Glokom-Katarakt
2011 , Vol 6 , Num 2
Is Transscleral Diode Laser Cyclophotocoagulation an Effective and Safe Treatment Method in Advanced and Refractory Glaucoma?
1Gazi Üniversitesi, Göz Anabilim Dalı, ANKARA, Uzm. Dr.2Gazi Üniversitesi, Göz Anabilim Dalı, ANKARA, Asist. Dr.
3Dünya Göz Hastanesi, Göz Anabilim Dalı, ANKARA, Prof. Dr.
4Gazi Üniversitesi, Göz Anabilim Dalı, ANKARA, Prof. Dr. Purpose: To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TDLCP) in advanced and refractory glaucoma.
Materials and Methods: Patients with advanced glaucoma refractory to medical or surgical treatment who were treated with TDLCP were retrospectively evaluated. Patients' intraocular pressure (IOP) measurements, ophthalmic examinations, complications, and medications were recorded before the procedure and at the 1st day, 1st week, 1st and 6th month, 1st year, and last follow up controls. Success was defined as final IOP of 8-22 mmHg or relief of pain in the eyes.
Results: Forty-one eyes of 40 patients (15 eyes with congenital glaucoma, 3 with pseudoexfoliative glaucoma (PSX), 2 with neovascular glaucoma (NVG), and 21 with secondary glaucoma) were included in the study. Mean age of patients and follow-up time were 34.5±2.4 years (1-83) and 11.7±17.0 months (3-69), respectively. Mean IOP was 33.3±8.2 (17-58) mmHg before the procedure, whereas it was 16.8±6.4 mmHg at the 1st day (p<0.0001), 14.0±6.2 mmHg at the 1st week (p<0.0001), 18.5±9.4 mmHg at the 1st month (p<0.0001), 22.7±8.0 mmHg at the 6th month (p=0.013), 28.6±11.2 mmHg at the 1st year (p=0.242), and 17.4±5.3 mmHg (p<0.0001) at the last follow-up. IOP of 8-22 mmHg was achieved in 75.6% of eyes at the last followup visit and pain relief was observed in 9.8% of eyes. Mean treatment number was 1.53 (1-6). Complications included hyphema in 3 (7.3%) eyes, hypotonia in 2 (4.9%) eyes, and choroid detachment due to hypotonia in 1 (2.4%) eye. No phthisis bulbi occurred.
Conclusion: TDLCP is an effective and safe method for the treatment of advanced and refractory glaucoma, although repeated treatments are often necessary. Keywords : Transscleral diode laser cyclophotocoagulation, refractory glaucoma
