Luo Jihan, An Xiaoju, Kuang Yi
1 Department of Ophthalmology, Chongqing General Hospital, Chongqing, China.
2 Chongqing Huaxia Eye Hospital, Jiangbei District, Chongqing, China.
J Int Med Res. 2018 Nov;46(11):4465-4471. doi: 10.1177/0300060518794245. Epub 2018 Sep 10.
To examine the efficacy and safety of yttrium-aluminium garnet (YAG) laser vitreolysis for the treatment of vitreous floaters.
Consecutive adult patients with symptomatic vitreous floaters who attended Chongqing General Hospital from April to December 2016 were included in this prospective study. Patients had >3 mm between the vitreous opacity and retina/lens and acceptable quality peri-papillary Optical Coherence Tomography (OCT) images (i.e., signal strength ≥5). Those with history of glaucoma, severe cataracts, vitreous haemorrhages, retinal holes and/or macular disease were excluded from the study. Best corrected visual acuity (BCVA) and non-contact intraocular pressure (IOP) were measured before and for up to 6 months post-YAG laser vitreolysis. Anterior segment photography and peripapillary retinal nerve fibre layer (RNFL) measured by OCT were taken before and 6 months post-procedure. Questionnaires on patient satisfaction were completed 6 months post-procedure.
No statistically significant differences in BCVA and IOP were observed before or after treatment. Anterior segment photography showed that vitreous opacities partially or completely disappeared after YAG laser treatment. The thickness of RNFL in four directions (upper, below, nasal and temporal) was not statistically significant different before or 6 months after the procedure. 75% patients reported significant improvement and 25% reported moderate improvement.
The results of this study conducted in a cohort of 30 Chinese patients showed that YAG laser vitreolysis was a well-tolerated and effective treatment for vitreous floaters. Randomised, controlled trials involving large numbers of participants monitored over an extended follow up period are required to confirm these results.
探讨钇铝石榴石(YAG)激光玻璃体溶解术治疗玻璃体混浊的疗效及安全性。
本前瞻性研究纳入了2016年4月至12月在重庆总医院就诊的有症状玻璃体混浊的成年连续患者。患者玻璃体混浊与视网膜/晶状体之间的距离>3mm,且视乳头周围光学相干断层扫描(OCT)图像质量可接受(即信号强度≥5)。有青光眼、严重白内障、玻璃体出血、视网膜裂孔和/或黄斑疾病史的患者被排除在研究之外。在YAG激光玻璃体溶解术前及术后长达6个月测量最佳矫正视力(BCVA)和非接触眼压(IOP)。术前及术后6个月进行眼前节照相及通过OCT测量视乳头周围视网膜神经纤维层(RNFL)。术后6个月完成患者满意度问卷调查。
治疗前后BCVA和IOP无统计学显著差异。眼前节照相显示YAG激光治疗后玻璃体混浊部分或完全消失。术后6个月与术前相比,四个方向(上方、下方、鼻侧和颞侧)的RNFL厚度无统计学显著差异。75%的患者报告有显著改善,25%的患者报告有中度改善。
本研究对30例中国患者的队列研究结果表明,YAG激光玻璃体溶解术是一种耐受性良好且有效的玻璃体混浊治疗方法。需要进行涉及大量参与者并进行长期随访监测的随机对照试验来证实这些结果。