传统格栅样激光与577nm黄色微脉冲激光光凝治疗黄斑水肿疗效对比

发布时间：2019-05-21 15:32

【摘要】：目的比较传统格栅样激光光凝(macular laser grid photocoagulation,MLG)与577 nm黄色微脉冲激光治疗黄斑水肿(macular edema,ME)的临床疗效。方法经眼底检查及光学相干断层扫描(optical coherence tomography,OCT)检查确诊的ME患者97例116眼纳入研究。将患者采用随机数字表法分为MLG组和微脉冲组,分别为46例57眼、51例59眼。MLG组行561nm黄绿光连续波长激光光凝治疗,微脉冲组患者行577 nm黄色微脉冲激光治疗。治疗前后所有患者均行眼底、矫正视力、OCT及微视野检查,检测其矫正视力、黄斑中心视网膜厚度(central macular thickness,CMT)及黄斑10°范围内视网膜光敏感度。以治疗后6个月为疗效判定时间点,观察患者治疗前后矫正视力、CMT及光敏感度的变化,对比分析治疗前后两组患者矫正视力、CMT及光敏感度差值之间的差异。结果治疗后6个月,MLG组、微脉冲组矫正视力分别为0.41±0.20、0.44±0.18,均较治疗前提高,差异均有统计学意义(t=2.703、3.398,均为P0.05)。两组治疗前后矫正视力的差值分别为0.07±0.03、0.09±0.02,两组间差值比较差异无统计学意义(t=0.584,P0.05)。治疗后MLG组、微脉冲组CMT分别为(328.13±107.66)μm、(316.54±73.21)μm,均较治疗前降低,差异均有统计学意义(t=2.028、4.086,均为P0.05)。两组治疗前后CMT的差值分别为(24.71±11.09)μm、(53.27±13.67)μm,两组差值比较差异无统计学意义(t=1.891,P0.05)。治疗后MLG组、微脉冲组光敏感度分别为(4.33±1.72)dB、(6.52±2.56)dB;MLG组光敏感度较治疗前降低,差异有统计学意义(t=3.381,P0.05);微脉冲组光敏感度较治疗前提高,差异也有统计学意义(t=3.569,P0.05)。MLG组、微脉冲组治疗前后光敏感度差值分别为(-0.89±0.26)dB、(1.12±0.31)dB,两组差值比较差异有统计学意义(t=4.791,P0.05)。结论 577nm黄色微脉冲激光治疗ME较MLG更为安全有效,在减轻ME、提高患者视力的同时,保护了视功能。
[Abstract]:Objective To compare the clinical effects of traditional grating-like laser photocoagulation (MLG) and 577nm yellow micro-pulse laser in the treatment of macular edema (ME). Methods 97 patients with ME were included in the study by fundus examination and optical coherence tomography (OCT). The patients were divided into the MLG group and the micro-pulse group by using the random digital table method. In the MLG group, 56nm yellow-green-green continuous-wavelength laser photocoagulation was performed, and the micro-pulse group was treated with a yellow micro-pulse of 577nm. All patients before and after treatment were examined by fundus, corrected vision, OCT and micro-visual field, and corrected visual acuity, central retinal thickness (CMT), and retinal light sensitivity in the 10 掳 range of the macula. The corrected vision, CMT and light sensitivity of the patients were observed before and after the treatment for 6 months, and the difference between the corrected vision, the CMT and the light sensitivity was observed in the two groups before and after the treatment. Results The corrected visual acuity of MLG and micropulse group was 0.41, 0.20, 0.44 and 0.18, respectively, and the difference was statistically significant (t = 2.703, 3.398, all P <0.05). The difference between the two groups was 0.07, 0.03, 0.09 and 0.02, and the difference between the two groups was not statistically significant (t = 0.584, P0.05). After treatment, the micropulse group (CMT) was (328.13-107.66). m, (316.54, 73.21). m, both decreased before and after treatment (t = 2.028, 4.086, both were P0.05). The difference of CMT between the two groups was (24.71, 11.09). m, (53.27, 13.67). m u.m, and the difference between the two groups was not statistically significant (t = 1.891, P0.05). The sensitivity of the micro-pulse group was (4.33-1.72) dB, (6.52-2.56) dB, and the light sensitivity of the MLG group was lower than that before treatment (t = 3.381, P0.05), and the light sensitivity of the micropulse group was higher than that before treatment (t = 3.569, P0.05). The difference between the two groups was (-0.89-0.26) dB, (1.12-0.31) dB, and the difference between the two groups was statistically significant (t = 4.791, P0.05). Conclusion The 577nm yellow micro-pulse laser treatment ME is more safe and effective than MLG, and the visual function is also protected while reducing ME and improving the patient's vision.
【作者单位】：唐山市眼科医院;
【分类号】：R779.63

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