CAJ | 학술논문

目的：评估视网膜脱离高危眼变性和裂孔区光凝对发生孔源性视网膜脱离的预防作用。方法2011年1月至2013年9月因高度近视、孔源性视网膜脱离、无晶状体眼、人工晶状体眼在我院眼科就诊的患者，若屈光间质透明可行眼底检查及治疗，则纳入本研究，对高危眼变性区或裂孔区进行激光光凝治疗。每6～12个月随访1次，每次详细记录视网膜病变情况。结果40例（63只眼）进行了预防性光凝，所有患眼均发生了玻璃体后脱离，其中完全性后脱离28例（39只眼）。31例（46只眼）进行了随访，其中27例（42只眼）痊愈，4例（4只眼）发生了视网膜脱离；最佳矫正视力（ BCVA ）＜0．05者7只眼，0．05≤BCVA＜0．3者13只眼，0．3≤BCVA＜0．6者20只眼，0．6≤BCVA＜0．8者4只眼，BCVA＞0．8者2只眼。4例（4只眼）视网膜脱离是由于玻璃体后脱离进展和新的视网膜裂孔形成。结论激光光凝治疗可有效预防视网膜脱离高危眼发生孔源性视网膜脱离，但光凝区病变进展和玻璃体后脱离的发展是预防治疗后发生视网膜脱离的主要原因。
목적：평고시망막탈리고위안변성화렬공구광응대발생공원성시망막탈리적예방작용。방법2011년1월지2013년9월인고도근시、공원성시망막탈리、무정상체안、인공정상체안재아원안과취진적환자，약굴광간질투명가행안저검사급치료，칙납입본연구，대고위안변성구혹렬공구진행격광광응치료。매6～12개월수방1차，매차상세기록시망막병변정황。결과40례（63지안）진행료예방성광응，소유환안균발생료파리체후탈리，기중완전성후탈리28례（39지안）。31례（46지안）진행료수방，기중27례（42지안）전유，4례（4지안）발생료시망막탈리；최가교정시력（ BCVA ）＜0．05자7지안，0．05≤BCVA＜0．3자13지안，0．3≤BCVA＜0．6자20지안，0．6≤BCVA＜0．8자4지안，BCVA＞0．8자2지안。4례（4지안）시망막탈리시유우파리체후탈리진전화신적시망막렬공형성。결론격광광응치료가유효예방시망막탈리고위안발생공원성시망막탈리，단광응구병변진전화파리체후탈리적발전시예방치료후발생시망막탈리적주요원인。
Objective To investigate the preventive effects of laser photocoagulation in degenerative or hiatal areas forrhegmatogenous retinal detachmentin high-risk eyes.Methods Patientswere recruited from our ophthalmology clinic be-tween January 2011 and September 2013.High-risk eyes are defined as eyes with high myopia , history of rhegmatogenous retinal detachment ,and aphakicor pseudoaphakic eyes .A patient with high-risk eyes was enrolled if the media is clear .La-ser photocoagulation was conducted at the degenerative or hiatal areas to prevent rhegmatogenous retinal detachment .Sub-jects were followed every 6~12 months.Results We recruitedand treated 40 subjects (63 eyes).Posterior vitreous de-tachment presented in all eyes ,and in 39 eyes the vitreous detachment was complete .Among the 31 subjects (46 eyes) who completed follow-ups, 27 patients (42 eyes) were cured, while retinal detachment recurred in 4 patients (4 eyes).Best corrected visual acuity was lower than 0.05 in 7 eyes, between 0.05 and 0.3 in 13 eyes, between 0.6 and 0.8 in 4 eyes, and higher than 0.8 in 2 eyes.Recurredretinal detachmentin 4 eyeswas due tonew retinal holes caused byprogressive poste-rior vitreous detachment .Conclusion Laser photocoagulation can effectively prevent the recurrence of retinal detachment in high-risk patients .Progression of retinopathyat the photocoagulation areasandprogression of posterior vitreous detachment are major causes of recurrence .