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目的:研究后发障患者在行YAG激光后囊切开术后人工晶体有无发生偏移,以及眼轴是否发生变化。方法:收集白内障超声乳化并人工晶体植入术后不同时间段内发生后发性白内障患者14例18眼。所有患者在行YAG激光术前均先参照标准对数视力表验光并获得最佳矫正视力,以眼前节OCT获得眼前段图像,并以CMOS测得眼轴。本研究中定义瞳孔所在的水平面与人工晶体的前表面所成的夹角为人工晶体偏移度(简称偏移度,单位:度)。完成相关检查后,对患者逐一行YAG激光后囊切开术,术后双氯芬酸钠滴眼液滴术眼一次,术后1h,1wk后对患眼行验光,眼前节OCT及CMOS检查。分别记录患眼人工晶状体的偏移度、眼轴长度及最佳矫正视力,并以SPSS进行统计分析。结果:YAG激光术前各例眼的平均偏移度为2.896±2.286度,平均眼轴为23.56±0.55 mm;术后1h平均偏移度为4.702±2.991度,平均眼轴为23.40±0.59 mm;YAG术后1h较术前相比最佳矫正视力提高了平均3.72±1.74行。YAG术后1wk回访患者有9例12眼,此12眼的YAG术后1h的平均偏移度为3.175±1.791度,术后1wk的平均偏移度为3.434±1.835度。YAG术后1h与术前相比人工晶体偏移度的差异有统计学意义;术后1h与术前相比眼轴的差异无统计学意义;YAG术后1wk与术后1h人工晶体偏移度的差异无统计学意义;YAG术后1h较术前提高的最佳矫正视力行数与术后1h较术前人工晶体偏移度的差值具有相关性,相关系数为-0.523。结论:后发障患者行YAG激光后囊切开术后人工晶体发生偏移,而眼轴长度几乎不变;且YAG术后人工晶体发生的偏移量越小,最佳矫正视力提高越多。
Objective: To study whether there is any deviation of the intraocular lens (IOL) after YAG laser posterior capsulotomy in patients with posterior capsulotomy and whether the ocular axis changes. Methods: Fourteen eyes (18 eyes) with cataract were collected at different time points after phacoemulsification and intraocular lens implantation. All patients underwent YAG laser before reference standard logarithmic visual acuity optometry and to obtain the best corrected visual acuity, the anterior segment of OCT obtained anterior segment images, and measured by CMOS ocular axis. In this study, the angle between the horizontal plane of the pupil and the anterior surface of the intraocular lens is defined as the degree of deviation of the intraocular lens (referred to as the degree of deviation in degrees). After completing the relevant examinations, the patients underwent YAG laser posterior capsulotomy one after the other. Postoperative diclofenac sodium eye drops were given to the eyes one time. After the first and the last week, the OCT and CMOS were examined. The deviation, axial length and best corrected visual acuity of the intraocular lens were recorded and statistically analyzed by SPSS. Results: The average deviation of each eye before YAG laser was 2.896 ± 2.286 degrees and the average axial length was 23.56 ± 0.55 mm. The mean deviation at 1 hour after operation was 4.702 ± 2.991 degrees and the average axial length was 23.40 ± 0.59 mm ; 1 h after surgery compared with preoperative best corrected visual acuity increased an average of 3.72 ± 1.74 lines. Nine patients were retrospectively analyzed in 12 eyes after 1-week YAG operation. The mean deviation of 1-h YAG was 3.175 ± 1.791 and the average deviation of 1-week after operation was 3.434 ± 1.835. There was a significant difference in IOD between IAG and preoperative Ih after operation. There was no significant difference in IOL at 1h after operation between 1h and 1h after IAG and 1h after IAG There was no significant difference in the degree of intraocular lens (IOL) between 1 h and 1 h after operation. The correlation coefficient was -0.523. CONCLUSIONS: Posterior capsulotomy patients underwent YAG laser posterior capsulotomy with intraocular lens (IOL) offset and axial length almost unchanged. The smaller the offset of IOL after YAG laser surgery, the more the best corrected visual acuity .