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KMID : 0381219710030020131
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Journal of RIMSK
1971 Volume.3 No. 2 p.131 ~ p.140
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THE CRYOGENIC OPHTHALMIC SURGERY
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Abstract
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In 1910, cryosurgery was first introduced by Scholar in the field of ophthalmology, cryosurgery has been widely used not only in the operation of cataract and retinal detachment, but is being useful for the absolute glaucoma, corneal ulcer, histological examination of intraocular tumors, destruction of tumor cells and vitreous surgery.
I) In cataract surgery, eresiphake and capsule forceps has been available. However, cryoextraction offers advantages over these instruments, especially with regard to the incidence of rupture of the lens capsule, which leads to lens induced uveitis or secondary membrane formation.
Cryoextraction has been able to reduce incidence of unexpected lens induced uveitis or secondary membrane formation due to capsular rupture.
Cryosurgery also gives a better results for the hypermature cataract, subluxated or dislocated lens, and diabetic cataract with fewer complications than with other means.
Cryosurgery reduced the incidence of retinal detachment or vitreous loss.
11) In retinal detachment surgery, cryopexy produces retinal exudate reaction similar to that seen with diathermy. It appears to have the advantage of being more selective than diathermy or photocoagulation. Cryopexy makes a chorioretinal scar with no scleral damage and less postoperative scleral abscess or infection as compared with diathermy, makes the operation less hazardous and, because inflammatory reaction is minimal, facilitates reoperation. Cryopexy also has an advantage that it is readily useful for the retinal tear under the Vortex vein or extraocular muscle, without resection of conjuntiva or sclera.
Cryopexy causes no damage to the blood vessels and is used for the prevention of retinal detachment in the surgery of large retinal tear, lattice degeneration and retinal tear with thin sclera.
For the retinal detachment with traction in retinal tear, cryopexy and Custodis method is useful, and for multiple retinal tear, cryopexy and encircling operation with silicon band without scleral resection gives a good result.
1(<) Cryosurgery is also useful in the diagnosis of intraocular tumor, of which diagnosis is able to be confirmed by biopsy.. For the destruction of tumor cells, cryosurgery is also useful but further study will be required.
Cryosurgery for retinoblastoma gives the most effective result.
N) Cryosurgery is being used for reposition of prolapsed iris.
It is also useful for herpes simplex keratitis, but it seems to be not more effective than I.D.U. Cryosurgery for absolute glaucoma has questionable effect and more study is required.
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