Semiconductor diode laser transscleral cyclophotocoagulation versus filtering surgery with Mitomycin-C

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Interventions

Background:

• Glaucoma management often requires surgical intervention for cases with poor prognosis.
• Filtering surgery with Mitomycin-C and diode laser cyclophotocoagulation are established alternatives.
• Comparative efficacy and safety data are crucial for treatment selection.

Purpose of the Study:

• To compare the efficacy and safety of diode laser cyclophotocoagulation versus filtering surgery with Mitomycin-C in a rabbit model.
• To evaluate intraocular pressure (IOP) reduction and associated complications.

Main Methods:

• Forty pigmented rabbits underwent either filtering surgery with Mitomycin-C (MMC) or diode laser (DL) cyclophotocoagulation.
• MMC group received 0.4 mg/ml MMC during filtering surgery.
• DL group received 15 applications of 1.8 J at 270 degrees.

Main Results:

• The diode laser group showed statistically significant higher IOP lowering between days 3-13 and 45-60.
• Ocular hypertension, hyphema, and inflammation were more frequent in the DL group (p=0.00011717 for ocular hypertension).
• Microscopic analysis revealed patent sclerostomies in 60% of MMC eyes and scleral necrosis in DL eyes.

Conclusions:

• Diode laser cyclophotocoagulation proved more effective in IOP reduction than Mitomycin-C augmented filtering surgery in this model.
• Both procedures offered acceptable IOP lowering up to two months.
• Increased ocular hypertension and inflammation necessitate careful consideration of diode laser treatment risks.