国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (2): 101-108.doi: 10.3760/cma.j.cn115500-20241023-25204

• 综述 • 上一篇    下一篇

后发性白内障的发生机制及药物治疗研究进展

丁雪菲  王震宇  宋旭东   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室,北京 100730
  • 收稿日期:2024-10-23 出版日期:2025-04-22 发布日期:2025-04-10
  • 通讯作者: 宋旭东,Email:drxdsong@sina.com
  • 基金资助:
    国家自然科学基金(82271067)

The mechanism and drug treatment of posterior capsular opacification

Ding Xuefei, Wang Zhenyu, Song Xudong   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Science, Beijing 100730, China
  • Received:2024-10-23 Online:2025-04-22 Published:2025-04-10
  • Contact: Song Xudong, Email: drxdsong@sina.com
  • Supported by:
     National Natural Science Foundation of China (82271067)

摘要: 后发性白内障(posterior capsular opacification,PCO)是白内障摘除术后晶状体上皮细胞(lens epithelial cell,LEC)经历炎性反应及上皮间质转化,进而引起LEC增生、迁移能力增强以及细胞外间质沉积,最终形成晶状体后囊膜表面沉积物。目前,YAG激光后囊膜切开是PCO的一线治疗方案,但仍有一定局限性。用于预防PCO的药物多处于体内外实验阶段,尚未广泛应用于临床,如非甾体抗炎药、免疫抑制剂、抗有丝分裂药物以及中药提取物等。此外,生物材料和药物缓释系统的发展也为有效药物递送提供了可能的策略。目前面临的主要挑战是如何在有效抑制LEC增生的同时,避免损害眼内其他组织结构。因此,未来应更加注重药物安全性与治疗窗的扩大,开发更精确、更安全的药物递送系统。(国际眼科纵览,2025, 49:101-108

关键词: 后发性白内障, 非甾体抗炎药, 免疫抑制剂, 抗代谢药, 自噬调控, 酶抑制剂, 中药单体

Abstract: Posterior capsular opacification(PCO) is a condition in which lens epithelial cells (LEC) undergo inflammatory and epithelial-mesenchymal transition after cataract extraction surgery, leading to increased  proliferation, migration, and extracelluar matrix deposition of LEC, ultimately manifesting as the formation of surface deposits on the lens posterior capsule.  Although posterior capsulotomy with YAG laser is the  first-line treatment for PCO, but it still has certain limitations. Although research on the mechanism of PCO has gradually deepened, there are currently no approved drugs specifically for the prevention or treatment of PCO in clinical practice, and most of the drugs currently used for research are in the in vitro and in vivo experimental  practice. The drugs, such as nonsteroidal anti-inflammatory drugs, immunosuppressants, anti mitotic drugs, and traditional Chinese medicine extracts, applied to prevent PCO are mostly in the vitro and  vivo experimental stages and have not yet been widely used in clinic. In addition, the development of biomaterials and drug-sustained delivery systems also provide possible strategies for targeted pharmacological intervention. However, the main challenge currently faced is effectively inhibiting LEC proliferation while avoiding damage to other structures in the ocular. Therefore, future investigation should focus on drug safety and  the expansion of treatment windows. More precise and safer drug delivery systems should also be developed. (Int Rev Ophthalmol, 2025, 49:  101-108)

Key words: posterior capsular opacification, non-steroidal anti-inflammatory drugs, immunosuppressants, antimetabolites, autophagy regulation, enzyme inhibitors, monomers of traditional Chinese medicine