YAG激光玻璃体消融术治疗玻璃体混浊效果分析及体会

Analysis and experience of YAG laser vitreous ablation for the treatment of vitreous turbidity

目的探讨YAG激光玻璃体消融术治疗玻璃体混浊的效果。方法回顾分析2016年至2017年本院门诊接受玻璃体消融术患者100例100眼,均为单眼明显飞蚊症状,视觉干扰严重,其中男65例,女35例,年龄41~73岁,中、高度近视者22例,所有患者表现为程度不同的玻璃体后脱离。所有患者治疗前行视力、眼压、裂隙灯、散瞳眼底和B超检查。术眼复方托吡卡胺滴眼液充分散瞳,由同一位有经验的临床医师采用YAG激光机进行治疗。结果所有患者治疗后1周复查视力较术前无下降,术后1 h、1周眼压无明显增高,飞蚊症状明显减轻或消失者71眼,占71%;眼前仍可见漂浮物但减小或自觉好转者24眼,占24%,其中经二次激光治疗症状减轻者8眼;5眼治疗后症状无改善,占5%。所有病例中2例发生视网膜下出血(因激光误伤视网膜所致),其余患者均未出现其他并发症。结论 YAG激光玻璃体消融术治疗玻璃体混浊可明显改善症状,且操作简单,安全有效。

Objective To explore the effect of YAG laser vitreous ablation in the treatment of vitreous opacity. Methods Retrospective analysis of 100 cases of 100 patients with vitreous ablation in our hospital from 2016 to 2017, all of which are symptoms of single-eye flying mosquitoes, visual noise is serious, among which 65 were male, female 35 cases, aged 41 to 73 years old, and high myopia in 22 cases, characterized by different degrees after vitreous from all the cases. All patients were treated with progressive vision, intraocular pressure, fissure lamps, dilated pupil fundus, and bultrasonography. Intraocular compound tropicaramine eye drops were fully dispersed, and YAG laser was used for treatment by the same experienced clinician. Results All cases showed no decrease in vision after 1 week after treatment, no significant increase in intraocular pressure after 1 hour and1 week after surgery, 71 eyes were significantly alleviated or disappeared from floaters. There were still floating objects in the eyes, but the reduction was 24 eyes, which accounted for 24%, and the secondary laser treatment showed 8 eyes. After treatment, the symptoms did not improve, accounting for 5%. In all cases, there were 2 cases of subretinal hemorrhage(caused by laser damage to the retina), and no other complications occurred in the remaining cases. Conclusion YAG laser vitreous ablation can obviously improve the symptoms of vitreous turbidity, and it is safe and effective.