ABSTRACT
PURPOSE: To investigate the intraocular pressure-lowering efficacy of laser goniopuncture in 5 cases after hypertrophy of the trabecular-Descemet membrane resulting from deep sclerectomy with collagen implant (DSCI). METHODS: Among the twenty-one patients (26eyes) who received DSCI, laser goniopuncture was performed in 5 patients (19%) by Nd:YAG laser at 5-10 mJ, 3 burst mode, and 2-10 times. RESULTS: Of the 5 cases who received Nd:YAG laser goniopuncture, 2 cases showed a decrease in intraocular pressure after 1 session of treatment while 3 cases resulted in increase of intraocular pressure due to anterior synechiae of the iris. The anterior synechiae were resolved by Argon and Nd:YAG laser in 1 case, peripheral iridectomy and iridoplasty in 1 case but in the third case, patient refused to receive recommended further laser treatment such as peripheral iridectomy and iridoplasty. CONCLUSIONS: In cases of increased intraocular pressure caused by hypertrophy of the trabecular-Descemet membrane after DSCI, laser goniopuncture is an effective method of treatment. However, iris prolapse and anterior synechiae may occur during the follow-up period which can be resolved by peripheral iridectomy and synechiolysis.