Studies of the Effect of Roentgen Rays on the Healing of Wounds

Pohle, Ernst A.; Ritchie, Gorton

doi:10.1148/20.2.102

Cited by 8 publications

(1 citation statement)

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“…It is interesting to note how rapidly the state of the fibroblasts must change following surgical injury, because radiotherapy one day prior to incision does not influence the repair, and yet treatment immediately after incision does have an effect. 34 In fistulising surgery, particularly in children, Figure 5 Decay path ofstrontium-90 showing emission and energy of particles which are electrons ofnegligible mass and one negative charge, and therefore rapidly slowed down when passing through tissues. the application of the radiation source is very convenient immediately after surgery.…”

Section: Timing Of Irradiationmentioning

confidence: 99%

Trabeculectomy combined with beta irradiation for congenital glaucoma.

Miller

Rice

1991

British Journal of Ophthalmology

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Sixty-six eyes with congenital glaucoma were subjected to trabeculectomy between July 1975 and June 1989 are presented. Thirty-one were treated with (3 irradiation at the time of surgery with a strontium-90 applicator; 35 were not treated with 13 irradiation. The usual dose was 750 rad. Analysis was limited to three years because of the shorter follow-up of the irradiated eyes. Failure in the two groups was compared statistically. When failure was categorised as IOP >21 mm Hg, 13 irradiation was found to be significantly protective with an adjusted risk ratio of 0*31 (95% confidence interval 0.11-090, p<005). Failure categorised as the need for additional medical treatment or further surgery showed significant protection with an adjusted risk ratio of 0*33 (confidence interval 0-12-0-94, p<0-05). Multiple regression models were used for the analysis ofintraocular pressure; 13 irradiation was associated with a significantly lower IOP at six months, one year, and three years (p<005). Other factors identified as being associated with a reduced failure rate or lower IOP were: no previous topical glaucoma medications: age over seven years; lack of previous surgery involving the conjunctiva. The results indicate that 13 irradiation may have a beneficial effect on the prognosis of trabeculectomy in children with congenital glaucoma. However, because of the retrospective and observational nature of the study, the results must be regarded as tentative.3 Irradiation has been used intermittently in glaucoma fistulising surgery for many years,9-6 but all reports were of small numbers of patients, and the irradiation tended to be used in mixed groups ofpatients with poor prognosis. There are no convincing data from these studies to suggest that 13 irradiation improves control of the IOP, and so the technique has not gained popularity.Animal studies on the effect of irradiation on the healing of skin wounds'7 showed reduced numbers of fibroblasts and reduced collagen, and the fibroblast activity was delayed. Animal studies on fistulising surgery' 18 and corneal or scleral wounds'"2' have also demonstrated reduced fibroblast proliferation and reduced collagen formation, so that the authors speculate that irradiation may benefit fistulising surgery. In addition the bleb survival was extended in rabbits. 18 In this report the results of66 trabeculectomies performed in children with congenital glaucoma are presented; 31 of these procedures were accompanied by treatment with 13 irradiation. In this retrospective analysis we show that a statistically significant improvement in IOP control was achieved in the group treated with 13 irradiation, and the rate of failure was significantly reduced. The retrospective collection of data from a period of 14 years means that variables other than 13 irradiation may have been changing. An attempt has been made to incorporate some of these into the analysis, but the study cannot take account ofall factors which might influence the results of surgery.

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Section: Timing Of Irradiationmentioning

confidence: 99%