Contact trans-scleral diode laser cyclophotocoagulation treatment for refractory glaucomas in the Indian population.

ABSTRACT

PURPOSE: This study aimed to evaluate the clinical efficacy of contact diode trans-scleral cyclophotocoagulation (TSCPC) for treatment of refractory glaucomas. METHOD: Fifty two eyes of 52 patients, (post-penetrating keratoplasty glaucoma 16 eyes; adherent leucoma with secondary glaucoma 8 eyes; aphakic glaucoma 6 eyes; neovascular glaucoma 6 eyes; narrow angle glaucoma 6 eyes; and other secondary glaucomas 10 eyes) were followed up from 3.5-18 months (average 12 months) after TSCPC. The treatment parameters using the contact G probe were--energy 3-4J; area 40 spots spread over 360 degrees; site 1.2-1.5 mm posterior to limbus. Retreatments (22 eyes; 42%) were given whenever intraocular pressure (IOP) exceeded 22 mmHg despite maximum tolerable topical therapy. RESULTS: IOP decreased from a baseline of 44.7 (+/- 7.3) mmHg to 15 (+/- 3.7) mmHg at first week and was 15.2 +/- (8.2) mmHg at the last follow up. Successful control of IOP (< 22 mmHg) occurred in 30 (58%) eyes after a single treatment and in 48 (92%) eyes following retreatment. Complications included reduction in visual acuity from light perception (LP) only to no light perception (NLP) in two eyes and phthisis bulbi in one eye. CONCLUSION: Contact trans-scleral diode laser cyclophotocoagulation is effective in lowering IOP in eyes with intractable glaucoma with few side effects in Indian subjects.