Nd:YAG激光门诊治疗后发性白内障临床疗效观察

目的 :探讨门诊采用 Nd:YAG激光行后囊膜切开术治疗后发性白内障的方法及其并发症的防治。方法 :回顾分析门诊对 74例 (98眼 )后发性白内障患者进行 Nd:YAG激光后囊切开术 ,探讨根据膜的厚薄选择激光能量 ,分别采用“十”字切开 (若后囊有张力者行张力线切开 )、横形、纵形切开及环形或瞳孔缘开罐式切开方法。结果 :一次性 Nd:YAG激光后发性白内障切除术成功 6 2例 (83只眼 )最佳矫正视力达 0 .3～ 1.0占 83.8% ;其余 12例 (15只眼 )经二次激光手术后 ,其中 8例 (10只眼 )视力亦有不同程度提高 ,最佳矫正视力大于或等于 0 .0 5 ,低于 0 .3,另外 4例 (5只眼 )因先天性白内障和外伤性白内障机化膜较厚 ,发现有钙化 ,未能击穿 ,视力无改善 ,最终手术治疗。激光术后主要并发症为短暂性高眼压和人工晶体损伤。结论 :Nd:YAG激光后囊切开术治疗后发性白内障效果满意 ,它是一种简便、安全、有效的方法 ,可在门诊开展。对明显影响视功能的后发性白内障 ,Nd:YAG激光后囊切开术可替代手术 ,立即恢复视力

Study of Nd:YAG Laser Capsulotomy Techniques for after Cataract in Out-patient

Objective To study the technique of using Nd:YAG laser in treating after cataract in out patient and to prevent complications.Methods According to the thickness of membrane to choose laser power.The methods of capsulotomy were crossed, horizontal, vertital, can opening or circular along papillary margin. Results The result was satisfactory.The best corrected visual acuity (BCVA) was improved significantly in 83.8 % cases(BCVA≥0.3) by Nd:YAG laser therapy first time; the rest 12 cases had to perform Nd:YAG laser therapy twice or more, 8 from 12 cases had BCVA of 0.05 or lower ,the other 4 cases being of congenital cataract or traumatic cataract,which formed thicker membrane, the BCVA was unchanged. The main complications were transient increase of IOP (65.21 %) and injury to IOL(22.6 %). Conclusion Nd:YAG laser capsulotomy is a kind of safe, simple and effective technique.It can take the place of surgery in treating after cataract which leads to the visual acuity decreasing significantly.