Transscleral versus endoscopic cyclophotocoagulation outcomes for refractory glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Management
• Surgical Interventions

Background:

• Refractory glaucoma presents a significant challenge in managing intraocular pressure (IOP).
• Cyclophotocoagulation techniques, including transscleral cyclophotocoagulation (TSCPC) and endoscopic cyclophotocoagulation (ECPC), are employed to reduce aqueous humor production.

Purpose of the Study:

• To compare the efficacy and safety of transscleral cyclophotocoagulation versus endoscopic cyclophotocoagulation in reducing intraocular pressure.
• To evaluate the long-term outcomes of these two cyclophotocoagulation methods in patients with refractory glaucoma.

Main Methods:

• A retrospective, non-randomized cohort study involving 62 eyes of 62 refractory glaucoma patients.
• Patients underwent either transscleral cyclophotocoagulation or endoscopic cyclophotocoagulation, with a follow-up period of 1 year.

Main Results:

• Both TSCPC and ECPC groups showed a significant reduction in IOP post-surgery.
• At 6 months and 1 year, the TSCPC group exhibited statistically lower IOP compared to the ECPC group.
• The TSCPC group had a higher success rate for achieving target IOPs (<18 mmHg and <16 mmHg), though not consistently significant across all targets.
• ECPC was associated with a statistically significant lower incidence of hypotony and two-line vision loss.

Conclusions:

• Both transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation are effective in lowering intraocular pressure in refractory glaucoma.
• Transscleral cyclophotocoagulation may offer superior IOP reduction, but is associated with a higher risk of complications.
• Endoscopic cyclophotocoagulation presents a safer profile with fewer complications, albeit with potentially less IOP reduction compared to TSCPC.