Rehák J
Department of Ophthalmology, Medical Faculty, Palacký University, Olomouc, Czechoslovakia.
Acta Univ Palacki Olomuc Fac Med. 1992;134:105-8.
The author evaluates the effect of two cryosurgical methods on the development of rubeosis iridis in neovascular glaucoma. In 12 eyes, cyclo-cryocoagulation was used as a single method, in 26 eyes, trans-scleral panretinal cryocoagulation was used in combination with cyclo-cryocoagulation in one session. Markedly better results were achieved by using the combined cryosurgical method. When trans-scleral panretinal cryocoagulation was applied in combination with cyclo-cryocoagulation, all the patients showed, 6 weeks postoperatively, a marked involution of rubeosis iridis. Complete regression of rubeosis iridis after cyclo-cryocoagulation was achieved only in one eye. The insufficient regression of rubeosis iridis in neovascular glaucoma, after the performance of single cyclo-cryocoagulation, the author explains in that way that by this surgical method only one component in the pathogenesis of rubeosis iridis is resolved. The author assumes that in the pathogenesis of rubeosis iridis in neovascular glaucoma, two components play their role: not only the underlying disease which conditions the development of proliferative retinopathy but also the high intraocular pressure which reduces the blood-flow in the retinal bed and thus increases retinal hypoxia.
作者评估了两种冷冻手术方法对新生血管性青光眼虹膜红变发展的影响。12只眼采用单纯睫状体冷凝术，26只眼在一次手术中采用经巩膜全视网膜冷凝术联合睫状体冷凝术。联合冷冻手术方法取得了明显更好的效果。当经巩膜全视网膜冷凝术与睫状体冷凝术联合应用时，所有患者在术后6周均显示虹膜红变明显消退。单纯睫状体冷凝术后仅一只眼实现了虹膜红变的完全消退。作者解释说，在新生血管性青光眼患者中，单纯睫状体冷凝术后虹膜红变消退不充分，是因为这种手术方法仅解决了虹膜红变发病机制中的一个因素。作者认为，在新生血管性青光眼虹膜红变的发病机制中，有两个因素起作用：不仅有导致增殖性视网膜病变发生的基础疾病，还有使视网膜床血流减少从而增加视网膜缺氧的高眼压。
