To Observe The Clinical Efficacy Of Nd:YAG Laser In The Treatment Of Capsular Contraction Syndrome After Combined Anterior And Posterior Segment Surgery

Objective:To investigate the clinical efficacy of Nd:YAG laser in the prevention and treatment of capsular contraction syndrome(CCS)after combined anterior and posterior segment surgery.Methods:A total of 51 patients(51 eyes)who underwent phacoemulsification and intraocular lens(IOL)implantation combined with pars plana vitrectomy(PPV)in Zhejiang Provincial People’s Hospital from September 2021 to September 2022 were selected.According to the inclusion and exclusion criteria and excluding the reasons such as loss to follow-up and refusal to participate in this study.A total of 38 patients were included in this prospective study.According to the principle of minimizing differences,the patients were randomly divided into three groups:12 patients in experimental group A(Nd:YAG laser radial cutting of the anterior capsule opening at 1 week after surgery),13 patients in experimental group B(Nd:YAG laser radial cutting of the anterior capsule opening at 1 month after surgery),and 13 patients in control group(Nd:YAG laser radial cutting of the anterior capsule opening at 1 month after surgery).There were 13 patients in the control group(without Nd:YAG laser radial incision during the follow-up period).The area,area change rate(the ratio of the decrease of the area value in each time period after operation compared with the area value at operation to the area value at operation),transverse diameter,transverse diameter change rate(the ratio of the reduction of the transverse diameter value at each time point after operation to the transverse diameter value at operation was calculated)and the three groups of eyes were observed.The changes of circumference were analyzed statistically.Results:1.Comparison of the average anterior capsule ostium area,transverse diameter and circumference at each time point after PPV:between groups:at 1 week after PPV,there was no significant difference in the area,transverse diameter and circumference of the capsule ostium among the three groups(P>0.05);At 1 month,3 months and 6 months after operation,there were statistically significant differences in the area,transverse diameter and perimeter of the capsule among the three groups(P<0.05).Within the group:at 1 month,3 months and 6 months after operation,the area,transverse diameter and circumference of the capsule mouth gradually decreased in the three groups,and the difference was statistically significant(P<0.05).2.Comparison of the average reduction rate of anterior capsule orifice area and transverse diameter at each time point after operation:between groups:1 month,3 months and 6 months after operation:there were significant differences in the reduction rate of anterior capsule orifice area and transverse diameter among the three groups(P<0.05).Within the group:at 1,3 and 6 months after operation,the reduction rate of cyst orifice area and transverse diameter gradually increased in the three groups(P<0.05)..3.Comparison of intraocular pressure at different time points after operation:there was no significant difference in intraocular pressure among the three groups at 1 week,1 month,3 months and 6 months after operation(P>0.05).4.Comparison of decentration distance at each time point after operation:at 1 week,1 month,3 months and 6 months after operation,there was no statistically significant difference in horizontal decentration distance and vertical decentration distance among the three groups(P>0.05).Conclusion:1.Early Nd:YAG laser can delay the contraction speed of the pocket and reduce the incidence of CCS,which can safely and effectively prevent CCS.2.From 1 month to 3 months after cataract phacoemulsification with intraocular lens implantation combined with PPV,the area,transverse diameter and perimeter of the anterior capsule changed most obviously,and the contraction of the anterior capsule mouth tended to be stable after 3 months.