倒睫激光疗效106例观察

目的 对氩激光光凝后的倒睫患者进行随诊,观察这种方法的临床效果.方法 应用氩激光治疗倒睫毛,将能量设为500～1000m W,时间为200m s,光斑50～200μm,使激光束对准倒睫毛的根部,产生2～3m m直径的小凹陷,继续激光破坏毛囊.激光后应用抗生素滴眼液一周.结果 73位患者106只眼接受了氩激光治疗.每根倒睫所需激光点数(53.7±19.1)点,68只眼经1次激光治愈,成功率64.2%,经3次激光,101只眼(95.3%)达到治愈效果.眼睑≤5个倒睫者,1次激光成功率78.9%;5～10个,33.3%;而超过10个倒睫的眼睑均需多次激光.沙眼1次激光成功率41.7%,睑缘炎72.4%,特发性倒睫81.8%.结论 氩激光光凝治疗倒睫是一安全、有效的方法.眼睑上的倒睫数越多,成功率越低.病因不同治疗效果也不同,其中沙眼的倒睫治疗效果差,需多次激光处理.

Treatment of trichiasis with argon laser photocoagulation

Objective To observe the clinical effect with the use of Argon laser photocoagulation for the treatment of recurrent trichiasis patients. Methods A total of 106 lids (73 patients) with aberrant lashes were treated in our study. Each lash was treated with a beam of 50-200μm (spot size), 0.2s (time), and 500-1000mW .power). Topical or infiltration anesthesia was used. The beam was focused at the root of the aberrant cilium and a 2-3mm crater was produced at its base. This was then deepened to destroy the whole lash follicle. At the conclusion of the laser treatment, the patient was discharged on topical antibiotic eye drops three times a day for one week. Results Successful treatment with no evidence of recurrence was achieved in 64.2% of lids after one laser session. Of 101 lids (95.3%) achieved no recurrence with three sessions laser treatment. With one laser session, the success rate was 78.9% when aberrant lashes per lid were below 5 and 33.3%when aberrant lashes were from 5-10. If the aberrant lashes per lid were above 10, several sessions of laser was needed. With one laser session, the success rate of trachoma was 41.7%, 72.4% for blepharitis and 81.8% for idiopathic trichiasis. Conclusions Argon laser treatment appears to be a safe and effective method to the treatment of trichiasis. The success rate is lower when the aberrant lashes per lid are more. Among the different causes of trichiasis, trachoma carries a significant low success rate.