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Contact transscleral Nd:YAG laser cyclophotocoagulation. Midterm results
J S Schuman1, A R Bellows, B J Shingleton
1New England Eye Center, Tufts University School of Medicine, Boston, MA 02111.
Ophthalmology
|July 1, 1992
Summary
Contact transscleral Nd:YAG laser cyclophotocoagulation (CYC) effectively lowers intraocular pressure in advanced glaucoma. However, midterm outcomes show a notable risk of hypotony, phthisis, and vision loss, necessitating careful patient selection.
Area of Science:
- Ophthalmology
- Glaucoma treatment
- Laser therapy
Background:
- Transscleral Nd:YAG laser cyclophotocoagulation (CYC) shows promise for glaucoma management.
- Concerns exist regarding hypotony and vision loss with noncontact CYC.
- This study evaluates the intermediate-term effects of contact CYC.
Purpose of the Study:
- To assess the intermediate-term efficacy and safety of contact transscleral Nd:YAG laser cyclophotocoagulation (CYC).
- To determine the impact of CYC on intraocular pressure and visual outcomes in advanced glaucoma patients.
Main Methods:
- A cohort of 116 eyes from 114 patients with advanced glaucoma underwent contact CYC.
- Patients were followed for a minimum of 1 year, with an average follow-up of 19 months.
- Intraocular pressure (IOP) and visual acuity were monitored throughout the study period.
Main Results:
- Mean preoperative IOP decreased significantly from 35.0 mmHg to 18.6 mmHg post-treatment.
- Successful IOP control (3-25 mmHg) was achieved in 72% of eyes; 27% required retreatment.
- Despite IOP reduction, 9.7% of eyes experienced hypotony or phthisis, and some eyes with good initial vision lost acuity.
Conclusions:
- Contact CYC offers encouraging midterm IOP reduction for advanced glaucoma.
- A significant incidence of hypotony, phthisis, and visual deterioration remains a concern.
- Careful patient selection and monitoring are crucial for optimizing outcomes with contact CYC.