Steinert R F, Puliafito C A, Kumar S R, Dudak S D, Patel S
Morse Laser Center, Massachusetts Eye and Ear Infirmary, Boston.
Am J Ophthalmol. 1991 Oct 15;112(4):373-80. doi: 10.1016/s0002-9394(14)76242-7.
A series of 897 Nd:YAG laser posterior capsulotomies were reviewed for the complications of cystoid macular edema, retinal detachment, new onset of glaucoma, and worsened preexisting glaucoma. After Nd:YAG capsulotomy, 11 patients (1.23%; 95% confidence interval, 0.51% to 1.95%) developed cystoid macular edema and eight patients (0.89%; 95% confidence interval, 0.28% to 1.5%) developed a retinal detachment. The new onset of glaucoma was observed in seven patients (0.78%; 95% confidence interval, 0.20% to 1.36%). Five patients (0.56%; 95% confidence interval, 0.07% to 1.05%) with preexisting glaucoma had persistent worsening of their glaucoma. Most patients with a complication had no identifiable risk factors in common. The numbers of laser pulses and energy delivered were not risk factors. Retinal detachment and cystoid macular edema developed most often many months after capsulotomy and many months to years after the cataract surgery. Patients undergoing Nd:YAG laser capsulotomy therefore require ongoing medical observation to detect and treat these serious complications.
回顾了897例钕:钇铝石榴石激光后囊切开术，以观察黄斑囊样水肿、视网膜脱离、新发青光眼以及原有青光眼病情恶化等并发症情况。在钕:钇铝石榴石激光后囊切开术后，11例患者（1.23%；95%置信区间为0.51%至1.95%）发生黄斑囊样水肿，8例患者（0.89%；95%置信区间为0.28%至1.5%）发生视网膜脱离。7例患者（0.78%；95%置信区间为0.20%至1.36%）出现新发青光眼。5例原有青光眼患者（0.56%；95%置信区间为0.07%至1.05%）的青光眼病情持续恶化。大多数发生并发症的患者没有共同的可识别风险因素。激光脉冲数和传递的能量并非风险因素。视网膜脱离和黄斑囊样水肿最常发生在囊切开术后数月以及白内障手术后数月至数年。因此，接受钕:钇铝石榴石激光后囊切开术的患者需要持续的医学观察，以检测和治疗这些严重并发症。
