Q开关Nd:YAG激光在黄斑部视网膜前出血中的应用分析

Analysis of Qs-Nd:YAG laser for macular preretinal hemorrhage

目的 :探讨对黄斑部视网膜前出血行Nd :YAG激光早期治疗的必要性。方法 :对 4例发病 7天至 1个月的黄斑部视网膜前出血患者 ,行Q开关Nd :YAG激光出血前表面膜切开。术后随访 7天至 3个月。结果 :其中 2例因视网膜分枝静脉阻塞 ,并黄斑部视网膜前出血 ,病程不超过 15天患者 ,接受激光治疗时 ,血池前表面膜切开后 ,出血引流彻底。随访 1个月视力由治疗前的光感提高到 0 8～ 1 0。另外 2例因病程达 1个月 ,一直药物治疗无效 ,就诊时视网膜前出血部分机化 ,膜切开后血液引流不完全 ,3个月随访时 ,黄斑部视网膜前出血吸收 ,机化膜形成 ,中心视力丧失。结论 :黄斑部视网膜前出血应早期用Q开关Nd :YAG激光治疗 ,效果显著 ,创伤小 ,并发症少 ,操作简单 ,病人无痛苦 ,是一种经济可行的治疗手段。

Objective:To explore the efficiency of Qs-Nd:YAG laser in early treatment for macular preretinal hemorrhage.Methods:The hemorrhage membranes in 4 patients with macular preretinal hemorrhage for 7 days to 1 month were incised with Qs-Nd:YAG laser and were followed up for 1 week to 3 months,Results:In 2 patients,who had BRVO complicated with macular preretinal hemorrhage less than 15 days,the hemorrhage was drained completely.1 month later,their visual acuities were improved from light perception to 0.8-1.0.In the other 2 patients,because they were treated more than 1 month later,the hemorrhage partially organized,and could not be drained completely.3 months postoperatively,it was found that though the hemorrhage was absorbed,but left an organized membrane.There was no improvement in their visual acuity.Conclusions:Qs-Nd:YAG laser is useful in treating macular preretinal hemorrhage,but must be used earlier.The operation is easy and economical,and there is less trauma or complications.