Nd∶YAG激光在不同类型后发性白内障中的应用

Application of Nd∶YAG in different types of after cataract

目的:观察Nd∶YAG激光对后发性白内障的治疗效果。方法:对652例830眼分别为Elschnig珍珠样小体性、皱褶性及纤维化性后发性患者行白内障YAG激光治疗,对Elschnig珍珠样小体性、皱褶性后发性白内障采用十字形切开法,对纤维化性后发性白内障视纤维化程度采用开罐式切开术或十字形切开法。根据不同的病变类型选择不同的激光参数,激光后分别于1wk;1mo和3～6mo进行随访眼压、视力及眼部情况。平均随访时间2.72mo。结果:Elschnig珍珠样小体性后发性白内障390眼,激光后眼压保持正常者385眼,视力有所提高者386眼(99.0%);皱褶性后发性白内障320眼,激光后眼压保持正常者320眼,视力提高318眼(99.3%);纤维化性后发性白内障120眼,激光后眼压保持正常者113眼,视力提高者118眼(98.3%)。结论:根据后囊膜混浊的程度和视力的情况灵活选择激光参数,确保高比例有效的脉冲能量,是YAG激光治疗后发性白内障的关键。

AIM ： To evaluate the effect of the Nd ： YAG on the after cataract. METHODS： A total of 652 cases 830 eyes including Elsching pearl after cataract, reductus after cataract and fibrosis after cataract were treated by YAG. According to the different type, different laser parameter was chosen. The Elsching pearl after cataract and reductus after cataract were treated by cruciform incision. And fibrosis after cataract was treated by cruciform incision or canopenning incision depends on the serious of the fibrosis. The intraocular pressure and visual acuity were observed 1 week, 1 month and 3-6 months after therapy, respectively. The average follow-up was 2.72 months.RESULTS.. Among the 390 eyes of Elsching pearl after cataract, the intraocular pressure of 385 eyes was normal, the visual acuity of 386 eyes （99. 0%） was improved. Among the 320 eyes of reductus after cataract, the intraocular pressure of 320 eyes was normal; the visual acuity of 318 eyes （99.3%） was improved. Among the120 eyes of fibrosis after cataract, the intraocular pressure of 113 eyes was normal, the visual acuity of 118 eyes （98.3%） was improved. CONCLUSION： We should choOse the laser parameter flexibly in order to ensure effective high proportion pulse energy, which is vital in the treatment of after cataract by YAG laser.