Jagger J D, Hamilton A M, Polkinghorne P
Moorfields Eye Hospital, London, United Kingdom.
Graefes Arch Clin Exp Ophthalmol. 1990;228(3):222-5. doi: 10.1007/BF00920024.
We describe our experience of ten cases of posterior segment vitreolysis, using the short-pulse neodymium YAG (Yttrium Aluminium Garnate) laser. Eight patients had proliferative diabetic retinopathy, one patient had had an intraocular foreign body removed and one patient had had uveitis. Of the ten, five patients had macular traction retinal detachments, three patients had progressive traction retinal detachments threatening the macula and two patients had recurrent vitreous haemorrhages from mechanical traction on areas of fibrovascular proliferation. Eight of the patients were successfully treated. One macular retinal detachment failed to flatten and a tear was found which may have been iatrogenic. In one patient with a traction retinal detachment significant traction was relieved but the detachment failed to flatten completely. We discuss the indications, techniques, difficulties and complications. Our experience suggests that this technique has an important role in the treatment of selected patients, sparing patients conventional vitrectomy, or making possible the treatment of those for whom vitrectomy has been contraindicated or refused. Anterior defocusing of the YAG would be a useful modification of current laser systems and improved aiming systems desirable for the future.
我们描述了使用短脉冲钕钇铝石榴石（YAG）激光治疗10例后段玻璃体溶解的经验。8例患者患有增殖性糖尿病视网膜病变，1例患者曾取出眼内异物，1例患者患有葡萄膜炎。10例患者中，5例患有黄斑牵拉性视网膜脱离，3例患有威胁黄斑的进行性牵拉性视网膜脱离，2例因纤维血管增生区域的机械牵拉而反复发生玻璃体出血。8例患者成功接受治疗。1例黄斑视网膜脱离未复位，发现一处裂孔，可能是医源性的。1例牵拉性视网膜脱离患者的显著牵拉得到缓解，但脱离未完全复位。我们讨论了适应证、技术、难点和并发症。我们的经验表明，该技术在选定患者的治疗中具有重要作用，可使患者免于传统玻璃体切除术，或使那些玻璃体切除术被禁忌或拒绝的患者得以治疗。YAG激光的前散焦将是当前激光系统的一项有用改进，未来需要改进瞄准系统。
