The Long-term Result of Diode Laser Transscleral Cyclophotocoagulation in the Management of Refractory Glaucoma after Intravitreal Silicone Oil Injection for Complicated Retinal Detachment

ABSTRACT

PURPOSE: To evaluate the long-term results of contact transscleral cyclophotocoagulation (TSCPC) in eyes with secondary glaucoma following intravitreal silicone oil injection. METHODS: Medical records of 18 eyes of 17 patients who underwent TSCPC following intravitreal silicone oil injection for complicated retinal detachment were reviewed. TSCPC was performed using diode laser at a power of 1.5 to 2.5 W, duration of 2 seconds, and with 14 to 27 applications. Intraocular pressure (IOP), number of glaucoma medications, status of anterior segment and retina, complications and visual acuity were evaluated. RESULTS: Overall mean number of treatments given per eye was 1.6. After a mean follow-up period of 122.7 (range, 49 to 228) weeks, the mean pretreatment IOP, 42.1+/-13.5 mmHg, decreased to 19.5+/-12.3 mmHg (p=0.001). The number of glaucoma medications was significantly decreased from 2.8+/-0.9 to 0.9+/-1.12 (p= 0.000). Hypotony or phthisis bulbi developed in one eye, respectively. Excluding the six eyes with no light perception before treatment, 4 (33.3%) of 12 eyes had stable or improved visual acuity at the final follow-up visit. Five of 8 eyes showing visual deterioration lost light perception. CONCLUSIONS: Medically uncontrolled glaucoma secondary to intravitreal silicone oil injection can be treated with TSCPC, although there is a significant risk of visual loss associated with the procedure.