laser iridectomy

Treating diseases: glaucoma Indication 1. Laser fundus tissue coagulation for retinal tears and cleft palate, retinal choroidal hemangioma, central serous retinal choroidal lesion, retinal vein inflammation, retinal vein branch and central venous obstruction, diabetic retinopathy. 2. Laser special treatment for ophthalmic diseases: 1 light path obstructive eye disease: corneal leukoplakia, L membrane closure, pupillary displacement. 2 glaucoma: primary or preclinical stage of primary angle-closure glaucoma, acute or subacute angle-closure glaucoma remission, secondary glaucoma iris bulging, incomplete iris resection, aphakic pupillary glaucoma. 3, laser trabeculoplasty for the treatment of glaucoma drug treatment of primary open angle glaucoma, traumatic angle retrograde glaucoma, pigmented glaucoma, aphakic glaucoma, anterior chamber without vitreous, intraocular lens open angle glaucoma, Glaucoma that cannot tolerate routine surgery. 4, laser lens capsule incision for extracapsular cataract extraction, posterior capsule opacification after intraocular lens implantation, traumatic cataract partial absorption of membranous cataract, combined with traumatic cataract or congenital cataract surgery preoperative treatment Wait. 5, laser flexion keratotomy for the treatment of myopia for -5.0D or lower degrees of myopia correction effect is better. 6, laser coagulation for corneal and conjunctival lesions corneal neovascularization, conjunctival neovascularization, hemangioma and pigmentation. Surgical procedure 1. Laser fundus tissue coagulation (1) preoperative examination: 1 retinal detachment with a hole, should check the location, shape, number of the hole and the vicinity of the omentum. The macular hole should be examined for distance, near vision (refraction if necessary), macular gaze function, color tone of the slit hole under the slit lamp and dislocation of the optical tangent. 2 retinal vasculopathy and its changes, should be described in detail and graphically indicated, should be performed under the fundus fluorescein angiography. Fundus photography was performed before and after surgery. (2) Fully dilated with 5%-10% phenylephrine and 2% post-matotropin, 1% tetracaine for topical anesthesia, and placed contact lens. (3) Laser operation: 1 commonly used argon ion laser and helium ion laser. 2 Check the output power or energy after starting up according to the operating procedures. 3 Adjust the required power, exposure time and spot size according to the nature and location of the lesion. 4 See the area to be irradiated and aim to trigger the irradiation. (4) Retinal tear treatment: 1 generally begins with lower energy. The reaction of photocoagulation on the omentum is to achieve grade II. 2 Macular hole: the laser beam is close to the outer edge of the hole to make a single row of dense light freezing point. 3 Peripheral hole: The laser beam is aligned with the periphery of the hole for 2-3 rows of light spots. If the area of the submucosal fluid around the hole does not exceed 1 PD, it can be surrounded by 2-3 rows of freezing points. The edge of the hole, the outer row in the outer circumference of the effusion, preoperative blood and probiotics, and postoperative vasodilators. (5) treatment of fundus vascular abnormalities: 1 retinal, choroidal hemangioma: direct coagulation of the tumor, with gray or yellow-white coagulated plaque is preferred, the extent of the lesion should be treated in divided doses, interval 1-3 weeks is appropriate. 2 retinal vein inflammation: for the retinal area with neovascularization, gray anoxic, no irrigation area or fluorescence leakage for photocoagulation. For the proliferating blood vessels that extend into the vitreous, the roots of the blood vessels are coagulated and photocoagulated by the omentum. (6) Note: During treatment, the operator should close the eyes at the moment of triggering the irradiation to prevent the laser from damaging the eyes. 2. Laser special treatment for eye diseases (1) preoperative examination: 1 glaucoma patients to measure intraocular pressure and anterior chamber depth, check the iris for pigmentation, dehydration or neovascularization. 2 iris lesions to check the shape of the pupil, the extent of iris adhesion, the presence or absence of new blood vessels, flash of aqueous humor, sedimentation and shedding pigments. (2) Patient preparation: 1 Explain the treatment and coordination points to the patient. 2 1 h before treatment with 2% pilocarpine sputum, once every 15 min. (3) Laser operation: 1 common ruby laser, argon ion laser, dye laser and Q-switched Nd:YAG laser. 2 According to the patient's iris color, thickness and transparency of the cornea, the laser energy parameters are determined. The commonly used amount is 1-3J. 3 The laser irradiation site is selected in the peripheral iris as far as possible, and the appropriate illumination angle is used to ensure focus on the iris surface to be illuminated. 4 If the transurethral cut is not performed once, the second dialysis can be performed after the iris anterior chamber reaction completely disappears, and the second energy is applied for the second transection. Eye drops of corticosteroids and atropine before and after surgery to control the inflammatory response. When 5 pairs of pupillary membranes are separated by adhesion, they can be sequentially irradiated on the side of the pupil edge and several clock orientation points below, and the fiber membrane is peeled off to reveal the clear area. (4) Note: The operator should close the binocular protection at the moment of triggering the irradiation. complication The cornea is turbid, and the anterior chamber pigment particles, tissue debris, and iris hemorrhage can absorb themselves. Anterior chamber pigmented opacity requires oral indomethacin and corticosteroids. Temporary elevated intraocular pressure can be treated with indomethacin, corticosteroids and antihypertensive drugs. Retinal hemorrhage should be treated by conventional hemostasis or by laser irradiation of clots to promote absorption.