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Abstract #15598 Published in IGR 1-3
Treatment of refractory glaucoma with trans-scleralcyclo-photocoagulation using a diode laser
Detry-Morel M; Gilon BBulletin de la Société Belge d'Ophtalmologie 1999; 272: 45-52
PURPOSE: The aim of this prospective study was to evaluate the clinical and IOP efficacy of transscleral contact cyclophotocoagulation with a diode laser in refractory glaucoma. MATERIALS AND METHODS: 33 patients (mean age: 52.2 years, range: one to 82 years) suffering from neovascular glaucoma (n=9), silicone oil-induced glaucoma (n=9) or miscellaneous glaucoma (n=15) were included in this prospective non-randomized study. The mean actual follow-up was 4.9 months (1-12 months). A contact diode laser using the Oculight Six Diode laser system emitting at 810 nm with the G probe delivery (Iris Medical Instruments) was used. Cyclophotocoagulations were performed under local anesthesia in an outpatient setting (n=26) on 270° of the circumference of the ciliary body (n=28) with the recommended parameters. The success criteria were an IOP of less than 22 mmHg with the same visual acuity, without pain and ocular inflammation. RESULTS: Except for one hypotonous eye at one month, no postoperative complications were observed. The pain was mild to moderate in the first postoperative days in the most cases. The ocular inflammation was mild and transitory. The mean preoperative IOP was 38.8 mmHg (range, 25-60 mmHg) and was reduced to 22.2 mmHg (0-50 mmHg) at the last examination. For all the patients, the IOP reduction was only significant at one and three months. The medication was reduced in 54.5%. According to the authors' success criteria, there were 15 failures and seven retreatments. Failures were more frequent in neovascular glaucoma (n=6/9 eyes). Nevertheless, silicone oil induced glaucomas had the lowest IOP at the last examination (mean IOP, 16.4 mmHg; range, 12-32 mmHg) and the highest success rate (n=7/9 eyes). CONCLUSION: This study confirms the findings of previous studies and shows that diode laser cyclophotocoagulation is a simple, effective and relatively safe procedure compared to other cycloablation techniques.
Dr. M. Detry-Morel, Clinique Universitaires, St. Luc Universités, Catholique de Louvain, Brussels; Belgium
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
