Cyclodiode laser in the treatment of acute angle closure

To describe the outcome of using diode laser transscleral cyclophotocoagulation (cyclodiode laser) as a safe technique in managing acute angle closure refractory to conventional treatment.

This is a retrospective case series from two ophthalmic units in the United Kingdom. Five patients with acute angle closure refractory to medical and laser treatment underwent cyclodiode laser treatment. Demographic information, symptoms, medical and surgical treatment, visual outcomes, and intraocular pressure (IOP) control were recorded.

All five patients had symptomatic acute angle closure. Conventional management, including topical and systemic medical treatment, laser iridotomy and laser iridoplasty, did not achieve adequate IOP control or relieve symptoms. Emergency cyclodiode laser treatment was performed within 2-23 days of presentation. All patients subsequently required lensectomy at a later date. At final follow-up (6-14 months), all patients had visual acuity of 6/12 or better with well-controlled IOPs (≤ 17 mm Hg). Only one patient was on topical treatment. One patient developed a persistent low-grade anterior uveitis.

Cyclodiode laser is a safe alternative to emergency lensectomy or trabeculectomy in cases of acute angle closure, which do not respond to treatment.