Nd:YAG激光治疗白内障术后切口内玻璃体嵌顿

Nd:YAG laser in the treatment of vitreous hernia after cataract surger

目的探讨Nd:YAC激光治疗白内障术后切口内玻璃体嵌顿的临床疗效。方法对18例(18只眼)白内障术后切口内玻璃体嵌顿患者进行Nd:YAG激光治疗。缩瞳后用激光击断前房内玻璃体纤维,解除牵拉。术后抗炎、监控眼压、随访。对比治疗前后视力、瞳孔及眼底情况,进行统计学分析。结果术后18例(18只眼)瞳孔恢复圆形,14例视力比治疗前提高,3例视力无改变,1例视力下降(P<0.01),原有3例黄斑囊样水肿2例完全消退,1例糖尿病性视网膜病变患者黄斑囊样水肿无变化。术中虹膜损伤5例,其中3例表面出血,2例色素脱落,对症处理,无其他并发症。结论Nd:YAG激光治疗白内障术后切口内玻璃体嵌顿,在提高视力和防治眼底并发症方面效果确切,并且安全实用、简便易行、费用低廉,在一-定程度上可以替代手术治疗,具有临床推广价值。

Objective To investigate the clinical effect of Nd:YAG laser treatment of vitreous hermia after cataract surgery.Methods Nd:YAG laser treatment was performed on 18 patients(18 eyes)with vitreous hernia after cataract surgery.Laser was used to break the vitreum fiber in the anterior chamber to remove traction after miosis.Anti inflammatory treatment after surgery and lowering the intraocular pressure was made.To compare the visual acuity,pupils,fundus conditions before and after the treatment,and the statistical analysis was made.Results After the operation,18 pupils(18 eyes)were recovered,14 cases improved visual acuity than before treatment,3 cases had no changes,I case of vision loss(P<0.01).The original 3 cases of macular edema,2 cases of complete regression were found.There were 5 cases of iris trauma in the operation,3 cases of iris surface bleeding,and 2 cases of iris depigmentation.There were no other complications after symptomatic treatment.Conclusions Nd:YAG laser in the treatment of cataract surgery in the vitreous hernia have exact effect in improving eyesight and prevention of fundus complications.This treatment was safe and practical,simple and easy to operate at low cost.To a certain extent,it can replace surgical treatment,and has the value of clinical application.