Therapeutic Effect Of Laser Photocoagulation On Diabetic Retinopathy At Different Laser Parameter

Objective To observe clinical therapeutic effect and damage of laser photocoagulation on different grade diabetic retinopathy at two different Laser parasures that is II grade spot with low energy small spot and III grade spot with high energy big spot,and to in- vestigate whether the treatment of low energy and small spot panretinal photocoagula- tion can achive the good effect and reduce the side effects at the same time. Methods A total of 228 eyes of 120 patients with DR diagnosed by fundus fluorescein angiography (FFA) were enrolled in this study. In the 114 eyes,60 eyes were moderate non-proliferative DR(NPDR),92 eyes were severe non-proliferative DR(NPDR),76 ey- es were proliferative DR(PDR).The general exams including blood pressure,blood sugar,HbAlc,blood fat and detailed ophthalmologist exams such as naked eyesight, optometry, tonometry, biomicroscopy of the anterior eye segment,visual field, VEP,ERG, FFA and color photo of fundus were carried out on every patient before the therapeutic. Then the patients were divided into A group and B group.The eyes of A group were treated by low energy and small spot laser.the eyes of B group were treated by high energy and big spot laser.Sub-Panretinal photocoagulation is performed on the paitents with moderate NPDR,panretinal photocoagulation were performed on the paitents with severe NPDR and PDR.Three months after the treatment, eyesight, fundus, color photo of fundus, FFA,VEP,ERG and visual field were examind. The results of the two groups were compared and statistically analyzed. Results1.After the operations, the eyesight of moderate NPDR and severe NPDR were not any statistical difference between the two groups (X2=0.373,0.276,P>0.05),but the eyesight of PDR is different between the two groups (X2=6.373,P>0.05).2.The positive of moderate NPDR and severe NPDR ,therapeutic effect on DR were not any statinstical difference between the two groups (X2=0.741,0.449, P>0.05), but the positive of PDR therapeutic effect on DR was difference between the two groups(X2=10.431,P<0.05).3.Before the operations, the average light sensitive of moderate NPDR and severe NPDR was not difference between the two groups(t30°=0.684, t60°=0.692,P>0.05).After the operations, the average light sensitive of moderate NPDR and severe NPDR was difference between the two groups(t30°=2.818 P<0.05;t60°=2.591 P<0.05).4.For moderate NPDR and severe NPDR,ERG, before the operations, aA, bA, aT and bT were not difference between the two groups (t=0.695,0.824,0.676,0.803, p>0.05);after the operations, aA and bA were difference between the two groups(t = 4.15,4.87,P<0.05), aT and bT were not any difference between the two groups(t = 0.738,0.813, p>0.05).5.For moderate NPDR and severe NPDR,VEP , before the operations,AP100 and LP100 were not difference between the two groups(t =0.771,0.665, p>0.05);after the operations, AP100 and LP100 were not difference between the two groups too(t=0.874, 1.246, p>0.05). Conclusion1.For the moderate NPDR and severe NPDR, II grade laser can achive the good effect as same as III grade laser, but the effect on the visual field ,VEP and ERG was less.2.For the PDR, III grade laser can achive better effect than II grade laser.3.In DR of photocoagulation treatment, we should adopt different flare reaction graded photocoagulation according to patients, illness weigh, we can not abate the treatment effect for avoiding the complications.