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Miscellaneous (32)

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Abstract #46895 Published in IGR 13-3

Diode laser cyclophotocoagulation versus cyclocryotherapy in the treatment of refractory glaucoma

Tzamalis A; Pham D-T; Wirbelauer C
European Journal of Ophthalmology 2011; 21: 589-596

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Purpose. The aim of the present study was to evaluate the efficacy of diode laser cyclophotocoagulation (DCPC) and cyclocryotherapy (CCT) in the treatment of refractory glaucoma and compare the postoperative complications and discomfort rates. Methods. In a prospective, randomized, controlled clinical study, 40 eyes of 40 patients with refractory glaucoma were randomly assigned in 2 groups of 20 eyes each to receive either DCPC or CCT. Patients underwent follow-up examinations on the first 3 days and then 1 week and 1, 3, 6, and 12 months after initial treatment. Complications and discomfort after treatment using a visual pain analogue scale were recorded. Results. In the DCPC group, the mean intraocular pressure (IOP) decreased (p<0.05) from 44.3(plus or minus)16.4 mmHg preoperatively to 24.1(plus or minus)7.6 mmHg, 22.8(plus or minus)5.6 mmHg, and 22.5(plus or minus)5.1 mmHg 3, 6, and 12 months posttreatment, respectively. Regarding the CCT group, the mean IOP was reduced (p<0.05) from 46.5(plus or minus)10.4 mmHg to 26.6(plus or minus)12.2 mmHg, 21.2(plus or minus)7.7 mmHg, and 20.6(plus or minus)5 mmHg at the same time intervals. In the DCPC group, the mean IOP reduction was strongly correlated with the number of laser effects (r=0.65; p<0.01), but 35% needed retreatments. The mean postoperative pain was 5.6(plus or minus)2.9 (DCPC) vs 5.7(plus or minus)2.3 (CCT) (p=0.91). No severe complications were observed. Conclusions. Both DCPC and CCT proved to be safe and effective IOP-lowering methods in patients with refractory glaucoma. Diode laser cyclophotocoagulation should be considered as the primary treatment option in refractory glaucoma using an individual treatment dosage.

A. Tzamalis. Second Department of Ophthalmology, Papageorgiou General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece.

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Classification:

12.10 Cyclodestruction (Part of: 12 Surgical treatment)

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