RESUMO
Laser cyclodestructive interventions are considered the method of choice in the treatment of refractory glaucoma. However, the traumatic nature of cyclocoagulation makes it necessary to search for more gentle methods of laser treatment. One of the possible directions is the development of laser transscleral technologies that mainly affect the uveoscleral outflow. This article presents a new technique for laser activation of scleral hydropermeability (LASH) using pulse-periodic erbium glass (Er-glass) fiber-optics laser with wave length of 1.56 µm. The article describes the parameters of laser emission and the technique of LASH, and presents the mechanism of reducing intraocular pressure associated with increased transcleral drainage of intraocular fluid by forming new pores in the sclera. The effectiveness and safety of LASH is supported by a detailed example from clinical practice. This technology has proven itself as a possible alternative to the conventional contact transcleral cyclocoagulation.
Assuntos
Glaucoma , Lasers de Estado Sólido , Corpo Ciliar , Glaucoma/diagnóstico , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Fotocoagulação a Laser , Esclera/cirurgiaRESUMO
Detachment of the retinal pigment epithelium (RPE) is a manifestation of a number of degenerative, vascular, inflammatory processes in the eye. The most common cause of RPE detachment in older individuals is the neovascular form of age-related macular degeneration (AMD). Only in 10% of cases the detachment is transudative (avascular), characterized by high domed serous RPE detachment. The article presents an analysis of a case of idiopathic bilateral avascular pigment epithelium detachment - clinical, morphological and functional features of the disease, its impact on the visual functions and the quality of life.