Chen Yung-Jen, Kou Hsi-Kung
Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Ophthalmologica. 2004 Nov-Dec;218(6):368-71. doi: 10.1159/000080938.
To evaluate the safety and effectiveness of krypton laser membranotomy.
Eleven patients (12 eyes) with premacular hemorrhage were enrolled from April 1998 to November 2002. The causes of premacular hemorrhage were proliferative diabetic retinopathy (7 patients, 8 eyes), Valsalva retinopathy (3 patients) and leukemia (1 eye). Krypton laser was used to create a membranotomy on the sloping edge of the premacular hemorrhage. Five eyes with proliferative diabetic retinopathy were treated with inferior panretinal photocoagulation and laser membranotomy simultaneously. After intravitreal dispersion of premacular blood, fundus examinations were performed in all eyes and fluorescein angiography in 5 patients to evaluate the retinal damage.
Vision was improved within 2 weeks after surgery in all eyes with premacular hemorrhage, which received krypton laser membranotomy. No retinal damage was seen at the site of membranotomy. No eye needed vitrectomy postoperatively during the follow-up (mean, 17 months).
Krypton laser membranotomy appears to be a safe and simple alternative procedure for treating selected cases of premacular hemorrhage. Further trials are necessary to evaluate its benefit.
评估氪激光膜切开术的安全性和有效性。
1998年4月至2002年11月纳入11例（12只眼）黄斑前出血患者。黄斑前出血的病因包括增殖性糖尿病视网膜病变（7例，8只眼）、瓦氏视网膜病变（3例）和白血病（1只眼）。使用氪激光在黄斑前出血的倾斜边缘进行膜切开术。5例增殖性糖尿病视网膜病变患者同时接受了视网膜全光凝和激光膜切开术。黄斑前血液在玻璃体内扩散后，对所有眼睛进行眼底检查，对5例患者进行荧光素血管造影以评估视网膜损伤。
所有接受氪激光膜切开术的黄斑前出血患者术后2周内视力均有改善。膜切开部位未见视网膜损伤。随访期间（平均17个月）无1只眼术后需要行玻璃体切除术。
氪激光膜切开术似乎是治疗部分黄斑前出血病例的一种安全、简单的替代方法。需要进一步试验来评估其益处。
