Secondary Glaucoma Treatment by Means of Leksell Gama Knife

Overview

The authors followed up 107 eyes of 103 patients with the diagnosis of painful secondary glaucoma treated by irradiation of the ciliary body by means of Leksell gama knife (LGK Elekta Instruments AB). The goal was to decrease patient’s subopejective problems in to the treatment resistant and painful stages using non-invasive stereo tactic neurosurgical procedure. The final version of the irradiation schedule uses 8 mm collimators and the irradiation dose in blind eyes is 40 Gy at the maximum and 20 Gy at the peripheral treating 50 % isodose; in partly sighted eyes it is 30 Gy at the maximum and 15 Gy at the peripheral treating 50 % isodose. The follow up period was 3–80 months, (average 26 months). The lowering of the intraocular pressure to the not painful level was achieved in 56 eyes (52.2 %) during the period of 1–8 weeks (median 4 weeks). The total disappearing of the pain after the treatment was noticed in 71 eyes (66.4 %), partial reduction of the pain in 31 eyes (29 %), and no effect was observed in 5 eyes. In all cases of neovascularization at least some decrease was noticed. The antiglaucomatous therapy was reduced in 42 patients (39.3 %) 2–3 months after the irradiation, unchanged remained in 51 patients (47.7 %). The stereotactic radiosurgical destruction of the ciliary body by means of Leksell gama knife, may reduce the pain, the intraocular pressure, and extensive medicament treatment in secondary painful glaucoma.

Key words:
secondary glaucoma, Leksell gama knife, radiosurgery