Nd:YAG laser anterior vitrectomy

During cataract surgery, if the vitreous overflows and the treatment is not appropriate, the vitreous and wound adhesion often occur after surgery. This vitreous strip often causes the pupil to move up, sometimes causing cystoid edema of the macula, which seriously affects vision. In 1983, Katzen et al first reported that vitreous traction was used to cut the vitreous and wound adhesions. The visual acuity of 14 cases increased to different degrees, which laid a practical foundation for laser vitrectomy. For cases that are ready for treatment, a detailed examination should be performed under the slit lamp. It is also necessary to check the angle of the vitreous strip to determine the nature of the vitreous strip and the type and extent of adhesion to the wound. Most of the vitreous strips that pass through the pupil are accompanied by different degrees of pupil deformation or up-shift, and the vitreous strips entering the anterior chamber from the peri-iris of the iris may not be accompanied by pupillary deformation. In some cases, a depigmentation change occurs at the position of the iris through which the vitreous strip passes, which may be related to the vitreous rubbing of the iris surface. There are three types of vitreous strips that enter the anterior chamber through the pupil: 1 isolated vitreous cord; 2 simple curtain-like traction; 3 extensive vitreous strip with iris adhesion or traction. The latter case is more difficult to handle. Treating diseases: eye diseases, surgical procedures The vitreous strip is inserted into the anterior chamber from the pupil. 2% of pilocarpine is applied once every 2 hours before surgery to tighten the vitreous strip by shrinkage, which increases the tension and facilitates the cutting of the strip. It can be cut at any part of the strip, but in order to increase the effect, it is best to choose a relatively large, relatively thin or thin portion. The most common focus is the neck that abuts the wound or through the pupil area. The former must use the corner mirror, use high energy, and easily damage other tissues in the corner; the latter is easy to identify, easy to locate, and easy to operate. Due to the uneven thickness of the glass body, the energy used is not fixed, but generally higher, usually 4-8 mJ, alternating with single pulse or multiple pulses. Each treatment can have up to hundreds of shots, but the total energy is preferably no more than 2000mJ, repeated treatment, at least one week apart.

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