倍频Nd:YAG激光治疗糖尿病性黄斑水肿的临床分析

目的:探讨倍频Nd:YAG激光治疗糖尿病性黄斑水肿的临床效果。方法:对218例(364只眼)分别为局限性黄斑水肿、弥漫性黄斑水肿、囊样黄斑水肿的糖尿病性视网膜病变患者行倍频Nd:YAG激光治疗。对局限性黄斑水肿采用局部光凝,对弥漫性、囊样黄斑水肿采用格栅状光凝。根据不同病变类型选择激光参数,激光后3个月复查视力、荧光血管造影,观察黄斑水肿消退情况。随诊3~39个月。结果:局限性黄斑水肿142只眼,光凝后视力保持不变和提高者139只眼,占97.89%,水肿全部或部分吸收者139只眼,占97.89%;弥漫性黄斑水肿157只眼,光凝后视力保持不变和提高者144只眼,占91.72%,水肿全部或部分吸收者146只眼,占92.99%;囊样黄斑水肿65只眼,光凝后视力保持不变和提高者53只眼,占81.54%,水肿全部或部分吸收者59只眼,占90.77%。结论:根据黄斑水肿类型、视力情况选择激光参数,确保光斑有效,同时治疗糖尿病及其并发症,是激光治疗糖尿病性黄斑水肿的关键。

Clinical analysis of frequently double Nd:YAG laser for diabetic macular edema

Objective:To verify the effects of the treatment of frequency double Nd:YAG laser for diabetic macular edema.Methods:A total of 364 eyes in 218 cases of diabetic focal macular edema,diffuse edema and cystoid edema were treated with frequency double Nd:YAG laser photo coagulation.Those with focal macular edema underwent the focal photocoagulaton,and those with diffuse edema and cystoid edema underwent the frid photocoagulation.According to the type of the macular edema,select the proper parameter of laser.The visual acuity examination,fundus fluoresecin angiography were performed in 3 months after the treatment.The changes of macular edema after the treatment were analysed.The follow-up duration was 3 to 39 months(with an average of 16.3 months).Results:After laser focal photocoagulation in 142 eyes with focal macular edema,visual acuity was improved or maintained in 139 eyes(97.89%).Edema disappeared completely or partially in 139 eyes(97.89%).After laser grid photocoagulation in 157 eyes with diffuse macular edema,visual acuity was improved or maintained in 144 eyes(91.72%).Edema disappeared completely or partially in 146 eyes(92.99%).After laser grid photocoagulation in 65 eyes with cystoid macular edema,visual acuity was improved or maintained in 53 eyes(81.54%).Edema disappeared completely or partially in 59 eyes(90.77%).Conclusion:The key of the treatment of frequency double Nd:YAG laser photocoagulation lies in the insurance of the effective laser macules,treatment of diabetes and its complications,the adaptability of selecting the proper parameter of laser according to the type of the macular edema,and the visual acuity.