{"id":2169,"date":"2020-03-16T15:40:48","date_gmt":"2020-03-16T15:40:48","guid":{"rendered":"http:\/\/gvcoftalmologia.com\/laser-glaucoma\/"},"modified":"2020-03-16T15:40:48","modified_gmt":"2020-03-16T15:40:48","slug":"laser-glaucoma","status":"publish","type":"post","link":"https:\/\/gvcoftalmologia.com\/ca\/laser-glaucoma\/","title":{"rendered":"L\u00e0ser glaucoma"},"content":{"rendered":"

Article de la Dra. Diana Mora<\/em><\/p>\n

\n

TRABECULOPLASTIA L\u00c0SER<\/strong><\/p>\n

En alguns pacients que pateixen glaucoma d’angle obert s’utilitza el l\u00e0ser com una alternativa per a disminuir la pressi\u00f3 intraocular (PIO) quan el tractament amb gotes \u00e9s insuficient o no responen
\nadequadament, o abans de decidir operar. La trabeculoplastia amb l\u00e0ser \u00e9s una alternativa terap\u00e8utica
\nsegura i efica\u00e7 en aquests pacients i en alguns casos de glaucoma secundari d’angle obert.\u00a0 <\/span>Aquesta
\nt\u00e8cnica millora el drenatge de la malla trab\u00e8cular i disminueix al seu torn la pressi\u00f3 intraocular.<\/p>\n

Existeixen dos tipus de trabeculoplastia:<\/em><\/p>\n

(i) amb l\u00e0ser d’arg\u00f3, l’efecte del qual hipotensor se sustenta en la modificaci\u00f3 de l’estructura de la trab\u00e8cula (reixeta per on filtra l’humor aqu\u00f3s). Redueix la PIO fins un 25% i \u00e9s efica\u00e7 en prop del 75% dels pacients.<\/p>\n

(ii) selectiva, amb l\u00e0ser neodimi yag (Nd:YAG) que actua espec\u00edficament en les c\u00e8l\u00b7lules pigmentades de la trab\u00e8cula a pot\u00e8ncies baixes d’energia. S’han observat reduccions de la PIO del 20-25% en els pacients amb una taxa d’\u00e8xit continuada de fins al 75% als 2.5 anys.<\/p>\n

Aquest procediment es realitza en la mateixa consulta sota anest\u00e8sia t\u00f2pica, amb l’ajuda d’una lent de contacte amb mirall que s’acobla a l’ull i enfoca el raig del l\u00e0ser en l’estructura espec\u00edfica de l’angle de la c\u00e0mera anterior a tractar. Les mol\u00e8sties despr\u00e9s de l’anest\u00e8sia solen ser m\u00ednimes i es requereix de tractament antiinflamatori t\u00f2pic els dies seg\u00fcents a la intervenci\u00f3.<\/p>\n

IRIDOTOMIA PERIF\u00c8RICA<\/strong><\/p>\n

La iridotomia perif\u00e8rica amb l\u00e0ser Nd:YAG est\u00e0 indicada en els pacients amb angle camerular (format
\nper la c\u00f2rnia i l’iris en la seva part perif\u00e8rica) estret i en les formes prim\u00e0ries i secund\u00e0ries de glaucoma
\nd’angle estret. Consisteix a realitzar un orifici petit en la porci\u00f3 perif\u00e8rica de l’iris per a facilitar el pas de l’humor aqu\u00f3s a l’interior de l’ull des de la c\u00e0mera posterior cap a la c\u00e0mera anterior de l’ull i aix\u00ed augmentar l’amplitud de l’angle camerular . Amb aix\u00f2 es busca: (I) facilitar el drenatge de l’humor aqu\u00f3s i (II) evitar un bloqueig pupil\u00b7lar que pugui desencadenar una hipertensi\u00f3 ocular aguda secund\u00e0ria (el que
\npopularment \u00e9s mal anomenat glaucoma agut) que pot comportar un mal irreversible del nervi \u00f2ptic i\/o la
\ntransformaci\u00f3 en un glaucoma cr\u00f2nic d’angle estret de dif\u00edcil tractament.<\/p>\n

Aquest procediment es realitza en la mateixa consulta sota anest\u00e8sia t\u00f2pica, amb l’ajuda d’una lent de contacte amb mirall que s’acobla a l’ull i enfoca el raig del l\u00e0ser en l’\u00e0rea de l’iris a tractar.\u00a0 <\/span>Les mol\u00e8sties despr\u00e9s de l’anest\u00e8sia solen ser m\u00ednimes i es requereix de tractament antiinflamatori t\u00f2pic els dies
\nseg\u00fcents a la intervenci\u00f3.<\/p>\n

CICLOFOTOCOAGULACI\u00d3<\/strong><\/p>\n

Consisteix en la destrucci\u00f3 del cos ciliar mitjan\u00e7ant la coagulaci\u00f3 del teixit impactat pel raig l\u00e0ser, la qual cosa produeix una disminuci\u00f3 de la producci\u00f3 d’humor aqu\u00f3s i la seva vegada la disminuci\u00f3 de la PIO. Es realitza amb anest\u00e8sia retro bulbar en quir\u00f2fan.\u00a0 <\/span>\u00c9s una t\u00e8cnica alternativa a la cirurgia filtrant que sol utilitzar-se en situacions molt determinades.<\/p>\n","protected":false},"excerpt":{"rendered":"

Article de la Dra. Diana Mora TRABECULOPLASTIA L\u00c0SER En alguns pacients que pateixen glaucoma d’angle obert s’utilitza el l\u00e0ser com una alternativa per a disminuir la pressi\u00f3 intraocular (PIO) quan el tractament amb gotes \u00e9s insuficient o no responen adequadament, o abans de decidir operar. La trabeculoplastia amb l\u00e0ser \u00e9s una alternativa terap\u00e8utica segura i […]<\/p>\n","protected":false},"author":2,"featured_media":1473,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[60,63],"tags":[],"class_list":["post-2169","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","category-dra-diana-mora-ca"],"yoast_head":"\nL\u00e0ser glaucoma - gvcoftalmologia.com<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gvcoftalmologia.com\/ca\/laser-glaucoma\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"L\u00e0ser glaucoma - gvcoftalmologia.com\" \/>\n<meta property=\"og:description\" content=\"Article de la Dra. Diana Mora TRABECULOPLASTIA L\u00c0SER En alguns pacients que pateixen glaucoma d’angle obert s’utilitza el l\u00e0ser com una alternativa per a disminuir la pressi\u00f3 intraocular (PIO) quan el tractament amb gotes \u00e9s insuficient o no responen adequadament, o abans de decidir operar. 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