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A NEW TECHNIQUE FOR C.R.V.O (CENTRAL RETINAL VEIN OCCLUSION) BY LASER BLAST THERAPY (see bottom)
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LASER Vs CONVENTIONAL SURGERY……. There
are distinct advantages to laser eye surgery over conventional surgery.
Because the laser light can pass through the cornea to be concentrated
inside the eye, a surgical opening does not need to be made in the
eyeball. This greatly decreases the risk of infection and bleeding.
Because of this decreased risk, laser procedures usually do not need to
be performed in an operating room. Recovery time is reduced and people do
not need to restrict their activities after surgery. What is a laser? The acronym LASER stands for Light Amplification by Stimulated Emission of Radiation. A laser is a device that produces a beam of monochromatic light in which all the waves are in phase or are coherent. The eye laser light can be focused onto the retina or any other part inside the eye, selectively treating the desired area while leaving the surrounding tissues untouched. The absorbed energy creates a microscopic spot to destroy lesions or weld tissues together. (LASERS are used in surgery because their power can be harnessed to cut, burn, vaporize or destroy different tissues.) Who needs laser surgery? Lasers were first used to treat eye diseases over 30 years ago and have become the standard of care for previously untreatable disorders. For many patients, laser can preserve or prevent vision loss if given in a timely fashion. LASER surgery is indicated in the treatment of many eye diseases. Lasers are used to treat the ocular complications of diabetes. For glaucoma patients, lasers help to control the pressure inside the eye when medications, alone do not succeed. Lasers are used to seal holes in the retina, and prevent or treat retinal detachments. Macular degeneration is another condition where laser can sometimes help prevent vision loss. Finally, laser is also used after cataract surgery to improve upon vision if necessary (for membranes after cataract surgery). Your eye will almost always look and feel normal with retinal diseases, even when there is hemorrhaging and leakage in the back of your eye. Your sight may also be normal for a while despite the presence of potentially blinding eye problems. The only way to tell if you need laser surgery is to have a careful, dilated retinal examination, often followed by a special test that evaluates the eye's circulation (fluorescein angiography). Lasers are commonly used to treat the following eye conditions: 1)Diabetic retinopathy: Diabetes causes circulation problems throughout the body, including the eyes, nerves, and kidneys. The retinal blood vessels are usually like pipes, bringing blood into and out of the back of the eye. In diabetes, however, the vessels may leak, causing the retina to swell and not work properly (diabetic macular edema). Vision is affected when the swelling involves the central vision area. Laser surgery can seal the leaks, thereby preventing further vision loss. Some patients will have new retinal blood
vessels grow to replace some which have closed from the diabetes
(proliferative diabetic retinopathy).
While this sounds good, these new blood vessels can cause
blindness from bleeding and scarring.
Laser treatment can often prevent severe vision loss by making
these new vessels disappear. 2) Retinal vein occlusions: The small blood vessels that drain blood from the
retina (retinal veins) can sometimes become blocked as part of the aging
process. This is more common
in patients with diabetes or high blood pressure.
A retinal vein occlusion can cause the retina to swell with fluid
and blood, blurring central and peripheral vision.
Other times, new blood vessels may grow and cause pain with very
high pressure inside the eye (neovascular glaucoma).
Laser treatment can help reduce this swelling or cause the new
blood vessels to disappear plus with latest technique “LASER BLAST
THERAPY” perfected at G.G.S.I. Eye Research & Cure Centre one can
get rid of disease (retinal vein occlusions). 3) Macular degeneration: Some people will develop aging changes in the macula, the portion of the retina responsible for our central reading vision. Most will experience the less harmful dry type, which usually causes minimal visual changes. The more severe, or wet type, causes the macula to swell with fluid and blood. Symptoms of wet macular degeneration include painless blurred or distorted vision. Urgent laser surgery can sometimes prevent or delay vision loss in some patients with this wet type. 4) GLAUCOMA : when glaucoma cannot be controlled with medication, LASER is a very effective tool used to lower the pressure inside the eye. Small burns are applied to the trabecular meshwork, the area where fluid drains from the eye. These burns stretch open the drainage channels and allow more fluid to escape the eye. By doing so, the pressure is reduced. In acute angle closure glaucoma, the laser is used to make a hole in the iris. This redirects the flow of fluid in the eye, opening the angle and allowing the pressure to return to normal. 5) Retinal holes and detachment : The retina lines the back of the eye like wallpaper.
Retinal tears or rips can occur as part of an aging phenomenon, or
following cataract surgery or eye injury.
Patients will often see cobweb-like floaters or light flashes when
a retinal tear develops. Liquid that normally fills the central portion
of the eye (the vitreous) can leak beneath the tear, lifting the retina
away from the eye wall. This
is called a retinal detachment, which can cause blindness if left
untreated.RETINAL HOLES, if left untreated, can lead to retinal
detachment. The LASER can be used to seal the retinal hole before a
retinal detachment occurs. If a retinal detachment does occur, laser
alone, cannot repair it. A retinal reattachment operation is performed to
bring the retina back in contact with the inner wall of the eye. LASER
can then be applied to secure it in place. 6) Ocular tumors : Some patients will have non-cancerous leaking vascular tumors that can cause the retina to swell and not function properly. Laser surgery can destroy these tumors and allow the swelling to go away. 7) CATARACT: When a cataract is removed, it is common practice to try to keep a membrane called the posterior capsule intact within the eye. This membrane serves to support the lens implant that is placed in the eye at surgery. It also serves as a barrier separating the front and back parts of the eye. In as many as 30% of people, this membrane will lose some of its clarity in the months and years after a cataract operation. In such a setting, the YAG LASER is used to create an opening in the center of the membrane to restore quality vision. What happens during my surgery? There are no special preparations before eye laser treatment. You should eat normally and take your regularly prescribed medications before surgery. Eye drops will be given to dilate the pupil and numb the eye. The treatment is performed while you are seated in a chair, similar to the one used for regular eye examinations. You will remain awake and comfortable. Treatment is usually painless, although some patients may require a numbing injection for discomfort or sensitivity to the laser light. The laser treatment usually takes less than 20 minutes to complete, and you can go home immediately following LASER surgery. PRECAUTION:Arrangements for transportation should be
made in advance since you may not be able to drive right away. What are the restrictions and side effects after laser? There are virtually no restrictions following EYE laser surgery, and you should be able to resume your normal activities and work schedule the following day.Most patients notice no vision changes following their laser surgery, although there may be some temporary blurring for several Days to months. In addition, depending on the condition being treated, some may notice a permanent blind spot or decrease in peripheral and night vision. Will I need more than one laser treatment? It will take several days to months before we can tell whether the laser surgery has been successful. Many patients, will need one or two laser treatment sittings to control their eye problem and prevent further loss of vision. ******** A
NEW REVOLUTIONARY TREATMENT FOR CENTRAL
RETINAL VENOUS OCCLUSION
G.G.S.I.EYE
RESEARCH & CURE CENTRE, 31, Defence Enclave, Vikas Marg, Delhi
110 092 (India) has discovered a new modality for early cure of central
retinal venous and branch retinal venous block. Q1.
What is Central Retinal Vein Block? Ans.
Blood is supplied by central retinal artery to the inner part of retina.
Impure blood is drained out of the eye by central retinal vein. The
arteries and veins cross each other at many points. The blockage of CRV
can occur at many places. Q2. What are the
causes of CRVO?
Ans.
Old age changes in the veins and arteries due to high blood pressure and
diabetes mellitus contribute a major role. Q3.
What are the sites of CRVO? Ans.
Block can occur: -
Q4. What are symptoms? Ans.
Patient gets up and finds he cannot see from one eye or is very hazy.
Before this episode, he may complain of transient attacks of dim vision
lasting for few seconds to minutes and automatic restoration. Q5. How does the doctor diagnose? Ans.
He finds a classical picture of retinal hemorrhages. In the retina as if
an artist, has sprinkled red color on retina with his brush and the veins
are dilated. Q6. How such cases were treated? Ans.
Earlier (1)
Wait and watch for glaucoma and abnormal vessels (2)
Pharmacological opening of vein lumen.
i.
Anti-fibrinolytic (Streptokinase and others)
ii.
Anti coagulants Results? (3)
Isometric Haemodilution by giving dextran infusion? (4)
30% photocoagulation by argon laser (Branch vein occlusion)
i.
It burns the retina which releases vasoproliferative factor
(vascular poison)
ii.
Photocoagulation burns budding vessels. Results:
- 30% improved with this treatment. (5)
Surgical: -
i.
Decompression of the optic nerve sheath
ii.
Sheathotomy by vitrectomy
iii.
Creation of chorio retinal anastomosis. Note:
- Complication are serious: - Retinal Detachment, Cataract and Central
Retinal artery occlusion. The
above treatment has been mostly of:
- (1)
Wait and watch for the complications to arises and then deal. The
period lasts for 3 months to 2 years. (2)
Photocoagulation: - It is to treat the complication. Results in
U.S.A. study groups are not very remarkable as regard improvement in visual
acuity. (3)
Surgical is hazardous as reported by some workers. Q 7. What are you doing in these cases? Ans.
OUR EYE CENTRE Protocol : (1)
To investigate and find out the cause and treat it accordingly. (2)
Blast Therapy to the veins or its branches and opening of the block vein
with the help of special technique of laser. Q 8. How do you know this technique has helped? Ans.
(1) In other techniques people are not sure about their results
because with passage of time some cases may improve to 1 or 2 lines (20%). (2)
In this technique, the result is dramatic as on next, the patients who
couldn’t see earlier starts reading about 3-4 at distance. (3)
The improvement is rapid and takes about 6 weeks for complete cure. While
in other techniques improvements starts from 3 months and goes up to 3
years. The Most Important Message: - There are many patients of old ages suffering from hypertension, diabetes or otherwise who can get blocked central retinal vein. In normal course of events and the therapy available is a drawn out process with indefinite horrible outcome. The people can lose their eyesight either due to 100-day glaucoma or from membrane formation in the retina leading to drastic complications. I want to tell my countrymen and my fellow colleagues in all the specialty disciplines that this new modality of treatment is very beneficial for the patients. |
