焦点激光治疗黄斑水肿的临床观察

A clinical research on treatment of macula edema with focal argon laser

目的 :试用焦点激光治疗黄斑水肿 ,以挽救和保存患眼视力。方法 :以眼底荧光血管造影进行分类 :(1)局限性黄斑水肿 :直接光凝渗漏点。 (2 )漫性黄斑水肿 :用格栅状光凝法 ,距黄斑中心凹 5 0 0 μm以外光凝 ,共光凝 2～ 3排。结果 :本组 45例 ,经3个月～ 3年的观察 :1视力 :保持原有视力者 35例 (43只眼 )占 78% ;提高 2行以上者 8例占 18% ;下降 2行以上者 2例占 4%。2黄斑水肿消退情况 :32例 (71% ) 3～ 6个月后经过眼底荧光血管造影复查证实黄斑渗漏消失 ,水肿完全吸收 ;11例 (2 5 % )水肿大部分吸收 ;2例 (4% )黄斑渗漏仍存在 ,原有水肿无明显吸收。结论 :焦点激光光凝是治疗黄斑水肿的有效方法之一 ,只要选择好病例 ,注意掌握好使用技术 ,可达到消除水肿 。

Objective:For saving and preserving the treated eyes vision,the therapeutic effect of focal argon laser photocoagulation for macular edema were presented in this paper.Method:The treated eyes were divided into two groups:①Focal macular edema:leakage points were photocoagulated by focal argon laser.②Diffuse macular edema:retina out of fovea by 500 micron were photocoagulated two to three lines burns by mode of scatter photocoagulation.Results:All the 45 patiets were followed up for 3 months to 3 years.The results were:(1)The visual acuity from the records in latest follow up in 45 eyes was found no change in 78%(43 cases),better in 18%(8 cases)and worse in 4% (2 cases).(2)The macular edema justified by fundus fluorescein angiography in 3 to 6 months follow ups was completely aborbed in 71%(32 cases),almostly absorbed in 25%(11 cases),almostly absorbed in 25%(11 cases)and no absorbed obviously in 4%(2 cases).Conclusion:The treatment of macular edema with focal argon laser photocoagulation was effective in our clinical study,whereas,we must select proper patients,master the techniques for preserving the patients vision.