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OPHTHALMIC INDICATIONS: GK SURGERY Dr Deepak Agrawal Assistant Professor, Department of Neurosurgery & Gamma Knife, All In...
INDICATIONS <ul><li>Uveal melanomas </li></ul><ul><li>Eye metastases </li></ul><ul><li>Advanced glaucoma </li></ul><ul><li...
EYE IMMOBILIZATION <ul><li>Retrobulbar anesthetic block of 2.5 ml mepivacain and 2.5 ml bupivacaine  </li></ul><ul><li>Tra...
POSITIONING <ul><li>The radiosurgical procedure is usually performed with the patient in the prone position  </li></ul>
UVEAL MELANOMA <ul><li>Fakiris AJ et al.  Gamma-knife-based stereotactic radiosurgery for uveal melanoma.  Stereotact Func...
 
 
 
 
 
ACCURACY <ul><li>Novotný J, Novotný J, Lišcák R, Spevácek V, Hrbácek J, Dvorák P, Cechák T, Tintera J, Vymazal J, Vladyka ...
COMPLICATION AVOIDANCE
Glaucoma <ul><li>chronic painful glaucoma refractory to medical treatment </li></ul>
THANK YOU
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Ophthalmic indications of_gk

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Ophthalmic indications of_gk

  1. 1. OPHTHALMIC INDICATIONS: GK SURGERY Dr Deepak Agrawal Assistant Professor, Department of Neurosurgery & Gamma Knife, All India Institute of Medical Sciences, New Delhi
  2. 2. INDICATIONS <ul><li>Uveal melanomas </li></ul><ul><li>Eye metastases </li></ul><ul><li>Advanced glaucoma </li></ul><ul><li>Age-related macular degeneration (ARMD) </li></ul><ul><li>Hemangioblastoma </li></ul><ul><li>Angioreticuloma </li></ul><ul><li>Pseudotumors </li></ul><ul><li>Vegetative pain. </li></ul>
  3. 3. EYE IMMOBILIZATION <ul><li>Retrobulbar anesthetic block of 2.5 ml mepivacain and 2.5 ml bupivacaine </li></ul><ul><li>Transconjunctival fixation of the four rectus muscles and fixation of the sutures to the stereo-tactic frame </li></ul>
  4. 4. POSITIONING <ul><li>The radiosurgical procedure is usually performed with the patient in the prone position </li></ul>
  5. 5. UVEAL MELANOMA <ul><li>Fakiris AJ et al. Gamma-knife-based stereotactic radiosurgery for uveal melanoma. Stereotact Funct Neurosurg. 2007;85(2-3):106-12 </li></ul><ul><li>40 Gy prescribed to the 50% isodose line for all patients </li></ul><ul><li>The 3- and 5-year tumor control rates were both 94% </li></ul>
  6. 11. ACCURACY <ul><li>Novotný J, Novotný J, Lišcák R, Spevácek V, Hrbácek J, Dvorák P, Cechák T, Tintera J, Vymazal J, Vladyka V. Assessment of the Accuracy in Ophthalmic Radiosurgery . Kondziolka D (ed): Radiosurgery. Basel, Karger, 2006, vol 6, pp 71-85 </li></ul>
  7. 12. COMPLICATION AVOIDANCE
  8. 13. Glaucoma <ul><li>chronic painful glaucoma refractory to medical treatment </li></ul>
  9. 14. THANK YOU

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