title: Incidence of hypotony and sympathetic ophthalmia following trans-scleral cyclophotocoagulation for glaucoma and a report of risk factors.
abstract: OBJECTIVE
  To report the incidence and risk factors for hypotony and estimate the risk of sympathetic ophthalmia following diode laser trans-scleral cyclophotocoagulation (TSCPC).
  
  
  METHODS
  Retrospective study using data from a private tertiary glaucoma clinic and review of the literature.
  
  
  METHODS
  Seventy eyes of 70 patients with refractory glaucoma who received TSCPC treatment.
  
  
  METHODS
  Review of the records of consecutive patients who underwent TSCPC by a single ophthalmic surgeon and review of the literature.
  
  
  METHODS
  Hypotony (including phthisis bulbi), sympathetic ophthalmia.
  
  
  RESULTS
  Seven eyes (10%; CI 5-19%) developed hypotony and included 4 eyes that developed phthisis. Higher total energy delivered during TSCPC treatment was associated with an increased risk of hypotony: eyes that developed hypotony received a mean total energy of 192.5 ± 73.2 joules, compared to a mean of 152.9 ± 83.2 joules in hypotony-free cases. The risk of sympathetic ophthalmia estimated from a review of the published literature and current series was one in 1512, or 0.07% (CI 0.03%-0.17%).
  
  
  CONCLUSIONS
  Total laser energy is one of several risk factors that act in a sufficient component cause-model to produce hypotony in an individual patient. The small sample size precluded inference for other individual putative risk factors but titrating laser energy may help decrease the occurrence of hypotony. The risk of sympathetic ophthalmia calculated from the literature is likely an overestimate caused by publication bias.
authors: City Eye Centre, Brisbane, Queensland, Australia; University of Queensland, Brisbane, Queensland, Australia.
authors: Jaskirat S
authors: JS
authors: Aujla
authors: Graham A
authors: GA
authors: Lee
authors: Stephen J
authors: SJ
authors: Vincent
authors: Ravi
authors: R
authors: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002924:Ciliary Body / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation / Q000009:adverse effects*; D054023:Lasers, Semiconductor / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D009879:Ophthalmia, Sympathetic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012590:Sclera; D014065:Tonometry, Ocular; D055815:Young Adult
keywords: cyclophotocoagulation; diode laser; glaucoma; hypotony; sympathetic ophthalmia