Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland.
J Glaucoma. 2014 Jan;23(1):50-5. doi: 10.1097/IJG.0b013e31825c0fb7.
To evaluate retrospectively the usefulness of the red diode and krypton laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of secondary glaucoma in eyes with uveal melanoma.
Twenty-seven eyes of 27 patients (mean age, 66 y; range, 33 to 85 y) with a uveal melanoma and secondary glaucoma were treated with a transscleral 670-nm diode (40 treatments) and 647-nm krypton (5 treatments) laser CPC; 25 eyes had been or were subsequently treated with brachytherapy. The energy used was 420 mW at the tip of the probe (exposure time, 10 s). Seventeen eyes were treated once, 6 eyes twice, and 4 eyes 3 to 6 times. The aim was to preserve vision in 21 patients and to relieve pain in 6 patients. Fourteen patients (52%) died during follow-up.
With ≥1 CPCs, the intraocular pressure decreased from a median of 40 mm Hg at baseline to 28 mm Hg at 12 months (n=18) and 23 mm Hg at 24 months (n=10). Hypotony developed in 6 eyes. Before CPC, 12 eyes had a best corrected visual acuity (BCVA) of 20/400 or better. At 12 months, 5 of 18 eyes had BCVA 20/400 or better, and at 24 months 4 of 10 eyes. Four eyes were removed. At the latest visit, 15 of 23 eyes had no light perception, but were preserved. All patients whose aim of treatment was to relieve pain achieved pain relief.
CPC lowered intraocular pressure and the number of medications needed for secondary glaucoma in eyes with uveal melanoma, also providing pain relief.
回顾性评估经巩膜二极管和氪激光接触性光凝术（CPC）治疗葡萄膜黑色素瘤继发青光眼的有效性。
对 27 例（33 至 85 岁，平均 66 岁）葡萄膜黑色素瘤继发青光眼患者的 27 只眼进行经巩膜 670nm 二极管（40 次治疗）和 647nm 氪激光 CPC 治疗；25 只眼已行或随后行巩膜敷贴放疗。使用的能量为 420mW 探针尖端（曝光时间 10s）。17 只眼治疗 1 次，6 只眼治疗 2 次，4 只眼治疗 3 至 6 次。治疗目的为 21 例患者保留视力，6 例患者缓解疼痛。14 例（52%）患者在随访期间死亡。
行≥1 次 CPC 后，21 例患者眼压从基线时的中位数 40mmHg 降至 12 个月时的 28mmHg（n=18）和 24 个月时的 23mmHg（n=10）。6 只眼出现低眼压。CPC 前，12 只眼最佳矫正视力（BCVA）≥20/400。12 个月时，18 只眼中 5 只眼 BCVA≥20/400，24 个月时 10 只眼中 4 只眼 BCVA≥20/400。4 只眼被摘除。末次随访时，23 只眼中 15 只眼无光感，但仍保留。所有治疗目的为缓解疼痛的患者均达到疼痛缓解。
CPC 可降低葡萄膜黑色素瘤继发青光眼的眼压和所需药物数量，并缓解疼痛。
