方法：回顾性队列研究。对2014-09/2015-05在北京爱尔英智眼科医院临床确诊为玻璃体混浊的患者263例340眼纳入研究，所有患者均行视力、眼压、裂隙灯、散瞳查眼底、B超检查，并记录玻璃体混浊物的形态，排除眼底病变。根据患者年龄分为两组：A组(<30岁)78例82眼，玻璃体混浊的形态多为细点、丝状、网状； B组(>45岁)185例258眼，玻璃体混浊的形态多为Weiss环，半透明絮状或致密纤维膜状。均排除外伤与眼内病变所致混浊，30～45岁患者由于混浊因素不典型被剔除。所有患者均由同一有经验医师行YAG玻璃体消融术(Ellex Medical Lasers)，对比分析治疗后1mo飞蚊症状缓解情况。

结果：行问卷调查，根据患者问卷得分将术后症状改善程度分为基本无改善(1～2分)、部分改善(3～5分)、显著改善(6～10分)。1mo后A组无改善9眼(11.0%)，部分改善57眼(69.5%)，显著改善16眼(19.5%)； B组无改善0眼，部分改善23眼(8.9%)，显著改善235眼(91.1%)； 所有患者无1例并发症发生。

结论：YAG玻璃体消融术治疗飞蚊症安全有效。对于年龄<30岁年龄组的飞蚊症患者，有改善但显著改善的几率不高。而对于年龄>45岁年龄组，因玻璃体后脱离导致的玻璃体混浊，患者效果更佳。

METHODS: Retrospective case series study. From September 2014 to May 2015 in Beijing Aier-Intech Eye Hospital, 263 cases(340 eyes)with vitreous floaters were involved. All patients underwent visual acuity, intraocular pressure, slit lamp, mydriatic fundus, B ultrasonic examination, and recorded the form of a vitreous opacity excluded pathological fundus lesions. All the patients were divided into two groups: Group A(<30 years old)78 cases(82 eyes); the morphology of vitreous opacity were dot, filiform and mesh. Group B(>45 years old), 185 cases(258 eyes), the morphology of vitreous opacity was Weiss ring, translucent flocculent clouds or dense fibrous membrane. Patients in 30-45 years old were eliminated because of the untypical opacity factor. The treatment was done by the same physician. Vision changes was analyzed before and after the treatment.

RESULTS: Questionnaire survey was done. According to the scores of the questionnaires, patients were divided into 3 groups: no improvement(1-2 points), partial improvement(3-5 points), significant improvement(6-10 points). At 1mo after treatment, Group A: no improvement in 9 eyes(11.0%), partial improvement in 57 eyes(69.5%)and significant improvement in 16 eyes(19.5%); Group B: no improvement in 0 eyes, partial improvement in 23 eyes(8.9%)and significant improvement in 235 eyes(91.1%); all the patients had no complications.

CONCLUSION: The treatment with YAG vitreolysis for vitreous floaters is safe and effective, especially for the patients more than 45 years old whose vitreous floaters caused by posterior vitreous detachment.