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[摘要]
目的：使用EPCO2000定量比较不同表面处理及设计人工晶状体(IOL)对后囊膜混浊(PCO)发生的影响。
方法：回顾性研究，随访观察2016-03/11在我院行白内障超声乳化吸除联合人工晶状体植入术后1a的年龄相关性白内障患者600例971眼。按IOL类型分为4组：ZCB00组43眼，ZA9003组365眼； HQ-201HEP组340眼，Human Optics组223眼。充分扩瞳后获取后照法图片，使用EPCO2000进行PCO程度评分并将各组进行比较分析。
结果：PCO累及瞳孔中央3mm的有167眼(17.2%)，发生显著性PCO或已行Nd：YAG激光后囊膜切开术的有78眼(8.0%)； 按IOL光学面材料疏水性分组，疏水组总分0.000(0.000，0.012)显著低于亲水组0.127(0.056，0.242)(P<0.05)； 按IOL光学面肝素修饰与否分组，无肝素修饰组总分0.127(0.056，0.242)低于肝素修饰组0.175(0.067，0.371)(P<0.05)； 按IOL一片式及三片式设计分组，一片式组总分0.000(0.000，0.012)显著低于三片式组0.120(0.041，0.247)(P<0.05)； 按襻成角分组，襻成角0°组总分0.107(0.000，0.212)低于襻成角5°组0.142(0.051，0.298)(P<0.05)。
结论：一片式疏水性直角边缘设计的丙烯酸酯IOL可以更有效地减少PCO形成。
[Key word]
[Abstract]
AIM: To quantitatively compare the effects of different surface treatments and designs of intraocular lens(IOL)on posterior capsule opacification(PCO)using EPCO2000.
METHODS: A retrospective study was conducted to observe 600(971 eyes)age-related cataract patients after 1a of phacoemulsification with implantation of intraocular lens in our hospital from March to November 2016. Patients were divided into 4 groups based on the type of IOL implant: 43 eyes in ZCB00 group, 365 eyes in ZA9003 group, 340 eyes in HQ-201HEP group and 223 eyes in Human Optics group. Retroillumination slit-lamp photographs were taken after the pupil was fully dilated and the degree of PCO was scored by EPCO2000 and compared among the groups.
RESULTS: There were 167 eyes(17.2%)with PCO involving the central 3mm of the pupil and 78 eyes(8.0%)with significant PCO or Nd:YAG laser capsulotomy. According to the hydrophobicity of IOL optical surface materials, the total score of hydrophobic group 0.000(0.000, 0.012)was obviously lower than that of hydrophilic group 0.127(0.056, 0.242)(P<0.05). The total score of heparin-free group 0.127(0.056, 0.242)was lower than that of heparin-modified group 0.175(0.067, 0.371), and the difference was statistically significant(P<0.05). The total score of single-piece group 0.000(0.000, 0.012)was obviously lower than that of three-piece group 0.120(0.041, 0.247)(P<0.05). According to the different haptic angular magnitude of IOL, the total score of the 0° haptic anglulation group 0.107(0.000, 0.212)was lower than that of the 5° haptic anglulation group 0.142(0.051, 0.298), and the difference was statistically significant(P<0.05).
CONCLUSION: A single-piece, square-edged, hydrophobic acrylic IOL can reduce PCO formation more effectively.
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