Using the hypertensive gas technique, before touching the melanoma eye for enucleation intraocular pressure is raised to maximum by an intravitreal gas injection (average 1.2 ml of perfluorocarbon or air), resulting in a rock-hard eye. Changes in intraocular pressure are no longer possible, since the hard eye condition and avascularity persist during enucleation. The vortex veins appear collapsed. Before cutting the optic nerve and vessels, they are compressed by a broad hemostatic clamp for three minutes and then severed by a blade located in the middle of the clamp. With the hypertensive gas technique there is neither bleeding of vortex veins nor of proximal end of stump, which continues to be compressed by the hemostatic clamp. Fifteen patients with choroidal melanomas were enrolled in a prospective study with the hypertensive gas technique from 9/1987 to 6/1989; prior radiotherapy was not performed. Average base diameter of melanoma measured 13.2 mm, height 8.4 mm. Cytology was: 11x spindle, 3x mixed, 1x epitheloid cells. At reexamination in 7/1991 (average follow-up 2.75 years), 2 diabetics had died with no detectable metastases, and 1 of the 15 melanoma patients (6.7%) had died with metastases 2 years after enucleation. The hypertensive gas technique does not postpone enucleation of a melanoma eye while presumed prophylaxis is administered, does not require additional instruments, and takes only a minute when the eye is already draped for surgery. The firm and avascular globe facilities a faster removal of the melanoma eye with practically no bleeding from the bulb.

• MeSH
• dospělí MeSH
• enukleace oka metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• melanom chirurgie   MeSH
• nádory oka chirurgie   MeSH
• nitrooční tlak MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

The authors give an account of the favourable results in 10 patients to whom after enucleation of the eye an implant prepared from adipose tissue from the planta pedis or its adipose tissue was used for correction of an excessive orbitopalpebral groove after enucleation. The material is easily available, readily shaped and well tolerated.

• MeSH
• dospělí MeSH
• enukleace oka metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• noha (od hlezna dolů) MeSH
• senioři MeSH
• tuková tkáň transplantace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH