endolaser

Endolaser
  • 文章类型: Journal Article
    本研究的目的是评估大鼠皮肤中1470nm波长(λ)的皮下高功率二极管激光器的光热效应。使用了20只雄性Wistar大鼠,分为2组:安慰剂激光(PL)和主动激光(AL)。将高功率二极管激光设备应用于动物背部区域的5个皮下载体。结果表明,活跃的激光动物表现出更好的胶原纤维带排列,真皮厚度和血管数量的增加。此外,与安慰剂组相比,用活性激光治疗的动物显示TGF-β和VEGF的免疫表达增加.目前的工作表明,皮下高功率二极管激光增加了血管形成和增强皮肤再生的因子的表达,并且可能是在美容和皮肤病学临床治疗皮肤嫩肤的有希望的资源。
    The aim of the present study was to evaluate the photothermal effects of a subdermal high-power diode laser at a wavelength (λ) of 1470 nm in the skin of rats. Twenty male Wistar rats were used, divided into 2 groups: placebo laser (PL) and active laser (AL). A high-power diode laser equipment was applied to 5 subdermal vectors on the animal\'s back region. The results demonstrated that active laser animals showed a better arrangement of collagen fiber bands, an increase in the thickness of the dermis and the number of vessels. Furthermore, animals treated with active laser showed an increased immunoexpression of TGF-β and VEGF compared to the placebo. The present work demonstrated that the subdermal high-power diode laser increases the vascularization and the expression of factors that enhance skin regeneration and may be promising resource in the esthetic and dermatology clinical treatment of skin rejuvenation.
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  • 文章类型: Journal Article
    视盘凹陷是视神经头的一种罕见但重要的异常,可导致视力损害和相关并发症。这些坑的特点是小,圆盘上的椭圆形凹陷,这可能会导致液体积聚和随后对相邻视网膜的损害。虽然视盘凹陷的病因和发病机制尚未完全了解,已经提出了几种理论,包括胚胎发育异常和退行性改变。诊断通常通过全面的眼科检查来进行,包括扩大眼底检查和光学相干断层扫描。管理方案因病情的严重程度和相关并发症而异,从观察到手术干预。
    Optic disc pits are a rare but significant anomaly of the optic nerve head that can lead to visual impairment and associated complications. These pits are characterized by a small, oval-shaped depression in the disc, which can cause fluid accumulation and subsequent damage to the adjacent retina. Although the etiology and pathogenesis of optic disc pits are not fully understood, several theories have been proposed, including abnormal embryonic development and degenerative changes. Diagnosis is typically made through a comprehensive eye examination, including a dilated fundus exam and optical coherence tomography. Management options vary depending on the severity of the condition and associated complications, ranging from observation to surgical intervention.
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  • 文章类型: Journal Article
    目的:评估内镜下睫状体光凝(ECP)治疗犬原发性和继发性青光眼的长期疗效。
    方法:回顾性回顾2004年至2023年在两个转诊中心接受ECP的狗。
    方法:回顾了389只眼(301只狗)在ECP后的病历。评估的结果包括随访时间,眼内压(IOP),视力状态,执行的其他ECP程序,药物的数量,和并发症。评估患者和手术变量及其与IOP控制和视力维持的关系。
    结果:中位随访时间为18个月。90%和95%的患者在1年和2年时IOP仍得到控制,分别,遵循ECP。在原发性(88%)和继发性(99%)青光眼的情况下,IOP得到长期控制(2年)。手术后视力在大约1年和2年时保持在63%和49%的眼睛中,分别。视力丧失的中位时间为6.5个月。在术后19天的中位数中,15.4%的眼睛需要重复ECP。与接受单一ECP手术(3.6个月;p=.0003)相比,接受超过一次ECP手术的眼睛的中位失明时间(13.8个月)明显更长。抗青光眼药物的中位数量从术前的三种减少到术后1年和2年的一种。并发症包括角膜溃疡(28%),致盲低眼压(11%),视网膜脱离(11%),和前房积血(10%)。
    结论:Endolaser睫状体光凝术是维持长期IOP控制和扩展视力的有效手术,用于治疗难治性青光眼犬患者。
    OBJECTIVE: To evaluate the long-term outcome of endoscopic cyclophotocoagulation (ECP) for the treatment of primary and secondary glaucoma in dogs.
    METHODS: Retrospective review of dogs that underwent ECP at two referral centers from 2004 to 2023.
    METHODS: Medical records of 389 eyes (301 dogs) following ECP were reviewed. Outcomes evaluated included follow-up time, intraocular pressure (IOP), vision status, additional ECP procedures performed, number of medications, and complications. Patient and surgical variables and their association with IOP control and vision maintenance were evaluated.
    RESULTS: Median follow-up time was 18 months. IOP remained controlled in 90% and 95% of patients at 1 and 2 years, respectively, following ECP. IOP was controlled long-term (2 years) in cases with primary (88%) and secondary (99%) glaucoma. Post-operative vision was maintained in 63% and 49% of eyes at approximately 1 and 2 years, respectively. Median time to vision loss was 6.5 months. Repeat ECP was required in 15.4% of eyes at a median of 19 days post-operatively. Eyes that underwent more than one ECP surgery had a significantly longer median time to blindness (13.8 months) than those that underwent a single ECP procedure (3.6 months; p = .0003). The median number of anti-glaucoma medications decreased from three pre-operatively to one at 1- and 2-year post-operatively. Complications included corneal ulceration (28%), blinding hypotony (11%), retinal detachment (11%), and hyphema (10%).
    CONCLUSIONS: Endolaser cyclophotocoagulation is an effective surgery for maintaining long-term IOP control and extending vision in canine patients with glaucoma refractory to medical management.
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  • 文章类型: Journal Article
    背景:比较术中局部和360度激光光凝在23号有限平面玻璃体切除术(PPV)治疗孔源性视网膜脱离(RRD)中的疗效。
    方法:本回顾性研究,比较,连续的,介入研究包括155例患者的155只眼,这些患者使用23号PPV进行了RRD的一期修复,随访至少6个月.对医疗记录进行回顾性审查,以及相应的人口统计数据,术前眼科特征,手术管理,记录术后病程。主要结局指标包括单次手术解剖成功,术前和术后视力,和并发症。
    结果:83例患者(A组)在PPV中接受了局部激光光凝,其余72例患者(B组)在PPV中接受了圆周360度激光光凝。两个熟练的外科医生做了所有的手术,和23号PPV仪表,广角观察系统,内激光光凝,在每种情况下都使用了气体填塞剂。在基线特征中没有发现显著差异。A组单次手术解剖成功率为96.4%,B组为95.8%,无显著性差异(p=1.00)。原发性解剖失败是由于每组2只眼断裂导致的再脱离引起的(没有新的断裂1只眼,A组新突破1eye,B组2只眼睛没有新的断裂),增殖性玻璃体视网膜病变每组1只眼。其他并发症为视网膜前膜7眼(A组3眼,B组4),B组1眼黄斑裂孔,术前和术后最佳矫正视力(BCVA)和BCVA改善无差异(分别为p=0.144,p=0.866和p=0.263)。
    结论:局部激光光凝显示RRD患者的解剖和视觉结果无差异,与有限PPV中的360度激光光凝相比。在没有严重PVR的原发性孔源性视网膜脱离的玻璃体切除术中,可能不需要常规的圆周360度激光光凝。
    BACKGROUND: To compare the efficacy of intraoperative localized and 360-degree laser photocoagulation in 23-gauge limited pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
    METHODS: This retrospective, comparative, consecutive, interventional study included 155 eyes of 155 patients who underwent primary repair of RRD utilizing 23-gauge PPV with at least six months of follow up. Medical records were retrospectively reviewed, and the corresponding demographic data, preoperative ophthalmic features, surgical management, and postoperative course were recorded. Main outcome measures included single surgery anatomical success, pre- and post-operative visual acuity, and complications.
    RESULTS: Eighty-three patients (group A) received localized laser photocoagulation in PPV, while the remaining 72 patients (group B) received underwent circumferential 360-degree laser photocoagulation in PPV. Two skilled-surgeons performed all the surgeries, and 23-gauge PPV instrumentation, a wide-angle viewing system, endolaser photocoagulation, and gas tamponade were used in each case. No significant difference was identified in baseline characteristics. The single surgery anatomical success rate was 96.4 % in group A, and 95.8 % in group B, showing no significant difference (p = 1.00). Primary anatomical failure was caused by re-detachment due to break in 2 eyes in each group (no new break 1 eye, new break 1eye in group A, 2 eyes with no new break in group B), and proliferative vitreoretinopathy in 1 eye in each group. Other complications were epiretinal membrane in 7 eyes (3 in group A, 4 in group B), and macular hole in 1 eye in group B. There were no differences in pre- and post-operative best-corrected visual acuity (BCVA) as well as BCVA improvement (p=0.144, p=0.866 and p=0.263, respectively).
    CONCLUSIONS: Localized laser photocoagulation showed no difference in anatomic and visual outcome in RRD patients, when compared with 360-degree laser photocoagulation in limited PPV. Routine circumferential 360-degree laser photocoagulation may not be necessary in vitrectomy surgery for primary rhegmatogenous retinal detachment without severe PVR.
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  • 文章类型: Case Reports
    报告一例医源性玻璃体切割术套管切管术诱导的环透析裂,术中氩激光成功治疗。
    一名有高度近视病史的68岁白种人男性接受了玻璃体切割术,以清除有症状的玻璃体混浊,但术后早期出现低眼压,在术后前6个月难以治疗。术中房角镜检查显示有环线透析裂口,并应用氩内激光封闭裂口。
    Endolaser是环线透析裂口的有效治疗方法,术中房角镜检查可以在受控的手术室环境中直接观察裂口。玻璃体切除术端口的放置应在高度近视的情况下小心进行,以避免意外刺穿睫状体并引起环透析裂隙。
    UNASSIGNED: To report a case of iatrogenic vitrectomy trochar-induced cyclodialysis cleft successfully treated with intraoperative argon endolaser.
    UNASSIGNED: A 68-year-old Caucasian male with a history of high myopia underwent pars plana vitrectomy to clear symptomatic vitreous opacities but developed early postoperative hypotony that was recalcitrant to medical management for the first 6 postoperative months. Intraoperative gonioscopy demonstrated a cyclodialysis cleft and argon endolaser was applied to close the cleft.
    UNASSIGNED: Endolaser is an effective treatment for cyclodialysis clefts and intraoperative gonioscopy allows direct visualization of the cleft in a controlled operating room setting. Placement of vitrectomy ports should be done with care in high myopes to avoid accidental piercing of the ciliary body and inducing a cyclodialysis cleft.
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  • 文章类型: Journal Article
    目的:确定在原发性孔源性视网膜脱离(RRD)修复和玻璃体切割(PPV)后,冷冻治疗和眼内激光光凝视网膜固定术在解剖成功率方面是否存在差异。
    方法:基于注册表,非随机化,观察性队列研究。
    方法:在进行了PPV修复并至少进行了3个月的随访的双边视网膜手术注册中,患有原发性RRD的眼睛。
    方法:由参与的外科医生前瞻性记录病例,并在3个月时记录结局.使用广义混合模型方法来比较视网膜固定术类型对结果的影响。已知与视网膜手术成功相关的变量被认为是最终模型的协变量。眼睛分为2组:冷冻组(接受冷冻治疗作为视网膜固定术的唯一形式)和激光组(接受眼内激光作为视网膜固定术的唯一形式)。
    方法:主要终点是稳定的视网膜复位而不需要进一步的视网膜脱离手术的患者比例,术后3个月评估。失败定义为视网膜再脱离或在终点长期填充硅油的中央凹附着。与基线测量相比,测量的次要结果是3个月时的视力。
    结果:共纳入2413例患者,整体单程成功率为85%。冷冻组成功再连接的调整比例(87%)与激光组成功再连接的比例(82%)之间的手术成功率无统计学差异(P=0.84;比值比,1.04;95%置信区间,0.74-1.46)。两组之间在3个月时视力结果的平均变化没有差异(Cryo组的最小分辨率角度[logMAR]的调整平均变化-0.48对数与-激光组的logMAR为0.50,P=0.82)。
    结论:观察到选择冷冻疗法和内激光视网膜固定术既不影响PPV治疗RRD的解剖学成功,也不影响术后3个月的视力结果。
    OBJECTIVE: To determine whether a difference exists between cryotherapy and endolaser photocoagulation retinopexy in terms of the rates of anatomic success after primary rhegmatogenous retinal detachment (RRD) repair with pars plana vitrectomy (PPV).
    METHODS: Registry-based, nonrandomized, observational cohort study.
    METHODS: Eyes with primary RRD in a binational retinal surgery registry that underwent repair with PPV and had a minimum of 3 months of follow-up.
    METHODS: Cases were recorded prospectively by participating surgeons, and the outcomes were recorded at 3 months. A generalized mixed model approach was used to compare the effect of retinopexy type on the outcomes. Variables known to be associated with retinal surgical success were considered as covariates for the final model. The eyes were divided into 2 groups: Cryo group (receiving cryotherapy as the only form of retinopexy) and Laser group (receiving endolaser as the only form of retinopexy).
    METHODS: The primary endpoint was the proportion of patients with stable retinal reattachment without the need for further retinal detachment surgery, assessed 3 months after the surgery. Failure was defined as either retinal redetachment or foveal attachment with long-term silicone oil tamponade at the endpoint. The secondary outcome measured was visual acuity at 3 months compared with baseline measurements.
    RESULTS: A total of 2413 patients were included, and the overall single-procedure success rate was 85%. There was no statistically significant difference in surgical success between the adjusted proportion of successful reattachment for the Cryo group (87%) and that of successful reattachment for the Laser group (82%) (P = 0.84; odds ratio, 1.04; 95% confidence interval, 0.74-1.46). There was no difference in the mean change in the visual outcomes at 3 months between the groups (adjusted mean change of - 0.48 logarithm of the minimum angle of resolution [logMAR] for the Cryo group vs. - 0.50 logMAR for the Laser group, P = 0.82).
    CONCLUSIONS: The choice of cryotherapy versus endolaser retinopexy was observed to influence neither the anatomic success of PPV for RRD nor the visual acuity outcomes at 3 months after the surgery.
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  • 文章类型: Case Reports
    脉络膜黑色素瘤,虽然罕见,是成人中最常见的原发性眼内恶性肿瘤,全球每年的发病率为6至7.5例/百万。这种肿瘤起源于眼睛中葡萄膜的黑素细胞。黑色素瘤通常发生在第六十年的年龄,发病率随着年龄的增长而增加。一名60岁的男性由于4级玻璃体出血而出现右侧突然无痛性视力下降。B扫描超声和轨道的CT扫描显示蘑菇状的脉络膜肿块高度提示脉络膜黑色素瘤,通过平面内切除术进行手术治疗,内透热,和内皮激光。腔内切除术是治疗孤立性非转移性脉络膜肿瘤的有效方法,尤其是那些已经有症状的。手术前和手术后的成像是必要的,以及仔细的随访以发现任何复发。
    Choroidal melanoma, although rare, is the most common primary intraocular malignancy among adults, with an incidence ranging from 6 to 7.5 cases per million per year globally. This tumor originates from the uveal tract\'s melanocytes in the eye. Melanomas usually arise from the sixth decade of age with increasing incidence with progressive age. A 60-year-old male presented with a right-sided sudden painless decrease in vision due to a grade 4 vitreous hemorrhage. B-scan ultrasonography and CT scan of the orbits revealed a mushroom-shaped choroidal mass highly suggestive of choroidal melanoma, which was managed surgically with pars plana endoresection, endodiathermy, and endolaser. Endoresection can be an effective method for the management of solitary non-metastasized choroidal tumors, especially those that have become symptomatic. Pre and post-surgical imaging are necessary, along with careful follow-up to detect any recurrence.
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  • 文章类型: Journal Article
    UNASSIGNED: To determine the rate of post-operative retinal detachment after elective pars plana vitrectomy for epiretinal membrane, and to test for the mitigating effect of prophylactic endolaser.
    UNASSIGNED: We identified 459 eyes of 411 patients undergoing vitrectomy for epiretinal membrane at Vanderbilt University Medical Center between January 2010 and May 2017. Patients who underwent concurrent endolaser without any identified retinal break were included in the exposure cohort. Patients who underwent no prophylactic retinopexy or ablation were included in the unexposed cohort. Exposure data, demographic data, and outcome data were tabulated for comparison.
    UNASSIGNED: The final analysis included 343 eyes of 343 patients. Approximately 7% of eyes undergoing ERM surgery were found to have a full-thickness retinal break which was not seen preoperatively. The overall rate of postoperative RD was 2.04%. Postoperative retinal detachment occurred in 0 of the 34 eyes exposed to prophylactic laser, and in 7 of the 309 control eyes. Odds ratio was found to be 0.60 (p = 0.598 (95%CI 0.0327-10.7), p = 0.72), indicated the results were not statistically significant.
    UNASSIGNED: Looking at patients undergoing routine vitrectomy surgery for epiretinal membrane, no retinal detachments occurred in the group receiving prophylactic treatment, though this association did not reach statistical significance. With modern surgical techniques, post-operative retinal detachment remains relatively rare after vitrectomy for ERM though a thorough intraoperative exam is critical to identify occult retinal breaks.
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  • 文章类型: Journal Article
    OBJECTIVE: To investigate clinical and surgical factors influencing the outcome after primary rhegmatogenous retinal detachment surgery.
    METHODS: A retrospective, single-centre, case-control study of 1017 eyes of 1017 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV), were included in the study. Analysed surgical factors were: combined procedure with phacoemulsification, type of retinopexy (cryocoagulation, endolaser, combined), type of tamponade (gas, silicone oil), and anatomical factors: primary proliferative vitreoretinopathy (PVR) and macular detachment at the time of surgery.
    RESULTS: Overall retinal re-detachment rate was 10.1%. The main reason for re-detachment was an insufficient retinopexy in 53.6%, followed by PVR (37.3%), and retinal detachment occurred at a different location caused by another break in 9.1%. No significant difference in the rate of re-detachment was found if a phacoemulsification with simultaneous IOL implantation was performed (p = 0.641). No significant difference between the various retinopexy techniques was found (p = 0.309). Risk factors re-detachment were primary PVR (p = 0.0003), silicone oil as initial tamponade (p = 0.0001) as well as macula off detachments (p = 0.034).
    CONCLUSIONS: The present study showed no significant difference between the types of retinopexy and if additional phacoemulsification was performed or not. Factors associated with a higher risk for re-detachment were detached macula at surgery, primary PVR and primary oil-filling.
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  • 文章类型: Journal Article
    OBJECTIVE: To present a combined treatment modality in the management of stage 3B Coats disease and to evaluate its efficacy in the long-term follow-up.
    METHODS: This study was a retrospective review of 29 eyes from 29 consecutive patients who had stage 3B Coats disease with total exudative retinal detachment (ERD). The combined treatment modality consisted of external drainage of subretinal fluid (SRF), followed by endolaser photocoagulation via a nonvitrectomy approach, and intravitreal ranibizumab injection. Final disease status, anatomic success, and final visual acuity were the main outcome measures.
    RESULTS: The treated eyes initially received one session of external drainage of SRF, followed by an average of 1.4 sessions (range, 1 to 3 sessions) of endolaser photocoagulation and intravitreal ranibizumab injection. With a median follow-up period of 40 months (range, 21-81 months), all eyes demonstrated no disease progression, including 6 eyes that required vitrectomy with silicone oil tamponade due to increasing ERD after initial treatment. No enucleation was required. At the final follow-up, anatomic success with retinal reattachment and no active disease was achieved in 24 of 29 eyes (82.8%). Fibrosis was observed in 22 eyes (75.9%) with a mean onset time of 9 months (range, 5-16 months); of these, 3 and 9 eyes developed tractional retinal detachment and epiretinal membrane, respectively. In 62.1% of the eyes, the final visual acuity was only light perception or no light perception.
    CONCLUSIONS: The combined treatment modality presented in this study is an effective way in the management of stage 3B Coats disease with total ERD.
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