方法：筛选符合条件的40例生理性玻璃体混浊患者，术前检查最佳矫正视力、非接触眼压、眼前节彩照，OCT测量黄斑中心小凹厚度(foveola thickness，FT)和视神经纤维层厚度(retinal nerve fiber layer，RNFL)，由同一位操作熟练的医师进行1～2次YAG激光消融术治疗，术后予以测量非接触眼压和普拉洛芬眼液点眼qid，3d，术后2d，1wk，1、3mo复查最佳矫正视力和非接触眼压，术后3mo进行眼前节彩照，术后1wk，1、3mo复查FT和RNFL。

结果：术前与术后2d，1wk，1、3mo的最佳矫正视力、非接触眼压的差异无统计学意义(P>0.05)； 术前眼前节彩照能够发现明显的单个或片状玻璃体混浊物，术后3mo玻璃体混浊物明显变小或者消失，玻璃体腔内未见其他异常变化； 术前黄斑和视盘OCT测量数据显示，术前FT为214.60±9.35μm，术后1wk，1、3mo的FT结果分别为213.75±9.07、213.40±8.83、213.85±9.22μm； 术前RNFL上方为130.26±14.23μm，下方133.15±14.46μm，鼻侧82.48±13.50μm，颞侧75.40±11.89μm； 术后1wk的RNFL分别为上方130.02±14.02μm，下方132.99±14.05μm，鼻侧82.35±13.07μm，颞侧75.42±11.66μm； 术后1mo的RNFL分别为上方130.28±14.43μm，下方133.08±13.99μm，鼻侧82.31±13.72μm，颞侧75.45±12.03μm； 术后3mo的RNFL分别为上方130.43±14.30μm，下方133.22±14.20μm，鼻侧82.27±13.11μm，颞侧75.46±11.91μm，术前与术后各时间点分别比较，FT和RNFL的差异均无统计学意义(P>0.05)。

结论：YAG激光消融术对生理性玻璃体混浊患者的玻璃体和视网膜结构未造成不良影响，疗效确切安全。

METHODS: The selected 40 patients of physiological vitreous floaters, before YAG laser ablation, were checked for best corrected visual acuity, non-contact intraocular pressure, took their anterior segment photos, measured their foveola thickness(FT)and retinal nerve fiber layer(RNFL)by OCT. The YAG laser ablation was completed by one experienced surgeon. After the YAG laser ablation, all patients were checked for non-contact intraocular pressure and gave pranoprofen eye drops tid for 3d. At 2d, 1wk, 1 and 3mo after the surgery, they were reviewed for best corrected visual acuity, non-contact intraocular pressure. At 3mo later anterior segment photos were taken. At 1wk, 1 and 3mo after the surgery, FT and RNFL were measured again.

RESULTS: The postoperative 2d, 1wk, 1 and 3mo, best corrected visual acuity, non-contact intraocular pressure of the patients had no significant difference with preoperative(P>0.05). The preoperative anterior segment photos showed obvious single or sheet opacity of vitreous, the postoperative 3mo photos showed that vitreous opacities decreased or disappeared, no other abnormal changes were found. The preoperative OCT data showed that FT was 214.60±9.35μm, the postoperative 1wk, 1 and 3mo FT were 213.75±9.07μm, 213.40±8.83μm, 213.85±9.22μm. The preoperative RNFL were upper 130.26±14.23μm, lower 133.15±14.46μm, nasal 82.48±13.50μm, temporal 75.40±11.89μm; The postoperative 1wk RNFL were upper 130.02±14.02μm, lower 132.99±14.05μm, nasal 82.35±13.07μm, temporal 75.42±11.66μm. The postoperative 1mo RNFL were upper 130.28±14.43μm, lower 133.08±13.99μm, nasal 82.31±13.72μm, temporal 75.45±12.03μm. The postoperative 3mo RNFL were upper 130.43±14.30μm, lower 133.22±14.20μm, nasal 82.27±13.11μm, temporal 75.46±11.91μm. The differences of preoperative and postoperative 1wk, 1 and 3mo FT and RNFL had no statistical significance(P>0.05).

CONCLUSION: YAG laser ablation has no adverse effects to vitreous and retinal structure in patients with physiological vitreous floaters, it is effective and safe.