背景:使用囊袋张力环(CTR)植入治疗弱带状白内障患者仍然存在争议。这项研究的目的是检查CTR植入对白内障超声乳化术后囊膜稳定性的影响,尤其是接受过平坦部玻璃体切除术(PPV)或患有严重近视的患者。
方法:共有42例接受超声乳化手术并接受人工晶状体(IOL)的患者被随机分为是否接受CTR植入术。对照组和CTR组在未矫正远距视力(UDVA)方面进行比较,最佳远距矫正视力(BCDVA),屈光预测误差,前撕囊区域,和IOL倾角。术后1天进行随访,1周,1个月和3个月。根据PPV和重度近视进行亚组分析。
结果:手术在CTR和对照组患者中显著改善了UDVA和BCDVA,两组在所有随访时间的屈光预测误差相似。手术后3个月,CTR患者的前撕囊面积明显大于对照组(p=0.0199).这些差异在重度近视患者的亚组之间也是显著的。术后3个月,CTR组垂直IOL倾角较小,尤其是重度近视患者(p=0.0286)。术后1周,在CTR患者中,晶状体后囊完全粘附于IOL后表面的个体比例明显较高(p=0.023).未观察到严重的手术并发症。
结论:CTR植入术可以通过保持囊袋的形状使弱小带的白内障患者受益,减少胶囊收缩和稳定IOL倾斜。
背景:中国临床试验注册中心ChiCTR-INR-17011217,注册日期2017年4月22日,前瞻性注册。
BACKGROUND: The use of capsular tension ring (CTR) implantation to treat cataract patients with weak zonules is still controversial. The aim of this study was to examine the effects of CTR implantation on capsular stability after phacoemulsification in patients with weak zonules, especially patients who have undergone pars plana vitrectomy (PPV) or those who suffer from severe myopia.
METHODS: A total of 42 patients who underwent phacoemulsification and received an intraocular lens (IOL) were randomized to undergo CTR implantation or not. The control and CTR groups were compared in terms of uncorrected distant visual acuity (UDVA), best corrected distant visual acuity (BCDVA), refractive prediction error, the area of anterior capsulorhexis, and IOL inclination angle. Follow-up visits were conducted postoperatively at 1 day, 1 week, 1 month and 3 months. Subgroup analyses were performed based on PPV and severe myopia.
RESULTS: Surgery significantly improved UDVA and BCDVA to similar extents in CTR and control patients, and refraction prediction error was similar between the two groups at all follow-up times. At 3 months after surgery, the area of anterior capsulorhexis was significantly larger in CTR patients than in controls (p = 0.0199). These differences were also significant between the subgroups of patients with severe myopia. Vertical IOL inclination was less within CTR groups at 3 months after surgery, especially in patients with severe myopia (p = 0.0286). At 1 week postoperatively, the proportion of individuals whose posterior lens capsule that had completely adhered to the posterior IOL surface was significantly higher among CTR patients (p = 0.023). No serious surgical complications were observed.
CONCLUSIONS: CTR implantation can benefit cataract patients with weak zonules by maintaining the shape of the capsular bag, reducing capsule shrinkage and stabilizing IOL inclination.
BACKGROUND: Chinese Clinical Trial Registry ChiCTR-INR-17011217 , date of registration April 22, 2017, prospectively registered.