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Abstract #15482 Published in IGR 1-3
Transpupillary argon laser cyclophotocoagulation in the treatment of traumatic glaucoma
Kim DD; Moster MRJournal of Glaucoma 1999; 8: 340-341
PURPOSE: A patient with traumatic glaucoma who underwent transpupillary argon laser cyclophotocoagulation (TALC) for management of uncontrolled intraocular pressure (IOP), despite maximally tolerated medical therapy, is discussed. METHODS: In this patient, pars plana vitrectomy, lensectomy, and removal of 180° of necrotic iris had been performed after a blunt trauma with a bungee cord. Six weeks after surgery, the patient presented with an IOP of 40 mmHg despite therapy with three aqueous suppressants. The patient refused further surgical intervention and opted for TALC. The laser setting was 1000 mW, with a 50-μm spot size for 0.1 seconds. A total of 293 laser exposures through a Goldmann contact lens was administered to all visible ciliary processes over 180° where iris structures were absent. RESULTS: Ten weeks after TALC, the patient's IOP remained controlled with medications at 16 mmHg, and visual acuity had improved to 20/25 with an aphakic contact lens. CONCLUSIONS: In selected patients whose ciliary processes are visible with indirect gonioscopy due to the defect in the iris, TALC may be an effective alternative cyclodestructure procedure to lower IOP when conventional medical or laser treatments are not successful.
Dr. M.R. Moster, Glaucoma Service, Wills Eye Hospital, Thomas Jefferson University, 900 Walnut Street, Philadelphia, PA 19107-5599; USA
Classification:
9.4.7 Glaucomas associated with ocular trauma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
