膜性后发障Nd:YAG激光切开术方法探讨

Study of Nd:YAG laser capsulotomy techniques for postoperative membrane cataract

为了探讨各种白内障术后应用Nd∶YAG激光进行膜性后发性白内障切开术的方法 ,对白内障术后35天～ 8年的膜性后发障 10 6眼散瞳下行Nd∶YAG激光 4mm～ 4 .5mm直径切开术。结果表明 ,76眼 (71.6 9% )一次性Nd∶YAG激光击射成功 ,2 4眼 (2 2 .6 4 % )需经 2次～ 4次激光补充击射。经过 3月～ 2年的随访 ,激光术后击穿成功、膜孔形成理想计 10 0眼 (94 .33% ) ,最佳矫正视力提高至 0 .6～ 1.5 ,矫正视力未达 1.0者中 ,有 2 1眼系治疗前原有眼部病变所致。术后并发症有虹膜出血、人工晶体表面细小击痕和玻璃体前界膜破裂 ,均对视力无影响。Nd∶YAG激光膜性后发性白内障切开术是一种安全、有效的治疗方法 ,把握最佳治疗时机、准确操作和预防并发症是提高疗效的关键。

The technique of capsulotomy for postoperative membr an e cataract using Nd∶YAG laser after various cataract extraction is s tudied in order to improve the therapeutic effects.In a postoperative stages ran ging 35 days ～ 8 years,106 eyes with postoperative membrane cataract after v arious types of surgery were treated with 4mm～4.5mm diameter Nd∶Y A G laser posterior capsulotomy under dilated pupils.The results as follow:76 ey es (71.69%) were successfully opened with a single shot and 24 eyes(22.64%)op ened with 2～4 times shots.In a follow up ranged from 3 months ～ 2 years,10 0 eyes(94.33%) were successfully opened on postoperative membrane with the suitabl e holes through Nd∶YAG laser therapy,and the best corrected visual a cuity was improved ranged 0.6～1.5.Other 21 eyes had the corrected visual acuity lower than 1.0 because of the primary eye diseases that existed before the laser treatment.The complications included iris haemorrhage,slight damage on the surf ace of intraocular lens and breakup of anterior vitreous membrance,but had no in fluence upon the vision.It can be concluded that Nd∶YAG laser capsul otomy is a safe and effective technique for postoperative membrane cataract. Han dling of the best opportunity,accurate methods, and preventing of complication i s the key of improving the effects.