Transscleral red laser cyclophotocoagulation for the treatment of therapy-resistant inflammatory glaucoma.
OBJECTIVE
To evaluate in a retrospective study the long-term usefulness of red 647 nm krypton and 670 nm diode laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy-resistant inflammatory glaucoma.


METHODS
The authors treated 48 eyes of 38 consecutive patients (mean age 36.8 years, range 6-81 years) with therapy-resistant inflammatory glaucoma secondary to chronic uveitis (45/48), chronic scleritis (1/48), or combined scleritis with keratouveitis (2/48) using transscleral red 647 nm Krypton or 670 nm Diode laser. All eyes had failed maximum tolerated medical therapy and 19/48 (40%) eyes also previous antiglaucoma surgery. Laser power at the scleral surface was 0.35 to 0.45 W and the application time 10 seconds each. The follow-up was 42.8+/- 40.0 (range 2-145) months.


RESULTS
The mean preoperative intraocular pressure (IOP) of 35.6+/-8.1 mmHg fell to 6-21 mmHg level in 75% after one or repeated CPC. Among adult patients this was achieved in 85%, among children in 54%. More than one treatment was needed in 52%. No cases of hypotony, phthisis bulbi, or other devastating complications occurred.


CONCLUSIONS
Transscleral CPC using red 647 nm krypton or 670 nm diode laser is an effective and well-tolerated procedure for the treatment of therapy-resistant inflammatory glaucoma in adults. CPC can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken.
Helsinki University Eye Hospital, 00026 HUS, Helsinki, Finland. Paivi.Puska@hus.fi
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Tarkkanen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D002924:Ciliary Body / Q000601:surgery*; D004351:Drug Resistance; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D017075:Laser Coagulation; D008875:Middle Aged; D012189:Retrospective Studies; D012590:Sclera; D015423:Scleritis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D014605:Uveitis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D014792:Visual Acuity