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Transscleral cyclophotocoagulation in refractory acute and chronic angle closure glaucoma
Imran H Yusuf1, Mital Shah1, Asifa Shaikh1
1Department of Ophthalmology, Stoke Mandeville Hospital, Aylesbury, UK.
BMJ Case Reports
|October 2, 2015
Summary
Transscleral cyclophotocoagulation (TSCP) offers rapid intraocular pressure (IOP) control for acute and chronic angle closure glaucoma. This emergency treatment provides symptomatic relief and stabilizes IOP before definitive surgery.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Innovation
Background:
- Angle closure glaucoma is a leading cause of global blindness.
- Transscleral cyclophotocoagulation (TSCP) is typically a non-urgent procedure for advanced glaucoma.
- Refractory cases often present with severe pain and high intraocular pressure (IOP).
Observation:
- A patient with acute angle closure glaucoma received emergency TSCP 12 hours after presentation.
- This intervention reduced IOP from 68 to 10 mm Hg.
- A second patient with chronic angle closure glaucoma underwent TSCP, lowering IOP from 78 to 14 mm Hg.
Findings:
- Both patients experienced prompt IOP reduction and symptomatic relief.
- Subsequent uneventful cataract surgery was performed in both cases.
- Long-term IOP control was achieved, preserving visual acuity.
Implications:
- Emergency TSCP can be a valuable tool for rapid IOP management in acute angle closure glaucoma.
- TSCP may serve as a temporizing measure, reducing the need for immediate definitive surgery.
- This approach can facilitate subsequent cataract or glaucoma surgery with improved outcomes.
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