二极管激光在治疗视网膜新生血管中的应用

目的 观察二极管激光在治疗视网膜新生血管伴有屈光间质浑浊中的光凝效果。方法 5 6例 (6 4眼 )中糖尿病性视网膜病变 2 2例 ,视网膜静脉阻塞 2 0例 ,视网膜静脉周围炎14例。 42眼伴有不同程度的晶状体、玻璃体浑浊 ,但能见眼底。治疗前常规行荧光素眼底血管造影。行全视网膜光凝或病变区限局性播散性光凝 ,一般做 1～ 5次。有 10眼玻璃体浑浊重或伴有视网膜脱离术前无法光凝者在玻璃体视网膜手术的术中进行光凝。结果 光凝治疗后随访观察 2～ 14月。视力进步者占 34% ,视力不变者占 5 6 % ,视力下降占 9 4%。视网膜新生血管完全萎缩 ,无渗漏者占 6 4% ;部分萎缩 ,尚有少许渗漏者占 2 5 % ;新生血管未消退 ,渗漏仍明显者占 11%。结论 二级管激光治疗视网膜新生血管特别是伴有一定程度屈光间质浑浊的患者效果较好 ,无明显副作用。

早产儿视网膜病变术后护理观察

目的探讨优质护理对激光治疗早产儿视网膜病变效果的影响。方法回顾性分析2009至2012在我院进行激光治疗的视网膜病变早产儿306例,将患儿分为对照组和实验组各153例。两组患儿均进行常规的激光治疗,其中给予对照组患儿常规术后护理,给予实验组患儿优质护理服务,分析两组患儿的临床护理效果。结果实验组单次手术治愈率为94.77%,总治愈率为98.04%;对照组单次手术治愈率为86.93%,总治愈率为91.50%;两组的单次手术治愈率和总治愈率相比,差异均具统计学意义(P<0.05)。结论优质护理能够有效提高激光治疗早产儿视网膜病变的治愈率,改善治疗效果。

Factors Related to Prognosis of Refractory Glaucoma with Diode Laser Transscleral Cyclophotocoagulation Treatment

Objective To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation(TSCP) in a midterm observation.Methods Fifty-four consecutive patients(54 eyes) with refractory glaucoma were enrolled and underwent TSCP(power of 1.5-2.0 W,exposure time of 2 seconds and 20-50 applications).Patients were regularly followed up for 12 months.Intraocular pressure(IOP) was measured before TSCP treatment and at each follow-up visit.Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP.The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit.Difference of age between the sensitive and insensitive groups was evaluated with Independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test.The success rate of different types of glaucoma to TSCP was calculated.Results A total of 32 patients were sensitive to TSCP(sensitive group) and 22 patients were insensitive to TSCP(insensitive group).The success rates of female(77.8%,14/18) and cases being over 50 years(71.4%,20/28) were higher than those of male(50.0%,18/36) and ones being under 50 years(46.2%,12/26)(all P>0.05).The age of the sensitive and insensitive groups was 56.0±15.5 and 46.4±15.4 years,respectively(P=0.029).The age(P=0.029) and gender distribution(P=0.046) of the two groups had significant difference.The success rate of neovascular glaucoma,primary angle-closure glaucoma,primary open angle glaucoma,traumatic glaucoma,uveitic glaucoma,and secondary glaucoma after silicone oil injection to TSCP was 57.1%,100.0%,50.0%,20.0%,81.8%,and 0%,respectively.Conclusion Age,gender,and type of glaucoma appear to be associated with effect of TSCP on IOP control.

睫状体光凝治疗新生血管性青光眼的治疗风险及规范

目的：探讨利用半导体激光透巩膜睫状体光凝治疗新生血管性青光眼的治疗风险及规范。方法：新生血管性青光眼患者32例32只眼；年龄19—81岁。其中糖尿病性视网膜病变19只眼，视网膜静脉阻塞7只眼，闭角型青光眼绝对期3只眼，硅油取出术后2只眼，Coats病1只眼。因睫状体二极管激光治疗过程中及治疗后可能出现：眼压控制不良、可能需要再次治疗及药物治疗、前房积血、角膜损伤、眼球萎缩、其他意想不到的情况（麻醉意外、心脑血管意外等），治疗前需告知患者，并签字同意。采用波长为810nm半导体激光的透巩膜睫状体光凝，时间2500～3000ms。