Advanced uncontrolled glaucoma. Nd:YAG cyclophotocoagulation or tube surgery

Forty-five patients with advanced uncontrolled glaucoma who had had noncontact neodymium:YAG (Nd:YAG) cyclophotocoagulation were matched and compared with 45 patients who underwent tube implantation surgery. The matching was based on selected criteria, including diagnosis, number of previous operations on the index eye, number of previous glaucoma operations, aphakia, vitrectomy, and age. The drop in intraocular pressure (IOP) was statistically significant in each of the 2 groups at 1, 4, 6, and 12 months of follow-up (P less than 0.001). The tube patients needed fewer antiglaucoma medications at 1 year (P less than 0.025) and more surgical intervention for IOP control, although this was not statistically significant (P greater than 0.1). Laser treatment was repeated in 49% of cases, and age younger than 40 years was identified as a risk factor for poor response to this mode of therapy. The effect on visual acuity and the expected complications also are discussed.