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1 General aspects (0)   1.1 Epidemiology (11)   1.2 Population genetics (0)   1.3 Pathogenesis (4)   1.4 Quality of life (12)   1.5 Glaucomas as cause of blindness (5)   1.6 Prevention and screening (9) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (4)   2.2 Cornea (18)   2.3 Sclera (4)   2.4 Anterior chamber angle (4)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (7)     2.5.2 Schlemms canal (1)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (0)     2.6.2 Outflow (2)       2.6.2.1 Trabecular meshwork (1)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (1)   2.7 Episcleral veins and venous pressure (1)   2.8 Iris (2)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (16)   2.14 Optic disc (8)   2.15 Optic nerve (1)   2.16 Chiasma and retrochiasmal central nervous system (9)   2.17 Stem cells (1)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (4)   3.3 Immunohistochemistry (5)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (33)   3.5 Molecular biology incl. 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Miscellaneous (8)

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Abstract #25485 Published in IGR 12-1

Controlled Cyclophotocoagulation with diode laser in refractory glaucoma and long term follow up at King Abdulaziz University Hospital, Riyadh

Osman E A; Al-Muammar A; Mousa A; Al-Mezaine H; Al-Obeidan S A
Saudi Journal of Ophthalmology 2010; 24: 9-13

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Purpose: To evaluate the clinical efficacy and safety of controlled contact transscleral diode laser Cyclophotocoagulation (COCO) procedure in reducing the Intraocular Pressure (IOP) among patients with refractory glaucoma. Methods: Thirty two patients (35 eyes) with refractory glaucoma in prospective clinical studies were treated with trans-sclera diode laser in a controlled manner. The energy power used was 5 W in adults and 3 W in children, exposure time was 0.5 s, a total of 16 shots were applied over ciliary body and four shots in each quadrant. Pre and postoperative IOP were measured at different postoperative visits. Snellen visual acuity, the number of anti-glaucoma medications and associated complications were also recorded. Student T test was used to compare the pre and post intervention IOPs, while Wilcoxon Signed Ranks test was used, to detect significance change in medication dependency. Results: The mean (SD) follow up time was 80.2((plus or minus)9.6) months, range (36-84) m, where the mean IOP was significantly reduced from 35.1 mm Hg ((plus or minus)10.7) before intervention to 18.8 mm Hg ((plus or minus)7.3) after intervention, in the final visit (P < 0.0001). Complete success was achieved in seven eyes (20%), 22 eyes (62.8%) showed qualified successes and complete failure was reported in six eyes (17.1%). The overall success rate was 82.8% (95% CI: 70.4-95.3). Visual acuity improved in three eyes (8.5%), no change took place in 27 eyes (77.1%) and decreased in five eyes (14.2%). The number of anti-glaucoma medications has significantly changed between pre and post intervention (P < 0.0001). No cases of hypotony, phthisis bulbi or sympathetic ophthalmia were reported. Conclusion: Controlled COCO is a simple procedure, safe with minimal complications and fewer side effects.

E.A. Osman. Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. essam.osman065@gmail.com

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Classification:

12.10 Cyclodestruction (Part of: 12 Surgical treatment)

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