Lam T T, Tso M O
Georgiana Dvorak Theobald Ophthalmic Pathology Laboratory, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, College of Medicine 60612, USA.
Retina. 1996;16(1):42-6. doi: 10.1097/00006982-199616010-00008.
More than 83 cases of retinal laser injury were reported in the literature. Most of these cases involved direct exposure of the patient's retina to laser. The authors observed two patients who had laser injury to the retina caused by the reflected beams from a pulsed neodymium: YAG (Nd:YAG) laser.
The clinical course of each patient after laser injury to the macular area with an Nd:YAG laser were followed for 2 1/2 and 3 1/2 months.
Both patients were graduate students and were injured by the reflected beams of short-pulsed Nd:YAG lasers (1064 nm). The affected eyes showed similar clinical courses with early subretinal/retinal/vitreous hemorrhage, resorption of blood, and subsequent macular pucker and macular hole formation, although the students' visual acuity improved. The unaffected eye of patient #2 showed chorioretinal scars, possibly from a previously unreported laser injury.
The clinical courses of these two cases resembled earlier reported ones showing hemorrhage and subsequent macular pucker and macular hole formation. The two cases reflect the need for closer examination of the standard procedures in laser handling. Unintended laser injury to the retina may be higher than reported in workers handling lasers.
文献中报道了83例以上的视网膜激光损伤病例。这些病例大多是患者视网膜直接暴露于激光下。作者观察到两名患者因脉冲钕：钇铝石榴石（Nd:YAG）激光的反射光束而导致视网膜激光损伤。
用Nd:YAG激光对黄斑区造成激光损伤后，对每名患者的临床病程进行了2个半月和3个半月的随访。
两名患者均为研究生，均因短脉冲Nd:YAG激光（1064nm）的反射光束而受伤。尽管患者视力有所改善，但患眼表现出相似的临床病程，早期出现视网膜下/视网膜/玻璃体出血、血液吸收，随后出现黄斑皱襞和黄斑裂孔形成。患者2的未受影响眼出现脉络膜视网膜瘢痕，可能来自先前未报告的激光损伤。
这两例的临床病程与早期报道的病例相似，表现为出血以及随后的黄斑皱襞和黄斑裂孔形成。这两例反映了对激光操作标准程序进行更密切检查的必要性。视网膜意外激光损伤可能比激光操作人员报告的情况更为常见。
