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Abstract #3647 Published in IGR 4-2
Sequential or simultaneous cyclophotocoagulation and glaucoma drainage implant for refractory glaucoma
Shields SR; Chen PJournal of Glaucoma 2002; 11: 203-208
PURPOSE: To describe the outcomes of combining cyclophotocoagulation and tube-shunt glaucoma drainage implants, either sequentially or simultaneously, for the control of refractory glaucomas. PATIENTS AND METHODS: A retrospective review was conducted of all patients that had been treated at the authors 'institute with both cyclophotocoagulation and a tube-shunt glaucoma drainage implant in the same eye between January 1996 and June 2000. Preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, vision, and complications data were collected for each eye. RESULTS: A total of ten eyes of nine patients met the study criteria. The minimum follow-up period after the last surgery was 15 months. IOP was reduced from 28.5 ± 7.2 mmHg preoperatively to 13.9 ± 5.4 mmHg postoperatively at 15 months (p < 0.000, n = 9). Medications were reduced from 2.7 ± 1.2 preoperatively to 0.3 ± 0.5 postoperatively at 15 months (p < 0.000, n = 9). Of the eight eyes with measurable Snellen acuity, postoperative vision decreased two or more lines in five eyes (63%). Complications included transient hypotony (one eye), transient serous choroidal detachment (two eyes), cystoid macular edema (two eyes), corneal edema (three eyes), and panuveitis with chronic hypotony and traction retinal detachment (one eye). CONCLUSIONS: Combining cyclophotocoagulation with tube-shunt glaucoma drainage implants can effectively reduce IOP and number of glaucoma medications needed to achieve target IOP goals. Further study is needed to determine the safety of this combined approach compared with other available options to manage refractory glaucomas.
Dr. S.R. Shields, St Louis University Eye Institute, St Louis, MO 63104, USA. shields@slu.edu
Classification:
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)
