Neovascular Glaucoma: Diode Laser Trans-Scleral Cyclophotocoaculation Versus Ahmed Glaucoma Valve Implant

ABSTRACT

PURPOSE: To retrospectively study the clinical outcomes of diode laser trans-scleral cyclophotocoagulation and Ahmed glaucoma valve implant in eyes with neovascular glaucoma. METHODS: We reviewed the medical records of patients who had undergone diode laser trans-scleral cyclophotocoagulation (group 1) and Ahmed glaucoma valve implant (group 2) with a follow-up period of 6 months or longer. The treatments were carried out to control high intraocular pressure (IOP) and ocular pain in the patients with visual acuity less than hand motions. RESULTS: Group 2 had a significantly lower IOP during the first postoperative month. The cumulative probability of success was higher in group 2 than group 1 throughout the follow-up period. The postoperative complications in most cases were transient and improved with conservative management in both groups. However, 3 cases in group 1 required evisceration secondary to phthisis. Subjective relief of ocular pain was higher in group 2. CONCLUSIONS: The Ahmed glaucoma valve implant group showed a higher success rate and fewer serious complications than the diode laser trans-scleral cyclophotocoagulation group in patients with high IOP and ocular pain with poor visual acuity. Diode laser trans-scleral cyclophotocoagulation may be considered in patients with poor general health.