| Objective: This research was to explore the safety and efficacy of treating posterior capsular opacification(PCO)by one-port pars plana vitrectomy and primary posterior capsulotomy,and to study its impact on vision,refraction,intraocular pressure and fundus.Methods: The prospective randomized controlled study method was adopted in this research.55 patients(60eyes),were recruited from October 2018 to October 2019,who were diagnosed with PCO in ××× hospital,including 27 males(29eyes)and 28 females(31eyes),aged from 52 to 76,at an average age of(64.6± 9.2)years,9-84(at an average of 14.37±3.56)months after the cataract surgery.According to the method of random digital table,the patients were randomly divided into vitrectomy surgery group(30eyes)and laser surgery group(30eyes).The inclusion criteria of the group were as follows:(1)the patients were diagnosed with PCO after the cataract surgery.(2)Their best corrected visual acuity was less than 0.3 examed by the standard logarithmic visual acuity chart.(3)Their posterior capsular opacities reached grade II(38eyes)or grade III(22eyes).The exclusion criteria:(1)Any history of serious ophthalmic diseases such as glaucoma,uveitis,diabetic retinopathy,hypertensive retinopathy,age-related macular degeneration,retinal vein occlusion.(2)Patients with any cause of refractive media opacity,such as corneal pannus,corneal lcer.(3)Patients whose intraocular len was not implanted in the pouch or was dislocated.(4)Patients who could not be followed up or had any surgical contraindication.Before and after the operation,all the patients in two groups were examed by eye routine examinations and record the best corrected visual acuity(BCVA),equivalent spherical endoscopy(D),intraocular pressure and central macular thickness.SPSS 25.0 software was used to compare the difference before and after the operation respectively and compare the difference between the two groups.Results: Vitrectomy surgery group: 30 eyes were performed by 23 G one-port pars plana vitrectomy and posterior capsulotomy successfully.The difference of the mean value of BCVA(Log MAR)after the operation was statistically significant compared with that before the surgical treatment(P<0.05).The difference between the mean value of equivalent spherical endoscopy(D)after the operation and the preoperative baseline was statistically significant(P<0.05).Every patient's intraocular pressure was normal(10-21 mm Hg)after the operation.The difference between the mean value of CMT after the operation and the preoperative baseline was not significant(P >0.05).Laser surgery group: 30 eyes were performed by Nd:YAG laser and posterior capsulotomy,5 eyes(with severe posterior capsular opacities and fibrosis)were performed twice.The mean value of BCVA(Log MAR)after the operation was significantly different from that before the treatment(P<0.05).The mean value of equivalent spherical endoscopy(D)after the operation was significantly different from that before the treatment(P<0.05).There were 12 patients(12 eyes)with elevated intraocular pressure(22-34 mm Hg)6 hours after the treatment,6 eyes returned to normal in one day,5 eyes appeared to normal in one week,one patients were asked to drop Carteolol hydrochlorlde Eye Drops and returned to normal until one month.The difference between the mean value of CMT at 1week and 1month after the operation and the baseline before the treatment was significant(P<0.05).The difference between the mean value of CMT at 3 months and 6 months after the treatment and the preoperative baseline was not significant(P >0.05).Conclusion: Treating posterior capsular opacification(PCO)by one-port pars plana vitrectomy was obviously safe and effective.The postoperative visual acuity,refractive status and visual experience of the patients were improved significantly and hyperpresbyopia or hyperopic shift disappeared after the operation.The fundus and intraocular pressure was normal after the operation and there was no serious ocular complications. |
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