山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (5): 41-45.doi: 10.6040/j.issn.1673-3770.0.2021.245

• 论著 • 上一篇    

接触镜使用与否在Nd∶YAG激光后囊切开术中的对比研究

胡尊霞,司马晶,秦波,曹加国,潘伟   

  1. 暨南大学附属深圳爱尔眼科医院, 广东 深圳 518000
  • 发布日期:2022-09-20
  • 通讯作者: 司马晶. E-mail:sima618@163.com
  • 基金资助:
    深圳爱尔眼科医院科研项目(SZAE2020B03)

Comparative study on the use of contact lens in Nd: YAG laser posterior capsulotomy

HU Zunxia, SIMA Jing, QIN Bo, CAO Jiaguo, PAN Wei   

  1. Shenzhen Aier Eye Hospital Affiliated to Jinan University, Shenzhen 518000, Guangdong, China
  • Published:2022-09-20

摘要: 目的 比较Nd∶YAG激光后囊切开术中使用接触镜及未使用接触镜两组患者的累积能量、激光点数、平均能量及操作过程耗费时间。 方法 前瞻性选择2019年11月~2021年5月于暨南大学附属深圳爱尔眼科医院门诊确诊的后发性白内障患者80例(80眼)。按照随机数字表法进行分组,单号患者激光过程中不使用接触镜作为观察组,共40例(40眼);双号患者使用接触镜作为对照组,共40例(40眼)。记录激光过程中使用的能量范围、累积能量、激光点数、激光操作过程耗时(分钟)。应用SPSS22.0统计学软件对两组患者数据进行方差齐性检验,符合方差齐性的资料采用配对样本t检验,不符合方差齐性的资料采用非参数秩和检验结果两组患者术后视力均明显提高,差异有统计学意义(P<0.001)。所有观察患者激光后0.5 h及术后7 d均未出现眼压明显升高,两组患者激光后0.5 h眼压、7 d眼压、激光后视力比较差异均无统计学意义(P=0.089,P=0.145,P=0.431)。观察组激光术中使用的累积能量与对照组比较差异无统计学意义(P=0.456),观察组激光术中使用的平均能量高于于对照组,两组比较差异有统计学意义(P<0.001)。观察组患者激光术中点数少于对照组,两组比较差异有统计学意义(P<0.001)。观察组操作过程耗时少于对照组,两组比较差异有统计学意义(P<0.001)。 结论 Nd∶YAG激光后囊切开术中未使用接触镜与使用接触镜相比,累积能量无明显差异,平均能量使用较大,但可减少激光点数、操作时间较短,两组患者临床效果观察差异无统计学意义。

关键词: 后发性白内障, Nd∶YAG激光, 接触镜, 后囊切开术, 后囊膜混浊

Abstract: Objective Comparison of Nd: YAG laser posterior capsulotomy using contact lens and not using contact lens in the two groups of patients with accumulated energy, laser points, average energy and operation process time-consuming. Methods A prospective collection of 80 eyes of patients with after-cataract diagnosed in the outpatient clinic of our hospital from November 2019 to May 2021. Number 1-80 according to the random number method, lottery method, single-number do not use contact lenses during the laser process, as the experimental group, 40 people(40 eyes); double-number use contact lenses, as the control group, 40 People(40 eyes). Record the range of energy used in the laser process, the accumulated energy, the number of laser points, and the time of the laser operation process. Results Postoperative visual acuity of the two groups was significantly improved, and the difference was not statistically significant(P<0.001). There was no significant increase in intraocular pressure in all observed patients half an hour after the laser and 7 days after the operation, and there was no significant difference of intraocular pressure half an hour after the laser, the intraocular pressure 7th day, and the visual acuity after the laser between two groups(P>0.05). There was no significant difference in the cumulative energy between the experimental group and the control group(P=0.456). The number of laser intraoperative points in the experimental group was less than that in the control group, and the difference between the two groups was statistically significant(P<0.001). The operation time of the experimental group was less than that of the control group, and the difference between the two groups was statistically significant(P<0.001). Conclusions Nd∶YAG laser posterior capsulotomy, no contact lens was used compared with the use of contact lens, there was no significant difference in accumulated energy, and the average energy used was larger, but the number of laser points could be reduced, and the operation time was shorter. The clinical effect of the two groups of patients No difference was observed.

Key words: Posterior cataract, Nd∶YAG laser, Contact lens, Capsulotomy, Posterior capsule opacification

中图分类号: 

  • R779.6
[1] Sundelin K, Almarzouki N, Soltanpour Y, et al. Five-year incidence of Nd∶YAG laser capsulotomy and association with in vitro proliferation of lens epithelial cells from individual specimens:a case control study[J]. BMC Ophthalmol, 2014, 14(2):116. doi:10.1186/1471-2415-14-116.
[2] Sen P, Kshetrapal M, Shah C, et al. Posterior capsule opacification rate after phacoemulsification in pediatric cataract: Hydrophilic versus hydrophobic intraocular lenses[J]. J Cataract Refract Surg,2019,45(10):1380-1385. doi: 10.1016/j.jcrs.2019.05.018.
[3] Kalauz M, Masnec S, Kordi c R, et al. Posterior Capsule Opacification and Nd∶YAG Rates with Two Acrylic Intraocular Lenses after Age-Related Cataract Treatment: Three-year Results[J]. Semin Ophthalmol, 2018, 33(3):395-401. doi: 10.1080/08820538.2016.1247182.
[4] Schartmüller D, Schriefl S, Schwarzenbacher L,et al. Posterior capsule opacification and Nd∶YAG laser rates with two hydrophobic acrylic single-piece IOLs[J]. Eye(Lond),2020,34(5):857-863. doi: 10.1038/s41433-019-0569-x.
[5] Schartmüller D, Schriefl S, Schwarzenbacher L, et al. Posterior capsule opacification and Nd∶YAG laser rates with two hydrophobic acrylic single-piece IOLs[J]. Eye(Lond), 2020,34(5):857-863. doi:10.1038/s41433-019-0569-x.
[6] 李凤鸣.中华眼科学[M].北京:人民卫生出版社,2005:1620-1621.
[7] Wormstone IM, Wormstone YM, Smith AJO, et al. Posterior capsule opacification: What's in the bag? [J]. Prog Retin Eye Res, 2021, 82:100905. doi: 10.1016/j.preteyeres.2020.100905.
[8] Schartmüller D, Schriefl S, Schwarzenbacher L,et al. Posterior capsule opacification and Nd∶YAG laser rates with two hydrophobic acrylic single-piece IOLs[J]. Eye(Lond), 2020, 34(5):857-863. doi:10.1038/s41433-019-0569-x.
[9] Nanu RV, Ungureanu E, Instrate SL,et al. An overview of the influence and design of biomaterial of the intraocular implant of the posterior capsule opacification[J]. Rom J Ophthalmol, 2018,62(3):188-193. doi: PMID: 30505987; PMCID: PMC6256071.
[10] 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.doi:10.3760/cma.j.cn115909-20190521-00146. ZHOU Ya, XU Xu, LIN Quankui. Research progress of intraocular lens surface modification in inhibiting posterior cataract[J]. Chinese Journal of Optometry and Vision Science, 2020,22(8):630-636. doi:10.3760/cma.j.cn115909-20190521-00146.
[11] Zhang Z, Huang W, Lei M, et al. Laser-triggered intraocular implant to induce photodynamic therapy for posterior capsule opacification prevention[J]. Int J Pharm, 2016, 498(1-2):1-11. doi: 10.1016/j.ijpharm.2015.10.006.
[12] 陈吉孟,李正义,陈宝伟,等.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. doi:10.3760/cma.j.cn115909-20190831-00238. CHEN Jimeng, LI Zhengyi, CHEN Baowei, et al. Nd∶YAG laser treatment of capsular bag shrinkage syndrome after cataract surgery[J]. Chinese Journal of Optometry and Vision Science, 2020,22(7):536-539. doi:10.3760/cma.j.cn115909-20190831-00238.
[13] 中华医学会眼科学分会白内障与人工晶状体学组. 我国散光矫正型人工晶状体临床应用专家共识(2017年)[J]. 中华眼科杂志,2017,53(1): 7-10. doi:10.3760/cma.j.issn.0412-4081.2017.01.003. Cataract and Intraocular Lens Group, Ophthalmology Branch of Chinese Medical Association. Expert consensus on clinical application of astigmatism-correcting intraocular lens in my country(2017)[J]. Chinese Journal of Ophthalmology, 2017, 53(1): 7-10. doi: 10.3760/cma.j.issn.0412-4081.2017.01.003.
[14] Peyman GA, Goldschmidt CR. A new contact lens for Nd∶YAG laser capsulotomy[J]. Can J Ophthalmol, 1986, 21(7):269-70. PMID: 3801974.
[15] March WF, Rol P. Proposal for a new contact lens for YAG laser posterior capsulotomies[J]. Ophthalmic Surg, 1987, 18(1):59-60. PMID: 3561939.
[16] Waseem M,Khan HA.Association of raised intraocular pressure and its correlation to the energy used with raised versus normal intraocular pressure following Nd∶YAG laser posterior capsulotomy in pseudophakes[J]. J Coll Physicians Surg Pak, 2010, 20(8):524-527. PMID: 20688017.
[17] Teshigawara T, Meguro A, Mizuki N. Nd∶YAG laser accidentally hitting the corneal layers during treatment of posterior capsule opacification after cataract surgery and Its postoperative process[J]. Int Med Case Rep J, 2020, 21(13):449-453. doi: 10.2147/IMCRJ.S271669.
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