Nd YAG LASER treatment for leukemic childhood blindness

الملخص

Aim of the study: is to study the rule of laser therapy by the (Nd-YAG) laser in the treatment of premacular haemorrhage in leukemic children
Method:
It is a prospective study was taken in department of ophthalmology in al hilla teaching hospital .eleven eyes of eight children 3 girls and 5 boys age between 7-14 years old and they have premacular haemorrhage due to leukaemia .family permission was taken after explaining to the family the surgical procedure .topical anesthesia by lidocaine and pupil dilatation by mydriacil and the Goldman 3 mirror and Nd –YAG laser was delivered the power was 5 mj and increased by 1 mj when the desired response not gained and the power should not exceed 11mj and the number of shoots should not exceed 10 per section and the pt was followed after 1 week then after 6 weeks then after 3 months.
Results:
Drainage of the premacular hemorrhage into the vitreous happened in 9 eyes of 11eyes after the end of the follow up period which is 3 months The mean force used was 6.5 mj.
After 1 week the improvement in VA was between hand movement and 6/6 and the mean was 6/18
After 6 weeks the improvement in VA was between hand movement and 6/6 and the mean was 6/9
There is no big difference in improvement in VA after 3 months to that after 6 weeks
One pt who had lymphoblastic leukemia had clotted hemorrhage that could not be drained into the vitreous
And another pt who had myeloid leukemia had re-hemorrhage as a result of deterioration in his illness
Conclusion:
From the result of this study we can see that the use of Nd-YAG laser in the treatment of leukemic pts with premacular hemorrhage is safe and effective in comparing with parsplana vitrectomy under GA specially when we use good selection of pt especially those with bilateral premacular hemorrhage and we can consider the Nd-YAG laser as a routine therapy for the leukemic children with premacular hemorrhage.