[Brief light coagulation with light of different spectral composition].
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The fluorescence angiogramme served as a basis for the plan of treatment and as a criterion of treatment success in 192 patients with diabetic retinopathy who underwent xenon-light coagulation between January 1971 and October 1972. In 64 patients this success could be statistically evaluated comparing the untreated partner eye according to the exact Fisher-test. The rate of success of light coagulation showed itself to be statistically highly significant (p less than 0.01%) with regard to retinal morphology and haemodynamics, but with regard to visual acuity only statistically barely significant (p less than 5%). For the influencing of the capillary occlusion process with light coagulation no statistical significance (p = 25.19%) was found, and for the influencing of the capillary permeation disturbances with light coagulation a slight statistical significancing of the capillary permeation disturbances with light coagulation a slight statistical significnace (p less than 5%) was calculated. For avoiding or hindering present or threatened new vessel formation with light coagulation we calculated a statistical significance of p less than 1%.
A brief description is given of the history and early application of light coagulation in ophthalmology. The technique was originally developed by Meyer-Schwickerath in 1949 following clinical observation of macular damage sustained from watching an eclipse. A variety of different light sources were attempted in the prototype instruments before Carl Zeiss (Oberkochen) developed the first commercial model using a high-pressure Xenon lamp in combination with an ophthalmoscopic view of the funds. The ophthalmological clinical procedure originally advocated by Meyer-Schwickerath for light coagulation is briefly outlined and its potential application as a prophylactic treatment in certain specified pathologies is indicated.
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A report on three patients with illustrations of their visual anomalies following light coagulation for their CSR disease is presented. The correspondence of the phenomena illustrated with the ophthalmoscopically visible fundus changes prove their objective origin.
With regard to prior positive results using the infrared-light-coagulator LC 250 for hemostasis of bleeding parenchymal organs and inoperable tumors, new tubes with 5 and 10 mm diameter were developed for laparoscopic purposes. The first clinical experiences showed the secure and rapid hemostasis after bleedings of the liver following a cholecystectomy, smaller resections and biopsies also resulted after lesions of the abdominal wall. The newly developed applicator consisting of a metal or teflon grip, improved the performance of these probes.
A retrospective study of 19 patients, who suffered from diabetic retinopathy, were submitted to a xenon-light-coagulation 10 years ago and have been regularly checked, shows better results in the treated eyes than in the untreated fellow-eyes in regard to visual acuity and background morphology. In cases of poorly controlled metabolism, heavy smoking and simultaneous suffering from hypertension and nephropathy the prognosis of the treated eyes is unfavourably affected.
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A 42-year-old male with beginning proliferative diabetic retinopathy developed a serous choroidal detachment as a complication following excessive light coagulation (retinal ablation); under conservative antiphlogistic treatment the choroidal detachment disappeared within one week.
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In diabetic retinopathy, a low resistance of flow between choroid and retina is found which goes with an increased intake of tissue fluid into the retinal vessels and the appearance of retinal oedema. Light coagulation destroys the choriocapillaris which does not regenerate. As less fluid becomes available to be sucked up by the retinal vessels, the oedema will now disappear and consequently, the retinopathy subsides.
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