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NR 1-2/2004
SUPLEMENT
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Zabiegi
cyklodestrukcyjne w jaskrze wtórnej u dzieci
Cyclodestructive procedures
in secondary glaucoma in children
Bronisława Koraszewska-Matuszewska1,
Rafał Leszczyński2, Elżbieta Samochowiec-Donocik1,
Lidia Nawrocka1
1Z Katedry i Kliniki Okulistyki Dziecięcej ¦l±skiej
Akademii Medycznej w Katowicach
Kierownik: prof. dr hab. n. med. Bronisława
Koraszewska-Matuszewska
2Z Katedry i Kliniki Okulistyki ¦l±skiej Akademii
Medycznej w Katowicach
Kierownik: prof. dr hab. n. med. Ariadna Gierek-Łapińska |
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| Summary: |
Purpose: comparison
of the effectiveness and safety of cyclocryocoagulation
and transscleral contact cyclophotocoagulation with
diode laser (TSCPC) in children.
Patients and method: Sixty nine eyes of 60
children at the age from 4 months to 16 years were
examinated. Majority of patients was aphakic after
congenital, traumatic and complicated cataract
extraction. Aniridia, Sturge-Weber disease and ROP
complications were observed. In 40 eyes cyclocryotherapy
(I group), in 29 eyes TSCPC (II group) were performed.
Intraocular pressure (IOP) was assessed in the early and
late postoperative period. The number of procedures per
one eye, IOP, visual acuity, and complications after
cyclodestructive procedures were estimated. Follow-up
ranged from 3 months to 4 years, mean 23 months.
Results: Transscleral cyclocryocoagulations were
performed once to 4 times in one eye with intervals from
1 month to 1 year, mean 1,3 procedures per eye. TSCPC
was performed once in 29 eyes and twice in 4 cases, it
was 1,14 procedures per eye. Before treatment IOP ranged
from 21,3 to 50,6 mmHg, mean 29,18 mmHg in the I group
and 24,4-54 mmHg mean 34,85 mmHg in the II group and in
the early postoperative period were 10-25 mmHg, mean
17,7 and 2-26 mmHg, mean 14,65 mmHg relatively.
Decreasing of IOP was observed in 39% of eyes after
cryotherapy and 57,9% after TSCPC, p = 0,0003. In the
long-term follow-up in IOP below 22 mmHg after
cyclocryotherapy in 60% of eyes and after TSCPC in 79%
was observed. Visual acuity ranged from no light
perception to 0,5, mean 0,04. No changes of vision after
cyclocryocoagulation were noted. After TSCPC transient
visual function decreased from 0,2 to 0,04 in 1 eye but
recovered after 2 weeks. After cyclocryotherapy only
conjunctival oedema was observed in majority of cases.
In the early postoperative period after TSCPC uveitis
occured in 3 eyes (10,35%), transient hypotony in 2 eyes,
hyphaema in one eye.
Conclusion: Diode cyclophtocoagulation decreases
IOP more effective than cyclocryocoagulation in children
but complications after TSCPC are more severe than after
cyclocryotherapy. |
| Słowa kluczowe: |
cyklokriokoagulacja,
poprzeztwardówkowa kontaktowa cyklofotokoagulacja
diodowa, jaskra wtórna, dzieci. |
| Key words: |
cyclocryocoagulation,
transscleral contact diode laser cyclophotocoagulation,
secondary glaucoma, children. |
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