Mid-term effects of neodymium: YAG transscleral cyclocoagulation in glaucoma

Neodymium: YAG (Nd:YAG) transscleral cyclocoagulation successfully lowers intraocular pressure (IOP) over the short term in animals and humans. Twenty-eight eyes with uncontrolled glaucoma were prospectively followed over a mean period of 21.9 months. Mean pretreatment IOP was 47.5 mmHg. Mean posttreatment IOP was 19.9 mmHg (P less than 0.005). Mean (+/- standard deviation) number of treatments was 1.86 (+/- 1.11) Mean number of drugs used before and after treatment was 3.28 and 2.48, respectively (P less than 0.01). A total of 10.7% eyes went phthisical. Thirty percent of eyes with vision and good IOP control (i.e., less than 21 mmHg) lost some vision after the procedure. Neodymium:YAG transscleral cyclocoagulation appears to be an effective method of controlling IOP over the mid-term, but is associated with significant complications.