title: Incidence, efficacy and safety of YAG laser goniopuncture following nonpenetrating deep sclerectomy at a university hospital in Riyadh, Saudi Arabia.
abstract: OBJECTIVE
  Assessing the frequency and evaluating the efficacy and safety of Neodymium:Yttrium Aluminum Garnet (Nd:YAG) Laser goniopuncture (LGP) following nonpenetrating deep sclerectomy (NPDS).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  We retrospectively reviewed the outcome of 197 eyes of 153 patients with open angle glaucoma who underwent either NPDS or NPDS combined with cataract extraction between January 2005 and September 2010 at King Abdulaziz University Hospital (KAUH). Both demographic and clinical data were retrieved and analysed.
  
  
  RESULTS
  Goniopuncture (GP) was needed in 48 (24.4%) of the eyes which had NPDS or NPDS with cataract extraction after a mean post operative interval of 9.78 (±11.16) months. The mean IOP had significantly decreased from 23.3 (±5.9) mmHg prior to Nd:YAG LGP procedure to 14.6 (±4.4) mmHg at the last post-procedure assessment. At the last follow-up; Nd:YAG LGP was successful in controlling IOP in 27 eyes (56.3%). Mean Nd:YAG LGP failure time was 6.04 (±5.80) months. Young age (<50 years) (p = 0.001); type of glaucoma (secondary versus primary open angle, p = 0.0258) and the use of drainage implant (p = 0.038) were the identified predicting factors for the need of Nd:YAG LGP. Complications following Nd:YAG LGP occurred in 5 eyes (iris touch to TDM (4.2%), Hyphema (2.1%), hypotony maculopathy (2.1%) and choroidal detachment (2.1%).
  
  
  CONCLUSIONS
  LGP is an efficient IOP lowering procedure after NPDS, when it is indicated. It is a simple and noninvasive procedure. However, certain precautions should be taken to avoid complications.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, King Abdul-Aziz Road, P.O. Box 245, Riyadh 11411, Saudi Arabia.
authors.forename: Saleh A
authors.initials: SA
authors.lastname: Al Obeidan
keywords: Deep Sclerectomy; Glaucoma; Goniopuncture; Nd:YAG