Kontić D, Buschmann W
Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1981;216(2):167-76. doi: 10.1007/BF00414584.
Diathermy and cryosurgery have different effects on living tissue. Cell membranes are ruptured by cryosurgery, but the proteins are less affected than by diathermy. A short review of experimental cyclocryosurgery and the clinical results are presented. Data from the literature as well as evaluation of patients confirm that, as yet, the results are not satisfactory. The sequelae of freezing are very different in slow-and fast-freezing procedures. Therefore, the results in rabbits treated with a cryosurgical unit used for retinal detachment surgery (Amoils, -80 degrees C) were compared with the results using a cryoprobe cooled with liquid nitrogen (-180 degrees C). A permanent reduction in intraocular pressure was not achieved using cyclocryotherapy applied with the equipment used for detachment surgery (-80 degrees C). Repeated cryosurgery of this type did not result in a permanent pressure reduction. Histopathology demonstrated that the ciliary epithelium had regenerated and prolongation of the cyclocryotherapy applications did not result in a permanent intraocular pressure reduction. Lens opacities occurred in all rabbits of this series. Application of cryotherapy with a nitrogen-cooled cryoprobe (2.5 mm2 contact area) caused severe damage, resulting in phthisis bulbi. Another nitrogen-cooled probe (contact area of about 1 mm2 diameter) resulted in a permanent reduction in intraocular pressure, but the anterior parts of the lens became opaque. Histopathology revealed total necrosis of the ciliary epithelium and the basal membrane. Three months after cyclocryotherapy of this type the ciliary processes were atrophic and covered with connective tissue and regeneration of epithelial cells was not found in areas of such cryotherapy scars. Further experiments have been commenced including a reduction of application time, in order to find the optimum application technique resulting in permanent intraocular pressure reduction and the fewest possible side effects.
透热疗法和冷冻手术对活组织有不同影响。冷冻手术会使细胞膜破裂，但蛋白质受影响程度小于透热疗法。本文对实验性睫状体冷凝术及临床结果进行简要综述。文献数据及患者评估均证实，目前结果并不令人满意。缓慢冷冻和快速冷冻过程中冷冻的后遗症差异很大。因此，将用于视网膜脱离手术的冷冻手术设备（Amoils，-80摄氏度）治疗兔子的结果与使用液氮冷却的冷冻探头（-180摄氏度）的结果进行了比较。使用用于视网膜脱离手术的设备（-80摄氏度）进行睫状体冷凝术未实现眼压的永久性降低。重复进行此类冷冻手术并未导致眼压永久性降低。组织病理学显示睫状体上皮已再生，延长睫状体冷凝术的应用时间并未导致眼压永久性降低。该系列所有兔子均出现晶状体混浊。使用液氮冷却的冷冻探头（接触面积2.5平方毫米）进行冷冻治疗造成严重损伤，导致眼球痨。另一个液氮冷却探头（接触面积约为直径1平方毫米）导致眼压永久性降低，但晶状体前部变得混浊。组织病理学显示睫状体上皮和基底膜完全坏死。进行此类睫状体冷凝术后三个月，睫状突萎缩，被结缔组织覆盖，在这种冷冻治疗瘢痕区域未发现上皮细胞再生。已开始进一步实验，包括缩短应用时间，以找到能实现眼压永久性降低且副作用尽可能少的最佳应用技术。
