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English to Chinese: 氩激光光凝术治疗小型睫状体脱离的长期结局 General field: Medical Detailed field: Medical: Instruments
Source text - English Long-term outcomes of argon laser
photocoagulation in small size cyclodialysis cleft
Jong Chul Han, Young Kyo Kwun, Seok Ho Cho and Changwon Kee*
Background: To evaluate the long-term outcomes of Argon laser photocoagulation compared to surgical direct
cyclopexy in small-size cyclodialysis cleft patients.
Methods: This is a retrospective study. Small-size cyclodialysis cleft patients who underwent Argon laser
photocoagulation and surgical direct cyclopexy were reviewed. The mean follow-up period were 82.4 (range, 61 – 145)
months and 99.9 (range, 62 – 184) months in both groups. The comparison of best corrected visual acuity (BCVA),
intraocular pressure (IOP), postoperative peak IOP and time to normalization of IOP before and after the treatment.
Results: The causes of all included 15 cyclodialysis cleft cases were blunt trauma. seven patients underwent Argon laser
photocoagulation and eight patients underwent surgical direct cyclopexy. The mean age of included patients was not
significantly different (p = 0.38). Preoperatively, the mean logMAR BCVA (standard deviation, SD) was 0.7 (0.2) and 1.1 (0.9)
and mean IOP was 4.4 (2.4) mmHg and 3.0 (1.5) mmHg in Argon laser group and surgical direct cyclopexy group (p=0.24
and p = 0.18, respectively). The extension of cyclodialysis and duration of cyclodialysis cleft were not significantly different
between the two groups (p=0.08 and p = 0.24, respectively). The mean follow-up period were 82.4 (range, 61 – 145)
months and 99.9 (range, 62 – 184) months in both groups (p = 0.41). Postoperatively, the mean logMAR BCVA was 0.0 (0.1)
and 0.2 (0.3) and mean IOP was 14.5 (3.1) mmHg and 16.8 (2.5) mmHg (p=0.15 and p = 0.16, respectively). Postoperative
peak IOP and time to normalization of IOP were not different between the two groups (p=0.75 and p = 0.91, respectively).
Discussion: It is necessary to use invasive treatment such as cryotherapy or surgical direct cyclopexy in cyclodialysis cleft
with hypotonic maculopathy. In the present study, Argon laser photocoagulation showed good prognosis in a small-size
cyclodialysis cleft below 1.5 clock-hours. Considering possible complications and cost of surgical direct cyclopexy, Argon
laser can be more beneficial than surgical direct cyclopexy in small-size cyclodialysis cleft below 1.5 clock-hours.
Conclusions: The clinical ourcome of Argon laser photocoagulation seems to be as good as surgical direct cyclopexy in
small-size cyclodialysis cleft below 1.5 clock-hours.
Keywords: Argon laser photocoagulation, Cyclodialysis cleft, Outcomes, Prognosis
Cyclodialysis cleft occurs when the ciliary body is detached
from the scleral spur. This is usually related to blunt
trauma or iatrogenic injury due to ophthalmic surgery. The
communication between the anterior chamber and the
suprachoroidal space can result in clinically significant
hypotony and its complications such as cataract or macular
edema . Clinically, direct suture closure is usually used
for repair [2, 3]. However, several alternative methods for
closing a cyclodialysis cleft have been used, including
penetrating diathermy , Argon laser photocoagulation
, cryotherapy [6, 7], scleral buckling , and vitrectomy
with gas tamponade .
Laser photocoagulation using Argon laser has been used
as one of the treatment of choice for repair of cyclodialysis
cleft to avoid major intraocular surgeries . Previously,
Argon laser photocoagulation in cyclodialysis cleft was
introduced by Joondpth . He reported one small-size
cyclodialysis cleft case who recovered visual acuity and
intraocular pressure (IOP) after Argon laser photocoagulation
treatment twice. Harbin also reported that three
small-size cyclodialysis cleft patients treated by Argon laser
photocoagulation showed good prognosis . However,the follow-up periods of the previous reports were relatively
short (2 months to 2 years), there are no long-term
outcomes of the Argon laser photocoagulation in smallsize
cyclodialysis cleft. Therefore, we intended to investigate
the long-term outcomes of Argon laser photocoagulation
compared to surgical direct cyclopexy in small-size cyclodialysis
The present study was retrospective study approved by the
Institutional Review Board of Samsung Medical Center and
adhered to the tenets of the Declaration of Helsinki. The
medical charts of the traumatic cyclodialysis cleft patients
who visited Samsung Medical Center and underwent
Argon laser photocoagulation from January 1999 to
December 2008 were reviewed.
We included the patients with small-size cyclodialysis
cleft below the extent of 2 clock-hours. A single surgeon
(CK) performed all the Argon laser treatment and surgical
direct cyclopexy. All included patients with small-size cyclodialysis
cleft used atropine at least for 2 months at first. In
case the patients had no improvement of the symptoms of
cyclodialysis cleft such as persistent ocular hypotony with
decreased visual acuity or macula edema with medical
treatment, they underwent Argon laser photocoagulation or
surgical direct cyclopexy. The decision which methods the
patient would undergo was made by the patient after
explaining the strength and weakness of the each treatment.
We only included the cases with medical records over five
years after the treatment. The cases with severe ocular complications
such as scleral laceration and choroidal rupture
were excluded. The treatments were fully explained to each
patient, and each provided written informed consent.
All patients underwent routine ophthalmologic examinations
including best-corrected visual acuity (BCVA), slitlamp
examination, Goldmann applanation tonometry and
fundus photo. Gonioscopic examination and ultrasound
biomicroscopy (UBM) (Fig. 1a and b) were used in all patients
for confirmation of the location and extent of cyclodialysis
cleft before laser treatment. After the treatment,
the patients underwent ophthalmologic examinations such
as BCVA, Goldmann applanation tonometry, gonioscopic
examination and fundus examination at 1 week, 1 month
and 3 months, and every 6 month. UBM was performed
at 3 month after the treatment. Follow-up period was
regarded as the duration between initial visit and last visit
to outpatient clinic for cyclodialysis cleft. Duration of
cyclodialysis cleft before treatment (DOC), postoperative
maximum IOP and time to IOP normalization (TNP) were
evaluated. Normalized IOP was defined as the IOP between
10 and 21 mmHg.
Translation - Chinese 氩激光光凝术治疗小型睫状体脱离的长期结局
Jong Chul Han，Young Kyo Kwun，Seok Ho Cho和Changwon Kee *
所有患者接受例行眼科检查，包括最佳矫正视力（BCVA）、裂隙灯检查、Goldmann压平式眼压测量和眼底照片。对所有患者施用前房角镜检查和超声生物显微镜（UBM）（图1a和b），以便在激光治疗前确认睫状体脱离的部位和范围。治疗后，患者在1周、1个月和3个月及每6个月时接受BCVA、GOldmann压平式眼压测量、前房角镜检查和眼底检查等眼科检查。治疗后实施UBM检查。随访期是指因睫状体脱离到门诊诊所初次就诊和末次就诊之间的持续时间。评估治疗前睫状体脱离持续时间（DPC）、术后最大IOP和IOP正常化时间（TNP）。正常化IOP被定义为介于10和21 mm Hg之间的IOP。
Japanese to Chinese: 物 理 General field: Science Detailed field: Other
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