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Abstract #21228 Published in IGR 10-2
Visual loss after transscleral diode laser cyclophotocoagulation for primary open-angle and neovascular glaucoma
Pokroy R; Greenwald Y; Pollack A; Bukelman A; Zalish MOphthalmic Surgery Lasers and Imaging 2008; 39: 22-29
BACKGROUND AND OBJECTIVE: Varying incidences of visual loss after transscleral diode laser cyclophotocoagulation for uncontrolled intraocular pressure (IOP) have been reported. This study compared the treatment response in primary open-angle (POAG) and neovascular (NVG) glaucoma, particularly regarding vision loss. PATIENTS AND METHODS: Case notes of consecutive patients who underwent transscleral diode laser cyclophotocoagulation between March 2001 and September 2005 were retrospectively reviewed. A diagnosis of POAG or NVG and at least 6 months of follow-up were required for inclusion. Conservative laser parameters were used. The treatment response of the POAG and NVG groups was compared. RESULTS: Twenty-five eyes of 23 patients with POAG and 14 eyes of 14 patients with NVG were studied. Mean follow-up was 22.4 and 12.9 months in the POAG and NVG groups, respectively. Post-treatment, both groups had significant reduction in mean IOP of 7.3 (29.2%) and 13.2 (36.6%) mmHg, respectively (between group P = .18). One eye in each group had mild hypotony of 4 mmHg, and no eyes became phthisical. Oral acetazolamide treatment was significandy reduced in both groups. Visual acuity post-treatment decreased in both groups; the POAG eyes had better initial visual acuity and lost more visual acuity. Nine of 25 (36%) POAG and 4 of 8 (50%) NVG eyes lost 2 or more LogMAR lines. CONCLUSIONS: Transscleral diode laser cyclophotocoagulation reduced IOP and medication requirements in POAG and NVG. Patients should be warned that visual loss may occur, especially in end-stage glaucoma.
Dr. R. Pokroy, Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
9.2.3 Open angle glaucoma with elevated IOP (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
6.20 Progression (Part of: 6 Clinical examination methods)
