兔眼视网膜二极管激光和氩离子激光光凝反应的比较

Comparison of diode and argon laser lesions in rabbit retina

目的 比较二极管激光和氩离子激光光凝后不同级别光斑与视网膜组织学改变 ,以指导二极管激光在临床的使用。方法 2 3只青紫蓝兔 42只眼 ,按不同光斑级别和光凝后不同时间分组 ,分别行二极管激光和氩离子激光光凝 ,光镜下观察、比较其组织学改变及定量图像分析。结果 两种激光同级光斑组织学改变比较 ,急性期 2 ,3级光斑均无明显差异 ,恢复期 2级光斑二极管激光病灶外核层细胞全部萎缩消失 ,而氩激光仅表现为外核层细胞减少。图像分析显示两种激光同级光斑即刻组面积均值二极管激光均明显大于氩离子激光 (P <0 0 5 ) ,但光凝后 1天的面积增长率二极管激光 ( 8% )明显低于氩激光 ( 2 3 % )。结论 临床应用二极管激光可以起到氩激光等同的治疗作用 ,而且其迟发损伤反应小于氩激光 。

ObjectiveTo compare histological alteration of each spot intensity of retina between diode and argon laser.Methodstranspupillary retinal photocoagulation were performed on 42 eyes of 23 pigmented rabbits.Histopathologic alteration of lesions in different intensity and different time interval after irradiation produced by diode and argon laser was observed and compared using optical microscope.Area of various acute lesions were taken by image analysis system.ResultsHistopathologically,both diode and argon lesions with similar clinical strength have no prominent difference.However,those two weeks old grade 2 lesions produced by diode laser were noticed slight different from that by argon.The photoreceptor nuclei atrophied completely in diode laser,but it only showed reduction of outer nuclear layer cells in argon,just like the appearance of grade 1 lesion caused by diode laser.Choroid damage was found in both diode and argon lesions.However,there was no obvious difference in degree was found.Data taken by Image Analysis System showed that all the areas of diode lesions immediately after photocoagulation were larger than argon ones in the same spot intensity ( P <0 05).The lesion area enlarged in a limited time.The rate of area growth of diode lesions which taken one day after photocoagulation (8%) showed much lower than argon laser (23%).ConclusionClinical use of diode laser is not only safe but can meet the same treatment requirement as argon laser.