李　静，谷　威



·临床报告·

Ultra Q-YAG玻璃体消融术治疗飞蚊症的临床初步观察

李静，谷威

Department of Ophthalmology,Beijing Aier-Intech Eye Hospital, Beijing 100021, China

•METHODS: Retrospective case series study. From September 2014 to May 2015 in Beijing Aier-Intech Eye Hospital, 263 cases (340 eyes) with vitreous floaters were involved. All patients underwent visual acuity, intraocular pressure, slit lamp, mydriatic fundus, B ultrasonic examination, and recorded the form of a vitreous opacity excluded pathological fundus lesions. All the patients were divided into two groups: Group A (<30 years old) 78 cases (82 eyes); the morphology of vitreous opacity were dot, filiform and mesh. Group B (>45 years old), 185 cases (258 eyes), the morphology of vitreous opacity was Weiss ring, translucent flocculent clouds or dense fibrous membrane. Patients in 30-45 years old were eliminated because of the untypical opacity factor. The treatment was done by the same physician. Vision changes was analyzed before and after the treatment.

•RESULTS: Questionnaire survey was done. According to the scores of the questionnaires, patients were divided into 3 groups: no improvement (1-2 points), partial improvement (3-5 points), significant improvement (6-10 points). At 1mo after treatment, Group A: no improvement in 9 eyes (11.0%), partial improvement in 57 eyes (69.5%) and significant improvement in 16 eyes (19.5%); Group B: no improvement in 0 eyes, partial improvement in 23 eyes (8.9%) and significant improvement in 235 eyes (91.1%); all the patients had no complications.

•CONCLUSION: The treatment with YAG vitreolysis for vitreous floaters is safe and effective, especially for the patients more than 45 years old whose vitreous floaters caused by posterior vitreous detachment.

目的：研究Ultra Q-YAG玻璃体消融术治疗不同年龄段临床有症状飞蚊症患者的疗效及安全性。

方法：回顾性队列研究。对2014-09/2015-05在北京爱尔英智眼科医院临床确诊为玻璃体混浊的患者263例340眼纳入研究，所有患者均行视力、眼压、裂隙灯、散瞳查眼底、B超检查，并记录玻璃体混浊物的形态，排除眼底病变。根据患者年龄分为两组：A组(<30岁)78例82眼，玻璃体混浊的形态多为细点、丝状、网状；B组(>45岁)185例258眼，玻璃体混浊的形态多为Weiss环，半透明絮状或致密纤维膜状。均排除外伤与眼内病变所致混浊，30～45岁患者由于混浊因素不典型被剔除。所有患者均由同一有经验医师行YAG玻璃体消融术(Ellex Medical Lasers)，对比分析治疗后1mo飞蚊症状缓解情况。

结果：行问卷调查，根据患者问卷得分将术后症状改善程度分为基本无改善(1～2分)、部分改善(3～5分)、显著改善(6～10分)。1mo后A组无改善9眼(11.0%)，部分改善57眼(69.5%)，显著改善16眼(19.5%)；B组无改善0眼，部分改善23眼(8.9%)，显著改善235眼(91.1%)；所有患者无1例并发症发生。

结论：YAG玻璃体消融术治疗飞蚊症安全有效。对于年龄<30岁年龄组的飞蚊症患者，有改善但显著改善的几率不高。而对于年龄>45岁年龄组，因玻璃体后脱离导致的玻璃体混浊,患者效果更佳。

飞蚊症；Nd:YAG激光；玻璃体消融术

引用：李静，谷威.Ultra Q-YAG玻璃体消融术治疗飞蚊症的临床初步观察.国际眼科杂志2016;16(7):1369-1371

0引言

过去出现“飞蚊症”往往是在40岁后，现在随着人们压力的增大，飞蚊症患者的年龄也越来越年轻。尽管飞蚊症对视力影响较小，症状轻微，但却严重影响着人们的视觉质量，由此所带来的烦恼不容小觑。以前国内大部分眼科医生对“飞蚊症”的处理仅仅是观察，或是口服卵磷脂络合碘片等药物，收效甚微。……