Long-term efficacy and visual acuity following transscleral diode laser photocoagulation in cases of refractory and non-refractory glaucoma.
OBJECTIVE
Transscleral diode laser cyclophotocoagulation (TSCP) is widely accepted in the treatment of refractory glaucoma especially in eyes with poor vision. However, until recently, there has been a reluctance to extend its use to eyes with good visual acuity (VA). The aims of this study were to evaluate the long-term efficacy and safety of TSCP for a range of glaucoma conditions, with particular emphasis on post-treatment VA in seeing eyes.


METHODS
A retrospective analysis of case notes of 74 treated eyes was conducted over a period of 4-30 months (mean 12.5 months).


RESULTS
Mean (SD) intraocular pressure (IOP) was reduced by 43% from 40.3 (6.7) to 21.1 mmHg (5.4) at the final index visit. Of all patients, 58% had a reduction in glaucoma drops and all discontinued oral Acetazolamide; 9% experienced complications. Mean VA was preserved in the subgroups with good vision, although 3/23 (13%) patients with primary open-angle glaucoma (POAG) lost vision due to cataract and glaucoma progression. There were no cases of hypotony (IOP<or=5 mmHg) or phthisis and only one eye required re-treatment.


CONCLUSIONS
TSCP is highly effective and safe for various types of glaucoma, and its use can be extended to eyes with good vision.
Ansari
E
E
Eye Department, Eye, Ear & Mouth Unit, Maidstone Hospital, Maidstone, Kent, UK. eaansari@aol.com
Gandhewar
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity