Suzuki R, Hanada M, Suzuki H, Kurimoto S
Department of Ophthalmology, Yamaguchi University School of Medicine, Ube City, Japan.
Ann Ophthalmol. 1992 Aug;24(8):285-7.
We report the case of a patient who had no light perception after neodymium:yttrium aluminum garnet (Nd:YAG) laser transscleral cyclocoagulation. To the best of our knowledge, no similar cases have been reported previously. A 56-year-old man with intractable open-angle glaucoma had intraocular pressures of 42 mmHg OD and 35mmHg OS. The patient rejected a recommended filtering operation, although argon laser trabeculoplasty and maximal medication had been ineffective OU. We used the free-running mode of an Nd:YAG laser to treat this patient. After the tenth application, the patient suddenly noticed acute visual loss OD. He was admitted to the hospital immediately. His retinal vessels and papilla OD could not be seen during fluorescein angiography. We administered pulsed corticosteroids and a stellate ganglion block. Gradually, his symptoms improved. The indications for using Nd:YAG laser cyclocoagulation have been expanded. However, as a result of our experience in this patient, we concluded that such therapy should be limited to cases not amenable to other forms of medical and surgical treatment.
我们报告了一例患者，其在钕：钇铝石榴石（Nd：YAG）激光经巩膜睫状体光凝术后无光感。据我们所知，此前尚未有类似病例报道。一名56岁患有顽固性开角型青光眼的男性，右眼眼压为42 mmHg，左眼眼压为35 mmHg。尽管氩激光小梁成形术和最大剂量药物治疗在双眼均无效，但患者拒绝了推荐的滤过手术。我们使用Nd：YAG激光的自由运行模式治疗该患者。在第十次照射后，患者突然出现右眼急性视力丧失。他立即被收治入院。荧光素血管造影检查时，其右眼视网膜血管和视乳头均不可见。我们给予脉冲式皮质类固醇和星状神经节阻滞治疗。患者症状逐渐改善。使用Nd：YAG激光睫状体光凝术的适应证已经扩大。然而，基于我们对该患者的治疗经验，我们得出结论，这种治疗应仅限于不适合其他药物和手术治疗形式的病例。
