间接检眼镜激光在玻璃体切割术中的应用

Binocular Indirect Ophthalmoscopic Laser Photocoagulation in Vitrectomy

目的 探讨间接检眼镜激光在玻璃体切割术中应用的方法和疗效。方法 对 76例 78只眼行玻璃体切割手术 ,术中应用间接检眼镜激光对视网膜进行光凝 ,光凝的范围是中周部以前的视网膜 ,重点是视网膜裂孔缘周围的视网膜、视网膜新生血管膜及视网膜无灌注区。曝光时间 10 0ms,输出功率为 2 40～ 6 5 0mW ,在裂孔缘视网膜及新生血管膜上形成Ⅲ级光斑 ,视网膜无灌注区形成Ⅰ～Ⅱ级光斑。结果 未脱离的视网膜及脱离的视网膜在重水或硅油充填复位的条件下顺利地进行了间接检眼镜激光光凝。术后 2周内对其中的 19例 2 2只眼行眼底荧光造影 (FFA)检查 ,13例需补充光凝。术后 1月复查 ,光斑色素增生 ,视网膜裂孔封闭好 ,术后 3个月复查FFA ,2 1只眼视网膜无灌注区和新生血管消失。结论 间接检眼镜激光在玻璃体切割术中的应用几乎能达到眼内激光相同的疗效。

Objective To study the efficacy and methods of binocular indirect ophthalmoscopic (BIOM) laser photocoagulation in vitrectomy procedure. Methods 76 cases (78 eyes) underwent vitrectomy. BIOM laser coagulation was used in midperipheral and peripheral retina, especially in margin of retina hole、neovascular membrane and capillary nonperfusion. Laser power level at 240 mW-650 mW for 100ms was used to produce grade Ⅰ-Ⅱ spot in capillary nonperfusion and grade Ⅲ spot in margin of retina hole or neovascular membrane. Results BIOM laser photocoagulation was performed successfully in attached retina or reattached retina with silicone oil or fluid perfluocarbon fill-in. Conclusions Efficacy of BIOM laser photocagulation may achieve similar results as that of intraocular laser photocoagulation in vitrectomy procedure.