Benner J D, Huang M, Morse L S, Hjelmeland L M, Landers M B
Department of Ophthalmology, University of California, Davis, Sacramento.
Ophthalmology. 1992 Oct;99(10):1554-63. doi: 10.1016/s0161-6420(92)31767-1.
The purpose of this study is to compare photocoagulation with the argon green, krypton red, and diode infrared laser indirect ophthalmoscopes in an experimental setting.
Photocoagulation was performed with each of the laser indirect ophthalmoscopes in a grid pattern within one sector of the same eye of 14 Dutch-belted rabbits. Treatment was performed either with or without scleral depression. Measurements of the retinal burn diameters were performed after hemisecting the globes, and the burns were examined with light microscopy.
Variation in burn intensity and diameter (10% to 28%) was common with all 3 laser indirect ophthalmoscopes. Five times more output energy was required to make equivalent burns with the diode laser indirect ophthalmoscope than with the argon or krypton laser indirect ophthalmoscopes. Choriovitreal hemorrhages only occurred during scleral depression. Histopathologically, the argon green laser indirect ophthalmoscope burns spared the choroid and inner sclera, while the intense krypton and diode burns had full-thickness choroidal involvement and even thermal injury to the inner sclera. Scleral depression reduced the mean energy required to create equivalent burns with all three laser indirect ophthalmoscopes. There was a 10% to 40% reduction in the mean retinal burn diameter with scleral depression (argon green, P < 0.0005; krypton red, P < 0.0005; and diode, P < 0.025).
Photocoagulation with the argon green, krypton red, or diode infrared laser indirect ophthalmoscopes is a safe and effective method of retinal ablation. Decreasing the posterior nodal distance of the eye with scleral depression will produce a smaller spot on the retina with the laser indirect ophthalmoscope.
本研究旨在比较在实验环境中使用氩绿激光、氪红激光和二极管红外激光间接检眼镜进行光凝治疗的效果。
对14只荷兰带兔的同一只眼睛的一个象限内，使用每种激光间接检眼镜以网格模式进行光凝治疗。治疗时采用或不采用巩膜压迫。在将眼球半切后测量视网膜灼伤直径，并通过光学显微镜检查灼伤情况。
使用所有3种激光间接检眼镜时，灼伤强度和直径的变化（10%至28%）很常见。与氩激光或氪激光间接检眼镜相比，使用二极管激光间接检眼镜产生等效灼伤所需的输出能量要多5倍。脉络膜玻璃体出血仅在巩膜压迫时出现。组织病理学上，氩绿激光间接检眼镜灼伤未累及脉络膜和内巩膜，而强烈的氪激光和二极管激光灼伤则有全层脉络膜受累，甚至内巩膜有热损伤。巩膜压迫降低了使用所有3种激光间接检眼镜产生等效灼伤所需的平均能量。巩膜压迫使平均视网膜灼伤直径减小了10%至40%（氩绿激光，P < 0.0005；氪红激光，P < 0.0005；二极管激光，P < 0.025）。
使用氩绿激光、氪红激光或二极管红外激光间接检眼镜进行光凝治疗是一种安全有效的视网膜消融方法。通过巩膜压迫减小眼球后节点距离，使用激光间接检眼镜时在视网膜上会产生更小的光斑。
