二极管激光睫状体光凝的眼压变化和病理学表现  

Pathological study of contact diode laser transscleral cyclophotocoagulation

作　　者：王光洁 宋艳萍[2] 黄震晞[2] 高文东 

机构地区：[1]济南军区第106医院眼科,济南市250022 [2]广州军区武汉总医院眼科激光中心,430070

出　　处：《眼科新进展》2002年第1期25-27,共3页Recent Advances in Ophthalmology

摘　　要：目的　探讨二极管激光接触式经巩膜睫状体光凝降眼压的机理。方法　对 4组家兔进行二极管激光接触式经巩膜睫状体光凝术 (DL - C- T SCPC)。激光聚焦头的中心位于角膜缘后 1.2 m m ,探头方向与眼轴平行 ,3 60°范围均匀分布作 2 4个光凝点。其中第 1、2组为有色素兔组 ,各 4只青紫蓝兔 ,分别用出现爆破声的能量和较低的能量 ;第 3组为无色素兔组 ,4只日本大耳白兔 ,能量 2 50 0 m W ,2 50 0 m s;3组均做 8周的眼压观察。第 4组为病理学检查组 ,7只青紫蓝兔和 3只日本大耳白兔做不同能量及激光术后不同时期的病理学检查。结果　有色素兔在 1.52 J± 0 .3 0 J达到烧灼阈值并出现爆破声 ;术后每眼在各次测量的平均眼压与该眼出现爆破声的次数呈负相关关系 ,相关系数 r=- 0 .814 3 86,P=0 .0 13 84 4。高能量有色素兔组的降眼压作用的持续时间最长 ,低能量及无色素组则较短。高能量光凝急性期病理变化在有色兔表现为睫状体血管充血及睫状上皮的脱落 ,低能量有色兔和无色兔主要表现为睫状上皮的脱落。术后 10 d各组睫状上皮均已修复几近正常 ,高能量组仍有血管充血。在术后 8周时高能量组血管充血完全消失。结论　 DL- C- TSCPC的降眼压作用与能量及组织色素的多少有关 ,是激光能量损伤血管和睫状上皮 2种作?Objective To investigate the mechanism of diode laser contact transscleral cyclophotocoagulation. Methods Four rabbit groups underwent diode laser transscleral cyclophotocoagulation. The application sites were 1.2mm from the corneal-scleral limbus, direction of the tip is parallel with the eye's axis and the laser was focused on the ciliary parsplicata. Twenty-four applications were placed 360°around the limbus. The first two groups were pigment group, each has 4 rabbits, with the energy to get 'pop sound' and lower energy than the 'pop sound' separately. The third group was non-pigment group,4 rabbits of which use the energy 2 500mW,2 500ms. These three groups were followed up 8 weeks for IOP. The fourth group was pathological group , with 7 pigment eyes and 3 non-pigment eyes were underwent pathological examination for different energy and different stages of cyclophotocoagulation.Results In pigment rabbits the mean IOP of each eye in its follow times was in negative correlation with the number of audible pop in laser procedure, r =-0.814386, P =0.013844. The period of decreasing IOP effect were different in the 3 groups. Pathological changes: in acute stage the pigment rabbits with high energy level displayed collapse of ciliarybody, tissue disintegration of ciliary epithelium and vascular congestion; In middle energy level they displayed ciliary epithelial disruption and vascular congestion; In low energy level,they only displayed ciliary epithelial disintegration. In the long stage, about 10 days the epithelial layer was recovered in all energy levels, congestion of vascular were dismissed completely and ciliary body atrophy could be seen in the high energy level at 8 weeks after laser procedure. Conclusion In DL- C-TSCPC , the effect of decreasing IOP is related with energy level and tissue pigments. Both the lesion of vascular and ciliary epithelial disintegration are contributed to IOP reduction. The main objective of the procedure should be destroying ciliary epithelial layer with more applications

关 键 词：二极管激光 睫状体光凝 眼压 兔 

分 类 号：R775[医药卫生—眼科] Q959.836[医药卫生—临床医学]