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Abstract #19206 Published in IGR 3-1
Diode laser transscleral cyclophotocoagulation as a primary surgical treatment for primary open-angle glaucoma
Egbert PR; Fiadoyor S; Budenz DL; Dadzie P; Byrd SArchives of Ophthalmology 2001; 119: 345-350
OBJECTIVES: To evaluate the feasibility of diode laser transscleral cyclophotocoagulation (TSCPC) as a primary surgical treatment for primary open-angle glaucoma and to compare two laser energy settings used for treatment. METHODS: In a prospective clinical trial in Cape Coast and Accra, Ghana, one eye of each of 92 patients with primary open-angle glaucoma was treated by diode laser TSCPC as a primary surgical treatment. Eyes were randomly assigned to receive treatment by 20 applications of either 1.5 W applied for 1.5 seconds or 1.25 W applied for 2.5 seconds. RESULTS: Seventy-nine (86%) of 92 patients completed three months of follow-up; follow-up was 13.2 ± 6.0 months (mean ±SD). Intraocular pressure decreased in 53 (67%) of the 79 eyes. The drop in intraocular pressure was 20% or more in 37 eyes (47%) and final intraocular pressure was 22 mmHg or less in 38 eyes (48%). An atonic pupil was a previously unreported complication that arose in 27 (28%) of 92 eyes. There were no serious complications of hypotony, phthisis bulbi, or sympathetic ophthalmia. Visual acuity decreased in 18 (23%) of 79 eyes treated by TSCPC and in ten (23%) of 47 fellow eyes treated only with glaucoma medications. There was no difference in outcomes between the two laser energy settings. CONCLUSIONS: Diode laser TSCPC is a practical, rapid, well-tolerated procedure that may provide a modest and variable lowering of intraocular pressure. The treatment, used with conservative energy levels applied to the eye, seems to have few serious complications, although a previously unrecognized complication of atonic pupil needs further evaluation. A moderate variation in laser energy settings does not influence the results of treatment.
Dr P.R. Egbert, Stanford University Medical Center, Stanford, CA 94305-5308, USA
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
