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目的观察短脉冲全视网膜光凝术(pattern scan laser photocoagulator panretinal photocoagulation,PASCAL-PRP)治疗糖尿病视网膜病变(diabetic retinopathy,DR)患者眼前段的早期影响。方法 DR患者41例74只眼,应用短脉冲多点扫描式光凝系统(pattern scan laser photocoagulator,PASCAL)行一次性全视网膜光凝(PRP),观察分析患眼光凝术前、术后中央前房深度、前房角、房角开放距离、睫状体及前段脉络膜的变化情况。结果与术前比较,短脉冲PASCAL-PRP术后第3天,患眼各象限前房角明显变窄,前房变浅(P<0.05)。25只眼(33.8%)同时发生全周睫状体脱离合并前段脉络膜浅脱离。24只眼(32.4%)未出现任何脱离。前房深度变化值与房角开放距离变化、鼻侧、下方、颞侧前房角的改变、睫状体脱离高度以及前段脉络膜脱离高度呈显著相关,但与年龄无明显相关关系。患眼发生的脱离(除4只眼外)均于术后第7天复查时自行消退恢复。结论短期观察中,短脉冲一次性PASCAL-PRP治疗糖尿病视网膜病变虽会引起部分DR患者早期暂时性前房角变窄、睫状体和脉络膜脱离等眼前段改变,但均可自行消退恢复。
Objective To observe the early effect of anterior segment of patients with diabetic retinopathy (DR) by pattern scan laser photocoagulator panretinal photocoagulation (PASCAL-PRP). Methods One hundred and forty-four eyes of 41 patients with DR were treated with one-off panretinal photocoagulation (PRP) by pattern scan laser photocoagulation system (PASCAL). Before the operation, Depth of the anterior chamber, anterior chamber angle, open angle of the anterior chamber, ciliary body and anterior choroid. Results Compared with the preoperative, the anterior chamber angle of each quadrant of the affected eyes was significantly narrower and the anterior chamber was lighter on the 3rd day after the short pulse PASCAL-PRP (P <0.05). Twenty-five eyes (33.8%) also developed peritrochoidal detachment combined with anterior choroidal detachment. 24 eyes (32.4%) did not appear any detachment. There was a significant correlation between the depth of anterior chamber and the open angle of the anterior chamber, the change of the nasal, inferior, temporal anterior chamber angle, the height of the ciliary body detachment and the anterior choroidal detachment height, but no significant correlation with age. Occurred from the occurrence of eye detachment (except 4 eyes) were 7 days after the review when the self-regression recovery. Conclusions In the short term, short-pulse one-time PASCAL-PRP treatment of diabetic retinopathy may cause some of the early DR patients with narrowing of the anterior chamber angle, ciliary body and choroidal detachment and other anterior segment changes, but both self-recovery from regression.