Incidence, efficacy and safety of YAG laser goniopuncture following nonpenetrating deep sclerectomy at a university hospital in Riyadh, Saudi Arabia

ABSTRACT

Assessing the frequency and evaluating the efficacy and safety of NeodymiumYttrium Aluminum Garnet [NdYAG] Laser goniopuncture [LGP] following nonpenetrating deep sclerectomy [NPDS]. Retrospective cohort study. We retrospectively reviewed the outcome of 197 eyes of 153 patients with open angle glaucoma who underwent either NPDS or NPDS combined with cataract extraction between January 2005 and September 2010 at King Abdulaziz University Hospital [KAUH]. Both demographic and clinical data were retrieved and analysed. Goniopuncture [GP] was needed in 48 [24.4%] of the eyes which had NPDS or NPDS with cataract extraction after a mean post operative interval of 9.78 [ +/- 11.16] months. The mean IOP had significantly decreased from 23.3 [ +/- 5.9] mmHg prior to NdYAG LGP procedure to 14.6 [ +/- 4.4] mmHg at the last post-procedure assessment. At the last follow-up; NdYAG LGP was successful in controlling IOP in 27 eyes [56.3%]. Mean NdYAG LGP failure time was 6.04 [ +/- 5.80] months. Young age [<50 years] [p = 0.001]; type of glaucoma [secondary versus primary open angle, p = 0.0258] and the use of drainage implant [p = 0.038] were the identified predicting factors for the need of NdYAG LGP. Complications following NdYAG LGP occurred in 5 eyes [iris touch to TDM [4.2%], Hyphema [2.1%], hypotony maculopathy [2.1%] and choroidal detachment [2.1%]. LGP is an efficient IOP lowering procedure after NPDS, when it is indicated. It is a simple and noninvasive procedure. However, certain precautions should be taken to avoid complications