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Abstract #10008 Published in IGR 5-3
Intraocular pressure results of contact transscleral cyclophotocoagulation with a neodymium YAG laser for refractory glaucoma
Quintyn JC; Grenard N; Hellot MF; Gruber D; Brasseur GJournal Français d'Ophtalmologie 2003; 26: 808-812
PURPOSE: To evaluate the effects of contact transscleral cyclophotocoagulation with an Nd:YAG laser for refractory glaucoma. METHODS: This was a retrospective study with 36 patients (37 eyes) who were treated at Rouen Hospital from February 1996 to February 2001. Patients had various types of glaucoma: glaucoma in pseudophakia (12), primary open-angle glaucoma (16), posttraumatic glaucoma (six), glaucoma associated with uveitis (four), neovascular glaucoma (three), and glaucoma after silicone oil (one). An Nd:YAG laser (Alcon) was used for treatment. Energy was delivered in up 32 applications of 7-9 W for 0.7 seconds each. All patients except for one ten-year-old child received retrobulbar anesthesia. Intraocular pressure (IOP) was measured after four hours, one month, and ten years. RESULTS: The mean preoperative IOP of 30.3 ± 1.3 mmHg decreased to 19.4 ± 2 mmHg at one month and to 22.2 ± 2.4 mmHg at one year. Seven patients underwent a second treatment during the year, since the first one was insufficient. Treatment lowered the number of medications used to decrease IOP from a pretherapy mean of 2.7 to 1.8 mmHg at one month and 2.07 mmHg at one year. In three patients who were treated for a painful sightless eye, the treatment failed. DISCUSSION: Nd:YAG laser necroses ciliary bodies. Treatment must be dosed to achieve the greatest efficacy without hypotonia, although hypotonia is rare, as is non-response to treatment. A few patients will have to be retreated during the year. The subgroup of sightless painful eyes had a high failure rate (75%), with half undergoing evisceration. No other differences were found regarding the origins of refractory glaucoma. CONCLUSION: Midterm results of contact transscleral cyclophotocoagulation with an Nd:YAG laser are encouraging in the treatment of refractory glaucoma. LA: French
Dr. J.C. Quintyn, Service d'Ophtalmologie, Hôpital Charles Nicolle, 1, rue de Germont, 76000 Rouen, France. qjc76@hotmail.com
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
