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[收稿日期]2007209204

[作者单位]安徽医科大学第一附属医院眼科,安徽合肥230022[作者简介]冯先余(1967-),男,硕士研究生,副主任医师(现在安徽

省庐江县人民医院眼科,231500)

[通讯作者]陶黎明,男,研究生导师,教授.

[文章编号]100022200(2009)0120087202・综　述・

人工晶体因素对后囊混浊的影响研究进展

冯先余　综述,陶黎明　审校

[关键词]晶体,人工;白内障摘除术;后囊混浊;综述

[中国图书资料分类法分类号]R 318.18;R 779.66 [文献标识码]A

后囊混浊(posteri or cap sule opacificati on,PCO )是白内障术后远期视力下降的主要原因。PC O 的影响因素较多且复杂。临床资料已证明,人工晶体(intraocular lens,I O L )不仅可以矫正视力,与白内障囊外摘除术相比还可以使术后PCO 发生率降低[1],可见I O L 与PCO 之间有一定的关系。有研究表明,人工晶体的诸多因素对PCO 的发生有较大影响。本文就人工晶体因素对后囊膜混浊的影响作一综述。1　人工晶体材料与PC O 不少研究者对I O L 植入术后患者后囊混浊情况的分析表明,植入软性丙烯酸酯(Acrys of )I O L 者后囊混浊发生的比例比聚甲基丙烯酸甲酯(P MMA )和硅凝胶(Silicone )者明显减少[2],而P MMA 和Silicone 之间并无统计学意义[3,4]。但同样是丙烯酸酯I O L,植入亲水性I O L 术后发生对视力有影

响的PCO 比率比植入疏水性I O L 高[5]。Georgopoul os 等[6]

比较了Silicon 和水凝胶(Hydr ogel )两种材料I O L 时发现术

后前6个月,Silicone 组前囊连续环形撕囊(ACCC )开口范围减小比Hydr ogel 组更明显。Silicone 组前囊截囊口收缩还伴有随后囊截囊口的扩大。Silicone 材料I O L 引起囊膜的主要变化为纤维化,而Hydr ogel I O L 主要引起I O L 表面的晶体上

皮细胞(LECs )增生。但N ishi 等[7]

研究了I O L 种类及光学部分形状与后发性白内障的关系时发现I O L 材料对于PC O 的发展并不重要。

Hollick 等

[4]

将90只眼随机植入P MMA 、Silicone 和

Acrys of 材料的I O L,所有I O L 都是相同大小的光学部及襻,

连续环形撕囊,术后6个月和1、2、3年复查。结果表明,3年后3种材料I O L 后囊膜混浊的百分数差异有统计学意义。Acrys of 后囊膜混浊(10%)比P MMA (56%)和Silicone (33.5%)少。认为使用Acrys of 材料的I O L 与使用P MMA 、

Silicon 材料的I O L 相比能显著降低后囊膜混浊的发生。

程金伟等[8]通过对不同生物材料人工晶体与后囊混浊相互关系的Meta 分析发现,4种常见I O L 材料的后囊混浊发生率由低至高依次为聚丙烯酸、硅凝胶、P MMA 、水凝胶。认