ABSTRACT
BACKGROUND: The long-term safety and efficacy of repeated applications of subliminal transscleral cyclophotocoagulation (SL-TSCPC) with a focus on cumulative energy was evaluated in glaucoma patients. METHODS: In this retrospective, multicentric study the data of a total of 82 eyes with various causes of glaucoma that were treated with a single or multiple applications of SL-TSCPC were collected. Treatments were performed under general or local anesthesia with an 810 nm diode laser. Power was 2000 mW; duty cycle, 31.3%; total treatment duration, 80-320 s; equaling a total energy of 50-200 J per treatment session. Fifty-five eyes (55 patients) presented for all follow-ups, and these eyes were selected for further statistical analysis. The mean age was 60.0 ± 17.1 years, and 22 (40%) of the patients were female. Intraocular pressure (IOP) and dependence on further glaucoma medication were evaluated at 12 months following the initial treatment. RESULTS: Eyes underwent 1 or 2 consecutive SL-TSCPC treatments. Median (min-max) baseline IOP of 34 (13-69) decreased to 21.5 (7-61), 22 (8-68), 20 (9-68), and 19.5 (3-60) mmHg at the 1, 3, 6, and 12-month postoperative timepoints respectively. The mean (± SD) IOP decrease at 12 months was 26 ± 27%, 39 ± 32%, and 49 ± 33% in the low (below 120 J, n = 18), medium (120-200 J, n = 24), and high (above 200 J, n = 13) cumulative energy groups respectively. At the 12-month timepoint, oral carbonic anhydrase use was discontinued in ¾ of the cases. CONCLUSIONS: It was found that the repeated application of SL-TSCPC safely and efficiently decreases IOP in a Caucasian population with heterogenous causes of glaucoma, eyes with silicone oil responded to a greater extent. Inclusion of cumulative energy scales may contribute to better addressing repeated procedures in a standardized fashion.
Subject(s)
Ciliary Body , Glaucoma , Intraocular Pressure , Laser Coagulation , Lasers, Semiconductor , Sclera , Humans , Retrospective Studies , Female , Male , Middle Aged , Intraocular Pressure/physiology , Laser Coagulation/methods , Ciliary Body/surgery , Aged , Sclera/surgery , Glaucoma/surgery , Glaucoma/physiopathology , Adult , Lasers, Semiconductor/therapeutic use , Visual Acuity/physiology , Aged, 80 and over , Follow-Up Studies , Treatment OutcomeABSTRACT
AIM: To present the early experience with the implantation technique, safety and efficiency of STARflo device for open angle glaucoma (OAG). METHODS: referring intra- and postoperative clinical experience with a series of seven cases in three glaucoma centers in Hungary. RESULTS: No intraoperative complications were observed. Postoperative inflammatory signs disappeared rapidly. The mean IOP reduction was from 27.6 ± 5.0 mmHg to 18.9 ± 3.4 mmHg (32% reduction/ patient) at six months postoperatively. CONCLUSION: STARflo implant was safe and (except for one case with neovascular glaucoma) effective in our cases. The learning curve for experienced anterior segment surgeons was short.