Long-term Results of Diode Laser Trans-scleral Cyclophotocoagulation in Neovascular Glaucoma

ABSTRACT

To determine the long-term efficacy of diode laser trans-scleral cyclophotocoagulation in neovascular glaucoma, a retrospective analysis was done in 30 patients(32 eyes) with intractable neovascular glaucoma treated with diode laser trans-scleral cyclophotocoagulation between March 1996 and June 1997, by reviewing the treatment parameters, complications, and preand postoperative intraocular perssure(IOP). The IOP was compared using a Wilcoxon signed rank test, and the success rate was evaluated by a Kaplan-Meier life-table analysis. Success was defined as an IOP of 21mmHg or lower in the absence of phthisis without any additional surgical procedure. The mean follow-up was 54.6+/-13.3 weeks. The mean preoperative IOP was 46.2+/-9.6mmHg. The mean postoperative IOP was 10.5+/-8.7mmHg(p=0.000). The mean number of preoperative medications was 2.2+/-0.6. The mean number of postoperative medications was 0.5+/-0.9(p=0.000). Kaplan-Meier survival analysis showed a probability of continued success at 44 weeks and 60 weeks to be 80.2% and 44.5%, each, without any antiglaucoma medications and 86.4% and 66.1%, each, with some antiglaucoma medications. Complications included phthisis(12.5%), hypotony(9.0%), and hyphema(25%). This study suggests that diode laser trans-scleral cyclophotocoagualtion provides a significant long-term reduction of intraocular pressure in eyes with intractable neovascular glaucoma.