Panretinal xenonphotocoagulation combined with cyclocryotherapy in the treatment of severe glaucoma

In 12 eyes with glaucoma (none of them neovascular and all eyes with vision) which had proved resistant to conventional types of medicine and surgery, a panretinal xenonphotocoagulation (XPRP) reduced intraocular pressure (IOP) from an average of 30 mmHg to 20 mmHg measured 3/4 month after the treatment. After cyclocryotherapy of the 2 lower quadrants (CCR), IOP, after an initial fall, had risen to pre-treatment values after a similar interval. XPRP followed by CCR had an especially strong and lasting IOP reducing effect. The combination was less painful than CCR alone, even if both generally had to be repeated. We suggest that XPRP potentiates the damage of the secretory epithelium made by CCR, by strangling the posterior (long ciliary) blood supply of the ciliary body. IOP measured 2 1/2 years after the treatments averaged 18 mmHg (range 11-22). Phthisis did not develop in any of the eyes.