Argon激光治疗复发性倒睫24眼

目的:评价氩激光治疗复发性倒睫的疗效和安全性。方法:Argon激光治疗18例(24眼)复发性倒睫,光斑50～200μm,时间0.25～0.5s,能量400～800mW。部分倒睫用美蓝染色后治疗。治疗全过程无需麻醉,平均随访时间6.12mo。结果:经过1～4次氩激光治疗,其中83.33%痊愈。刺激症状消失或明显减轻。激光治疗次数与倒睫数量间明显相关。治疗6wk后所有患者无睑缘畸形和新生血管形成。结论:氩激光治疗复发性倒睫较其他治疗方法安全、有效、简便、副作用小。     

Argon laser treatment of an abnormal angle vessel producing recurrent hyphema

Spontaneous hyphema has been linked to many conditions. We describe a patient with recurrent spontaneous hyphema caused by an abnormal angle vessel without associated rubeosis iridis, glaucoma, or other vascular abnormalities as documented by iris fluorescein angiography. After treatment with several sessions of argon laser photocoagulation, the patient has remained asymptomatic during ten months of follow-up.     

Argon laser intraocular photocoagulation

Argon laser intraocular photocoagulation is now available during vitreous surgery, to treat retinal breaks and to give panretinal photocoagulation. Twenty patients, including phakic patients with gas-filled eyes, were treated using a new operative contact lens without complication. This intraoperative technique allows controlled rapid application of laser lesions at a safe distance from the retina, and eliminated the need for attempting treatment through the often hazy media of an irritated postoperative eye. A group of five rhesus monkeys were treated with various power settings to assess the histopathologic features of these laser lesions.     

氩激光光凝治疗糖尿病视网膜病变疗效观察

目的：观察氩激光视网膜光凝术治疗增殖前期和增殖期糖尿病视网膜病变（diabetic retinopathy,DR）疗效。方法:对70例（118眼，其中增殖前期25眼，增殖期93眼）DR病人，依病变程度分别行全视网膜光凝或次全视网膜光凝治疗。术后随访1年，观察光凝后患者的视力、眼底及荧光血管造影变化，并进行分析和对比。结果：光凝治疗后102眼有效。总有效率为86.4%，其中增殖前期23眼有效，有效率92％，增殖期79眼有效，有效率85％，二者有显著差异（P＜0.01），治疗后27眼视力提高（23％）；77眼视力不变（65％）；14眼视力下降（12％）。在治疗前有黄斑水肿的62眼中，治疗后有13眼黄斑水肿安全吸收（21％），40眼部分吸收（64.5%），9眼不变（14.5%）。结论：氩激光视网膜光凝术是治疗DR的有效手段，对其增殖前期应尽早发现及时进行光凝治疗，以阻病情发展，保护视功能。     

激光光凝治疗黄斑水肿

应用氩绿激光治疗视网膜血管性疾病所致黄斑水肿50例,73只眼。治疗后,有20.5％(15/73)的患眼视力提高2行以上,76.8％(56/73)的患眼视力保持稳定。局部性和/或非囊样黄斑水肿患眼的视力预后较好,水肿易于吸收。弥漫性和/或囊样黄斑水肿患眼的视力预后较差,水肿较难吸收。术前视力可影响预后。对激光光凝治疗本病的疗效、影响因素、激光治疗技术及其机理,也进行了讨论。     

糖尿病视网膜病变的Argon激光治疗

目的 探讨糖尿病视网膜病变(diabetic retinopathy,DR)的Argon激光治疗方式及提高疗效、减少并发症的措施.方法 对310例(511眼)DR患者行激光治疗,包括局部光凝、改良格栅样光凝、标准全视网膜光凝术、超全视网膜光凝术、次全视网膜光凝术,观察其疗效及并发症.随访6～48个月.结果 增生前期糖尿病视网膜病变(preproliferative diabetic retinopathy,PPDR)视力提高和不变148眼(82.7%),非高危增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)视力提高和不变162眼(80.2%),高危PDR视力提高和不变82眼(63.1%);PPDR有效167眼(93.3%),非高危PDR有效182眼(90.1%),高危PDR有效86眼(66.2%).PPDR 28眼(15.6%)、非高危PDR 92眼(45.5%)、高危PDR 113眼(86.9%)需补充光凝.结论 掌握适宜的激光方式及时机和操作技巧、定期随诊、及时补充光凝、全身治疗,是提高DR激光光凝术疗效、减少并发症的关键.     

超全视网膜光凝治疗虹膜新生血管

目的了解光凝治疗虹膜新生血管的疗效及其激光治疗时的参数。方法回顾总结15例出现虹膜新生血管接受氩离子激光超全视网膜光凝治疗患者的术后虹膜新生血管消退情况和眼底激光治疗参数。结果11眼(73.3%)完成超全视网膜光凝,术后3月虹膜新生血管完全消退,视力无显著下降。结论早期诊断和及时、充分、有效的眼底激光光凝治疗,能有效地促使虹膜新生血管消退,阻止病变进展。     

硅油填充眼下方复发性视网膜脱离的氩激光光凝治疗

目的 探讨氩激光光凝术应用于硅油填充眼下方复发性视网膜脱离临床治疗的适应症并观察其临床疗效。方法 对45例硅油填充术后下方视网膜再脱离的患者采用氩激光光凝“筑堤”的办法，以限制视网膜脱离范围的进一步发展，待硅油填充术后3～4个月后再行硅油取出术；术中BIOMⅡ镜直视下用笛针经裂孔吸出脱离区视网膜下液复位视网膜后，激光光凝脱离区视网膜。激光参数为：能量120～150mw，曝光时间0．1s，光斑直径300～500um。结果 45眼中．氩激光光凝术后除4眼视网膜脱离范围扩大需及时行硅油置换视网膜复位术外，其余41眼视网膜脱离范围固定，硅油取出术后4眼因增殖性玻璃体视网膜病变发生视网膜脱离。结论 对于硅油填充术后下方复发性视网膜脱离患者，氩激光光凝是一种能稳定视网膜脱离范围、操作简单、节省治疗时间和费用，以便硅油早期取出的较为理想的治疗方法。     

氩激光视网膜光凝治疗糖尿病性视网膜病变

目的观察糖尿病性视网膜病变的光凝治疗效果。方法对136例(261只眼)糖尿病性视网膜病变患者,根据病变的程度行氩激光视网膜光凝治疗,并随访1年,观察光凝治疗变后患者的视力、眼底及荧光血管造影的变化,并进行分析和比较。结果在136例(261只眼)糖尿病性视网膜病变中,有效226只眼,总有效率 86．5％,其中增生前期糖尿病视网膜病变64只眼,有效60只眼,有效率93．7％;增生期糖尿病视网膜病变197只眼,有效眼166,有效率84．2％％。经统计学检验P<0．01,两者有显著差异。讨论对早期糖尿病性视网膜病变患者,如有光凝指征,应尽早行氩激光视网膜光凝治疗,这对于控制或延缓糖尿病性视网膜病变的进展,稳定患者视力有重要意义。     

氩激光治疗视网膜中央静脉阻塞的时机探讨

目的:探讨氩激光治疗视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)的时机。方法:根据CRVO发病后至接受激光治疗的时间不同分为3组,A组为CRVO发生后4~8wk共23例23眼,B组为CRVO发生后12~16wk共9例9眼,C组为CRVO发生20wk以后共6例6眼。激光治疗方法分为黄斑区格栅样光凝,局灶性视网膜光凝及全视网膜光凝。结果:2a后A组视力>0.3者为17眼占74%;B组视力>0.3者为4眼占44%;C组视力>0.3者仅1眼占17%,2例发展成为新生血管性青光眼(NVG)。结论:CRVO发生后早期光凝治疗对视力的恢复有较好的效果,晚期光凝治疗主要是预防并发症的发生。     

Argon laser photocoagulation of circumscribed choroidal hemangiomas

PURPOSE: Therapeutic retrospective results obtained after Argon laser photocoagulation of 17 circumscribed choroidal hemangiomas were analyzed. MATERIAL AND METHODS: Seventeen circumscribed choroidal hemangiomas associated with serous retinal detachment were analyzed. All patients were symptomatic but one. Duration of visual symptoms varied from 2 weeks to 3 years. Mean tumor thickness was 3,3mm (1 to 6,5mm). Mean tumor diameter was 6,5mm (2.5 to 15mm). Tumors were juxtapapillary in 9 cases (57%). The mean distance from the fovea was 1,5mm (0 to 3mm), and the fovea was pathological in all cases but two. The tumoral surface was covered by Argon laser spots with the central avascular area spared in the case of subfoveal hemangioma. In the case of subretinal fluid persistence 3 months later, 1 or more photocoagulation sessions were carried out. Follow-up was 27 months (6 to 156 months). RESULTS: Success (complete subretinal fluid resolution) was obtained in 82.4% with 1 or 2 laser photocoagulation sessions. Recurrence was observed in 4 cases (23.5%) but treated with success. Final visual acuity, related to the initial foveal condition, was >=0.5 in 23.5% of cases, and >=0.1 in 70.6% of cases. DISCUSSION: Anatomical and functional results were satisfactory considering initial foveal conditions. Irradiation (external beam irradiation, proton beam therapy, brachytherapy) has been used with success for several years. However, radiation-induced damage was described in addition to a few practical disadvantages. CONCLUSION: Argon laser photocoagulation was an effective noninvasive therapy for circumscribed choroidal hemangioma. It remains for us the reference method for treating this tumor.     

Argon laser photocoagulation for retinopathy of prematurity: long-term outcome

PURPOSE: To assess the visual, refractive, ocular structural, and neurodevelopmental outcome in a group of children who were screened, treated with laser photocoagulation for threshold retinopathy of prematurity (ROP), and followed up at our institution. METHODS: The 21 survivors of a cohort of 23 children were recalled at the age of 5 years or more. They underwent a full ophthalmologic examination. A paediatric neurologist and/or developmental paediatrician performed a neurodevelopmental assessment and a neuropsychologist performed psychological testing. RESULTS: A total of 30 eyes (71.4%) had a best-corrected visual acuity (BCVA) of 20/40 or better. In all, 26 (62%) eyes were myopic; the overall mean spherical equivalent was -4.95 D. No eye had Stage 4 findings and only one eye (2.4%) progressed to stage 5 despite photocoagulation. In total, 14 patients (66.6%) showed evidence of stereopsis. Strabismus was seen in six patients (28.5%) and nystagmus in three (14.3%). Periventricular leukomalacia (PVL) was identified in five patients (23.8%), cerebral palsy (CP) in seven (33.3%), and intraventricular haemorrhage (IVH) in 13 (62%). Cerebral palsy and IVH associated strongly with visual acuity of less than 20/40 (P=0.009 and 0.047). There was also a strong association between visual acuity of 20/40 or above and a better cognitive outcome (P=0.013). CONCLUSIONS: Retinal scarring and detachment are relatively rare causes of visual morbidity 5 years or more after laser treatment for threshold ROP, but the neurological sequelae of extreme prematurity and amblyopia remain important causes of impaired visual function.     

Argon laser photocoagulation treatment of diabetic cystoid maculopathy

Forty-one patients with diabetic cystoid macular edema were treated with argon laser photocoagulation and followed for a mean period of 22 months. The fellow eye was held as control. In the treated group (33 eyes), 6 had an improvement in visual acuity (greater than 2 lines), 19 had visual acuity which remained the same (+/- 1 line), and 8 had a decrease in visual acuity (more than 2 lines). In the control group (33 eyes untreated), 18 had a visual acuity which remained the same, one had an improvement in visual acuity (greater than 2 lines) and 14 had a decrease (greater than 2 lines) in visual acuity. The control eyes of 14 patients were treated because of significant reduction in visual acuity. Although the general tendency toward stabilization in the treated group and toward deterioration in the untreated group was definitely observed, statistical evaluation did not show a significant difference between the 2 groups. Occasionally, patients with cystoid in the control eye cleared spontaneously without treatment.     

经瞳孔睫状突光凝术治疗难治性青光眼

本文对于难治性青光眼用氩激光经瞳孔睫状突光凝固25例26只眼。26只眼中13只眼的眼压控制在2.74kPa(21mmHg)以下,眼压控制率为50%。其手术效果取决于光凝睫状突的范围。睫状突光凝术作为睫状体破坏手术方法之一,与睫状体冷凝相比,具有疼痛少、安全、并发症少的特点。