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Diode laser transscleral cyclophotocoagulation as a primary surgical treatment for primary open-angle glaucoma.

AbstractOBJECTIVES:
To evaluate the feasibility of diode laser transscleral cyclophotocoagulation (TSCPC) as a primary surgical treatment for primary open-angle glaucoma and to compare 2 laser energy settings used for treatment.
METHODS:
In a prospective clinical trial in Cape Coast and Accra, Ghana, 1 eye of each of 92 patients with primary open-angle glaucoma was treated by diode laser TSCPC as a primary surgical treatment. Eyes were randomly assigned to receive treatment by 20 applications of either 1.5 W applied for 1.5 seconds or 1.25 W applied for 2.5 seconds.
RESULTS:
Seventy-nine (86%) of 92 patients completed 3 months of follow-up; follow-up was 13.2 +/- 6.0 months (mean +/- SD). Intraocular pressure decreased in 53 (67%) of the 79 eyes. The drop in intraocular pressure was 20% or more in 37 eyes (47%) and final intraocular pressure was 22 mm Hg or less in 38 eyes (48%). An atonic pupil was a previously unreported complication that arose in 27 (28%) of 92 eyes. There were no serious complications of hypotony, phthisis bulbi, or sympathetic ophthalmia. Visual acuity decreased in 18 (23%) of 79 eyes treated by TSCPC and in 10 (23%) of 47 fellow eyes treated only with glaucoma medications. There was no difference in outcomes between the 2 laser energy settings.
CONCLUSIONS:
Diode laser TSCPC is a practical, rapid, well-tolerated procedure that may provide a modest and variable lowering of intraocular pressure. The treatment, used with conservative energy levels applied to the eye, seems to have few serious complications, although a previously unrecognized complication of atonic pupil needs further evaluation. A moderate variation in laser energy settings does not influence the results of treatment.
AuthorsP R Egbert, S Fiadoyor, D L Budenz, P Dadzie, S Byrd
JournalArchives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 119 Issue 3 Pg. 345-50 (Mar 2001) ISSN: 0003-9950 [Print] United States
PMID11231767 (Publication Type: Clinical Trial, Comparative Study, Evaluation Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Ciliary Body (surgery)
  • Feasibility Studies
  • Female
  • Glaucoma, Open-Angle (surgery)
  • Humans
  • Intraocular Pressure
  • Laser Coagulation
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Reoperation
  • Sclera
  • Treatment Outcome
  • Visual Acuity

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