Nd：YAG激光治疗后发性白内障280例临床分析

摘要

Objective：To evaluate the effect of the Nd：YAG on the posterior capsule opacification.Methods：A total of 280 eyes with diseases including Elsching pearl posterior capsule opacification,reductus posterior capsule opacification and fibrosis posterior capsule opacification were treated by YAG.According to the differences in types,different laser parameter was chosen.The Elsching pearl posterior capsule opacification and reductus posterior capsule opacification were treated by cruciform incision.And fibrosis posterior capsule opacification was treated by cruciform incision or can openning incision depends on the serious of the fibrosis.The intraocular pressure and visual acuity were observed 1 week,1 month and 3--6 months after therapy,respectively.The average follow-up phase was 4 months.Results：Among the 90 eyes of Elsching pearl posterior capsule opacification,,the intraocular pressure of 90 eyes was normal,the visual acuity of 89 eyes（99.0%） was improved.Among the 145 eyes of reductus posterior capsule opacification,the intraocular pressure of 145 eyes was normal;the visual acuity of 144 eyes（99.7%） was improved.Among the 45 eyes of fibrosis posterior capsule opacification,the intraocular pressure of 45 eyes was normal,the visual acuity of 44 eyes（98.8%） was improved.Conclusion：We should choose the laser parameter flexibly in order to ensure effective high proportion pulse energy,which is vital in the treatment of posterior capsule opacification by YAG laser.%目的：观察Nd：YAG激光对后发性白内障的治疗效果。方法：对280例（280眼）分别诊断为Elschnig珍珠样小体性、皱褶性及纤维化性后发性患者行白内障YAG激光治疗,对与Elschnig珍珠样小体性、皱褶性后发性白内障采用十字形切开法,对纤维化性后发性白内障视纤维化程度采用开罐式切开术或十字形切开法。根据不同的病变类型选择不同的激光参数,激光后分别于1周、1月和3～6月进行眼压、视力及眼部情况随访。平均随访时间为4个月。结果：Elschnig珍珠样小体性后发性白内障90例（90眼）,激光后眼压保持正常者90例（90眼）,视力有所提高者89例（89眼）（99.0%）;皱褶性后发性白内障145例（145眼）,激光后眼压保持正常者145例（145眼）,视力提高144例（144眼）（99.7%）;纤维化性后发性白内障45例（45眼）,激光后眼压保持正常者45例（45眼）,视力提高者44例（44眼）（98.8%）。结论：根据后囊膜混浊的程度和视力的情况,灵活选择激光参数,确保高比例有效的脉冲能量,是YAG激光治疗后发性白内障的关键。