Diode laser transscleral cyclophotocoagulation for refractory glaucoma.
OBJECTIVE
To evaluate the efficacy of contact diode laser transscleral cyclophotocoagulation using different treatment parameters.


METHODS
All eyes undergoing contact diode laser transscleral cyclophotocoagulation between April 1991 and September 1997 at our two institutions were enrolled. Success was defined as an intraocular pressure less than or equal to 22 mm Hg or absence of pain for poorly sighted and blind eyes.


RESULTS
Two hundred six eyes of 204 patients (Salzburg, 117 eyes; New York, 89 eyes) were enrolled. Mean patient age was 65.8 +/- 18.7 years (range, 4-96 years). Mean follow-up was 9.2 +/- 11.2 months (range, 3-56 months). Mean preoperative and postoperative IOPs were 42.1 +/- 11.0 mm Hg (range, 24-76 mm Hg) and 17.3 +/- 10.9 mm Hg (P < 0.001) and 20.3 +/- 13.2 mm Hg (P < 0.001) at 12 and 24 months, respectively. The number of laser applications (mean, 18.6 +/- 4.2; range, 10-40) and maximal laser power (mean, 2,352 +/- 408.5 mW; range, 1,500-3,000) were not associated with a lower postoperative IOP. An IOP less than or equal to 22 mm Hg was achieved in 72.7% of eyes at the mean follow-up of 9 months. Thirty-three (16.0%) eyes required at least one retreatment. Phthisis occurred in four (1.9%) eyes.


CONCLUSIONS
Contact diode laser transscleral cyclophotocoagulation is useful in eyes with refractory glaucoma in which the risks of outflow surgery are deemed unacceptable.
Mistlberger
A
A
Department of Ophthalmology, County Hospital Salzburg (Landeskliniken Salzburg, St. Johanns-Spital), Austria. a.mistberger@lks.at
Liebmann
J M
JM
Tschiderer
H
H
Ritch
R
R
Ruckhofer
J
J
Grabner
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002924:Ciliary Body / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012590:Sclera; D016896:Treatment Outcome; D014792:Visual Acuity