氪黄激光治疗糖尿病性黄斑水肿的疗效观察  

The effects of the treatment of krypton yellow laser for diabetic macular edema

作　　者：马自勤 张亚丽 郭建慧 杜磊 岳秀 王光璐[2] 

机构地区：[1]山西省运城市同德医院眼科,044000 [2]北京同仁医院眼科

出　　处：《中华眼底病杂志》2003年第1期14-17,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　探讨糖尿病性黄斑水肿氪黄激光治疗的疗效。　方法　对 2 5 1例 4 30只眼分别为局限性黄斑水肿、弥漫性黄斑水肿、黄斑囊样水肿患者行氪黄激光治疗 ,对局限性黄斑水肿采用焦点样光凝 ,对弥漫性、囊样黄斑水肿采用格栅状光凝。根据不同病变类型选择激光参数 ,激光后每 3～ 4个月复查视力 ,行荧光素眼底血管造影及彩色眼底照像 ,观察黄斑水肿消退情况。随诊 3～ 2 3个月 ,平均随访时间15 .5 9个月。　结果　局限性黄斑水肿 186只眼 ,光凝后视力保持不变和进步者 183只眼 ,占 98.39% ;水肿全部或部分吸收者 184只眼 ,占 98.93% ;弥漫性黄斑水肿 175只眼 ,光凝后视力保持不变和进步者 16 3只眼 ,占 93.14 % ;水肿全部或部分吸收者 16 4只眼 ,占 93.71% ;黄斑囊样水肿 6 9只眼 ,光凝后视力保持不变和进步 5 9只眼 ,占 85 .5 1% ;水肿全部或部分吸收者 6 4只眼 ,占 92 .75 %。　结论　根据黄斑水肿程度、范围和视力情况灵活选择激光参数 ,确保高比例的有效光斑 。Objective To verify the effects of the treatment of krypton yellow laser for diabetic macular edema. Methods A total of 430 eyes in 251 cases of diabetic focal macular edema, diffuse edema and cystoid edema were treated with krypton yellow laser photocoagulation. Those with focal macular edema underwent the focal photocoagulation, and those with diffuse edema and cystoid edema underwent the grid photocoagulation.The visual acuity examination, fundus fluoresecin angiography and colour photo graphy of the fundus were performed before and every 3 or 4 months after the treatment.The changes of macular edema after the treatment were analysed.The follow up duration was 3 to 23 months (with an average of 15.5 months). Results After laser focal photocoagulation in 186 eyes with focal macular edema, visual acuity was improved or maintained in 183 eyes (98.39%). Edema disappeared completely or partially in 184 eyes (98.93%). After laser grid photocoagulation in 175 eyes with diffuse macular edema, visual acuity was improved or maintained in 163 eyes (93.14%). Edema disappeared completely or partially in 164 eyes (93.71%). After laser grid photocoagulation in 69 eyes with cystoid macular edema, visual acuity was improved or maintained in 59 eyes (85.5%). Edema disappeared completely or partially in 64 eyes (92.75%). Conclusion The linchpin of the treatment of krypton yellow laser for diabetic macular edema lies in the insurance of the effective laser macules and the adaptability of selecting the proper para meter of laser according to the degree and scope of the macular edema and the visual acuity.

关 键 词：糖尿病视网膜病变 激光凝固术 氪黄激光 糖尿病性黄斑水肿 疗效 

分 类 号：R774.5[医药卫生—眼科] R587.2[医药卫生—临床医学]