Safety and Efficacy of Transscleral Cyclodiode Laser in Advanced Glaucoma: A Retrospective, Single-center...

Glaucoma is a leading cause of irreversible blindness worldwide. Its global prevalence is projected to exceed 110 million individuals by 2040 (Tham et al., 2014). In 2020, the disease accounted for an estimated 3.6 million cases of blindness and 4 million cases of moderate to severe visual impairment. Between 3 and 17% of patients develop refractory glaucoma, in which progression continues despite maximal medical and surgical treatment (Saunders et al., 2016). Optimizing management of these patients is essential to reduce the global burden of visual disability.

This was a single-center, observational, retrospective cohort study conducted at York and Scarborough Teaching Hospitals. We included patients with refractory glaucoma treated with a single session of transscleral cyclodiode laser between 2019 and 2023. Baseline demographics, intraocular pressure (IOP), and medication use were recorded. Treatment success was defined as ≥20% reduction in IOP and a final IOP ≤ 21 mm Hg at 12 months posttreatment or cessation of oral antihypotensive medication and/or reduction in the number of topical antiglaucoma drops.

A total of 108 patients had cyclodiode laser treatment between 2019 and 2023. A total of 62 eyes from 57 patients were included. The average age of the patient was 71.5 ± 15.8 years. The mean baseline IOP was 36.4 ± 12.4 mm Hg, which significantly reduced to 19.0 ± 9.0 mm Hg at 12 months (p < 0.001). There was no significant correlation between baseline and posttreatment IOP. The average number of topical medications decreased from 3.4 ± 1.2 to 2.5 ± 1.4 (p < 0.001).

Transscleral cyclodiode laser achieved a 77.4% success rate in reducing IOP ≤ 21 mm Hg and ≥20% reduction. It was an effective and well-tolerated option for managing refractory glaucoma.

This study supports the use of a single session of transscleral cyclodiode laser as a viable standalone treatment for patients with advanced, treatment-resistant glaucoma. Its ability to significantly lower IOP and reduce the need for systemic medications, with a favorable safety profile, makes it especially valuable for elderly and frail patients who are poor candidates for further surgery.

Salari Y, Venugopal D, Sohail T, et al. Safety and Efficacy of Transscleral Cyclodiode Laser in Advanced Glaucoma: A Retrospective, Single-center Observational Cohort Study. J Curr Glaucoma Pract 2025;19(4):175-181.