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Contact transscleral cyclophotocoagulation for end stage glaucoma
Annals of the Academy of Medicine, Singapore
|January 1, 1994
Summary
Transscleral cyclophotocoagulation effectively lowers intraocular pressure in refractory glaucoma. Lower laser energy reduced complications but also success rates, necessitating retreatment in 50% of cases.
Area of Science:
- Ophthalmology
- Medical Technology
Background:
- Refractory glaucoma requires effective intraocular pressure (IOP) lowering treatments.
- Cyclodestructive procedures target ciliary processes to reduce aqueous humor production.
Purpose of the Study:
- To evaluate the efficacy of Neodymium: Yttrium-Aluminium-Garnet (Nd:YAG) laser transscleral cyclophotocoagulation for pain relief and IOP control in refractory glaucoma.
- To assess the impact of a modified treatment protocol using lower total energy.
Main Methods:
- Sixteen patients with refractory glaucoma were treated using the Lasag microruptor III Nd:YAG laser.
- Laser energy was delivered transsclerally via a fiber-optic probe to the ciliary processes.
Main Results:
- Mean preoperative IOP decreased from 48.3 mmHg to 30.6 mmHg (p=0.0001) over a mean follow-up of 294 days.
- Retreatment was needed in 50% of eyes, and 27% experienced vision decrease.
- No cases of phthisis bulbi or other severe complications were observed.
Conclusions:
- Transscleral cyclophotocoagulation is an effective therapy for refractory and end-stage glaucoma.
- Lowering total energy may reduce complications but increases retreatment rates and lowers success rates.