Ciliary body diathermy coagulation

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. Ciliary body diathermy is currently replaced by ciliary body cryopreservation. In addition to the use of high-frequency current to destroy the ciliary body, microwave and ultrasound methods have also been used to destroy the ciliary body. It is reported that the surgical effect of the latter is better than that of ciliary body cryopreservation, and the complications are low, but the clinical application is still small, pending further evaluation. . Treatment of diseases: neovascular glaucoma glaucoma Indication Ciliary body diathermy coagulation applies to: 1. Absolute glaucoma relieves pain by keeping the eyeball. 2, multiple anti-glaucoma surgery failed, can not establish effective filtration, and the intraocular pressure is still high. 3. Neovascular glaucoma. 4, congenital glaucoma, corneal opacity, enlargement, other anti-glaucoma surgery failed. 5. Aphakic eye or intraocular lens glaucoma. Surgical procedure 1. Puncture ciliary body diathermy, puncture electrode head length 1 ~ 1.5mm, 2.5 ~ 5mm from the limbus, do two rows of puncture scleral coagulation, diathermy current 40 ~ 50mA, last 3 ~ 5s, each puncture Open 3mm between the points, generally do 180 ° range, surgery can cut the ball conjunctiva or do not cut the ball conjunctiva. 2. Non-penetrating ciliary body diathermy, the upper half or lower half of the conjunctival flap based on the dome, with 2mm spherical electrode, 2mm from the limbus, current 50 ~ 60mA for two rows of scleral coagulation, each 6 to 8 points, the electrocoagulation time is the scleral surface contraction, yellowish is better. In order to prevent the formation of scleral staphylocystosis after electrocoagulation and to make the electrocoagulation result more reliable, the lamellar scleral flap can be made first in the electrocoagulation zone, then electrocoagulation is performed under the valve, and the scleral flap is sutured in situ. , suture the ball conjunctiva. Puncture electrocoagulation has the potential for significant low intraocular pressure and eyeball atrophy as well as sympathetic ophthalmia, and clinical applications are limited.

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