永存瞳孔膜激光切开术

Laser section for treatment of congenital persistent pupillary membrane

目的 评价严重的永存瞳孔膜Nd∶YAG激光切开术的效果.方法 永存瞳孔膜26例（31眼）,表麻下置角膜接触镜,在裂隙灯显微镜引导下.Nd∶YAG激光准确聚焦于瞳孔缘处的瞳孔膜进行发射.单脉冲切开能量为0.4～0.8 mJ,每次治疗总量为5～10 mJ,平均（2±0.18）mJ.结果 永存瞳孔膜激光切开术1次切开者5眼,占16.13％;2～3次切开者12眼,占38.71％;4～5次切开者14眼,占45.16％.矫正视力;0.1 ～0.25者5眼,占16.13％;0.3～0.5者7眼,占22.58％;0.6～0.8者8眼,占25.81％;≥1.0者,11眼占35.48％.术后未发生晶状体浑浊、视网膜损伤或眼压持续增高等并发症.结论 Nd∶YAG激光切开术治疗严重的永存瞳孔膜可增进视力,不需要专门的手术设备,表面麻醉下就可在门诊施行手术,是一种简便、安全、有效的治疗方法.

Objective To evaluate the clinical effects of Nd∶ YAG laser section for serious congenital persistent pupillary membranes.Methods The contact lens was placed on the cornea under topical anesthesia.The Nd ∶ YAG laser was used in single-pulse mode with energy ranged from 0.4 to 0.8 mJ.The operation was carried out under the slit lamp microscope.The total energy was ranged from 5 to 10 mJ in each treatment time,mainly （2±0.18） mJ.Results 5 eyes were cured by once treatment,accounting for 16.13%.12 eyes （38.71%）were implemented by two or three times of treatment.And 14 eyes（45.16%） had four or five times of treatments.The best corrected visual acuities were 0.1-0.25 in 5 eyes（16.13%）,0.3-0.5 in 7 eyes（22.58%）,0.6-0.8 in 8 eyes （25.81%）,and no less than 1.0 in 11 eyes （35.48%）.The complications,such as lens opacity,retinal damage or continuous ocular hypertension was not observed during the follow-up.Conclusion The Nd∶YAG laser section for serious congennital persistent pupillary membranes is an easy,safe and effective method,which can be performed under surface anaesthesia without special surgical instruments,and can improve visual acuities.