Nd:YAG激光应用中对眼组织的损害及预防

Application of Nd:YAG laser for damage and prevention laser in ocular tissue

目的:Nd:YAG激光在应用中所发生的并发症,系统分析了出现的原因,提出了治疗方法及预防措施。方法:2009-12/2012-12共计387例597眼激光爆破中对眼组织的损害:包括炎性反应,一过性高眼压,角膜内皮点状混浊,前房出血,人工晶状体损伤等,并对相关的指标进行了量化处理。结果:青光眼虹膜穿孔术:炎性反应93.7%,一过性高眼压78.9%,前房出血23.7%,虹膜后粘连2.63%,虹膜根部断离0.53%,视网膜出血0.53%。人工晶状体前膜切开术:炎性反应20%,一过性高眼压33.3%,前房出血46.7%,人工晶状体损伤33.3%。人工晶状体后囊膜切开术:炎性反应19.2%,一过性高眼压17.8%,前房出血0.3%,人工晶状体损伤26.0%。结论:Nd:YAG激光在眼前节中的治疗作用是安全确实的,其对眼组织的损害与机器性能,操作者的经验,疾病的种类及程度,患者的配合等密切相关,了解了这些因素有针对的干预可避免或减少对眼组织的损害。

AIM. To study the causes of complications in the application of Nd.YAG laser and provide the treatment and prevention. METHODS： There were 387 cases （597 eyes）injured on ocular tissues by laser blasting, and the damage included inflammatory reaction, transient high intraocular pressure, corneal endothelial punctate opacity, anterior chamber hyphema, intraocular lens injury, and etc. The related values were dealt with quantitative processing. RESULTS： Glaucoma iris perforation： inflammatory reaction in 93.7%, transient high intraocular pressure in 78.9%, anterior chamber hyphema in 23.7%, posterior synechia in 2. 63%, iridodialysis in 0. 53%, retinal hemorrhage in 0. 53%. Intraocular lens anterior membrane incision： inflammatory reaction in 20%, transient high intraocular pressure in 33.3%, anterior chamber hyphema in 46. 7%, intraocular lens injury in 33.3%. Intraocular lens posterior capsule incision： inflammatory reaction in 19.2%, transient high intraocular pressure in 17.8%, anterior chamber hyphema in 0.3%, intraocular lens injury in 26.0%. ~ CONCLUSION： It is safe to use Nd：YAG laser in the treatment of anterior segment. The ocular tissue damage is related with the performance of the machine, the types and degree of the diseases, and the cooperation of the patients. Learning these will help to avoid and decrease the ocular tissue damage.