OPHTHALMIC OPHTHALMIC INDICATIONS:INDICATIONS:GK SURGERYGK SURGERY
Dr Deepak AgrawalDr Deepak AgrawalAssistant Professor,Assistant Professor,
Department of Neurosurgery & Gamma Knife,Department of Neurosurgery & Gamma Knife,All India Institute of Medical Sciences, New All India Institute of Medical Sciences, New
DelhiDelhi
Ophthalmic indications of GK
INDICATIONSINDICATIONS Uveal melanomasUveal melanomas Eye metastasesEye metastases Advanced glaucomaAdvanced glaucoma Age-related macular degeneration Age-related macular degeneration
(ARMD)(ARMD) HemangioblastomaHemangioblastoma AngioreticulomaAngioreticuloma PseudotumorsPseudotumors Vegetative pain. Vegetative pain.
Ophthalmic indications of GK
EYE IMMOBILIZATIONEYE IMMOBILIZATION
Retrobulbar anesthetic block of 2.5 Retrobulbar anesthetic block of 2.5 ml mepivacain and 2.5 ml ml mepivacain and 2.5 ml bupivacaine bupivacaine
Transconjunctival fixation of the four Transconjunctival fixation of the four rectus muscles and fixation of the rectus muscles and fixation of the sutures to the stereo-tactic framesutures to the stereo-tactic frame
Ophthalmic indications of GK
POSITIONINGPOSITIONING
The radiosurgical procedure is The radiosurgical procedure is usually performed with the patient in usually performed with the patient in the prone position the prone position
Ophthalmic indications of GK
UVEAL MELANOMAUVEAL MELANOMA
Fakiris AJ et al. Fakiris AJ et al. Gamma-knife-based Gamma-knife-based stereotactic radiosurgery for uveal stereotactic radiosurgery for uveal melanoma.melanoma. Stereotact Funct Stereotact Funct Neurosurg. 2007;85(2-3):106-12Neurosurg. 2007;85(2-3):106-12
40 Gy prescribed to the 50% 40 Gy prescribed to the 50% isodose line for all patientsisodose line for all patients
The 3- and 5-year tumor control The 3- and 5-year tumor control rates were both 94% rates were both 94%
Ophthalmic indications of GK
Ophthalmic indications of GK
Ophthalmic indications of GK
Ophthalmic indications of GK
Ophthalmic indications of GK
Ophthalmic indications of GK
ACCURACYACCURACY
Novotný J, Novotný J, Lišcák R, Novotný J, Novotný J, Lišcák R, Spevácek V, Hrbácek J, Dvorák P, Spevácek V, Hrbácek J, Dvorák P, Cechák T, Tintera J, Vymazal J, Cechák T, Tintera J, Vymazal J, Vladyka V. Vladyka V. Assessment of the Assessment of the Accuracy in Ophthalmic Accuracy in Ophthalmic RadiosurgeryRadiosurgery. Kondziolka D (ed): . Kondziolka D (ed): Radiosurgery. Basel, Karger, 2006, Radiosurgery. Basel, Karger, 2006, vol 6, pp 71-85vol 6, pp 71-85
Ophthalmic indications of GK
COMPLICATION AVOIDANCECOMPLICATION AVOIDANCE
Ophthalmic indications of GK
GlaucomaGlaucoma
chronic painful glaucoma refractory chronic painful glaucoma refractory to medical treatmentto medical treatment
Ophthalmic indications of GKTHANK YOUTHANK YOU
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