advertisement
Abstract #6270 Published in IGR 2-2
Long-term results of transscleral Nd:YAG cyclophotocoagulation for refractory glaucoma postpenetrating keratoplasty
Beiran I; Rootman DS; Trope GE; Buys YMJournal of Glaucoma 2000; 9: 268-272
PURPOSE: To determine the effects of noncontact transscleral Nd:YAG cyclophotocoagulation (NCTY) in the treatment of refractory glaucoma postpenetrating keratoplasty (PKP) with respect to intraocular pressure (IOP), corneal graft survival, and reduction of glaucoma medications. METHODS: The records of all patients treated with NCTY for refractory glaucoma after PKP at the authors' institution over an 11-year interval, were reviewed. The LASAG noncontact Nd:YAG laser (Lasag AG; Thun, Switzerland) was used. Approximately 40 laser applications were delivered per eye. Visual acuity, IOP, glaucoma medications, and corneal graft clarity, were evaluated. RESULTS: Fifty-two eyes met the inclusion criterion. The mean pretreatment IOP was 38.7 ± 11.9 mmHg. The mean post-treatment IOP was 15.8 ± 9.7 mmHg. From life table analysis, the probability of having a post-treatment IOP of 21 mmHg or less with or without medication was 70% at one year and 63% at five years. The probability of a graft remaining clear was 79% at one year and 56% at five years. In 85% of patients, the visual acuity remained stable, in 11% the visual acuity improved, and in 4% the visual acuity deteriorated, after treatment. One patient developed hypotony. Twenty patients (36.5%) were able to discontinue one or more glaucoma medications post-treatment. CONCLUSIONS: In this group of patients with PKP glaucoma, NCTY effectively lowered IOP over the long term, with 36.5% of patients discontinuing one or more glaucoma medications. However, there was a significant incidence of graft failure at five years.
Dr. Y.M. Buys, The Toronto Western Hospital, Edith Cavell Wing 7-042, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
