Fraunfelder Frederick W
Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA.
Trans Am Ophthalmol Soc. 2009 Dec;107:229-32.
To report a case series of conjunctival lymphangiectasia treated with liquid nitrogen cryotherapy.
A 1.5-mm Brymill cryoprobe was applied in a double freeze-thaw method after an incisional biopsy of a portion of the conjunctiva in patients with conjunctival lymphangiectasia. Freeze times were 1 to 2 seconds with thawing of 5 to 10 seconds between treatments. Patients were reexamined at 1 day, 2 weeks, 3 months, 6 months, and yearly following cryotherapy.
Five eyes of 4 patients (3 male and 1 female) with biopsy-proven conjunctival lymphangiectasia underwent liquid nitrogen cryotherapy. The average patient age was 53 years. Ocular examination revealed large lymphatic vessels that were translucent and without conjunctival injection. Subjective symptoms included epiphora, ocular irritation, eye redness, and occasional blurred vision. After treatment with liquid nitrogen cryotherapy, the patients' symptoms and signs resolved within 2 weeks. Lymphangiectasia recurred twice in one patient, at 1 and 3 years postoperatively. In another patient, lymphangiectasia recurred at 6 months. The average time to recurrence in these 3 eyes was 18 months. Average length of follow-up was 24.5 months for all subjects.
Liquid nitrogen cryotherapy may be an effective surgical alternative in the treatment of conjunctival lymphangiectasia. Cryotherapy may need to be repeated in some instances.
报告一系列采用液氮冷冻疗法治疗结膜淋巴管扩张症的病例。
对于结膜淋巴管扩张症患者，在对部分结膜进行切开活检后，使用1.5毫米的Brymill冷冻探头采用双重冻融法。每次冷冻时间为1至2秒，两次治疗之间的解冻时间为5至10秒。在冷冻治疗后的1天、2周、3个月、6个月及每年对患者进行复查。
4例经活检证实为结膜淋巴管扩张症的患者（3例男性，1例女性）的5只眼睛接受了液氮冷冻疗法。患者的平均年龄为53岁。眼部检查发现大的淋巴管呈半透明状，无结膜充血。主观症状包括溢泪、眼部刺激感、眼红和偶尔的视力模糊。经液氮冷冻疗法治疗后，患者的症状和体征在2周内消失。1例患者在术后1年和3年淋巴管扩张症复发两次。另1例患者在术后6个月淋巴管扩张症复发。这3只眼睛复发的平均时间为18个月。所有受试者的平均随访时间为24.5个月。
液氮冷冻疗法可能是治疗结膜淋巴管扩张症的一种有效的手术替代方法。在某些情况下可能需要重复进行冷冻治疗。
