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Abstract #9245 Published in IGR 5-2
Diode laser transscleral cyclophotocoagulation in the treatment of chronic angle-closure glaucoma: a preliminary study
Lai JSM; Tham CCY; Chan JCH; Lam DSCJournal of Glaucoma 2003; 12: 360-364
PURPOSE: To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation in the treatment of chronic angle-closure glaucoma. PATIENTS AND METHODS: A prospective, non-comparative interventional pilot study was conducted. Fourteen eyes of 14 Chinese patients with chronic angle-closure glaucoma whose intraocular pressure (IOP) was greater than 21 mmHg on medications were treated with diode laser transscleral cyclophotocoagulation using the G-probe at the United Christian Hospital between February 2000 and May 2001. The inferior 270° quadrant (from 2 to 11 o'clock for right eye and from 1 to 10 o'clock for left eye) was treated and the patients were followed up regularly. The initial laser energy was set at 2000 mW with a duration of two seconds. The post-treatment anti-glaucoma medications were adjusted according to the IOP. If medications failed to lower the IOP to below 21 mmHg, cyclophotocoagulation to the same inferior 270° quadrant was repeated. RESULTS: All patients completed a 12-month follow-up period. The total success rate defined as IOP < 21 mmHg with or without medication(s) was 85.7% at one year of follow-up review. The mean ± SD IOP decreased from the pre-treatment level of 36.9 ± 11.7 mmHg to 18.9 ± 6.5 mmHg at one year after treatment. The difference was statistically significant (p < 0.001) (paired t test). The mean ± SD number of IOP-lowering eye drops was significantly reduced from 1.9 ± 0.7 before cyclophotocoagulation to 0.4 ± 0.8 at one year after treatment (p = 0.0002) (paired t test). Two eyes required repeat treatment. Seven eyes (50%) had atonic pupil following the laser treatment. CONCLUSIONS: Diode laser transscleral cyclophotocoagulation is effective in lowering IOP in chronic angle-closure glaucoma and its effect lasts for at least one year.
Dr. J.S.M. Lai, Department of Ophthalmology, United Christian Hospital, Hip Wo Street, Kwun Tong, Kowloon, Hong Kong. laism@ha.org.hk
Classification:
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
