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目的比较氩离子激光、5%和10%负载循环阈下微脉冲激光治疗糖尿病性黄斑水肿的疗效。方法对符合DME患者121例145只患眼,随机分为3组,氩离子激光组40例49只眼、5%负载循环阈下微脉冲激光组44例50只眼和10%负载循环的阈下微脉冲激光组37例46只眼。行黄斑水肿区的局灶或格栅样激光光凝,分别于光凝前及光凝后1,3和6个月随访视力、FFA和OCT。对比三种激光治疗有临床意义的黄斑水肿的疗效。结果治疗后氩离子激光组视力提高者11例11只眼(占22.4%),视力稳定者20例27只眼(占50.1%),视力下降者9例11只眼(占22.4%);5%和10%负载循环阈下微脉冲组视力提高者分别为9例10只眼(占20.0%)、8例11只眼(占23.9%),视力稳定者分别为21例29只眼(占58.0%)、22例24只眼(占52.2%),视力下降者分别为8例11只眼(占22.0%)、4例11只眼(占23.9%)。治疗后FFA显示氩离子激光组、5%和10%负载循环阈下微脉冲组水肿完全消退者分别为14例14只眼(占28.6%)、10例11只眼(占22.0%)和9例10只眼(占21.7%),水肿部分消退者分别为19例24只眼(占49.0%)、23例28只眼(占56.0%)和21例28只眼(占60.9%),水肿加重者分别为7例11只眼(占22.4%)、11例11只眼(占22.0%)和7例8只眼(17.4%)。三组比较差异无显著意义(P>0.05)。其中局限性水肿者激光治疗后视力提高优于囊样水肿和弥漫水肿。结论氩离子激光同阈下微脉冲激光均对糖尿病性黄斑水肿治疗有效,但三组在疗效上比较差异无显著意义。
Objective To compare the efficacy of argon ion laser and 5% and 10% duty cycle subthreshold micropulse laser in the treatment of diabetic macular edema. Methods One hundred and forty-one eyes of 145 patients with DME were randomly divided into three groups, 40 cases in argon laser group, 49 eyes in 50 cases, 50 cases in 5% load cycle subliminal micropulse laser group and 10% load cycle threshold Under the micro-pulse laser group 37 cases 46 eyes. Macular edema area focal or grid-like laser photocoagulation, visual acuity, FFA and OCT were followed before photocoagulation and 1, 3 and 6 months after photocoagulation. Comparison of three laser treatment of clinical significance of the efficacy of macular edema. Results Eleven eyes (22.4%) had visual acuity in argon laser group, 27 eyes (50.1%) in 20 cases with stable vision, 11 eyes (22.4%) in 9 cases with decreased vision; The percent of visual acuity in the% and 10% duty cycles subliminal micropulse group was 9 eyes (20.0%), 11 eyes (23.9%), and 21 eyes (29 eyes) 58.0%), 22 eyes (52.2%) and 8 eyes (11 eyes) (22.0%) and 4 eyes (11 eyes) (23.9%). After treatment, FFA showed 14 eyes (28.6%), 10 eyes (22.0%) and 9 eyes (9 eyes) of argon ion laser group and 5% and 10% duty cycle subthreshold micro pulse group, respectively Nineteen eyes (49.0%), 23 eyes (56.0%), 21 eyes (60.9%), edema Elevated in 11 eyes (22.4%) were in 7 cases, 11 eyes (22.0%) in 11 cases and 7 eyes (17.4%) in 7 eyes. There was no significant difference between the three groups (P> 0.05). One of the limitations of edema after laser treatment to improve visual acuity better than cystoid edema and diffuse edema. Conclusion Argon plasma laser with subthreshold micropulse laser are effective in the treatment of diabetic macular edema, but there is no significant difference between the three groups in curative effect.