Anwendung der Elektrochirurgie am Auge

Safar, Karl

doi:10.1007/978-3-7091-7821-8_4

Elektrochirurgie Am Auge 1953

DOI: 10.1007/978-3-7091-7821-8_4

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Anwendung der Elektrochirurgie am Auge

Karl Safar

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1958

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“…Safar (1953), for instance, with the aid of his Ziel-Ophthalmoskop coupled with a diathermic needle electrode, cauterized the macular hole at the moment when the light of the ophthalmoscope fell upon it. Mamoli (1936Mamoli ( , 1937, Bangerter (1940), and Dellaporta (1953a, b) used needles 27 to 30 mm.…”

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“…Bangerter (1954) has also described another method involving the surgical implantation of pieces of placenta. Meyer-Schwickerath (1956) cauterized tears in the macula by using a beam from an arc lamp, the action of which resembled that of the sun's rays on the naked eye during an eclipse (Sedan, 1956); this methcd caused permanent injury to the macula lutea, leaving a dark pigmented spot and central scotoma. Kettesy (1957) reported that he had cauterized a macular hole by direct solar rays; he achieved the apposition of the retina, but the visual acuity was only 0X08 after 6 weeks, and the macular vision was completely lost.…”

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New Method of Operation for Detachment of the Retina With Tearing of the Macula Lutea

Madroszkiewicz¹

1958

British Journal of Ophthalmology

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DETACHMENTS of the retina with a hole in the macula lutea or posterior pole are very difficult to cure by diathermy coagulation or electrolysis. To perform this operation it has been the custom to lay bare the sclera and resect the lateral rectus muscle in order to bring the posterior pole into view by rotating the eyeball. An Arruga speculum or other suitable glass spatula was then introduced, so that the region of the posterior pole could be measured with callipers and marked with indian ink, and after these preliminaries, the diathermy operation was begun. Some surgeons even resorted to resection of the lateral wall of the orbit (Kr6nlein's method).This was time-absorbing and tiring, and usually provoked a marked postoperative reaction in the tissues surrounding the eyeball. The two cases described below gave me the idea of constructing a special "calibrated" electrode, and this led me to evolve a new and simpler method of approach to the macula.Preliminary Case Reports Case 1, a man aged 29, had a fresh traumatic retinal detachment, with a large convoluted vesicle which refused to flatten out after rest in bed. The hole in the macula lutea was round with sharp edges, as if stamped out. Two electrolytic punctures were made in the posterior pole, in order to evacuate the subretinal fluid before beginning the actual operation. To my surprise, on the second day after what I had regarded as a preliminary procedure, the retina had completely adhered. The aperture in the macula then became covered with a delicate exudate like a fine veil, and later quite disappeared.The detachment healed completely and permanently, the visual acuity on discharge being 6/18, and 5 years after the operation 6/12.This case showed me that a tear in the macula could be cured and closed by cauterization not of the macula itself but of its surroundings.Case 2, a woman aged 52, had a traumatic retinal detachment with a hole in the macula lutea in her only remaining eye. The detachment occurred after the patient had fallen and struck her head on the pavement. A primary electrolytic-diathermy operation gave no result, but a cure was obtained by means of a special diathermy electrode, curved to fit the circumference of.the eyeball. With this electrode, two cauterizations of the retina were performed in the region of the macula lutea. The detachment was permanently cured, and the visual acuity was 6/24 with -2 D sph., -2 D cyl., axis 150. This electrode, although useful, did not give complete satisfaction, since the straight section of the instrument passed gradually into the curved section. For this reason I could not calculate the exact distance of the coagulation *

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New Method of Operation for Detachment of the Retina With Tearing of the Macula Lutea

Madroszkiewicz¹

1958

British Journal of Ophthalmology

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Anwendung der Elektrochirurgie am Auge

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New Method of Operation for Detachment of the Retina With Tearing of the Macula Lutea

New Method of Operation for Detachment of the Retina With Tearing of the Macula Lutea

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