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目的 探讨Nd∶YAG激光解除瞳孔膜闭的临床疗效。方法 应用Nd∶YAG激光对13例(13眼)前葡萄膜炎(活动性7例,陈旧性6例,其中复发者1例)并发瞳孔膜闭者行瞳孔膜切开术。自上方瞳孔缘作切口,借瞳孔扩大肌收缩力撕破瞳孔膜,扩大切口至瞳孔膜卷缩于前房内。术后抗炎、扩瞳、控制眼压、随诊。结果 术后1周视力05～12,平均077±011(x±s,下同),活动性炎症明显缓解,6例眼压异常者中4例恢复正常。术后1个月视力06～12(083±015),眼压全部正常。7例活动性炎症者中6例术后1个月炎症消失,1例术后2个月痊愈。除1例晶体遗留限局性击痕斑、4例出现短暂轻度眼压升高外,无其他并发症。结论 对强效扩瞳剂无法撕开的瞳孔膜行Nd∶YAG激光切开术,既能改善活动性前葡萄膜炎症状,减少并发症,又可显著改善患眼视力,经济、简便、快速、准确、安全有效,可收到事半功倍的效果。
Objective To investigate the clinical efficacy of Nd:YAG laser in the treatment of mydriasis. Methods 13 cases (13 eyes) of anterior uveitis (active in 7 cases, old in 6 cases and recurrence in 1 case) were treated by Nd:YAG laser with pupil membrane excision. From the top of the pupil margin for incision, through the pupil to expand muscle contraction force to tear the pupil membrane, expand the incision to pupil membrane curl in the anterior chamber. Postoperative anti-inflammatory, pupil dilation, intraocular pressure control, follow-up. Results One week after operation, visual acuity was 05-12, with an average of 077 ± 011 (x ± s, the same below). Active inflammation was relieved significantly. Four of the six patients with abnormal IOP returned to normal. One month after surgery, visual acuity 06 ~ 12 (083 ± 015), intraocular pressure were all normal. Six of seven active inflammatory patients disappeared at 1 month after operation, and one patient recovered after two months. In addition to a case of crystal left over limit finger marks, 4 cases of transient mild intraocular pressure increased, no other complications. Conclusions Nd:YAG laser incision can not tear the pia mater, which can not tear the potent pupil dilation agent. It not only can improve the activity of anterior uveitis but also reduce the complication, but also can significantly improve the visual acuity. It is economical, simple and quick , Accurate, safe and effective, can receive a multiplier effect.