Laser photocoagulation of neovascular lesions in senile macular degeneration.

Eighty-four eyes with aging macular degeneration were included in this five-year retrospective study (1989-1994). Sixty-four eyes were treated with laser, whereas in 20 eyes photocoagulation was not performed because these patients refused laser treatment. The latter served as a control group. Out of 64 laser-treated eyes, 48 (75%) eyes had extramacular choroidal, and 15 (25%) juxtafoveal neovascular membrane. A comparable percentage and alterations were recorded in the control group of eyes. At the beginning of the study, the mean visual acuity distribution was 0.5 in both the treated and untreated group of eyes, which was not statistically significant (p > 0.16). Recurrent neovascularization developed in 33 (52%) out of 64 eyes at the end of the first and in the second year after photocoagulation, being the main cause of severe vision impairment. At the beginning of the second year, the risk of severe vision loss by six or more Snellen's lines was recorded in 14 (41%) out of 33 eyes with the vision of 0.15, and after five years in 22 (73%) out of 33 eyes with the vision of 0.08. A the end of the study, unchanged or slightly deteriorated visual acuity (0.5-0.4) was found in 27 (42.1%) out of 64 laser-treated eyes, and in only 2 (10%) out of 20 untreated eyes. At the end of the five-year study, total risk of severe vision loss by six or more Snellen's lines was present in 30 (52.8%) out of 64 laser-treated eyes, and in 15 (74%) out of 20 untreated eyes. Study results showed laser treatment of neovascular aging macular degeneration to be absolutely useful in decreasing visual acuity reduction as compared to the untreated control group.

Comparison between efficacy of full- and mild-scatter (panretinal) photocoagulation on the course of diabetic rubeosis iridis.

The study enrolled 59 eyes with rubeosis iridis and proliferative diabetic retinopathy. The efficacies of two types of panretinal photocoagulation ('full' and 'mild' scatter) on the course of diabetic rubeosis iridis were compared. The mean posttreatment follow-up period was 22 +/- 4.8 months. After application of full-scatter photocoagulation (1,200-1,600 spots) in 27 eyes, rubeosis iridis regressed in 70.4% cases, remained unchanged in 14.8% and deteriorated in 14.8%. After mild-scatter photo-coagulation (400-650 spots) in 32 treated eyes, rubeosis iridis regressed in 37.5% cases, 34.4% was unchanged, while deterioration was found in 28.1%. A better therapeutic effect of panretinal photocoagulation in regression of diabetic rubeosis iridis was obtained, if the total dose of the applied laser spots was higher.

Argon laser photocoagulation for the treatment of diabetic macular oedema. Comparative study of efficacy between focal extramacular treatment and focal macular perifoveolar treatment.

In this paper a comparative study of efficacy between focal extramacular and focal macular perifoveolar argon laser photocoagulation for the treatment of diabetic macular oedema is presented. The follow-up period was 12 months and was based on fluorescein angiograms. After focal extramacular treatment, diabetic macular oedema was resorbed in 54.6% of the cases, remained unchanged in 28.4% and deteriorated in 17.0%. After focal macular perifoveolar treatment resorption of diabetic macular oedema was achieved in 73.7% of the cases, remained unchanged in 17.1% and deteriorated in 9.2%. Focal macular perifoveolar treatment gives statistically significantly better clinical results than focal extramacular treatment (p < 0.05).

Combined technique of argon-laser and neodymium-YAG laser photocoagulation for narrow-or closed-angle glaucoma.

A combined laser technique was applied in 76 eyes with narrow- or closed-angle glaucoma. In the first act circular Argon-laser iridoplasty was performed, to be followed by peripheral Nd-YAG laser iridotomy. Before the laser application, intraocular pressure was decreased using medicamentous antiglaucoma therapy to 30 mmHg or less. Argon-laser iridoplasty was performed in the peripheral third of the total iris circumference applying cca 20 laser spots. Eight days later, Nd-YAG laser iridotomy was performed at the site of the previous Argon-laser spot. Postoperative intraocular pressure was normal in 64 out of 76 eyes (84.2%) on the last check-up, and the additional antiglaucoma medications was significantly reduced. In a small number of cases i.e. 24 eyes (31.6%), the medical therapy was altogether cancelled. In 12 eyes (15.8%) the laser treatment has failed, and antiglaucoma surgery had to be performed subsequently. The observation period ranged from 4 to 25 months.

[Treatment of narrow- or closed-angle glaucoma using combined argon and Nd-YAG laser photocoagulation]. / Lijecenje glaukoma uskog ili zatvorenog kuta kombiniranom argonskom i Nd-YAG laserskom fotokoagulacijom.

Combined laser technique was applied on 38 eyes with closed-angle glaucoma. In the first act circular argon laser iridoplasty was performed, followed by peripheral Nd-YAG iridotomy. First, intraocular pressure was decreased by anti-glaucoma medicament therapy to 30 mmHg or less. Then, circular argon laser iridoplasty was performed on the peripheral third of the total circumference of the iris (cca 20 spots). Eight days later, Nd-YAG laser iridotomy was performed at the location where previously a spot was made with argon laser. Postoperative intraocular pressure was normal in 84.2% at the last control examination and the anti-glaucoma medicament treatment was significantly reduced. In a smaller number of cases this treatment was cancelled all together. In 6 eyes (15.8%) laser treatment was not successful and anti-glaucoma surgery had to be performed subsequently. The observation period lasted from 3 to 15 months.