康柏西普及光凝治疗弥漫型糖尿病性黄斑水肿的效果

目的:比较单纯康柏西普玻璃体内注射、单纯黄斑格栅激光光凝及二者联合治疗对弥漫型糖尿病性黄斑水肿(DME)的效果。方法:回顾性研究。将2016年8月至2019年10月长治医学院附属和平医院弥漫型DME 74例(82眼)分为单纯康柏西普玻璃体内注射组(A组,31眼)、单纯黄斑格栅激光光凝组(B组,24眼)和康柏西普联合激光光凝组(C组,27眼)。治疗后随访6个月,观察比较治疗前后视力、黄斑中心区厚度、FFA及注射次数。结果:治疗后A组和C组BCVA及黄斑中心区厚度(CMT)均较治疗前改善(P<0.05);B组治疗后BCVA无改善;B组CMT治疗后1个月无改善,治疗后3及6个月CMT下降(P<0.05)。治疗后BCVA及CMT的改善程度A组和C组差异无统计学意义,但均优于B组(P<0.05)。治疗后6个月FFA改善率3组间差异无统计学意义。治疗后6个月内康柏西普平均注射次数C组少于A组(P=0.001)。结论:康柏西普玻璃体内注射联合黄斑格栅激光光凝与单纯康柏西普注射治疗弥漫型DME效果相近,均优于单纯黄斑格栅激光光凝;黄斑格栅激光光凝可减少康柏西普注射次数。     

视网膜母细胞瘤D期化疗联合激光光凝的效果

目的:观察静脉化疗、经眼动脉灌注化疗联合激光光凝治疗D期视网膜母细胞瘤所有患者的效果。方法:回顾性病例研究。分析郑州大学附属儿童医院2015年12月至2018年12月单眼视网膜母细胞瘤D期13例的临床资料,采取静脉化疗、经眼动脉灌注化疗和激光光凝治疗。随访6～60个月。观察治疗效果、视力及并发症。结果:随访期内,10例...     

LASIK术前周边视网膜变性的预防性光凝

目的 探讨周边视网膜变性的预防性光凝对于LASIK手术的重要意义.方法 对拟行LASIK手术的38例（44眼）近视眼合并周边视网膜变性的患者进行预防性光凝治疗,年龄19～42岁,术前屈光状态：等效球镜-2.00～-12.75D.结果 38例眼底光凝治疗后3-4周,行LASIK手术,术后随访6个月以上,无一例发生视网膜脱离.结论 对拟行LASIK手术的患者进行详细的眼底检查,并对周边视网膜变性严重者实施预防性光凝治疗可大大降低术后视网膜脱离地发生率.     

阈值前病变１型和阈值期早产儿视网膜病变的激光和冷冻治疗

目的评价激光和（或）冷冻治疗阈值前病变１型和阈值期早产儿视网膜病变(ROP)的疗效。方法回顾分析2003年 1 月30日至2005年1月13日期间通过ROP筛查发现并施行视网膜激光和（或）冷冻治疗的阈值前病变１型和阈值期ROP共15例（29只眼），随访比较治疗前后的ROP病变情况，记录任何有关的局部和全身并发症。结果激光和（或）冷冻治疗的29只眼中，19只眼（65.5%）病变完全退化，7只眼（24.1%）残存牵引状视网膜，3只眼（10.3%）进展为视网膜脱离。初次治疗病变即完全退化者12只眼（41.4%），再次治疗后完全退化者7只眼（24.1%）。治疗中2只眼出现一过性角膜混浊，1只眼发生玻璃体积血，1只眼黄斑区误光凝1处。所有病例均未出现全身并发症。结论对阈值前病变１型和阈值期ROP进行及时的激光和（或）冷冻治疗具有比较满意的疗效。（中华眼底病杂志，2005，21：278-281）     

Morphological studies about the efficiency of laser beams upon the structures of the angle of the anterior chamber

Working at a power density above optical breakdown threshold, irradiation effects upon the angle of the anterior chamber of the Macaca speciosa monkey by a Nd glass Q-switched laser, have been analysed with scanning electron microscopy.Two different damage effects can be identified: openings of Schlemm's canal and the creation of a cyclodialysis, that is opening the uveoscleral outflow routes; the latter may be a more effective one than the former. Also a third mechanism, namely a structural alteration of the trabecular meshwork, at the molecular level by laser action, has been inferred. The physical effects leading to optically induced mechanical damage are discussed. Applicability of such effects upon the morphological findings described here, is limited and to a greater part speculative. A better definition of the physical parameters, required for optimal therapeutical damage effects in the treatment of the wide angle glaucoma may be obtained by trial and error methods, which are guided by the results of electron microscopical analyses of samples obtained from in vivo and in vitro experiments.Work supported by the Swiss National Science Foundation, the Commission for the Promotion of Scientific Research, and the ASUAG.     

Nd-YAG laser photocoagulation in gastroenterology: Its role in palliation of colorectal cancer

The merits of the Nd-YAG laser were evaluated in palliation of obstruction, or bleeding, or both, in 84 patients with colorectal malignancy. Luminal patency was restored in 20 of the 24 patients with obstructing colonic cancers. Haemostasis was achieved in 37 of the 40 patients with bleeding. Combined bleeding and obstruction responded favourably in 19 of the 20 patients treated. Only a few laser photocoagulation sessions, over a short period of time, were needed, and further laser treatment could be continued on an outpatient basis.Major complications such as perforation (6), stenosis necessitating a colostomy (3), and delayed post-treatment bleeding (2) were seen in 13% of patients, with a laser-related mortality in three patients. Minor complications, such as transient stenosis (22) and laser-induced bleeding (11), responded well to further laser application. Pain and warmth (20) resolved spontaneously. Treatment failures and complications were mainly due to inadequate accessibility or were related to tissue characteristics. Laser photocoagulation appears to constitute a valuable alternative treatment, not only to resection and colostomy, in the case of obstruction, but also for haemorrhage that cannot be controlled in other ways. Palliation, in its broad sense, is guaranteed because of the rapid results, reduced time in hospital, the avoidance of hospital admission, and the good tolerance of treatment.     

Nd-YAG laser photocoagulation of canine myocardium with the transparent contact probe

Laser photocoagulation of myocardium is an alternative to surgical resection in the treatment of drug resistant ventricular tachycardia. In certain areas, of the heart, however, bare fibre delivery of laser energy involves a risk of unintentional damage to nearby structures. The purpose of the study was to determine whether Nd-YAG laser irradiation, delivered with the transparent contact probe, would produce adequate laser photocoagulation of the canine myocardium in comparison to bare fibre delivery of the laser energy. In nine mongrel dogs, continuous wave Nd-YAG laser irradiation with and without a transparent contact probe was directed at the epicardium. Pulse power was 10, 15 and 20 W, pulse duration 5, 7 and 10 s, and spot size was 1 mm. A total of 178 lesions were analyzed microscopically. After a 200 J pulse energy delivered by the contact probe, the lesion depth was 4.9±0.5 mm (mean±s.d.), which is usually adequate to ablate arrhythmia sites. Bare fibre delivery of laser energy did not produce deeper lesions. There was no difference between the bare fibre and the transparent probe in the occurrence of major arrhythmias (4/86 bare fibre, 3/92 transparent probe). We conclude that the transparent contact probe allows safe and effective laser irradiation of sites of origin of ventricular arrhythmias.     

氪离子黄光与红光联合治疗视网膜血管病致黄斑水肿

目的：分析氪离子黄光与红光联合光凝治疗视网膜血管病致黄斑水肿的临床效果。方法：对确诊黄斑弥漫性水肿与囊样水肿29例41只眼，包括糖尿病视网膜病变(diabetic retinopathy,DR)23例35只眼；视网膜静脉阻塞(retinal venous occlusion,RVO)6例6只眼采用氪离子黄光与红光联合光凝，对其效果进行分析。结果：41只眼术后1个月视力提高27只眼占65．8％；3个月视力提高37只眼占90．2％；6—12个月后随访到31只眼，其中5只眼发生玻璃体出血，其余26只眼中有24只眼视力提高占92．3％。术后3个月，黄斑水肿消退7只眼占17．1％；水肿明显减轻26只眼占63．4％；水肿无变化6只眼占14．6％；水肿加重2只眼占4．9％。结论：两种波长激光联合治疗视网膜血管病致黄斑水肿，可达到更有效的治疗目的。     

超声引导经皮Nd:YAG激光肝组织光凝固术的基础研究

作者等采用Nd：YAG激光以2～5W输出功率，照射5～20分钟，对离体猪肝、狗肝进行了体外光凝固实验，并在超声引导下对犬、小型猪肝脏进行了经皮穿刺组织间光凝固的在体实验。激光照射中实时监测了受照组织的温度变化及其范围，观察了超声影像与肝组织改变的对应关系，对比了激光照射能量与肝组织温度变化、热损伤程度的关系。实验结果表明，超声引导下经皮Nd：YAG激光肝肿瘤凝固术是可行的，并为进一步的临床研究提供了有参考价值的实验数据。     

Proliferative diabetic retinopathy inauguring gestational diabetes

Introduction

Diabetic retinopathy is one of the diabetic microangiopathy complications generally occurring after insulin-dependent diabetes has evolved for a few years.

Observation

We report a 24-year-old pregnant woman with severe proliferative diabetic retinopathy discovered at the time of the gestational diabetes diagnosis. Argon laser photocoagulation of retinal ischemic territories was initiated. The disease progressed to vitreous haemorrhage in the right eye.

Discussion

Proliferative diabetic retinopathy is exceptionally present at the time of the gestational diabetes. We did not find any similar case in the literature.

Conclusion

Fundus examination seems necessary at the onset of gestational diabetes. It can prevent blindness in young women.