激光消融术治疗玻璃体浑浊的效果探讨  

Initial efficacy of vitreous laser ablation in the treatment of vitreous opacity

作　　者：杨平孙 邱新文[2] Yang Pingsun;Qiu Xinwen(Department of Ophthalmology,Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine,Hangzhou 311201,China;Department of Ophthalmology,the First People's Hospital of Xiaoshan District,Hangzhou 311201,China)

机构地区：[1]杭州市萧山区中医院眼科,杭州311201 [2]杭州市萧山区第一人民医院眼科,杭州311201

出　　处：《中华眼外伤职业眼病杂志》2023年第1期35-41,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评估激光消融术治疗玻璃体浑浊的效果。方法回顾性队列研究。以杭州市萧山区中医院2018年6月至2019年8月治疗的玻璃体浑浊120例(136眼)作为研究对象,按治疗方式患者分为两组。A组为对照组,60例(69眼),以口服卵磷脂络合碘治疗;B组为激光组,60例(67眼),以Ultra Q∶YAG玻璃体激光消融术治疗。每组按玻璃体浑浊的形态分成两个亚组:其中A1组与B1组,形态多为细点状、细网状及细丝状;A2组与B2组,形态多为棉絮状、致密性膜状及Weiss环。对比对照组与激光组以及激光组中两亚组的治疗效果。结果激光组的有效率为95.52%(64/67),高于对照组的57.97%(40/69)(χ^(2)=26.64,P<0.001)。激光组的视力(BCVA,logMAR)由治疗前的0.45±0.06提升至治疗后6个月的0.15±0.04(P_(时间)<0.001),激光组术后6个月的视力提升优于对照组(t=37.86,P<0.001)。B1组与B2组行激光1次和2次的患眼比例比较差异有统计学意义(χ^(2)=10.12,P=0.002)。仅激光组发生高眼压1例,其余患者均未出现晶状体浑浊、玻璃体积血或视网膜出血等严重并发症。结论激光消融术是治疗玻璃体浑浊有效且实用的方法,对致密性浑浊物效果更佳。Objective To evaluate the efficacy of laser ablation for the treatment of vitreous turbidity.Methods This was a retrospective cohort study.The data of 136 eyes of 120 cases with vitreous turbidity treated from Jun.2018 to Aug.2019 in Xiaoshan Hospital of Traditional Chinese Medicine,Hangzhou,were used as study subjects,and patients were divided into two groups based on the treatment methods:69 eyes of 60 cases in the group A as control group,and 67 eyes of 60 cases in the group B as laser group,The control group was treated with oral lecithin complexed iodine;the laser group was treated with Ultra Q:YAG vitreous laser ablation.Each group was divided into two subgroups according to the morphology of vitreous turbidity:group A1 and group B1,which were mostly in the form of fine dots,fine mesh and fine filaments;group A2 and group B2,which were mostly in the form of cotton wool,dense membranes and Weiss rings.To compare the therapeutic effects of control group,laser group and two subgroups of laser group.Results The effective rate of laser group was 95.52%(64/67),higher than 57.97%(40/69)of the control group(χ^(2)=26.64,P<0.001).The visual acuity(BCVA,logMAR)of the laser group improved from 0.45±0.06 before treatment to 0.15±0.046 months after treatment(P<0.001),the visual acuity improvement at 6 months after laser surgery which was better than that of the control group(t=37.86,P<0.001).There was a statistically significant difference between Group B1 and Group B2 in the comparison of the first and second lasers(χ^(2)=10.12,P=0.002).During the follow-up,high intraocular pressure occurred in 1 case in the laser group,and there was no serious complication,such as lens opacity,vitreous hemorrhage or retinal hemorrhage.Conclusion Laser ablation is an effective and practical method for the treatment of vitreous opacities,with better initial results in dense opacities.

关 键 词：消融术 激光 浑浊 玻璃体 卵磷脂络合碘 

分 类 号：R776.4[医药卫生—眼科]