber intraocular lens disease. Methods The clinical data of 58 patients with posterior capsular cataract who underwent Nd:YAG laser posterior capsulotomy were analyzed retrospectively. 58 eyes of different types (fibrinolytic type, Elschnig pearl type, mixed type, with partial cortical residual type) and different grades of disease (grade 1, 2 and 3) of the posterior cataract, according to the thickness of the posterior capsule And the degree of mechanization is different, and the distance between the artificial lens and the posterior capsule, etc., the choice of energy and power density and cross-shaped incision method. Results The success rate of cysts was 100%. Postoperative corrected visual acuity were significantly improved from preoperative ≤ 0 5, were changed to ≥ 0 5, 45 eyes (77 6%) corrected visual acuity of 0 7 or more. The main complications were anterior vitreous membrane rupture (276%) and intraocular lens punctate injury (69%). Conclusion Cross-shaped incision technique is suitable for the treatment of various types of posterior cataract, safe and effective. Precise focus, individual energy settings, appropriate incision method and timely treatment are the key to improve curative effect and reduce complications.