术后光凝代替术中冷凝治疗高度近视视网膜脱离疗效及舒适度分析

Argon laser photocoagulation treatment efficacy and comfort analysis of high myopia retinal detachment instead of condensation

目的观察高度近视视网膜脱离手术后应用氩激光光凝封闭视网膜裂孔和术中巩膜外冷凝封闭视网膜裂孔的疗效与舒适度。方法利用同期性对照研究方法。将高度近视视网膜脱离手术后应用氩激光光凝封闭视网膜裂孔患者2l例21只眼（术后光凝组），与同期术中冷凝封闭视网膜裂孔患者19例19只眼（术中冷凝组）进行对照，并进行短期随访观察疗效以及评价两组患者的术后舒适度。结果随访时间为6个月，术后光凝组一次治愈率为95．23％，术中冷凝组为94．73％，两组差异无统计学意义（P〉O．05）。术后6月脱盲（视力t〉0．05）率术后光凝组为90．48％（19／21），术中冷凝组为52．63％（10／19），两组差异具有统计学意义（x2=7．16，P〈0．05）。以5分法评估两组患者术后眼部的疼痛程度来评价两组患者的术后舒适度，其中术后光凝组、术中冷凝组在术后1h以及术后1周的舒适度相当，两组差异比较均无统计学意义（P〉O．05）。术后光凝组术后第1天、第2天、第3天的舒适度均优于术中冷凝组，两组差异均具有统计学意义（P〈0．05）。结论高度近视视网膜脱离术后应用氩激光光凝封闭裂孔，定位准确，简化手术操作，对视功能的恢复有帮助，且有较好地舒适度，患者易接受。

Objective To observe the effect and comfort of the argon laser phatocoagulation in stead of cryotherapy for retinal detachment （RD） in high myopia after surgery. Methods Patients were divided into two groups. After the surgery of 21 high myopia patients with 21 retinal detach ment in group 1, the application of argon laser photocoagulation of retinal break alternative intraop erative scleral condensation closed hole （19 high myopia patients with 19 retinal detachment in group 2）, and shortterm followup effects were observed. Results All cases were followed up for 636 months, postoperatively healing rate was 95.23% in group 1 and 94.73% in group 2. There was no significant difference between two groups in healing rate （P 〉0.05）. The visual acuity was improved in 19 cases （90.48%） of group 1, and 10 cases （52.63%） of group 2. There was signifi cant difference between two groups （Z2=7.16, P 〈0.05）. Postoperative ocular pain severity was mea sured using 5 point evaluating method to evaluate patients＇ comfort of the two groups. Comfort of the two groups showed no significant statistical significance （P 〉0.05） after 1 hour and 1 week of operation. But the first day, two days, three days of comfort after operative of the group 1 were bet ter than the group 2, the difference between the two groups were statistically significant （P 〈0.05）.Conclusions Using postoperative argon laser treat accurate retinal detachment in high myopia can ac curately position and simplify the surgical procedure, shortly operative time. And patients have a bet ter comfort, fewer complications and benefit to visual function.