通讯作者: 田鹏飞, tpf1006@126.com

DOI：10.12201/bmr.202602.00032

• 摘要：膨胀期白内障前囊膜放射状撕裂征（Intumescent Cataract Anterior Capsular Radial Tear Sign, IC-ACRTS）是白内障超声乳化手术中一种特异且严重的前囊膜并发症，主要表现为连续环形撕囊（continuous curvilinear capsulorhexis，CCC）过程中，撕囊边缘向晶状体赤道部发生放射状撕裂，经台盼蓝染色后呈现典型的放射状撕裂外观。随着人口老龄化加剧，膨胀期白内障及假性剥脱综合征等复杂病例比例逐年上升。尽管IC-ACRTS的发生率为2%-8%，但其极易继发后囊破裂、玻璃体脱出等严重并发症，严重威胁手术安全性及患者预后。本文系统综述了IC-ACRTS的病理机制（晶状体囊内高压、囊膜生物力学改变）、风险防控体系（术前超声生物显微镜（ultrasound biomicroscopy，UBM）或前节光学相干断层扫描（anterior segment optical coherence tomography，AS-OCT）评估、前囊穿刺减压、飞秒激光辅助）及术中分级处理策略（利特尔挽救手法、囊袋张力环（capsular tension ring，CTR）植入）。规范化的防治策略对提升复杂白内障手术安全性具有重要临床意义。

  关键词： 前囊膜撕裂；白内障超声乳化术；连续环形撕囊；囊膜张力环；并发症防治; ; ; ; ; 

   

  Abstract: Argentine Flag Sign (AFS) is a specific and severe anterior capsule complication during phacoemulsification for cataract, characterized by radial tears extending from the edge of the continuous curvilinear capsulorhexis (CCC) to the lens equator. After trypan blue staining, the tear presents a blue-white-blue striped appearance, resembling the Argentine national flag, hence the name. With the aging of the population, the proportion of complex cataract cases such as intumescent cataract and pseudoexfoliation syndrome is increasing. Although the incidence of AFS is only 2%-8%, it can easily lead to severe secondary complications such as posterior capsule rupture and vitreous prolapse, significantly affecting surgical safety and patient prognosis. This article systematically reviews the clinical pathogenesis, risk prevention and control, and intraoperative management strategies of AFS. Studies have shown that the core pathogenic factors include abnormally increased intraocular lens pressure (up to 40-60 mmHg in intumescent cataract), decreased biomechanical properties of the anterior capsule due to disordered collagen fiber arrangement (thickness reduced by 20%-30%), and irregular capsulorhexis techniques. Clinical prevention should establish a dual system of preoperative accurate evaluation and intraoperative technical optimization: preoperatively, ultrasound biomicroscopy (UBM) or anterior segment optical coherence tomography (AS-OCT) is used to quantify lens thickness and anterior chamber depth, and different risk types such as cortical liquefaction type and core swelling type are distinguished; intraoperatively, anterior capsule puncture decompression (success rate 85%-92%), two-step capsulorhexis (incidence reduced to 1.3%) or femtosecond laser-assisted technology are preferred, combined with capsule staining to improve operational controllability. Once AFS occurs, graded treatment should be carried out according to the tear severity: small tears (<2 mm) are repaired by viscoelastic agent filling and edge alignment; large tears (>3 mm) are converted to can-opener capsulotomy or circular capsulorhexis conversion technology, combined with capsular tension ring (CTR) implantation to stabilize the capsular bag structure (success rate 95%-99%). After standardized treatment, 80%-90% of patients can achieve a best-corrected visual acuity of ≥0.5 at 6 months postoperatively. The prevention and control strategies and graded management plan summarized in this article have important clinical guiding significance for improving the safety of cataract surgery and optimizing patient prognosis.

  Key words: Argentine Flag Sign; Anterior Capsule Tear; Phacoemulsification; Continuous Curvilinear Capsulorhexis; Capsular Tension Ring; Complication Prevention and Treatment

  提交时间：2026-02-10

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-01-13	10.12201/bmr.202602.00032V1	下载

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