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Abstract #15306 Published in IGR 8-4
Refractory glaucoma - tube or diode?
Malik R; Ellingham RB; Suleman H; Morgan WHClinical and Experimental Ophthalmology 2006; 34: 771-777
BACKGROUND: The aim of the present study was to assess the relative effectiveness of tube surgery and cyclodiode laser in terms of achieving intraocular pressure control. METHODS: A retrospective study was undertaken to compare patients undergoing double plate Molteno tube implantation with patients undergoing diode cyclophotocoagulation. Intraocular pressure (IOP) was documented at 7 days prior to surgery and postoperatively at various time points. Surgical success was defined as a final IOP between 6 (inclusive) and 21 mmHg (inclusive), without the use of topical medication, while 'qualified' success was defined as IOP within the same range with the use of topical medication. RESULTS: Twenty-eight diode patients and 26 tube patients were included for the study. An average follow up of 150 weeks (range = 21-322 weeks) was available. Mean preoperative IOP was 37 ± 12 mmHg for the tube group and 39 ± 16 mmHg for the diode group (t = 0.51, P = 0.61). The final IOP was 17 ± 12 mmHg for the tube group and 21 ± 13 mmHg for the diode group (t = 0.35, P = 0.73). Surgical success was achieved in 46% of tube eyes and 11% of diode eyes, while qualified success was achieved in 81% of tube eyes compared with 64% of eyes in the diode group. Two eyes which underwent diode became phthisical. CONCLUSIONS: IOP control may be achieved in a greater number of patients with tube surgery. The possible benefits of IOP control in diode patients need to be weighed against the risks of long-term visual loss and the need for multiple re-treatments in this group.
Dr. R. Malik, Bristol Eye Hospital, Bristol, UK. rzmalik@doctors.org.uk
Classification:
12.1 General management, indication (Part of: 12 Surgical treatment)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
