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.
Schuman
J S
JS
Morse Laser Center, Massachusetts Eye and Ear Infirmary, Boston.
Puliafito
C A
CA
Allingham
R R
RR
Belcher
C D
CD
Bellows
A R
AR
Latina
M A
MA
Shingleton
B J
BJ
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