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塔德乌什·克瓦维茨,医学博士:眼科冷冻手术的发明者。

Tadeusz Krwawicz, MD: The inventor of cryosurgery in ophthalmology.

作者信息

Grzybowski Andrzej, Kanclerz Piotr

机构信息

1 Department of Ophthalmology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.

2 Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland.

出版信息

Eur J Ophthalmol. 2019 May;29(3):348-356. doi: 10.1177/1120672118823125. Epub 2019 Jan 14.

Abstract

Tadeusz Krwawicz (1910-1988) pioneered the use of cryosurgery in, as ophthalmology. The idea arose in 1959 while experimenting because on lyophilization to store corneas and lenses for transplantation it was difficult to remove the lens without damage the capsule was usually torn. Subsequent experiments on rabbits revealed that touching the lens with a wire cooled to 203°K (-70°C) resulted in firm attachment of the lens capsule and subcapsular masses. A cryoextractor was developed and employed for clinical use in cataract extraction, likewise in intumescent cataracts and lens subluxation. Cataract surgery utilizing cryoextraction led to substantial progress to ophthalmology by reducing the number of complications, particularly capsule rupture, and resulted in achieving better outcome compared to other methods. This surgery soon and for almost 20 years became a routine method used all around the world in cataract removal. Simultaneously, Krwawicz developed techniques for corneal refractive surgery-partial lamellar removal of the corneal stroma and temporary interlaminar introduction of a plastic disk in order to change the corneal curvature. Krwawicz presented other ophthalmic interests-his research concerned immunology, histology, histochemistry, biochemistry of ocular tissue, and mainly corneal and experimental surgery with a particular focus on the pathology of the cornea.

摘要

塔德乌什·克瓦维茨(1910 - 1988)开创了冷冻手术在眼科领域的应用。这个想法始于1959年,当时在进行冷冻干燥保存角膜和晶状体以供移植的实验时,发现不损坏晶状体囊而取出晶状体很困难,晶状体囊通常会撕裂。随后在兔子身上进行的实验表明,用冷却到203°K(-70°C)的金属丝接触晶状体,会导致晶状体囊和囊下肿物牢固附着。一种冷冻摘除器被开发出来并用于白内障摘除的临床手术,同样也用于膨胀期白内障和晶状体半脱位手术。利用冷冻摘除术的白内障手术通过减少并发症数量,特别是囊膜破裂,为眼科带来了实质性进展,并且与其他方法相比取得了更好的效果。这种手术很快并且在近20年里成为了全世界用于白内障摘除的常规方法。同时,克瓦维茨还开发了角膜屈光手术技术——部分层状切除角膜基质并临时在层间引入塑料盘以改变角膜曲率。克瓦维茨还展现出了其他眼科研究兴趣——他的研究涉及免疫学、组织学、组织化学、眼组织生物化学,主要是角膜和实验性手术,尤其关注角膜病理学。

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