【摘要】  近10～15a内，随着超乳手术和植入技术的快速发展，白内障手术的成功率大大提高，手术并发症明显减少，但后囊混浊(posterior capsular opacification，PCO)仍然是一个严重的长期并发症。防治PCO已成为目前致力于白内障治疗研究的眼科专业人员不懈努力的目标。目前，通过人工晶状体（intraocular lens，IOL）设计的革新，以减少白内障超乳联合人工晶状体植入手术后后囊混浊的研究是令人瞩目的，并已经取得一些进展，这主要表现在新的人工晶状体设计改善了囊袋弯曲结构的品质。视将对目前正在进行的关于囊袋弯曲结构对后囊混浊影响的研究的一些进展进行综述，并通过探索一些有助于建立囊袋弯曲的因素来帮助眼科医生了解PCO防治的进展。

   【关键词】  白内障　后囊混浊　人工晶状体　囊袋弯曲　囊袋张力环　Soemmering’s ring

　　The new progresses of studies on the influence of capsular opacification with capsular bend formation

    Yi Zhang, Qiang Wu

    Department of Ophthalmology, the Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China

    Abstract In recent 10-15 years, along with phacoemulsification and the technology of intraocular lens transplantation fast development, the success rate of the cataract surgical operation improves greatly and the surgical operation complications obviously reduces, but posterior capsular opacification (PCOs) still keeps being the long-term complication of a severity. To prevent and cure the PCO has become the target for the oculists who concentrate on the researches on the cataract treatment. With the innovation of the intraocular lens design, the researches to reduce PCOs after phacoemulsification with transplanting the IOLs attracts the oculists' attention and causes some progresses which express in the new IOLs' design improving the quality of capsular bend formation. This review investigates the factors contributed to build up the capsular bend formation to help the oculists understanding PCO prevention and cure.

    · KEYWORDS: cataract; capsular opacification; intraocular lens; capsular bend formation; capsular tension rings; Soemmering's ring

　　0引言

    临床的经验告诉我们，白内障手术后很短时间内，晶状体上皮细胞（lens epithelial cells，LECs）就可以开始缓慢的从IOL光学部边缘开始重新填满晶状体囊袋，并在周边部逐步形成一些以再生皮质为实质的结构，即Soemmering’s 环，这过程可能持续3～5a或更久的时间，但是目前的工艺技术无法确定的阻止它的发生。一些新的方法，比如通过密闭囊膜灌洗，囊袋内应用药物，或者通过生物技术，免疫学及基因治疗等也为清除残余LECs提供了新的思路，但这些方法仅仅是针对清除LECs而言。相比而言，通过IOL设计的革新，改善囊袋弯曲结构（capsular bend formation）的建立，以减少PCO进展的研究更令人瞩目。下面将通过探索一些有助于建立囊袋弯曲的因素来帮助眼科医生了解PCO防治的进展。

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