氩离子激光光凝治疗高度近视视网膜脱离的远期疗效观察  

Remote Therapeutic Effects of Argon Laser Photocoagulation on Retinal Detachment Related to High Myopia

作　　者：陈丽妃[1] 徐帆[1] 赵昕[1] 李敏[1] 

机构地区：[1]广西壮族自治区人民医院眼科,南宁市530021

出　　处：《中国激光医学杂志》2013年第1期21-25,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：广西壮族自治区卫生厅重点科研课题(重200710)

摘　　要：目的观察高度近视视网膜脱离手术后应用氩离子激光光凝封闭视网膜裂孔和术中巩膜外冷凝封闭视网膜裂孔的疗效。方法利用前瞻性非随机对照研究方法,将患者分为两组。术后光凝组:高度近视视网膜脱离手术后应用氩离子激光光凝封闭视网膜裂孔患者21例21只眼。术中冷凝组:同期术中冷凝封闭视网膜裂孔患者19例19只眼。两组进行比较,并进行长期随访观察疗效。结果随访时间为6～36个月,术后光凝组一次治愈率为95.23%,术中冷凝组为94.73%,两组差异无显著意义(P>0.05)。术后6个月脱盲(视力≥0.05)率术后光凝组为90.48%(19/21),术中冷凝组为52.63%(10/19),两组差异具有显著意义(P<0.05)。术后光凝组中1眼术后玻璃体混浊较术前增加,术中冷凝组7眼术后玻璃体浑浊度增加,两组差异具有显著意义(P<0.05)。术后新发视网膜裂孔率术后光凝组为14.29%(3/21),术中冷凝组为42.11%(8/19),两组差异具有显著意义(P<0.05)。结论高度近视眼视网膜脱离术后应用氩离子激光光凝封闭裂孔,定位准确、简化手术操作、缩短手术时间、术后并发症少,对视功能保留和恢复有帮助,远期疗效确切。Objective To compare argon laser photocoagulation with cryotherapy in therapeutic effects on retinal break after the retinal detachment （RD） surgery for patients with high myopia. Methods The patients were divided into two groups. A group of 21 high myopia patients were given argon laser photoeoagulation to close the retinal breaks after the retinal detachment surgery, the other group, with 19 high myopia patients, were applied with cryother- apy during the operation. A long-term follow-up was conducted, and the effects were observed and compared. Results The follow-up for all the patients lasted for 6 to 36 months. The postoperative healing rate was 95.23% in group 1, and 94. 73% in group 2, indicating a difference that was not significant （P 〉0. 05）. Visual acuity improvement was found in 19 patients （90.48%） in group 1, and in 10 patients （52. 63% ） in group 2. The difference was statistically significant （ P 〈 0. 05 ）. As to the postoperative complications, only 1 patient had worsened vitreous opacity in group 1 while 7 patients in group 2 being found of more se- rious vitreous opacity, showing a remarkable difference （P 〈 0.05）. Moreover, the postoperative occurrence rate of retinal breaks was 14.29% （3/21） in group 1 and 42. 11% （8/19） in group 2 respectively, revealing that the difference was significant （P 〈0. 05）. Conclusions Applying argon laser to close retinal breaks after retinal detachment surgeries features accurate positioning, simplified surgical procedure, shorter operation duration, fewer complications and better preservation and recovery of visual functions. The long-term effects of this method are positive.

关 键 词：激光 术后 高度近视眼视网膜脱离 

分 类 号：R779.63[医药卫生—眼科]