光凝治疗视网膜静脉阻塞的临床研究

目的 分析比较几种光凝器在视网膜静脉阻塞中的应用价值，并探讨光凝术的时机。方法 选用半导体532倍频激光格栅光凝黄斑囊样水肿64眼：播散性光凝治疗早期非缺血型RVO32眼；全视网膜光凝缺血型60眼(其中39眼是由非缺血型转化为缺血型)，14眼应用8l0半导体激光治疗。结果 格栅光凝黄斑囊样水肿有效率为75．00％，视力进步51．57％。非缺血型RVO 6个月后出血吸收率71．87％，视力进步43．75％，12．5％转化为缺血型。2l眼缺血型RV0532倍频激光治疗有效率23．8l％，出血吸收后补充光凝42．86％，无效33．339／6；由非缺血型转化为缺血型的有效率为84．62％，视力进步33．33％；8l0半导体激光治疗14眼，有效率100％，视力进步28．57％。结论 黄斑囊样水肿应尽早行光凝术，应选择波长大于514mm的激光器；非缺血型RVO早期光凝仍无法阻止新生血管的产生，其治疗价值有待进一步探讨；缺血型RVO应尽早进行全视网膜光凝，但伴明显出血时应选择红光治疗。

The clinic research on laser treatment in retinai vein clusion

Objective To compare and analyze the valuation of four kinds of laser in treatment of RVO,and research the time of laser treatment.Methods Using nd:YAG 532 laser treat cvstoid macular edema with grid pattem photocoagulation 64 eyes,scatter photocoagulation treat early-stage nonischemic RVO 32 eyes,PRP treat ischemic RVO 60 eyes,14 eyes using 810-semiconductor laser.Results The effective rate of grid pattem photocoagulation on CME was 75.00%,visual acuity progress was 51.57%,the blood absorb rate with nonischemic RVO six months was 71.87%,the visual acuity progress was 43.75%,about 12.5%changed to ischemic RVO.The effective rate of 21 eyes of ischemic RVO using 532 laser was 23.81%.The second laser treatment of blood absoebed was 42.86%,no-effective was 33.33%.The effective rate of ischemic changed from nonischemic was 84.62%,the visual acuity progress was 33.33%.810-semiconductor laser treat 14 eyes,effective rate was 100%,visual progess was 28.57%.Conclusion The CME must treat early using laser which wavelength is above 514 nm.Early treatment of nonsichemic RVO don'tprevent nevasculisation,which need research furth.Ischemic RVO need treat early with PRP,if ischemic RVO with blood,choice red-color laser.