Contact transscleral continuous wave neodymium:YAG laser cyclophotocoagulation.
Advanced glaucoma in 140 eyes of 136 patients was treated with contact transscleral continuous wave neodymium:YAG (Nd:YAG) laser cyclophotocoagulation (CYC) with a sapphire-tipped probe. The anterior edge of the probe was placed 0.5 to 1.5 mm posterior to the limbus, using 7 to 9 W of power for 0.7 seconds with 32 to 40 applications, sparing the 3 and 9 o'clock meridians. Patients were studied prospectively. The mean preoperative intraocular pressure (IOP) of 36.7 +/- 0.97 mmHg decreased to 21.2 +/- 0.99 mmHg (P = 0.004) after treatment (mean follow-up, 3.2 +/- 0.35 months) for a mean decrease in IOP of 15.5 +/- 1.21 mmHg and a mean percent decrease of 39%. Forty-one eyes were followed 6 or more months (mean, 6.7 +/- 0.25 months). The CYC reduced IOP to 25 mmHg or less in 71% of eyes, to 22 mmHg or less in 62% of eyes, and to 19 mmHg or less in 49% of eyes. Maximum lowering of IOP occurred 1 week to 1 month after treatment and remained at that level through 6 months of follow-up. Retreatment was required in 11% of patients; only one patient was retreated more than once. Four patients treated with 9 W of power developed IOPs below 5 mmHg; two of these patients had an IOP of 0 mmHg. Other complications of therapy were minimal, and patients had little pain. There was no significant change in visual acuity. Early results of this newly available therapy are encouraging.
Morse Laser Center, Massachusetts Eye and Ear Infirmary, Boston.
J S
JS
Schuman
C A
CA
Puliafito
R R
RR
Allingham
C D
CD
Belcher
A R
AR
Bellows
M A
MA
Latina
B J
BJ
Shingleton
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002924:Ciliary Body / Q000601:surgery*; D002986:Clinical Trials as Topic; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000209:etiology; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D010149:Postoperative Pain; D011379:Prognosis; D011446:Prospective Studies; D044469:Racial Groups; D012086:Reoperation; D013223:Statistics as Topic; D014792:Visual Acuity
D009883:Ophthalmic Solutions