Szemészet, 2002 (139. évfolyam, 1-4. szám)
2002-12-01 / 4. szám
Szemészet 76 Transscleral cyclophotocoagulation in the treatment of neovascular glaucoma Borbándy, Ágnes, Bereczki, Árpád, Süveges, Ildikó Is' Dept, of Ophthalmology, Medical Faculty, Semmelweis University, Budapest Purpose: To evaluate the results of transscleral cyclophotocoagulation as carried out in our Department. Patients and method: Seventy patients underwent transscleral cyclophotocoagulation between January 1997 and December 2000. During the follow-up period we recorded the pre- and postoperative intraocular pressure (IOP), the parameters of the treatment, the occurrence of postoperative inflammation, and the number of any additional treatments needed. Results: The average age of the 70 patients was 59.4 years (range 17-93 years), and 37% were female. The preoperative average IOP was 44.0±10.7 mmHg. All patients were treated using diode laser equipment over a circumference between 180 and 360 degrees, with energy levels ranging from 1.5 to 2.5W. At six months the average IOP was 20.1 ±12.7 mmHg. In eighteen cases we had to repeat the treatment. We found moderate postoperative inflammation in 18% of cases. Conclusion: With appropriate patient selection, transscleral cyclophotocoagulation is a safe procedure in the management of neovascular glaucoma. Nem-penetráló glaucoma műtét: hol tart ma ez a technika? Scharioth Gábor B. Szemészeti Központ, Recklinghausen, Németország Az utóbbi 30 évben a trabeculectomia számít a leghatékonyabb/legmegbízhatóbb eljárásnak a glaucoma műtétek között. A posztoperatív szövődmények (alacsony szemnyomás, sekély elülső csarnok, hyphaema, a lebeny megnagyobbodása, érhártyaleválás, a lebeny infekciója stb.) miatt azonban sokszor nem javasolják az alkalmazását. Helyette a betegeket inkább intenzív gyógyszeres kezelésnek vetik alá. Az előadó egy izgalmasan új nem-penetráló műtéti technikát mutat be alternatívaként. Négy éves tapasztalattal a háta mögött részletesen ismerteti az eljárást (deep sclerectomy with peeling of the juxtacanalicular trabecular meshwork). A módszer változatait, az implantátumok használatát, valamint a phaco műtéttel kombinált trabeculectomiát videofelvétellel illusztrálja. Non-penetrating glaucoma surgery: state of the art Scharioth, Gábor В. Augenzentrum Recklinghausen, Germany For the last three decades, trabeculectomy has been the “gold-standard” in glaucoma surgery. However, postoperative complications such as hypotonia, flat anterior chamber, hyphema, excessive bleb formation, choroidal detachment, blebitis etc. resulted in a hesitation to recommend glaucoma surgery in many cases. Many patients are therefore treated instead with an intensive regime of antiglaucomatous medication. An exciting alternative is presented by the new techniques of non-penetrating glaucoma surgery. Following four years of experience, the surgical technique and the results of deep sclerectomy with peeling of the juxtacanalicular trabecular meshwork will be demonstrated in detail. Variations in the surgical approach, use of implants, and combined phaco and non-penetrating glaucoma surgery are illustrated with a video recording. 2002 augusztus 30.
