Fankhauser F, Kwasniewska S, van der Zypen E
Arch Ophthalmol. 1985 Aug;103(8):1166-71. doi: 10.1001/archopht.1985.01050080078025.
We present an overview concerning the current status of photodisruptive methods used in the treatment of pathologic changes in the vitreous space. In one series of 320 cases studied, 65% of the planned dissections of pathologic structures were successful. In a second series of 34 more complicated cases, the success rate was even lower. Complications included 15 retinochoroidal hemorrhages and one damaged posterior lens capsule. When one compares optical-surgical methods with conventional methods, it is obvious that the former aim at achieving goals that are less ambitious than those of classic vitrectomy and, in many cases, serve only to prepare for - and facilitate - a classic vitrectomy. By definition, laser vitreolysis dissects, but cannot remove, the fragments of disrupted structures from the eyeball. However, despite the obvious risks, photodisruptive laser surgery is considered less dangerous than is classic vitrectomy because photodisruption is a "noninvasive" procedure. Since laser vitreolysis is able to solve a number of clinical problems, obviating the need for vitrectomy, the former procedure should receive increasing attention for the treatment of pathologic problems in the vitreous cavity.
我们对用于治疗玻璃体腔病理改变的光致破裂方法的现状进行了概述。在一项对320例病例的研究系列中,计划对病理结构进行的切割手术有65%取得成功。在另一组34例更复杂的病例中,成功率甚至更低。并发症包括15例视网膜脉络膜出血和1例晶状体后囊受损。当将光学手术方法与传统方法进行比较时,很明显前者的目标不如经典玻璃体切除术那么宏大,而且在许多情况下,仅用于为经典玻璃体切除术做准备并使其更顺利。根据定义,激光玻璃体溶解术能切割但无法从眼球中清除破碎结构的碎片。然而,尽管存在明显风险,但光致破裂激光手术被认为比经典玻璃体切除术危险性小,因为光致破裂是一种“非侵入性”手术。由于激光玻璃体溶解术能够解决一些临床问题,从而无需进行玻璃体切除术,因此该手术方法在治疗玻璃体腔病理问题方面应受到越来越多的关注。