Cyclocryotherapy: a review of cases over a 10-year period

There are conflicting reports on the value of cyclocryotherapy in the management of glaucoma. This retrospective study was carried out to assess the efficacy and complication rate of this procedure. The case notes of all patients undergoing cyclocryotherapy at a single centre over a 10-year period were reviewed. Case records were available for 68 eyes of 64 people. Thirty-eight eyes had neovascular glaucoma, nine had aphakic glaucoma, nine had angle closure glaucoma, three had primary open angle glaucoma, and nine had secondary open angle glaucoma. The mean follow-up periods for these groups varied from 2.0-6.3 years. The mean reduction in intraocular pressure following treatment varied from 7.9 mm Hg in the secondary open angle glaucoma group to 24.3 mm Hg in those with angle closure glaucoma. Pressure was controlled in 29.4% overall, ranging from 66.7% in the angle closure and primary open angle groups to 0% in the secondary open angle group. Of the painful eyes 71% were rendered comfortable, indicating that pain relief from cyclocryotherapy is not due solely to pressure control. 30% of the patients lost their vision following the procedure, phthisis occurred in 11.8% and four eyes (5.9%) went on to enucleation. Our results indicate that cyclocryotherapy affords good pain relief, without good pressure control, in various types of glaucoma. While there is an apparent high complication rate, visual loss and phthisis cannot be ascribed directly to the procedure, since these are eyes with a poor prognosis.