Zusammenfassung
Die Kryokoagulation von Netzhautforamina kann zur Ausstreuung von retinalem Pigmentepithel führen, was die proliferative Vitreoretinopathie (PVR) stimulieren kann. In einer konsekutiven Reihe von 15 Augen von insgesamt 15 Patienten mit Netzhautablösungen < als 3 Quadranten ohne PVR wurde eine transsklerale Diodenlaserkoagulation (TD) durchgeführt. In keinem Fall wurde eine Exodrainage angeschlossen, eine Silikonplombe diente als Tamponade des Foramens (in 3 Augen 2 Foramen), eine primäre Netzhautanlegung wurde in allen Fällen erreicht, eine proliferative Vitreoretinopathie wurde in keinem Fall beobachtet, als einzige Komplikation trat eine Verbrennung am Muskelrand des Musculus rectus temporalis auf. Durch eine Laserbehandlung entsteht eine sofortige Verbindung zwischen retinalem Pigmentepithel und Netzhaut, eine Ausschwemmung von Zellen wird verhindert, womit theoretisch das PVR-Risiko vermindert wird. Obwohl der Zeitaufwand für eine transsklerale Diodenlaserkoagulation größer als für eine Kryobehandlung ist, lassen unsere vorläufigen Ergebnisse diesen Aufwand als gerechtfertigt erscheinen.
Summary
15 patients (15 eyes) were treated with transscleral diode lasercoagulation for uncomplicated retinal detachment without signs of proliferative Vitreoretionpathy (PVR). Exodrainage was not necessary in any case. A silicone buckle was used to tamponade the retinal break. Permanent sealing of the break was achieved in all eyes. Follow up was overall one year. No serious adverse effect, exept one small burn in a muscle (M.r.inf.) was observed. Lasercoagulation can avoid dispersion of retinal pigment epithelial cells (one possible reason for PVR), which occurs normally in cryocoagulation of retinal breaks. Beside the fact that TD is more timeconsuming than cryocoagulation, it may eventually avoid PVR.
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Kieselbach, G., Kralinger, M., Kremser, B. et al. Transskierale Diodenlaserkoagulation bei konventioneller Ablatiochirurgie. Spektrum Augeheilkd 14, 11–13 (2000). https://doi.org/10.1007/BF03162855
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DOI: https://doi.org/10.1007/BF03162855