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Abstract #90680 Published in IGR 21-3
Comparison of the diurnal efficacy and safety of cyclocryocoagulation and cyclophotocoagulation in patients with refractory glaucoma
Waibel S; Herber R; Herber R; Pillunat LE; Pillunat KRInternational Ophthalmology 2020; 40: 2191-2199
PURPOSE: To compare the diurnal IOP-lowering efficacy and safety of cyclocryocoagulation (CCC) and cyclophotocoagulation (CPC) in patients with refractory glaucoma. METHODS: Forty eyes of 40 Caucasian patients with advanced primary or secondary glaucoma with only tunnel vision left were included in this retrospective, comparative interventional case series. Twenty eyes treated with CCC were compared with 20 eyes treated with CPC. Primary endpoint was the reduction of 24 h mean diurnal intraocular pressure (IOP; mean of 6 measurements), peak IOP and diurnal IOP fluctuations 3 and 6 months post-treatment. Secondary outcomes were the occurrence of postoperative complications and the identification of factors influencing the postoperative IOP reduction. RESULTS: In the CCC group (mean age 70.6 ± 13.4 years), mean diurnal IOP was significantly reduced from 20.0 ± 4.5 mmHg to 14.7 ± 2.5 (p < 0.001) at 3 months and 13.9 ± 3.34 mmHg at 6-month follow-up (p < 0.001). In the CPC group (mean age 74.9 ± 9.0 years), mean diurnal IOP significantly decreased from 18.2 ± 3.1 mmHg to 13.2 ± 2.2 (p < 0.001) at 3 months and 13.1 ± 2.6 mmHg (p < 0.001) at 6 months. At 6 months, 75% of the CCC and 63% of the CPC group had mean diurnal IOP reductions of 20% or more. The most frequent complication (25%) was a transient IOP increase during the first days after CCC. A higher preoperative mean diurnal IOP was recognized as the only factor influencing the postoperative IOP reduction after CCC and CPC. CONCLUSIONS: Both cyclodestructive methods seem to be reasonably safe and effective in lowering 24 h mean diurnal IOP in the perspective of 6 months in patients with refractory glaucoma. The IOP-lowering effect after CCC was better but not statistically significantly different compared to CPC. A higher rate of complications was observed in the CCC group, however.
Department of Ophthalmology, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany. soeren.waibel@uniklinikum-dresden.de.
Full articleClassification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
