Treatment of Advanced Glaucomas Using Leksell Gamma Knife (LGK)--A Pilot Clinical Study

Abstract

The use of radiosurgery in treatment of the glaucomas is a completely new way of treating advanced stages of this treacherous disease. Up to now, the most common indications for the LGK therapy in ophthalmology at our department are malignant melanoma, vascular diseases, intraocular and intraorbital metastasis, and glioma of the optic nerve. Our pilot study shows that focal irradiation of the ciliary body in advanced glaucoma can ameliorate the main symptoms and thus prevent the otherwise inevitable enucleation of the eye. We treated in 12 patients, 13 very painful eyes, who were blind or with very diminished vision, and where the conventional treatment was ineffective. The ocular pain was alleviated in all patients and their intraocular pressure was reduced or normalized. There were no early side effects. Further studies are needed to elucidate the best treatment parameters and the involved pathophysiological mechanisms. However, it is evident that gamma knife radiosurgery can be considerably extended in this way.