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中华眼科医学杂志(电子版) ›› 2020, Vol. 10 ›› Issue (06) : 321 -325. doi: 10.3877/cma.j.issn.2095-2007.2020.06.001

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重视超声乳化白内障吸除联合人工晶状体植入术后后囊膜混浊的危险因素及预防
刘燕1, 蒋永祥1,†()   
  1. 1. 200031　上海，复旦大学附属眼耳鼻喉医院眼科　国家卫生健康委员会近视眼重点实验室（复旦大学）中国医学科学院近视眼重点实验室和上海市视觉损伤与重建实验室
  • 收稿日期:2020-11-02 出版日期:2020-12-28
  • 通信作者: 蒋永祥
  • 基金资助:
    国家自然科学基金项目(82070943); 科技部国家重点研发计划项目(2018YFC0116000)

Pay attention to the risk factors and prevention of posterior capsule opacity after phacoemulsification combined with intraocular lens implantation

Yan Liu1, Yongxiang Jiang1,†()   

  1. 1. Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai 200031, China
  • Received:2020-11-02 Published:2020-12-28
  • Corresponding author: Yongxiang Jiang
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刘燕, 蒋永祥. 重视超声乳化白内障吸除联合人工晶状体植入术后后囊膜混浊的危险因素及预防[J]. 中华眼科医学杂志(电子版), 2020, 10(06): 321-325.

Yan Liu, Yongxiang Jiang. Pay attention to the risk factors and prevention of posterior capsule opacity after phacoemulsification combined with intraocular lens implantation[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2020, 10(06): 321-325.

白内障是我国主要致盲疾病之一，超声乳化白内障吸除联合人工晶状体植入是目前唯一有效的治疗手段。预后结果表明后发性白内障是导致术后视力低下的主要原因。近年来，随着研究的不断深入，业内对后发性白内障危险因素的认识及预防措施越来越多，并在人工晶状体(IOL)的设计、材料和表面修饰技术方面取得了一定的成效。本文中笔者就超声乳化白内障吸除联合人工晶状体植入术后后发性白内障的危险因素及预防进行了归纳，并综合分析得出在尽可能提高手术技术的前提下，对人工晶状体进行表面改性，以期相对安全且具有前景地为临床和科研工作提供参考。

关键词: 后囊膜混浊, 危险因素, 人工晶状体, 预防

Cataract, as one of the major blinding diseases in China, is an opacification of the transparent crystalline lens. The appearance of phacoemulsification has brought good news to the patients, but there are still some complications. One of the most important is posterior cataract, which is also an important cause of postoperative low vision. In recent years, with the deepening of research, the understanding of risk factors has become more comprehensive, more and more preventive measures for posterior capsular opacification have been taken. Surgical techniques, intraocular lens (IOL) optic edge designs, IOL materials and the application of related drugs tend to be diversified and more effective. In this paper, risk factors and prevention of posterior capsular opacification after phacoemulsification were reviewed in order to provide reference for clinical work and scientific research.

Key words: Posterior capsular opacification, Risk factors, Intraocular lens, Prevention
[1]
吴丹萍，吴强. 不同表面处理及设计人工晶状体对后囊膜混浊影响的量化分析[J]. 国际眼科杂志，2019，19(11)：1908-1911.
[2]
Zemaitiene R. Posterior capsule opacification: incidence and pathogenesis[J]. Medicina(Kaunas, Lithuania), 2003, 39(9): 830-837.
[3]
Wormstone IM, Wormstone YM, Smith AJO, et al. Posterior capsule opacification: What's in the bag？[J]. Progress in retinal and eye research, 2020: 100905.
[4]
Trivedi RH, Werner L, Apple DJ, et al. Post cataract-intraocular lens (IOL) surgery opacification[J]. Eye, 2002, 16(3): 217-241.
[5]
Pérez-Vives C. Biomaterial Influence on Intraocular Lens Performance: An Overview[J]. J ophthalmol, 2018: 2687385.
[6]
夏小平. 后发性白内障与晶状体后囊厚度的关系探讨[J]. 眼科研究，1998，16(4)：3-5.
[7]
隗菱，卢奕，竺向佳. 高度近视并发性白内障相关机制研究进展[J]. 中国眼耳鼻喉科杂志，2020，20(2): 124-127.
[8]
刘婕，赵娴，张恒丽，等. 不同类型白内障患者术后晶状体后囊膜混浊发生率的比较[J]. 眼科，2014，23(2)：91-93.
[9]
李克勤，杨怡，黄怀洁，等. 轴性高度近视白内障和非近视性白内障患者眼轴长度与晶状体厚度的相关性研究[J]. 临床和实验医学杂志，2015，14(18)：1543-1546.
[10]
林涛. 囊袋张力环在高度近视眼后发性白内障手术中的应用[J]. 眼科新进展，2012，32(9)：868-869.
[11]
Zhao Y, Li J, Lu W, et al. Capsular Adhesion to Intraocular Lens in Highly Myopic Eyes Evaluated In Vivo Using Ultralong-scan-depth Optical Coherence Tomography[J]. American Journal of Ophthalmology, 2013, 155(3): 484-491.
[12]
Vasavada AR, Praveen MR. Posterior Capsule Opacification After Phacoemulsification: Annual Review.[J]. Asia-Pacific journal of ophthalmology (Philadelphia, Pa.), 2014, 3(4): 235-240.
[13]
Hecht I, Dubinsky Pertzov B, Karesvuo P, et al. Association between intraocular lens diopter and posterior capsular opacification.[J]. Clinical and experimental ophthalmology, 2020, 48(7): 889-894.
[14]
Raj SM, Vasavada AR, Johar SRK, et al. Post-operative capsular opacification: a review[J]. International journal of biomedical science: IJBS, 2007, 3(4): 237-250.
[15]
Wu S, Tong N, Pan L, et al. Retrospective Analyses of Potential Risk Factors for Posterior Capsule Opacification after Cataract Surgery[J]. J Ophthalmol, 2018: 9089285.
[16]
Lutz EA, Gemensky-Metzler AJ, Wilkie DA, et al. Effects of pulsed fluid lens capsule washing following phacoemulsification on lens epithelial cells and posterior capsule opacification formation ex vivo[J]. Veterinary ophthalmology, 2015, 18(3): 221-228.
[17]
Liu Z, Cao Q, Qu B, et al. Fluid-jet technique to polish the posterior capsule for phacoemulsification surgeries: efficacy and safety evaluation [J]. Journal of cataract and refractive surgery, 2020, 46(11): 1508-1514.
[18]
王子杨，朱思泉. 人工晶状体材料的生物相容性评价[J]. 国际眼科纵览，2012，36(4)：276-280.
[19]
Findl O, Buehl W, Bauer P, et al. Interventions for preventing posterior capsule opacification[J]. The Cochrane database of systematic reviews, 2010, 17(2): CD003738.
[20]
张旻，蒋永祥. 把握白内障手术的发展趋势与精准运用人工晶状体各种类型的特点[J/CD]. 中华眼科医学杂志(电子版)，2019，9(5)：257-266.
[21]
Duman R, Karel F, Özyol P, et al. Effect of four different intraocular lenses on posterior capsule opacification.[J]. International journal of ophthalmology, 2015, 8(1): 118-121.
[22]
Katayama Y, Kobayakawa S, Yanagawa H, et al. The relationship between the adhesion characteristics of acrylic intraocular lens materials and posterior capsule opacification[J]. Ophthalmic Research: Journal for Research in Experimental and Clinical Ophthalmology, 2007, 39(5): 276-281.
[23]
Shah AR, Praveen MR, Vasavada AR. Posterior capsule opacification after extra capsular cataract extraction in Indian rural population: Foldable acrylic vs poly (methyl-methacrylate) intraocular lenses a randomized clinical trial[J]. Eye, 2008, 22(7): 889-894.
[24]
Vasavada AR, Raj SM, Shah A, et al. Comparison of posterior capsule opacification with hydrophobic acrylic and hydrophilic acrylic intraocular lenses[J]. Journal of Cataract and Refractive Surgery, 2011, 37(6): 1050-1059.
[25]
Topete A, Tang J, Ding X, et al. Dual drug delivery from hydrophobic and hydrophilic intraocular lenses: in-vitro and in-vivo studies [J]. Journal of Controlled Release, 2020, 326: 245-255.
[26]
Heatley CJ, Spalton DJ, Kumar A, et al. Comparison of posterior capsule opacification rates between hydrophilic and hydrophobic single-piece acrylic intraocular lenses. 2005, 31(4): 718-724.
[27]
张振平，郑丹莹，林郁，等. 不同边缘形状的人工晶状体与后发性白内障的临床研究[J]. 中华眼科杂志，2002(10)：33-36，68.
[28]
Lindholm JM, Laine I, Tuuminen R. Five-Year Cumulative Incidence and Risk Factors of Nd：YAG Capsulotomy in 10044 Hydrophobic Acrylic 1-Piece and 3-Piece Intraocular Lenses[J]. American Journal of Ophthalmology, 2019, 200: 218-223.
[29]
Katsuki Y, Matsushima H, Mukai K, et al. Open-capsule intraocular lens to prevent posterior capsule opacification[J]. Journal of cataract and refractive surgery, 2019, 45(7): 1007-1012.
[30]
Fong CSU, Mitchell P, Rochtchina E, et al. Three-Year Incidence and Factors Associated With Posterior Capsule Opacification After Cataract Surgery: The Australian Prospective Cataract Surgery and Age-related Macular Degeneration Study[J]. American Journal of Ophthalmology, 2014, 157(1): 171-179.
[31]
周涯，徐栩，林全愧. 人工晶状体表面改性抑制后发性白内障的研究进展[J]. 中华眼视光学与视觉科学杂志，2020, 22(8): 630-636.
[32]
黄琪. 后发性白内障与人工晶状体材料的体外实验研究[D]. 南方医科大学，2016.
[33]
Zhang H, Zhang X, Kuang Z, et al. Bionic antibacterial modification of IOL through SI-RAFT polymerization of P(TOEAC-co-MPC) brushes to prevent PCO and endophthalmitis [J]. Polymer Testing, 2020, 88: 8.
[34]
Mao Y, Yu S, Kang Y, et al. CuInS/ZnS quantum dots modified intraocular lens for photothermal therapy of posterior capsule opacification[J]. Experimental eye research, 2020: 108282.
[35]
Seo Y, Kim S, Lee HS, et al. Femtosecond laser induced nano-textured micropatterning to regulate cell functions on implanted biomaterials [J]. Acta Biomaterialia, 2020, 116: 138-148.
[36]
MacLean KD, Werner L, Kramer GD, et al. Evaluation of stability and capsular bag opacification of a new foldable adjustable intraocular lens[J]. Clinical & Experimental Ophthalmology, 2015, 43(7): 648-654.
[37]
丁正华，严宏，王建伟. 后发性白内障的发病机制和药物防治的研究现状及前景[J]. 国际眼科杂志，2006，6(2)：412-416.
[38]
Walker TD. Pharmacological attempts to reduce posterior capsule opacification after cataract surgery a review.[J]. Clinical & experimental ophthalmology, 2008, 36(9): 883-890.
[39]
滕贺，张红，田芳，等. 环孢霉素A修饰人工晶状体抑制兔眼后发性白内障的研究[J]. 中华眼科杂志，2016，52(2)：110-116.
[40]
王曼，孙兴怀，吴伟. 曲尼司特微球对兔晶状体后囊膜混浊的抑制作用[J]. 眼视光学杂志，2006，13(1)：21-25.
[41]
Zhang RP, Xie ZG. Research Progress of Drug Prophylaxis for Lens Capsule Opacification after Cataract Surgery [J]. J Ophthalmol, 2020: 2181685.
[42]
黎蕾. Visudyne光动力疗法预防晶状体后囊膜混浊的实验研究[D]. 复旦大学，2008.
[43]
滕贺，张红. 药物修饰人工晶状体抑制后发性白内障[J]. 国际眼科杂志，2013，13(1)：72-75.
[44]
Wertheimer C, Kueres A, Siedlecki J, et al. The intraocular lens as a drug delivery device for an epidermal growth factor-Receptor inhibitor for prophylaxis of posterior capsule opacification[J]. Acta Ophthalmologica, 2018, 96(7): E874-E882.
[45]
Ongkasin K, Masmoudi Y, Wertheimer CM, et al. Supercritical fluid technology for the development of innovative ophthalmic medical devices: Drug loaded intraocular lenses to mitigate posterior capsule opacification[J]. European Journal of Pharmaceutics and Biopharmaceutics, 2020, 149: 248-256.
[46]
Lei M, Peng Z, Dong Q, et al. A novel capsular tension ring as local sustained-release carrier for preventing posterior capsule opacification[J]. Biomaterials, 2016, 89: 148-156.
[47]
张军. 后囊环形撕开联合人工晶状体植入术临床观察[J]. 中国实用眼科杂志，2015，33(6)：681-684.
[48]
Wejde G, Kugelberg M, Zetterström C. Position of anterior capsulorhexis and posterior capsule opacification[J]. Acta ophthalmologica Scandinavica, 2004, 82(5): 531-534.
[49]
汪婷艳. 溴芬酸钠对人晶状体上皮细胞增殖、迁移的效应研究[D]. 浙江大学，2014.
[50]
彭华琮，袁媛，刘保松. 晶状体囊袋张力环植入对高度近视白内障术后后发性白内障发生的影响[J]. 眼科新进展，2010，30(11)：1065-1067.
[51]
Halili I, Mutlu FM, Erdurman FC, et al. Influence of capsular tension ring on posterior capsule opacification in myopic eyes[J]. Indian Journal of Ophthalmology, 2014, 62(3): 311-315.
[52]
Packer M, Fishkind WJ, Fine IH. et al. The physics of phaco: A review[J]. Journal of Cataract and Refractive Surgery, 2004, 31(2): 424-431.
[53]
Verdina T, Peppoloni C, Barbierl L, et al. Long-Term Evaluation of Capsulotomy Shape and Posterior Capsule Opacification after Low-Energy Bimanual Femtosecond Laser-Assisted Cataract Surgery [J]. J Ophthalmol, 2020: 6431314.
[54]
易允娣，翁朝龙，史冰洁，等. 超声乳化联合囊袋张力环植入术治疗白内障的效果分析[J]. 中国实用眼科杂志，2018(4)：277-281.
[55]
刘圆媛，路承喆，汤欣. 前节OCT在观察后发性白内障方面的应用价值[J]. 中国实用眼科杂志，2017，35(3)：247-251.
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