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Transscleral contact krypton laser cyclophotocoagulation for treatment of glaucoma
I J Immonen1, P Puska, C Raitta
1Department of Ophthalmology, Helsinki University Hospital, Finland.
Purpose:
To evaluate the usefulness of the krypton laser for transscleral contact cyclophotocoagulation.
Methods:
Transscleral contact krypton laser cyclophotocoagulation was performed in 62 eyes of 57 patients with therapy-resistant glaucoma. A minimum follow-up for 6 months was obtained for 59 eyes. The krypton laser was delivered via a fiberoptic probe with compression of the sclera by the probe. The energy used was 4 to 5 J per application at the tip of the probe with an exposure time of 10 seconds.
Results:
The intraocular pressure (IOP) decreased from the baseline mean of 34.8 +/- 11.0 mmHg to 20.4 +/- 8.3 mmHg within 10 days, to 22.6 +/- 12.5 mmHg at 1 month, to 21.3 +/- 11.3 mmHg at 3 months, and to 20.9 +/- 9.1 mmHg at 6 months postoperatively. Intraocular pressures of 8 to 24 mmHg were obtained in 62% of the eyes at 1 month, 60% at 3 months, and 73% at 6 months postoperatively with one or more cyclophotocoagulations but no other hypotensive procedures. The corresponding success rates after 6 months were 82% for eyes in which the procedure was performed to preserve vision and 50% for eyes in which the procedure was performed to relieve pain. No clinical signs of scleral injury or cyclodestruction-related loss of vision were detected.
Conclusions:
Krypton laser cyclophotocoagulation appears to be an effective and well-tolerated means of lowering IOP in therapy-resistant glaucoma. An advantage of the method is that standard retinal krypton photocoagulators can be used for the procedure.