[Cyclophotocoagulation with the diode laser. Study of long-term results]

To assess the clinical effectiveness of glaucoma therapy with diode laser cyclophotocoagulation, 106 eyes (51 eyes with primary open-angle glaucoma, 22 eyes with secondary glaucoma, 10 eyes with narrow-angle glaucoma, 23 eyes with other glaucomas) of 87 patients were treated. Using a diode laser coupled with a fiberoptic probe, ending in a focusing tip, all eyes were treated with 24-30 spots over 360 degrees and 2.8-3.5 J of energy, 1.5 mm posterior to the limbus. The intraocular pressure was obtained over a period of time until 8-24 months after operation. Additionally, morphological changes of the ciliary body were observed in 25 eyes by means of ultrasound biomicroscopy.

The IOP decreased from a baseline mean of 25.0 +/- 5.7 mm Hg to 17.6 +/- 5.3 mm Hg directly after operation and increased slightly to 18.0 +/- 6.0 mm Hg in the following 24 months. Successful control of IOP (IOP constantly < 22 mm Hg or pain relief in blind eyes) occurred in 90 of 106 eyes (84.9%). In 23 eyes more than one treatment was given. In 6 eyes another IOP-reducing operation had to be performed. In 19 eyes slightly elongated intraocular inflammatory reactions were seen, without any serious complications. The morphological investigations showed in 22 of 25 cases temporary edema of the ciliary body. A temporary detachment of the ciliary body was seen in 8 eyes.

Diode laser cyclophotocoagulation is an effective and safe procedure to reduce IOP in different types of glaucoma over a long time. Postoperatively, a temporary inflammatory reaction of the ciliary body was observed with no correlation to the degree of reduction of the IOP.