激光诱导脉络膜视网膜吻合初步实验研究

Experimental Research of Laser-induced Chorioretinal Venous Anastomosis in Retinal Vein Occlusion

目的 探讨不同激光能量诱导脉络膜视网膜静脉在家免视网膜分支静脉阻塞眼的吻合成功率及安全性。方法 通过光动力法建立 20只兔眼视网膜静脉阻塞模型,24h后以 50 m 光斑,0.1 s的氪红离子激光的不同能量(A组 800mW.B组 1000mW)诱导脉络膜视网膜静脉间的吻合。对侧无静脉阻塞眼以作对照。在实验1、2、4、6 周时进行眼底照相和荧光眼底血管造影检查,测定吻合成功率。结果 在建立 BRVO模型的 20只眼中。A组诱导成功率 30%,激光对周围组织损伤中等;B组诱导成功率 40%;但激光对周围组织的损伤重。在对照组眼中,1只眼形成脉络膜视网膜静脉吻合。A、B实验组与对照组相比,诱导成功率差异有非常显著性意义(P < 0.001);A、B组之间比较成功率差异没有显著性意义(P > 0.1)。结论 利用激光诱导脉络膜视网膜静脉吻合,在技术上可行,较为安全;但在提高成功率方面尚有待进一步研究。

Objective To evaluate the rate of success of anastomosis and safety with different power levels of photocoagulation in rabbit eyes with a model of branch retinal vein occlusion by laser induced chorioretinal venous anastomosis. Methods Byusing different power levels of laser photocoagulation, a chorioretinal venous anastomosis was created in rabbit eyes in which a branch retinal vein occlusion had previously been established photochemically. A similar attempt to create an anastamosis was made in the control eyes in which no branch vein occlusion was present. Fundus photography and fundus fluorescein angiography were performed at various times after the treatment. Results In the 20 eyes with the model of branch retinal vein occlusion, At the power levels of 800mW and 1 000mW (A and B groups) an anastomosis 30% and 40% rate of success were obtained. However, the damage to the retinal and choroids tended to be severer B than A groups. In the control eyes, an anastomosis in one eye presented. The difference of the rate of success of anastomosis between experimental and control group was highly significant (P < 0.001), and the difference between group A and group B was not significant (P > 0.1). Conclusion Chorioretinal venous anastomosis can be created by using laser photocoagulation. This technique is relatively safe. However, to improve the rate of successfully creating an anastomosis, more research work needs to be performed. 〔