Purpose: To demonstrate a new method of therapy of glaucoma.The first ever use of Leksell gamma knife (LGK) in treatment of advanced glaucoma is reported.
Methods: Leksell gamma knife was used in treating a group of 30 patiens/32 eyes with advanced glaucoma. The irradiation was centered on the ciliary body. In the first group (6 eyes) the radiation was focused to the front part of the ciliary body and center dose of 28 Gy was used. In the second group (26 eyes) we moved the radiation backward to the ciliary processes with a more circular distribution of radiation and the dose was increased to 40 Gy.
Results:
Postoperatively the irradiated eyes were without pain and irritation already during the first month. First group:
Mean preoperative IOP: 45,3+/-7,9 mmHg.
Mean postoperative IOP: 25,2+/-9,6 mmHg. (l eye remains with uncorrected IOP)
Second group:
Mean preoperative IOP: 40,2+/-9,6 mmHg.
Mean postoperative IOP: 19,7+/-8,6 mmHg. (the IOP was reduced in all eyes of this group)
Conclusions: Irradiation of the ciliary body by LGK is a new method in patients with advanced glaucoma. Radiosurgical irradiation of the ciliary body ameliorated the IOP and severe ocular pain was reduced considerably in all treated patients. Our two-year conclusions show good effects in treatment of advanced glaucomas and are very promising.