新型Nd:YAG激光治疗中老年玻璃体混浊患者的视觉质量评价研究  

Evaluation of visual quality of middle⁃aged and elderly patients with vitreous opacity treated by novel Nd:YAG laser

作　　者：宋爽[1] 谷潇雅 张鹏[1] 喻晓兵[1] SONG Shuang;GU Xiaoya;ZHANG Peng;YU Xiaobing(The ophthalmology department of Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院眼科国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中国老年保健医学》2024年第2期23-26,共4页Chinese Journal of Geriatric Care

基　　金：中央高水平医院临床科研业务费项目(编号:BJ⁃2220⁃167);中央高校基本科研业务费项目(编号:3332021079)。

摘　　要：目的通过新型Nd:YAG激光治疗中老年玻璃体混浊患者的视觉质量评价研究,评估新型Nd:YAG激光治疗玻璃体混浊的疗效及应用价值。方法本研究为前瞻性观察性队列研究,本研究共筛选入组47例患者54只眼,其中男性20例,女性27例,年龄30~81岁,平均年龄(58.32±10.38)岁。所有患者术前进行最佳矫正视力(BCVA)、眼压、眼B超、超广角扫描激光眼底照相、裂隙灯散瞳眼底检查、光相干断层扫描(OCT),评估患者玻璃体混浊的位置及玻璃体后脱离情况。术后2周、4周随访,记录BCVA、眼压、眼底情况。采用配对t检验方法比较治疗前后BCVA、眼压的变化,P<0.05为差异有统计学意义的标准。结果Nd:YAG激光术前患者BCVA为0~1.0,平均为(0.18±0.27),眼压为10~20mmHg,平均为(14.84±2.22)mmHg。术后4周患者BCVA为0~1.0,平均为(0.17±0.25),眼压为9~19mmHg,平均为(14.30±2.39)mmHg。统计学分析发现,术前术后视力变化无显著性差异(P=0.129),但术后眼压轻度下降,差异有统计学意义(P=0.015)。术后4周患者视觉质量满意度评价平均分为5~10分,平均为(8.10±1.18)分。82%的患者术后3天内黑点增多,98%的患者术后2周眼前遮挡黑影消失,96%的患者术后4周视觉质量明显改善。结论经新型Nd:YAG激光治疗后的中老年玻璃体混浊患者,飞蚊症症状改善明显,患者视觉质量满意度高,尤其是伴有明显weiss环患者,患者的视觉质量改善显著。Objective To evaluate the therapeutic effect and application value of the novel Nd:YAG laser in the treatment of vit⁃reous opacity by evaluating the visual quality satisfaction of middle⁃aged and elderly patients with vitreous opacity.Methods This was a prospective observational cohort study.A total of 47 patients with 54 eyes were enrolled in this study,including 20 males and 27 females,aged 58.32±10.38(30~81).All patients underwent preoperative best corrected visual acuity(BCVA),IOP,B⁃ultra⁃sound,ultra⁃wide⁃angle scanning laser fundus photography,slit⁃lamp dilated fundus examination,and optical coherence tomography(OCT)to evaluate the position of vitreous opacity and posterior vitreous detachment.The BCVA,intraocular pressure and fundus were recorded at 2 weeks and 4 weeks after the operation.Paired t⁃test was used to compare the changes of visual acuity and IOP before and after treatment,and P<0.05 was considered to be statistically significant.Results The BCVA was 0~1.0,the average value was(0.18±0.27),IOP was 10~20mmHg,the average value was(14.84±2.22)mmHg.Four weeks after the laser treatment,BC⁃VA was(0.17±0.25)(0~1.0)IOP was 9~19mmHg,the average value was(14.30±2.39)mmHg.Statistical analysis showed that there was no significant difference in visual acuity changes before and after the treatment(P=0.129),but postoperative IOP de⁃creased slightly,the difference was statistically significant(P=0.015).The average score of visual quality satisfaction at 4 weeks af⁃ter the treatment was 5~10,the average value was(8.10±1.18).82%of the patients'black spots increased within 3 days after the treatment,98%of the patients'black shadows disappeared 2 weeks after the treatment,and 96%of the patients'visual quality im⁃proved significantly 4 weeks after the treatment.Conclusion After the novel Nd:YAG laser treatment,the middle⁃aged and elderly patients with vitreous opacity can significantly improve their floater symptoms and have high satisfaction with visual quality,especially in patients

关 键 词：玻璃体混浊 飞蚊症 YAG激光 视觉质量 中老年患者 

分 类 号：R779.63[医药卫生—眼科]