[Diode laser cyclophotocoagulation in refractory glaucoma]

To evaluate the effect of contact transscleral diode cyclophotocoagulation for refractory glaucoma.

Thirty-three patients with intractable glaucoma were treated with contact diode cyclophotocoagulation. Laser radiation (810-nm) was delivered to the eye by a fiberoptic (G-probe) placed 1.2 mm behind the limbus. Laser setting used was 2 W power for the duration of 2 seconds. Forty to 45 laser spots were applied over 360 degrees. Intraocular pressure (IOP), the number of glaucoma medications, visual acuity and complications were all assessed at last follow-up visit 12 months after laser treatment. Success was defined as IOP of less than 22 mmHg with medications at the last follow-up visit.

The mean IOP decreased from 37.8 +/- 8.0 mmHg pre-diode treatment to 18.2 +/- 9.2 mmHg at last follow-up visit after treatment (p < 0.05). About 73% of patients achieved IOP of between 2 and 22 mmHg at final follow-up. The mean number of medications required decreased from 3.4 +/- 1.1 before to 2.4 +/- 1 after treatment (p < 0.05). Fifty five percent of the patients had a deterioration in visual acuity. Other complications were few and included transient hyphema, uveitis, choroidal detachment and hypotony.

Contact transscleral diode cyclophotocoagulation is effective in lowering IOP and reducing the number of glaucoma medications in refractory glaucoma. The deterioration in visual acuity post-laser is a limitation of the treatment.