摘要
目的 探讨Nd∶YAG激光十字形后囊切开治疗人工晶体眼后发性白内障的技术要点和并发症的预防方法。方法 对 5 8例接受Nd∶YAG激光十字形后囊切开术治疗的后发性白内障患者的临床资料进行回顾性分析。 5 8只患眼中包括不同类型 (纤维膜型、Elschnig珍珠型、混合型、伴部分皮质残存型 )和不同病情分级 (1、2和 3级 )的后发性白内障 ,术中根据后囊厚薄和机化程度的不同 ,以及人工晶体与后囊的距离等 ,选择能量和功率密度以及十字形切开的方法。结果 截囊成功率 10 0 %。术后矫正视力均明显提高 ,由术前均≤ 0 5 ,改变为均≥ 0 5 ,45只眼 (77 6 % )矫正视力达 0 7以上。主要并发症是玻璃体前界膜破裂 (2 7 6 % )和人工晶体点状损伤 (6 9% )。结论 十字形切开技术适用于各种类型后发性白内障的治疗 ,安全有效。精确聚焦、个体化的能量设定、适当的切开方法以及适时治疗是提高疗效、降低并发症的关键。
Objective To explore the technique of Nd∶YAG laser cruciate posterior capsulotomy for the treatment of after cataract occurred after lens implant surgery and the prevention of complications. Methods The clinical data of 58 after cataract patients who had undergone Nd∶YAG laser cruciate posterior capsulotomy were analyzed retrospectively. 58 eyes showed different types of after cataract (fibrosis , Elschnig pearls , mixed and cortical remnant types) of varying grades (grade 1, 2, 3). Power, power density and cruciate discission methods were selected according to the thickness of the posterior capsule and degree of fibrosis as well as the space between intraocular lens and capsule. Results Successful rate of capsulotomy was 100%. After laser operation, in all patients the corrected visual acuity was improved markedly from ≤0 5 preoperatively to ≥0 5 postoperatively, with 45 eyes (77 6%) reached ≥0 7. The incidence of complications was low, with intraocular lens pitting appeared in only 6 9% of the eyes and anterior hyaloid membrane rupture in 27 6%. Conclusions Nd∶YAG laser cruciate posterior capsulotomy is a safe and effective method for the treatment of all types of after cataract. High accuracy of laser focusing, individual selection of power, appropriate method and timing of capsulotomy is essential to achieve the desired results and to minimize risks of the treatment.
出处
《中国激光医学杂志》
CAS
CSCD
2000年第2期96-99,共4页
Chinese Journal of Laser Medicine & Surgery
