Ultra Q:YAG与传统Nd:YAG激光玻璃体消融术治疗飞蚊症的疗效比较

Comparison of Ultra Q:YAG and traditional Nd:YAG laser treatment in vitreous ablation for floaters

目的:通过观察Ultra Q∶YAG玻璃体消融术治疗飞蚊症的长期效果,评价Ultra Q:YAG较传统Nd∶YAG激光的治疗优势。方法:回顾性分析2018-05/2020-01于我院确诊为玻璃体混浊并接受激光玻璃体消融术治疗的112例130眼患者的临床资料。所有患者均接受了激光玻璃体消融术治疗,根据不同治疗方法分为A、B两组,A组(60例70眼)接受Ultra Q∶YAG玻璃体消融术治疗;B组(52例60眼)接受传统Nd∶YAG激光治疗。根据患者玻璃体混浊的形态将A、B组各分为两亚组:其中A1组45例52眼和B1组30例38眼,玻璃体混浊形态多为Weiss环、絮状、致密膜状;A2组15例18眼和B2组22例22眼,玻璃体混浊形态多为细点状、丝状、网状。比较治疗前后的BCVA,治疗次数差异及主觉症状改善情况。结果:BCVA:治疗前A1组和A2组、B1组和B2组、A组和B组均无差异(P>0.05);A组和B组在治疗后2wk,1mo时均有差异(P<0.001),A1组和A2组在治疗后1、6、12mo均有差异(P=0.019、0.042、<0.001)。A组患者治疗后的主觉症状改善程度优于B组(P=0.006)。A1组治疗后的主觉症状改善程度优于A2组(P<0.001)。Ultra Q∶YAG比传统Nd∶YAG激光所需的激光治疗次数少(P<0.001)。同一种激光方法,不同玻璃体混浊形态,治疗次数无差异(P>0.05)。结论:Ultra Q∶YAG较传统Nd∶YAG激光进行玻璃体消融治疗飞蚊症,更易于操作、更安全、具有更好的主觉症状改善,尤其是对于伴有Weiss环、絮状、致密膜状混浊物的患者。

AIM:To observe the long-term effect of Ultra Q∶YAG vitreous ablation in the treatment of floaters,and to evaluate the advantages of Ultra Q∶YAG over traditional Nd∶YAG laser.METHODS:Retrospective study.Totally 112 patients(130 eyes)were diagnosed with vitreous opacity were included and treated with laser vitreous ablation in our hospital from May 2018 to January 2020.All patients were performed the laser treatment for vitreous ablation and divided into groups A and B by different laser types.Group A(60 patients,70 eyes)underwent Ultra Q∶YAG vitreous ablation,and group B(52 patients,60 eyes)underwent traditional Nd∶YAG laser treatment.Then,we divided subgroups by the morphology of vitreous floaters.Subgroup A1(45 patients,52 eyes)and subgroup B1(30 patients,38 eyes)both with the morphology of Weiss ring,floccule and dense membrane;Subgroup A2(15 patients,18 eyes)and subgroup B2(22 patients,22 eyes)with the morphology of filiform and mesh.We observed the difference of frequency and visual improvement by patients compared to baseline.RESULTS:BCVA:There was no significant difference between groups A1 and A2,groups B1 and B2,group A and group B at baseline(P>0.05).After treatment,there were statistically significant differences in BCVA between group A and group B at 2wk and 1mo.There were statistically significant differences between group A1 and group A2 at 1,6 and 12mo(P=0.019,0.042,<0.001).The effect of the laser treatment was significantly different between the two groups,group A was better than group B(P=0.006),group A1 was significantly better than that in group A2(P<0.001).Compared to traditional Nd∶YAG laser,Ultra Q∶YAG laser requires less frequency of laser treatment(P<0.001),and had no significant relationship with vitreous opacity(P>0.05).CONCLUSION:Ultra Q∶YAG is easier to operate,safer and has better subjective symptom improvement than traditional Nd∶YAG laser treatment of vitreous floaters,especially for the patients with Weiss ring,floccule and dense membrane.