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Contact transscleral cyclophotocoagulation with diode laser in refractory glaucoma
R Brancato1, R G Carassa, P Bettin
1Department of Ophthalmology and Visual Sciences, S. Raffaele Hospital, University of Milano, Italy.
European Journal of Ophthalmology
|January 1, 1995
Summary
Contact transscleral cyclophotocoagulation (CTCP) with diode laser effectively reduces intraocular pressure in refractory glaucoma patients. This treatment offers a successful option for both seeing and blind eyes, managing pain and improving outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Laser Therapy
Background:
- Refractory glaucoma presents a significant challenge in managing intraocular pressure (IOP).
- Traditional treatments may be insufficient for advanced or complex glaucoma cases.
- Contact transscleral cyclophotocoagulation (CTCP) is an alternative therapeutic modality.
Purpose of the Study:
- To assess the clinical efficacy of diode laser-assisted contact transscleral cyclophotocoagulation (CTCP).
- To evaluate CTCP outcomes in patients with refractory glaucoma, including those with seeing and blind eyes.
Main Methods:
- Sixty-eight patients with refractory glaucoma (48 seeing eyes, 20 blind painful eyes) underwent CTCP.
- A diode laser system delivered 16-20 laser spots (3.9 J) at 360 degrees, 1.5 mm from the corneolimbal junction.
- Treatment parameters included a 400-micron optic fiber with a 3-mm focusing tip.
Main Results:
- In seeing eyes, post-treatment IOP significantly decreased from 37.1 to 19.5 mmHg (p < 0.0001), with a 70.8% success rate (IOP ≤ 21 mmHg).
- Blind, painful eyes achieved 100% success, indicated by pain remission, with IOP dropping from 50.7 to 20.6 mmHg (p < 0.0001).
- Complications were minimal, including one case of vitreous hemorrhage and three eyes becoming hypotonic; no conjunctival, lens, or scleral damage was observed.
Conclusions:
- Diode laser CTCP is a clinically effective treatment for refractory glaucoma.
- The procedure demonstrates high success rates in reducing IOP in seeing eyes and alleviating pain in blind eyes.
- CTCP offers a safe and viable therapeutic option with a low complication profile.