不同参数激光诱导脉络膜视网膜静脉吻合  

Chorioretinal venous anastomosis induced by laser with different paramenters

作　　者：付海涛[1] 施彩虹[1] 蒋坚[1] 沈泽民[1] 

机构地区：[1]上海第二医科大学附属宝钢医院眼科,201900

出　　处：《眼科新进展》2004年第1期35-38,共4页Recent Advances in Ophthalmology

摘　　要：目的　探讨不同激光参数、不同击射部位对脉络膜 视网膜静脉吻合形成的影响。方法　在视网膜分支静脉阻塞模型上 ,以不同参数在不同部位诱导吻合支的形成 ,以荧光素眼底血管造影、连续组织切片观察吻合支的建立及其周围组织反应情况。结果　功率 90 0、12 0 0、15 0 0、180 0mW诱导吻合支的成功率为 0、2 0 .83%、4 5 .83%、6 2 .5 0 % (P=0 .0 0 1) ;直径 5 0、10 0 μm诱导吻合支的成功率分别为 4 3.75 %、2 0 .83% (P =0 .0 16 ) ;击射部位距视盘边缘 2DD与 3DD对吻合支形成的影响无统计学意义 (P =0 .732 ) ,2DD与4DD间 (P =0 .0 2 8) ,3DD与 4DD间 (P =0 .0 2 3)差异均有显著性 ;12 0 0、15 0 0mW诱导的吻合支周围组织损伤较轻 ,180 0mW诱导的吻合支周围组织损伤较重。结论　功率、光斑直径是影响脉络膜 视网膜静脉吻合形成的 2个主要因素 ,其中功率起决定性作用 ;5 32nm激光诱导吻合支形成的最适功率和直径为 12 0 0～ 15 0 0mW、5 0 μm ;击射部位以距视盘Objective To investigate the influence of laser induced chorioretinal venous anastomosis with different parameters and sites.Methods Chorioretinal venous anastomosis was induced with laser of different parameters at different sites in the model of branch retinal vein occlusion,the successful rate of anastomosis and the reaction of tissue was evaluated by Fundus fluorescein angiography and serial section.Results At the power levels of 900,1 200,1 500,1 800mW the anastomosis formed in 0,20.83%,45.83% and 62.50% respectively ( P =0.001). The size of spot at 50μm and 100μm,the successful rate of 43.75%and 20.83% was obtained ( P =0.016).The difference of the successful rate of anastomosis between 2DD and 3DD was not significant ( P =0.732),the difference between 2DD and 4DD,3DD and 4DD was significant (respectively P =0.028, P =0.023).At the power levels of 1 200 mW and 1 500mW,the damage in the retina was mild,while at power of 1 800mW,the damage in the retina and choroid was severe.Conclusion Power levels and the sizes of spot are the two main factors involved in the evolution of a chorioretinal venous anastomosis,in which the power is the dominated one.The optimal power for the formation of CRVA ranges from 1 200mW to 1 500mW,and the optimal size of spot for CRVA is 50μm.The optimal site for the creation of CRVA is at 3DD from the optic disc.

关 键 词：激光 脉络膜视网膜静脉吻合 视网膜静脉阻塞 

分 类 号：R779.63[医药卫生—眼科]