Cyclophotocoagulation and cyclocryocoagulation as primary surgical procedures for open-angle glaucoma.
OBJECTIVE
Comparative study of cyclophotocoagulation (CPC) and cyclocryocoagulation (CCT) as primary surgical procedures in patients with open-angle glaucoma with regard to efficacy and complications.


METHODS
In this retrospective cohort study, 184 eyes of 112 patients in whom cyclodestructive surgery was performed as a primary surgical procedure were examined. CPC was performed on 133 eyes and CCT on 51 eyes. A standardised multiple measurement of intraocular pressure (IOP) was performed on all patients preoperatively and at the follow-up examination after an average of 5.5 (1.5-12) months. In addition, the best-corrected visual acuity and the number of antiglaucoma agents were recorded.


RESULTS
On average, a reduction in IOP was observed after both of the cyclodestructive procedures (CPC: -1.55 ± 2.50 mmHg, p < 0.05; CCT: -2.33 ± 3.06 mmHg; p < 0.05). The average difference in IOP reduction between the two procedures (0.78 mmHg) proved to be statistically insignificant (p = 0.08). In contrast, greater patient age and higher preoperative IOP values were found to be highly significant influencing factors. In 45 % and 70 % of the patients treated with CPC and CCT, respectively, IOP was reduced by at least 20 %, with no increase in medication or with a reduction in medication of at least one substance with no increase in pressure. CPC and CCT produced an average loss of visual acuity of more than two lines in 10.5 % and 9.8 % of cases, respectively. Permanent hypotension did not occur in any of the cases.


CONCLUSIONS
A moderate reduction in IOP is achievable with both procedures, with CCT tending to produce a greater reduction in pressure. The efficacy of primary cyclodestructive procedures increases with increasing patient age and with higher preoperative IOP values. The risk of serious complications can be considered low.
Department of Ophthalmology, Otto von Guericke University, Leipziger Straße 44, 39120, Magdeburg, Germany.
Isabel
I
Gorsler
Department of Ophthalmology, Otto von Guericke University, Leipziger Straße 44, 39120, Magdeburg, Germany.
Hagen
H
Thieme
Department of Ophthalmology, Otto von Guericke University, Leipziger Straße 44, 39120, Magdeburg, Germany. mail@dr-meltendorf.de.
Christian
C
Meltendorf
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002924:Ciliary Body / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
Cyclocryotherapy; Cyclophotocoagulation; Primary open-angle glaucoma; Primary treatment