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Abstract #18271 Published in IGR 3-3
Diode laser trans-scleral cyclophotocoagulation for glaucoma following silicone oil removal
Kumar A; Dada T; Singh RP; Kedar SClinical and Experimental Ophthalmology 2001; 29: 220-224
PURPOSE: To evaluate the effect of transscleral cyclophotocoagulation (TSCP) on intraocular pressure (IOP) in eyes with medically uncontrolled secondary glaucoma persisting after intravitreal silicone oil removal. METHODS: The clinical records of 21 eyes of 21 patients who underwent TSCP for medically uncontrolled glaucoma persisting after the removal of intravitreal silicone oil, injected during vitreoretinal surgery for proliferative vitreoretinopathy (PVR), were reviewed retrospectively. Diode laser contact TSCP was applied at a power setting of 1.5-2.5 W, for a maximum duration of two seconds, and a total of 40 spots (ten spots in each quadrant). All the patients were evaluated for visual acuity, IOP and number of medications used. RESULTS: The patients were followed up for a mean ± SD period of 39.9 ± 4.27 weeks (range, 36-48 weeks). IOP was found to have decreased significantly from a pretreatment value of 34.5 ± 5.37 mmHg (range, 24-44 mmHg) to 20.47 ± 4.49 mmHg at six months of follow-up (range, 12-30 mmHg, p < 0.01, Student's paired t test). The total number of glaucoma medications being used reduced from 3.38 ± 0.5 to 1.08 ± 0.80 postoperatively (p < 0.01, Wilcoxon's rank sum test). There was no significant difference in the visual acuity before and after the procedure. Thirteen eyes required a second sitting of TSCP, and five of these required a third sitting. For a successful outcome (IOP < 24 mmHg), a mean of 1.56 sittings (range, one to three sittings) per eye were needed. CONCLUSIONS: Patients with medically uncontrolled glaucoma persisting after intravitreal silicone oil removal can be treated with TSCP; however, the reduction of IOP is variable. The IOP usually falls after a mean of two to three sittings of TSCP.
Dr A. Kumar, Malcha Marg, Chanakyapuri, New Delhi 110029, India. akum66mm@ndf.vsnl.net.in
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)