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Abstract #10170 Published in IGR 6-1
Trans-scleral diode laser cyclophoto-coagulation in the treatment of diabetic neovascular glaucoma
Nabili S; Kirkness CMEye 2004; 18: 352-356
AIMS: To assess efficacy of transscleral diode laser cyclophotocoagulation in the treatment of diabetic neovascular glaucoma refractory to medical therapy. METHODS: Case notes of 20 eyes of 20 patients who had the treatment were analyzed. The mean follow-up after initial treatment was 22.5 months (range of 18-24). RESULTS: Mean (SD) pretreatment intraocular pressure (IOP) for the 20 eyes was 34.4 mmHg (9.5), reducing to 18.2 mmHg (12.4) at the final index visit (p = 0.0001). The mean (SD) number of topical antiglaucoma medication was significantly lowered from 3.9 (0.3) to 1.2 (1.3). Four patients had visual acuity of 6/60 or better before the treatment. Two of them maintained the same level of vision and the other two had their vision reduced over the course of study; however, none of them deteriorated beyond 6/60. Six out of the remaining 16 patients who had vision of counting fingers or worse before treatment progressed to no perception of light at the final index visit. The mean (SD) number of treatment sessions was 1.45 (0.68). A total of ten patients had previous pars plana vitrectomy (PPV). Patients with two or more PPVs developed hypotony (IOP ≤ 5). There were five eyes with hypotony, one of which became phthisical. CONCLUSIONS: Transscleral diode laser cyclophotocoagulation is a useful tool in the management of diabetic neovascular glaucoma. The current treatment regime needs to be adjusted to reflect higher risk of hypotony and phthisis in diabetic neovascular glaucoma in eyes that have had multiple pars plana vitrectomies.
Dr. S. Nabili, The Tennent Institute of Ophthalmology, University of Glasgow, Gartnavel General Hospital, Glasgow, UK
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
