title: Long-term results of noncontact transscleral neodymium:YAG cyclophotocoagulation.
abstract: OBJECTIVE
  To determine the long-term efficacy of noncontact transscleral neodymium:YAG (Nd: YAG) cyclophotocoagulation.
  
  
  METHODS
  A retrospective analysis was made of 167 patients (173 eyes) with intractable glaucoma treated with noncontact Nd:YAG cyclophotocoagulation between December 1987 and November 1993, reviewing the treatment parameters, complications, and pre- and posttreatment intraocular pressure (IOP). The IOP was compared using a Student's t test, and the results were subjected to a Kaplan-Meier life-table analysis. Success was defined as an IOP of 22 mmHg or lower in the absence of phthisis and without having undergone any additional surgical procedures.
  
  
  RESULTS
  Mean follow-up was 30.5 +/- 22.8 months. Mean preoperative IOP was 40.0 +/- 12.9 mmHg. Mean postoperative IOP was 19.8 +/- 11.4 mmHg (P < 0.05). The mean number of treatment sessions was 1.8 +/- 1.3 (range, 1-8) with 95 eyes (55%) having only one treatment. Kaplan-Meier survival analysis showed a probability of continued success at 3 years of approximately 73% and at 5 years of 45%. Complications included loss of two or more lines of Snellen visual acuity or one or more categories in the low-vision range (40%), phthisis (6.9%), epithelial defects (1.9%), and hyphema (0.6%).
  
  
  CONCLUSIONS
  This study suggests that Nd:YAG transscleral cyclophotocoagulation provides a useful long-term reduction of IOP in eyes with advanced or complicated glaucoma, but there is a significant risk of visual loss associated with the procedure.
authors.affiliation: Shaffer Associates Medical Group, San Francisco, CA, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Dickens
authors.forename: N
authors.initials: N
authors.lastname: Nguyen
authors.forename: J S
authors.initials: JS
authors.lastname: Mora
authors.forename: A G
authors.initials: AG
authors.lastname: Iwach
authors.forename: M M
authors.initials: MM
authors.lastname: Gaffney
authors.forename: P C
authors.initials: PC
authors.lastname: Wong
authors.forename: H
authors.initials: H
authors.lastname: Tran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002924:Ciliary Body / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D017075:Laser Coagulation; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014792:Visual Acuity