Ciliary cryosurgery

Reduced aqueous humor secretion surgery, also known as ciliary body destruction surgery, surgery is represented by ciliary body cryoablation, ciliary body diathermy, transscleral microwave ciliary body destruction surgery, etc., with different types of energy on the ciliary body Destruction reduces the formation of atrophy of the ciliary body and reduces the intraocular pressure. Because this kind of surgery has damage to the eyeball to a certain extent, the predictive effect of the operation is poor, too little to achieve the purpose, and too much causes the eyeball to shrink, so this type of surgery can only be used as the last resort for glaucoma surgery or other Surgery as an adjuvant therapy. In recent years, Nd:YAG laser or semiconductor diode laser through the sclera or through the pupil to destroy the ciliary body, especially the latter part of the ciliary body photocoagulation is relatively accurate, and achieved good clinical results. Reduced complications. The development of intraocular endoscopy combined with intraocular laser surgery in recent years will provide a better surgical method for patients with advanced glaucoma. The principle of ciliary body cryosurgery is to directly destroy the ciliary body epithelium and vascular system through the resulting low temperature effects. Treatment of diseases: congenital glaucoma glaucoma Indication Mainly used for absolute glaucoma, neovascular glaucoma and other drugs and general anti-glaucoma surgery can not satisfactorily control intraocular pressure, need to relieve eye pain in patients with glaucoma cases. Contraindications 1. When the residual visual function still plays a major role in the patient's life, the ciliary body destructive surgery, including ciliary body cryopreservation, cannot be easily selected. 2. Glaucoma without painful symptoms. 3. Other glaucoma for glaucoma surgery can be selected. Preoperative preparation In order to prevent transient high intraocular pressure and uveal inflammatory response after surgery, corticosteroids and diclofenac sodium eye drops were applied topically for 3 days before operation. Oral indomethacin 50 mg was given 30 minutes before surgery. If the intraocular pressure is high, oral acetazolamide can be administered. 500mg, intravenous infusion of mannitol 250ml. In severe cases, 50 mg of meperidine was administered intramuscularly 30 min before surgery, and 25 mg of phenergan. Surgical procedure 1. Check the freezing performance of the freezer and test whether the freezing head is frosted immediately. The temperature is lower than -80 °C. 2, open the device to open the sputum, suck the surface of the bulbar conjunctiva, the center of the cryopreservation head is placed on the surface of the sclera and the bulbar conjunctiva corresponding to the ciliary process, usually 2mm behind the limbus. 3. When freezing begins, the freezing head should be pressed against the sclera. Start to form a frozen zone of 3~4mm around the freezing head (20~30s). At -80 ° C, freeze for 40 ~ 60s. (If the freezing head temperature is -60 ° C, the freezing time can be extended to 90 s). 4. Turn off the freezer switch. After the ice hockey around the freezing head is melted and the freezing head is separated from the tissue, place the freezing head at the next freezing point and repeat the above steps. 5, generally do 6 freezing points. 6, after the surgery, drop 1% atropine and antibacterial eye ointment, cover after gauze.

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