Intraocular pressure control after contact transscleral diode cyclophotocoagulation in eyes with intractable glaucoma

The effect of contact transscleral diode cyclophotocoagulation (TDC) on intraocular pressure (IOP) and its safety was determined in eyes with intractable glaucoma.

The charts of 41 consecutive patients (43 eyes) who underwent the laser procedure were reviewed. After surgery, data were collected from chart entries at I hour, 1 day, 4 to 6 weeks, 4 to 6 months, and at the final visit (6-24 months). Mean differences in IOP before and after treatment were compared using the paired Student t test. Associated complications also were assessed.

The mean +/- standard deviation follow-up period was 11.9+/-5.3 months (range, 6-24 months). One patient who died after 1 month of follow-up and another patient with neovascular glaucoma who underwent an anterior chamber washout 1 week after laser to treat an uncontrolled IOP spike were excluded from the study. Repeat treatment was done in 12 (28%) eyes. At each follow-up visit postoperatively, a significant reduction from preoperative IOP was obtained (mean reduction of 50% at the final visit). At the final visit, 64% of patients achieved an IOP of <22 mmHg and a reduction of > or =20%. An IOP spike occurred in three (7%) eyes. Long-term complications included loss of vision (> or =2 lines) in eight (22%) patients, corneal decompensation in one (2%), phthisis bulbi in one (2%), and corneal graft rejection in one (2%).

Although effective IOP reduction was demonstrated in eyes with intractable glaucoma after TDC, a significant proportion (26%) of eyes had severe long-term complications.