方法： 回顾性研究。收集行超声乳化白内障吸除+囊袋内IOL植入术的患者，所植入人工晶状体为两襻三片式IOL(HOYA PY60AD)、四襻一片式IOL(Bausch & Lomb AO)、两襻一片式IOL(AMO Tecnis ZCB00)中任意一种。收集纳入该研究的患者的年龄、性别、眼轴、眼压、人工晶状体类型。术后2d在裂隙灯下评估后囊膜皱褶形成情况。采用logistic回归分析确定后囊膜皱褶发生的风险指标。

结果： 一共收集187例242眼，其中80眼植入HOYA PY60AD IOL，81眼植入Bausch & Lomb AO IOL，81眼植入AMO Tecnis ZCB00 IOL。植入HOYA PY60AD IOL的患眼后囊膜皱褶发生率显著高于植入AMO Tecnis ZCB00 IOL者(56.3% vs 38.3%，P=0.027)。植入Bausch & Lomb AO IOL的患眼后囊膜发生率显著低于植入AMO Tecnis ZCB00 IOL(14.8% vs 38.3%，P=0.001)。多因素logistics回归分析显示人工晶状体类型和眼轴长度是影响皱褶发生的独立风险因素。相较于AMO Tecnis ZCB00 IOL，使用HOYA PY60AD IOL提高后囊膜皱褶发生风险\〖P=0.020，OR(95%CI)=2.145(1.129，4.073)\〗，使用Bausch & Lomb AO IOL降低后囊膜皱褶发生风险\〖P=0.001，OR(95%CI)=0.274(0.127，0.591)\〗； 眼轴越短，后囊膜皱褶发生风险越大\〖P=0.012，OR(95%CI)= 0.669(0.489，0.915)\〗。

结论： 在人工晶状体设计中，晶状体襻是重要考虑因素。相比于AMO Tecnis ZCB00 IOL，HOYA PY60AD IOL更容易出现后囊膜皱褶，Bausch & Lomb AO IOL不容易出现后囊膜皱褶； 眼轴较短的患眼更容易出现后囊膜皱褶。

METHODS:It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification(PHACO)and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs(HOYA PY60AD), 4-haptic 1-piece IOLs(Bausch & Lomb AO), 2-haptic 1-piece IOLs(AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient's age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis.

RESULTS: One hundred eighty-seven patients(242 eyes)had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch & Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs(56.3% vs 38.3%, P=0.027). While the incidence of patients implanted with Bausch & Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs(14.8% vs 38.3%, P=0.001). Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds \〖P=0.020, OR(95%CI)=2.145(1.129,4.073)\〗, while using Bausch & Lomb AO IOLs reduced the risk \〖P=0.001, OR(95%CI)=0.274(0.127, 0.591)\〗. Shorter ocular axis might increase the risk of posterior capsule folds \〖P=0.012, OR(95%CI)=0.669(0.489, 0.915)\〗.

CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch & Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.