钇铝石榴石激光治疗白内障摘除术后并发症的临床研究  

Postoperative use of YAG laser for cataract surgery

作　　者：陈彤[1] 高岩[1] 侯虞辉[1] 李龙[1] 

机构地区：[1]北京医院眼科,100730

出　　处：《中华眼科杂志》2001年第4期291-294,共4页Chinese Journal of Ophthalmology

摘　　要：目的　探讨白内障摘除术后钇铝石榴石 (yttriumaluminumgarnet,YAG)激光的应用范围 ,激光后囊膜切除术的方法、疗效和并发症。方法　超声乳化白内障吸除人工晶状体 (intraocularlens,IOL)植入手术 46 0 0只眼 ,术后YAG激光治疗 45 1只眼 ,其中行后囊膜切除 380只眼 ,切除方法采用连续环状切开及后推膜瓣二步法 ;连续环状切开时平均单脉冲能量为 (1 2 1± 0 31)mJ,平均总能量为(5 2 44± 14 6 2 )mJ;后推膜瓣时平均单脉冲能量为 (2 12± 0 43)mJ ,平均总能量为 (5 0 88± 10 32 )mJ。IOL前膜切除 42只眼 ,脉冲能量为 1 0～ 1 4mJ,平均总能量为 (5 6 2 8± 32 74)mJ。治疗其他术后并发症 2 9只眼。结果　白内障摘除术后行YAG激光治疗 45 1只眼 (9 8% )。后囊膜切除手术率为8 3% ;1次激光手术成功率为 96 3% ;平均裸眼视力提高 0 2 6 ,矫正视力为 0 85 ;未出现明显的IOL损伤和移位 ;36 2只眼 (95 3% )眼压正常 ;2只眼视网膜脱离。结论　YAG激光无需切口可在眼内完成精确的分割手术 ,且操作方便、安全 ,疗效好、并发症少、应用范围广。Objective To study and analyze the postoperative use of YAG laser for cataract surgery, the method, effects and complications of laser posterior capsulotomy. Methods Four hundred and fifty one eyes out of 4 600 eyes with phacoemulsification in a single horizontal groove manner were dealt with YAG laser for postoperative complications, and of them, 380 eyes had a posterior capsulotomy with a two steps method: posterior capsular circular incision and push down of the capsular chip. Forty two eyes were treated for anterior membrane on the intraocular lens (IOL) by circular resection and peeling it off. The other 29 eyes were treated for different complications. Results The rate of YAG laser treatment for postoperative complications was 9 8% and of them, the rate of posterior capsulotomy was 8 3%. The rate of eyes with posterior capsular opacification and one or more other complications was 14 2%. The mean energy of a single pulse for posterior capsular resection was (1 21 ±0 31) mJ, and the mean total energy was (52 44±14 62) mJ; the mean energy of a single pulse for push down of the capsular chip was (2 12±0 43) mJ, and the mean total energy was (50 88±10 32) mJ. The average naked visual acuity after posterior capsulotomy was increased to 0 58 from 0 32 before the laser treatment, and corrected visual acuity was 0 85. The energy of a single pulse was 1 0 to 1 4 mJ for anterior membrane resection of IOL, and the mean total energy was (56 28±32 74) mJ. No obvious damage or decentration of the IOL was found. After the treatment, the IOP in 95 3% of eyes was kept in normal range. Only did 2 eyes suffer from retinal detachment in follow up. Conclusions YAG laser therapy for postoperative complications is easy to control, safe, effective, and has less complications. Besides the posterior capsulotomy, some other complications also can be cured with it.

关 键 词：白内障 手术后并发症 人工植入术晶体 钇铝石榴石激光治疗 

分 类 号：R776.1[医药卫生—眼科]