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Abstract #9008 Published in IGR 5-2
Long-term results of noncontact neodymium:yttrium-aluminum-garnet cyclophotocoagulation in neovascular glaucoma
Delgado MF; Dickens CJ; Iwach AG; Novack GD; Nychka DS; Wong PC; Nguyen NOphthalmology 2003; 110: 895-899
PURPOSE: To determine the long-term efficacy and safety of noncontact transscleral Nd:YAG cyclophotocoagulation (CP) for the treatment of neovascular glaucoma (NVG). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: One hundred and fifteen eyes of 111 subjects treated from December 1987 to January 2001. METHODS: Eyes with uncontrolled NVG underwent noncontact Nd:YAG CP. Treatment parameters and pre- and post-treatment intraocular pressure (IOP) were reviewed. Pre- and postoperative IOP was compared using paired Student's t test. Success was defined as an IOP ≤ 22 mmHg, with or without medications, in the absence of phthisis bulbi, and without having undergone further surgical procedures. Results were subjected to a Kaplan-Meier life-table analysis. RESULTS: Mean follow-up was 27.0 ± 34.3 months (range, 1-148 months). Mean preoperative IOP was 47.4 ± 11.1 mmHg (range, 26-70 mmHg). Mean postoperative IOP was 18.3 ± 12.2 mmHg (range, 0-44 mmHg). The mean number of treatment sessions was 1.4 ± 0.7 (range, 1-6), with 82 eyes (71.3%) having only one treatment. Kaplan-Meier survival analysis showed a probability of continued success at one year of 65.0%, at three years of 49.8%, and at six years of 34.8%. Phthisis developed in 8.6% of the eyes. CONCLUSIONS: Noncontact Nd:YAG CP provides long-term IOP reduction in eyes with medically uncontrolled NVG. This can be associated with complications that include inflammation, visual loss, and hypotony. Repeat treatment may be necessary.
Dr. M.F. Delgado, Glaucoma Research & Education Group, San Francisco, CA, USA
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
