Change in Visual Acuity Following Trans-Scleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

PURPOSE: To evaluate the effects of trans-scleral diode laser cyclophotocoagulation (TSDLC) on best corrected visual acuity (BCVA) in patients with refractory glaucoma. METHODS: The medical records of 148 eyes of 148 patients with refractory glaucoma who were followed-up for over 6 months after TSDLC were analyzed retrospectively. Among them, 49 eyes of 49 subjects who had BCVA greater than no light perception (NLP) before TSDLC were classified as Group 1 and the other 99 eyes of 99 patients who had NLP vision were classified as Group 2. The outcomes of TSDLC including change in BCVA following surgery were analyzed for all patients and 49 subjects. RESULTS: The mean follow-up period in Group 1 was 19.1 +/- 13.5 months and 16.7 +/- 12.7 months in Group 2. The intraocular pressure (IOP) and the number of IOP lowering medications decreased in both groups (both p or = 0.2 log MAR was found in 31 eyes (63.3%) and light perception was lost in 15 eyes (30.6%). After treatment, corneal edema developed in 5 eyes (3.4%), phthisis bulbi and chronic hypotony occurred in 3 eyes each (2%) and iridocydlitis occurred in 2 eyes (1.4%). CONCLUSIONS: TSDLC in patients with refractory glaucoma showed an efficient reduction in IOP and the number of IOP-lowering medications. However, there was a significant loss in BCVA in many patients and therefore, careful monitoring regarding potential visual loss is necessary when considering TSDLC in glaucoma patients with useful vision.

The Effect of Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

The purpose of this study was to validate the efficacy of transscleral diode laser cyclophotocoagulation (CPC)procedure in refractory glaucoma cases for which conventional medical or surgical filtering procedures had failed or were thought to have a poor likelihood of success. Thirty-eight eyes of 38 consecutive patients with refractory glaucoma received transscleral diode CPC. Patients were followed for a mean of 5.5 months. We reviewed available data at preoperative state and at 1 day, 1week, 1 month, 2 months and 4 months postoperatively. Data analyzed were visual acuity, intraocular pressure(IOP)and postoperative complications. There was a statistically significant decrease in IOP at postoperative 1day, 1 week, 1 month, 2 months and 4 months compared with preoperative IOP. Postoperative complications were hyphema in 4 eyes and fibrinousuveitis in 1 eye but all of these complications were controlled with medical treatment. We concluded that transscleral diode CPC could be a good treatment proce-dure for the IOP control in refractory glaucoma cases.