Long-term results of noncontact neodymium:yttrium-aluminum-garnet cyclophotocoagulation in neovascular glaucoma.
OBJECTIVE
To determine the long-term efficacy and safety of noncontact transscleral neodymium:yttrium-aluminum-garnet (Nd:YAG) cyclophotocoagulation (CP) for the treatment of neovascular glaucoma (NVG).


METHODS
Retrospective, noncomparative, interventional case series.


METHODS
One hundred fifteen eyes of 111 subjects treated from December 1987 to January 2001.


METHODS
Eyes with uncontrolled NVG underwent noncontact Nd:YAG CP. Treatment parameters and pretreatment and posttreatment intraocular pressures (IOP) were reviewed. Preoperative and postoperative IOP were compared using a paired Student's t test. Success was defined as an IOP </=22 mmHg, with or without medications, in the absence of phthisis bulbi, and without having undergone further surgical procedures. Results were subjected to a Kaplan-Meier life-table analysis.


RESULTS
Mean follow-up was 27.0 +/- 34.3 months (range, 1-148 months). Mean preoperative IOP was 47.4 +/- 11.1 mmHg (range, 26-70 mmHg). Mean postoperative IOP was 18.3 +/- 12.2 mmHg (range, 0-44 mmHg). The mean number of treatment sessions was 1.4 +/- 0.7 (range, 1-6), with 82 eyes (71.3%) having only one treatment. Kaplan-Meier survival analysis showed a probability of continued success at 1 year of 65.0%, at 3 years of 49.8%, and at 6 years of 34.8%. Phthisis developed in 8.6% of the eyes.


CONCLUSIONS
Noncontact Nd:YAG CP provides long-term IOP reduction in eyes with medically uncontrolled NVG. This can be associated with complications that include inflammation, visual loss, and hypotony. Repeat treatment may be necessary.
Glaucoma Research & Education Group, San Francisco, California, USA.
Maria F
MF
Delgado
Christopher J
CJ
Dickens
Andrew G
AG
Iwach
Gary D
GD
Novack
Diana S
DS
Nychka
Patricia C
PC
Wong
Ngoc
N
Nguyen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002924:Ciliary Body / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015355:Glaucoma, Neovascular / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000379:methods*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity