Objective To evaluate the influence of Nd:YAG laser capsulotomy size on refraction,intraocular pressure and macular thickness in posterior capsule opacification (PCO)patients. Methods We retrospectively evaluated 83 eyes of 76 patients treated with Nd:YAG laser posterior capsulotomy for PCO. Patients were divided into two groups ac-cording to the size of capsulotomy,Group A (3. 5 ~ 4. 5 mm)and Group B (4. 6 ~ 5. 5mm). Changes in best corrected visual acuity (BCVA),spherical equivalent (SE),intraocular pressure and macular thickness were examined preopera-tively and 1 day,1 week,and 1 month after capsulotomy. Results Postoperative BCVA in both groups significantly im-proved after surgery (P < 0. 05),and there was no difference between the two groups. Postoperative SE were also signifi-cantly higher (P < 0. 05). SE at later (1 month)was higher than that at early time point (1 day or 1 week)after surger-y. In addition,SE in Group B were significantly higher than that in Group A (P < 0. 05). Intraocular pressure at 1 day significantly increased in both groups,but returned to preoperative levels from 1 week. No significant difference was found between the two groups. Macular thickness at 1 day and 1 week were significantly higher (P < 0. 05)but return to normal at 1 month. Conclusions The changes of intraocular pressure and macular thickness after Nd:YAG capsulotomy were in-dependent to the size of capsulotomy,yet a larger capsulotomy induced a higher hyperopic shift.%目的 探讨Nd:YAG激光后囊膜切开孔径大小对后发性白内障患者术后屈光度、眼压和黄斑厚度的影响.方法 回顾性分析Nd:YAG激光后囊膜切开术治疗后发性白内障患者76例(83只眼),根据后囊膜切开孔径大小,将患者分为两组:A组3.5~4.5 mm,B组4.6~5.5 mm,观察术前以及术后1 d、1周、1个月患者最佳矫正视力(BCVA)、等效球镜(SE)、眼压和黄斑厚度的变化.结果 A组和B组术后BCVA均较术前明显提高(P<0.05),而两组间BCVA差异均无统计学意义(P>0.05).术后两组SE均较术前增加(P<0.05);术后1个月两组SE均高于术后1 d、1周(P<0.05),且B组患者SE大于A组(P<0.05).术后1 d两组眼压均较术前升高(P<0.05);而与术前相比,术后1周、1个月两组眼压差异无统计学意义(P>0.05);两组间眼压差异均无统计学意义(P>0.05).术后1 d、1周两组黄斑厚度均较术前增加(P<0.05);而术后1个月两组黄斑厚度与术前相比,差异无统计学意义(P>0.05);两组间黄斑厚度差异均无统计学意义(P>0.05).结论 Nd:YAG激光后囊膜切开孔径的大小与术后眼压、黄斑厚度的改变无关,但较大的切开孔径会引起更多的远视漂移.
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