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Cryotherapy and Laser for Intermediate Uveitis

  • Chapter
Surgical Management of Inflammatory Eye Disease

Abstract

■ Pars plana exudates in intermediate uveitis (IU) are associated with more severe vitreous disease and increased incidence of cystoid macular edema (CME).

■ Cryotherapy and laser photocoagulation are used in the treatment of the pars planitis variant of corticosteroid resistant IU.

■ Cryotherapy should be avoided in retinal detachment or marked peripheral vitreoretinal adhesions. A B-scan ultrasound may be needed.

■ Technique for cryotherapy:

- Peribulbar or sub-Tenon anesthesia.

- “Freeze-thaw-freeze” or “double row single freeze” of inferior snowbank.

- Treat contiguous, uninvolved retina (one third width of snowbank) and area with dense exudates.

- Average of 20 freezes per eye.

- Postoperative posterior sub-Tenon injection of long-acting corticosteroids and topical steroids.

■ Technique for laser photocoagulation:

- Topical anesthesia is preferred for office treatment.

- Endophotocoagulation may be performed during pars plana posterior vitrectomy, under peribulbar, retrobulbar or general anesthesia.

- Nonconfluent, grayish laser marks, 300–500-μm wide, 0.2 s duration.

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Author information

Authors and Affiliations

  1. Instituto Oftalmológico de Alicante, VISSUM, Pio del Rio Hortega University Hospital, Valladolid, Spain

    Javier A. Montero

  2. Department of Ophthalmology, Castilla La Mancha University School of Medicine, Albacete, Spain

    Jose M. Ruiz-Moreno

Authors
  1. Javier A. Montero
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  2. Jose M. Ruiz-Moreno
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Editor information

Editors and Affiliations

  1. Universitäts-Augenklinik Heidelberg, Interdisziplinäres Uveitiszentrum, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Matthias Becker

  2. Dept. of Ophthalmology, Triemli Hospital Zürich, Birmensdorfer Straße 497, 8063, Zürich, Switzerland

    Matthias Becker

  3. Ophthalmology, Univ. of Miami Bascom Palmer, 900 NW 17th Street, 33136, Miami, FL, FL, USA

    Janet Davis

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Montero, J., Ruiz-Moreno, J. (2008). Cryotherapy and Laser for Intermediate Uveitis. In: Becker, M., Davis, J. (eds) Surgical Management of Inflammatory Eye Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33862-8_5

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  • DOI: https://doi.org/10.1007/978-3-540-33862-8_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33861-1

  • Online ISBN: 978-3-540-33862-8

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