Comparison between cryoapplication and argon laser coagulation.
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The infra-red coagulation is a new outpatient method for the treatment of benign changes in gynaecology. It causes little pain and is suitable for haemostasis at the cervix, in the vagina and in the vulva. The effect of this treatment is comparable to laser coagulation. An exact dosage of the coagulation energy is possible and therefore the depth of treatment and the surface of the treatment are known accurately. The side effects of the treatment are minimal, a fast and good healing of the coagulation area can be expected. The results of infra-red coagulation in 72 patients are presented.
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The author reports two clinical tests performed in 6 patients for explaining the pathogenesis of serous macular detachment associated with congenital optic pit. The results of these tests indicate, that the detachment is caused by the fluid of vitreal origin. The treatment of this disease with the laser coagulation is also reported.
The treatment of vascular naevi with lasers is widely practised. The concept of specific vascular damage was an early ideal but it is much harder to attain than had been anticipated. The favourable results achieved by coagulation necrosis of the epidermis and upper dermis with the argon and CO2 lasers prompted us to try to produce the same changes with non-laser radiation. We have used an infra-red coagulator to treat flat vascular naevi and ectatic blood vessels. The handpiece which looks like a gun has a light guide capped by a 6 mm diameter sapphire. This size combined with a pulse duration of less than 1.0 second enables large areas of skin to be treated quickly. Preliminary results are presented.
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Corneal sensitivity was determined with the Draeger aesthesiometer in 39 patients with proliferative diabetic retinopathy who underwent treatment with a xenon photocoagulator or argon laser. In 29 patients measurements were performed before and after photocoagulation; in 10 patients the unaffected eye was used for comparison. Statistical evaluation showed a significant difference between the mean values for corneal touch threshold before and after argon laser coagulation. After xenon photocoagulation, corneal sensitivity was reduced in all patients (n = 7). It was shown that corneal sensitivity was significant lower after xenon photo coagulation than with argon laser coagulation.
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We report on the new method of interstitial laser coagulation for the treatment of benign prostatic hyperplasia (BPH). The procedure is based on the interstitial application of Nd:YAG laser irradiation, delivered through a new light guide system. Such light applicators coagulate constant tissue volumes in a homogeneous manner, as proven by in vitro studies in different tissues, including surgically removed prostate adenoma. The extent of the coagulation is determined by laser power and irradiation time. At 5 W, for example, and during a 10-min period, this zone reached a diameter of up to 20 mm. Temperatures generated in the process were over 100 degrees C, as measured by time/space resolution. These results were confirmed by in vivo studies in canine prostates. In the course of 7 weeks, the coagulated areas formed scars with degeneration and fibrosis, accompanied by marked shrinking. Neighbouring organs were not affected. The method was successfully transferred to clinical practice. The application of the light guides to the lateral lobes was performed percutaneously from the perineum under transrectal ultrasound guidance. The median lobe was punctured transurethrally under direct vision. Twenty-seven patients with an average age of 67.7 years were treated between July 1991 and March 1992. At the time of evaluation 15 patients had a follow-up of more than 2 months. They experienced a mean increase of peak flow rate from 6.6 to 15.2 ml/s and a mean decrease of residual volume from 206 to 38 ml. This was accompanied by a marked lessening of symptoms. The average prostate weight decreased from 63 to 44 g. Sexually active patients did not experience retrograde ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS)