目的探讨可有效预防后发性白内障发生的白内障手术方式。方法将18例实验家兔随机分为A、B、C 3个组，分别进行超声乳化晶状体吸除术、超声乳化晶状体吸除联合后囊膜连续环形撕囊术及超声乳化晶状体吸除联合后囊膜连续环形撕囊及前部玻璃体切除术。术后3个月对3个组术眼进行裂隙灯、眼底、组织病理学及电镜检查。结果术后3个月3个组术眼周边囊膜的混浊情况相似；A、B组术眼中央视区混浊情况相似，C组多数术眼中央视区清亮。3个组均无玻璃体疝、视网膜脱离及黄斑囊样水肿等并发症发生。3个组周边后囊膜均可见形态改变的晶状体上皮细胞及程度相似的Elschnig小体和晶状体纤维。A组后囊膜中央可见Elschnig小体及晶状体纤维，B组可见与后囊膜撕囊孔相连续的纤维增生，C组后囊膜撕囊孔缘未见明显病理改变，无纤维增生。结论超声乳化白内障吸除联合后囊膜连续环形撕囊及前部玻璃体切除术可有效预防中央视区后发性白内障的发生；远期疗效尚需进一步观察。%Objective To discuss the surgical method which can efficiently prevent the occurrence of after cataract. Methods Eighteen experimental rabbits were randomly divided into 3 groups. Group A was treated with phacoemulsification, group B with phacoemulsification combined with posterior continuous curvilinear capsulorhexis (PCCC) and Group C phacoemulsification combined with PCCC and anterior vitrectomy. Post-operatively, all the surgical eyes were checked with slit lamp microscope and ophthalmoscope. At the post-operative 3 months, histopathologic examinations were performed. Results There were no post-operative complications, such as retinal detachment, cystoid macular edema, etc. There were Elschnig′s pearls and fibers in the peripheral area of the posterior capsule, and the amount was about the same in the 3 groups. There were Elschnig′s pearls and fibers at the central area in group A. The fibrous membrane grew from the edge of the PCCC in group B. But in group C, the central area of the posterior capsule was clear, and there was no obvious pathological changes. Conclusion Phacoemulsification combined with PCCC and anterior vitrectomy is a safe cataract surgical method which can effectively prevent the formation of after cataract.
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