Holmium laser sclerectomy. Success and complications.
OBJECTIVE
To investigate the safety and efficacy of holmium YAG laser sclerectomy, a new laser filtration procedure.


METHODS
The authors performed holmium YAG laser sclerectomy on 49 eyes of 46 patients (mean follow-up, 12.3 +/- 1.1 months).


RESULTS
Mean preoperative intraocular pressure (IOP) was 26.9 +/- 1.3 mmHg; postoperative mean IOP on last follow-up visit was 19.7 +/- 1.6 mmHg. Thirty (61%) of 49 eyes achieved a final IOP of 5 to 22 mmHg, 29 (59%) of 49 had a final IOP of 5 to 19 mmHg, and 21 (43%) of 49 had a final IOP of 5 to 15 mmHg. Sixteen (73%) of 22 eyes treated postoperatively with 5-fluorouracil (5-FU) had a final IOP of 21 mmHg or less. Twenty-seven percent of eyes lost one or more lines of vision, and 36% of eyes gained one or more lines of vision; there was no median change in visual acuity. Complications included suprachoroidal hemorrhage in 7 (14%) of 49 eyes and intraoperative vitreous hemorrhage in 2. Seventeen (35%) of 49 eyes required a second IOP-lowering procedure.


CONCLUSIONS
Holmium YAG laser sclerectomy is an effective means to perform glaucoma filtration surgery. This is a full-thickness filtering procedure, with all of the risks attendant.
Schuman
J S
JS
New England Eye Center, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111.
Stinson
W G
WG
Hutchinson
B T
BT
Bellows
A R
AR
Puliafito
C A
CA
Lytle
R
R
D000368:Aged; D002832:Choroid Hemorrhage / Q000209:etiology; D002908:Chronic Disease; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000009:adverse effects*; D011379:Prognosis; D012599:Sclerostomy / Q000009:adverse effects* / Q000379:methods; D014792:Visual Acuity
D005472:Fluorouracil