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目的 比较半导体激光、氩激光、532nm激光经瞳孔光凝兔眼视网膜的组织学反应。方法 灰兔5只,每眼以视神经乳头为界分成上、下两个术区,分别经瞳孔用半导体激光、氩激光或532nm激光照射视网膜,每眼均有半导体激光术区。半导体激光、氩激光、532nm激光功率分别为100～300、90～110、100～200mW,脉宽分别为02、01、01s,光斑直径均为200μm。结果 肉眼见半导体激光光斑比氩激光、532nm激光光斑更灰白。形成相似的光斑,半导体激光能量密度为氩激光、532nm激光的3～4倍。光镜下3种激光轻、中度光斑的表现相似,主要影响色素上皮、视细胞层和内外颗粒层;重度光斑表现不同,半导体激光致脉络膜、巩膜内层损伤,视网膜内层影响不大;氩激光、532nm激光使视网膜全层结构混乱,脉络膜改变不明显。透射电镜下见半导体激光光凝致脉络膜毛细血管闭塞,视网膜内界膜正常;氩激光、532nm激光光凝后色素上皮细胞内溶酶体功能活跃,双极细胞空泡变。结论 半导体激光视网膜、脉络膜的吸收率为氩激光、532nm激光的14,光凝时不易掌握合适的反应程度,常规视网膜光凝治疗时,应该选用氩激光或532nm激光。
Objective To compare the histopathological changes of retinal photocoagulation rabbit eyes with semiconductor laser, argon laser and 532nm laser. Methods Five gray rabbits were divided into two upper and lower surgical regions, each of which was irradiated with semiconductor laser, argon laser or 532 nm laser through the pupil. Each eye had a semiconductor laser area. Semiconductor laser, argon laser, 532nm laser power were 100 ~ 300,90 ~ 110,100 ~ 200mW, pulse width was 02,01,01s, spot diameter is 200μm. The results of the naked eye see semiconductor laser spot argon laser, 532nm laser spot more gray. The formation of a similar spot, the semiconductor laser energy density argon laser, 532nm laser 3 to 4 times. The laser light and moderate light spots showed similar performance under the light microscope, which mainly affected the pigment epithelium, the retinal layer and the inner and outer granule layers. The performance of the severe plaque was different. The laser induced choroid and scleral inner layer had little effect on the inner retina. Argon laser, 532nm laser confused the whole retina structure, choroidal changes were not obvious. Under the transmission electron microscope, we found choroidal capillaries occluded by laser diode laser photocoagulation and the normal inner retinal membrane. After laser photocoagulation with 532nm laser photolysis, lysosomes were active in the epithelial cells and vacuolated cells were bipolar cells. Conclusions The absorption rate of semiconductor laser retina and choroid is Argon laser, 532nm laser is 14, it is not easy to grasp the proper reaction degree when photocoagulation. In conventional retinal photocoagulation, argon laser or 532nm laser should be used.