Офтальмохирургия (Jul 2018)
INDICATIONS FOR RECONSTRUCTIVE LASER SURGERY IN EYE PATHOLOGY OF CHILDREN: RESULTS OF LONG-TERM OBSERVATIONS
Abstract
Purpose. To provide updated and expanded indications for YAG laser surgery in ocular diseases of children, developed on the basis of 25 years of experience, for the introduction into the broad practice of pediatric ophthalmology in the Russian Federation.Material and methods. The indications were developed on the basis of the analysis of results in 4422 laser reconstructive surgeries (62% in conditions of general anesthesia) for children from 2 months to 17 years (1/3 children – up to 3 years) with congenital, post-traumatic, postinflammatory eye pathology performed by the authors in the Pediatric Department of the Moscow Helmholtz Research Institute of Eye Diseases from 1991 to 2016. There were used combined laser installations including the IAG laser destructor (1064 nm) and Argon or Diode laser coagulator (532 nm) and the laser tehniques adapted for children and their own patented methods.Results. The safety of laser interventions in children with strict observance of the fulfilled energy parameters of laser operations has been proved. The efficiency of the 4422 YAG laser surgeries performed to children (after 2-16 years was 87.7 to 97.3%), the long-term experience and improvement of laser techniques allowed to expand the spectrum of laser interventions in children and to work out a list of indications for the YAG-laser reconstructive surgery in children with the ophthalmic pathology.Conclusion. The YAG laser reconstructions are recommended for pupillary membranes (including congenital, secondary, membranous and regenerative), precipitates on the IOL, linear vitreo-, iridocorneal synechias, pupil block, deformation, dislocation or obturation of pupil, cysts of the iris and anterior chamber, flocculi of the pupillary margin, internal fistulae obturation after trabeculectomy, thin vitreous strands, and also for anterior capsulotomy (as a stage of the subsequent extraction of cataracts, especially with subluxation of the lens). The main kinds of reconstructive laser operations recommended for introduction into the practice of pediatric ophthalmology of the Russian Federation are presented as for illustration exemplary.
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