Reyhing U, Dannheim R
Doc Ophthalmol. 1976 Oct 15;41(2):257-85. doi: 10.1007/BF00146763.
In 178 eyes 223 perforating cyclodiathermies (PCD) have been performed. The technique described by Vogt was modified by additional coagulations around the insertions of the recti-muscles. This procedure was done if one or repeated glaucoma procedures (fistulas, iridectomies or trabeculotomies) were not successful of if these surgical methods were not reasonable because of the morphological conditions of the iris and the chamber angle. If one compares in this retrospective study the average diurnal curves of 60 eyes preoperatively and 7 days postoperatively the PCD has lowered the curve and removed the morning peak that was visible preoperatively. In 153 eyes (86%) the intraocular pressure could be lowered at least for some time. A new increase was seen in most cases during the first 6 months postoperatively. 116 eyes had a postoperative follow-up of 6 months up to 3 years. 45 (39%) of these eyes were controlled without and another 31 eyes (27%) with additional medical therapy (single measurement or average of the diurnal curve less than or equal to 21 mmHG). In some eyes a repetition of the PCD was necessary to be successful. The best results had been achieved in primary glaucoma, in secondary glaucoma after uveitis and in aphacic eyes. In congenital glaucoma only 12 out of 25 eyes could be controlled and this was similar in secondary glaucoma of the vascular type. There is no influence of the preoperative pressure level on the rate of success. But the effect correlates with the preoperative visual acuity: the worse the visual function, the lower the percentage of controlled eyes. The intra-operative complications are not important. The most important postoperative complication is a phthisis bulbi which was seen in at least 10 out of 178 eyes. Most of these eyes were suffering from a secondary glaucoma of the vascular type with high preoperative pressure. All eyes had a visual acuity of 1/50 or less. To repeat the PCD after a few weeks is another factor that facilitates this serious complication. After at least 3 months the repetition of a PCD seems to be without a special risk of phthisis bulbi.
对178只眼睛进行了223次穿透性睫状体透热凝固术（PCD）。Vogt所描述的技术通过在直肌附着处周围进行额外的凝固而得到改良。如果一次或多次青光眼手术（造瘘术、虹膜切除术或小梁切开术）不成功，或者由于虹膜和房角的形态状况这些手术方法不合理，就采用此手术。在这项回顾性研究中，如果比较60只眼睛术前和术后7天的平均日眼压曲线，PCD降低了眼压曲线并消除了术前可见的早晨眼压峰值。在153只眼睛（86%）中，眼压至少在一段时间内有所降低。在大多数情况下，术后头6个月眼压又出现升高。116只眼睛术后随访6个月至3年。其中45只眼睛（39%）无需药物治疗眼压得到控制，另外31只眼睛（27%）通过辅助药物治疗（单次测量或日眼压曲线平均值小于或等于21 mmHg）眼压得到控制。在一些眼睛中，需要重复进行PCD才能成功。原发性青光眼、葡萄膜炎后继发性青光眼和无晶状体眼中取得了最佳效果。在先天性青光眼中，25只眼睛中只有12只眼压得到控制，血管型继发性青光眼的情况与此相似。术前眼压水平对成功率没有影响。但效果与术前视力相关：视力越差，眼压得到控制的眼睛百分比越低。术中并发症并不严重。最重要的术后并发症是眼球痨，在178只眼睛中至少有10只出现。这些眼睛大多数患有血管型继发性青光眼，术前眼压较高。所有这些眼睛的视力均为1/50或更低。术后几周重复进行PCD是促使出现这种严重并发症的另一个因素。至少3个月后重复进行PCD似乎不会特别增加眼球痨的风险。
