Fankhauser F, Messmer E
St. Thomas' Hospital, United Medical School, Department of Ophthalmology, London, United Kingdom.
Retina. 1997;17(5):414-20. doi: 10.1097/00006982-199709000-00009.
Intraoperative retinopexy currently is performed transsclerally during surgery for retinal detachment by means of cryocoagulation, which usually results in much damage to the tissue. In this study, we investigated the potency of transscleral chorioretinal laser photocoagulation in achieving retinopexy with less breakdown of the blood-retina barrier and resulting in decreased protein leakage and reduced dispersion of the retinal pigment epithelium.
A continuous wave (CW) Nd:YAG laser with a custom-made optical tip was used. The tip consists of an optical fiber protected by a steel casing for indentation of the sclera. Eight patients underwent the procedure.
Three to six pulses of 5.2-6.6 W and exposure duration of 300-500 mesec per spot were used to obtain mild to moderate photocoagulation; no retinal complications were observed. An average of 45 coagulations were obtained per patient. One patient showed mild scleral thermal effects. All retinas were attached after surgery, and seven remained attached at the 6-month follow-up examination.
Transscleral chorioretinal irradiation with the CW Nd:YAG laser is a suitable method for performing retinopexy. Because no thermal damage to the sclera occurred, this method seems to be a safe and effective procedure.
目前，视网膜脱离手术中通过经巩膜冷冻疗法进行术中视网膜固定术，这通常会对组织造成很大损伤。在本研究中，我们研究了经巩膜脉络膜视网膜激光光凝术在实现视网膜固定方面的效能，该方法对血视网膜屏障的破坏较小，导致蛋白质渗漏减少，视网膜色素上皮细胞的扩散减少。
使用带有定制光学尖端的连续波（CW）Nd:YAG激光。该尖端由一根由钢制外壳保护的光纤组成，用于压陷巩膜。8名患者接受了该手术。
使用5.2 - 6.6 W的三到六个脉冲，每个光斑的曝光持续时间为300 - 500毫秒，以获得轻度至中度的光凝；未观察到视网膜并发症。每位患者平均进行了45次光凝。1名患者出现轻度巩膜热效应。所有视网膜在手术后均已复位，7只眼睛在6个月的随访检查中仍保持复位状态。
使用连续波Nd:YAG激光进行经巩膜脉络膜视网膜照射是一种进行视网膜固定术的合适方法。由于未对巩膜造成热损伤，该方法似乎是一种安全有效的手术。
