白内障             1673                                      PO0030

　　Primary Evaluation For Severity And Visual Function Of Posterior Capsule Opacification

　　Mingxing Wu, Liangzhu Jiang, Hongpei Ji, Qingning Bian, Ruiping Peng

　　Key Laboratory of Ophthalmology (Sun Yat-sen University), Ministry of Education; Zhongshan Ophthalmic Center. 510060

　　Purpose: To evaluate the severity of posterior capsule opacification (PCO) using subjective and semiobjective analysing methods and to investigate the correlation between the change in visual function and the difference in semiobjective POCOman scores before and after neodymium:YAG (Nd:YAG) laser capsulotomy in cases of PCO.

　　Methods: Following dilation of the pupil (>6.00mm), 38 eyes with PCO in 30 cases were analyzed. Standardized digital retroillumination images were acquired by using slitlamp photogrghic system (digital camera, computer included). The images were evaluated by subjective grading using slitlamp and Volk +90D supplementary lens, and semi-objective quantification method（posterior capsule opacification manual [POCOman] software）by the same and experienced examiners. Best corrected visual acuity (BCVA), contrast sensitivity and glare sensitivity were obtained before and after Nd:YAG laser capsulotomy and the correlation between visual function and PCO score were analyzed.

　　Results: The subjective grading score (grade 0 to 3): 12 eyes belong to grade 1(mild), 17 eyes belong to grade 2(moderate), 9 eyes belong to grade 3(severe). The mean POCOman score (scale 0 to 3) was 1.36 before and 0.12 after Nd:YAG treatment. The severity scores using POCOman show a good correlation with clinical severity scores(r=0.82).   BCVA were significantly improved in all 38 eyes after treatment (p<0.05)：0.2-0.4 in 11 eyes, 0.5-0.9 in 22 eyes, and 1.0 or better in 5 eyes. Contrast sensitivity and glare sensitivity at all visual angles have been more obviously improved postoperatively than before laser treatment (p<0.05). The semi-objective PCO score correlate well with the PCO-induced decrease in visual function at the central area (inside the pupillary aperture) of the posterior lens capsule (r=0.76). Pearls type of PCO at central 3.00mm portion correlated with improvements in visual acuity and contrast sensitivity after capsulotomy. Amount of fibrosis visible at slit lamp and glare assessment were not correlated with vision improvements after laser treatment.

　　Conclusion:  POCOman software has a capability to detect visually significant and early progressive PCO. Before Nd:YAG laser capsulotomy, visual functions correlate significantly with the severity of PCO. Visual acuity is not a “sensitive” enough measurement, the test of contrast sensitivity and glare sensitivity can sensitively, generally reflect sight function of PCO. The combined evaluation for severity and visual function of PCO may be an effective means to offer scientific foundations for selecting operation occasion and accessing surgery curative effect.

　　This work was supported by NSFC30572003 and GZ 2003Z3-E0031.

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