Diode transscleral cyclophotocoagulation lowered IOP in refractory glaucoma

Contact diode laser transscleral cyclophotocoagulation lowered IOP in eyes with refractory glaucoma with few adverse events, researchers in India found.

Rakhi Mehta and colleagues at Aravind Eye Hospital in Madurai reviewed their results with diode laser transscleral cyclophotocoagulation in 106 eyes of 97 patients. All had uncontrolled IOP on maximum tolerated medical treatment and a high risk for failure of filtering surgery.

The investigators grouped cases according to glaucoma type, including 30 eyes with congenital glaucoma, 28 eyes with rubeotic glaucoma, 13 eyes with post-traumatic glaucoma, six eyes with chronic angle-closure glaucoma, three eyes with post-penetrating keratoplasty glaucoma and 21 eyes with other types of glaucoma.

With up to 18 months' follow-up, only eyes that had previously undergone vitreoretinal surgery did not show a significant reduction in IOP. Across all other glaucoma types, IOP decreased an average of 59%, from 39.6 mm Hg to 22.6 mm Hg.

Success, defined as IOP of less than 22 mm Hg, was achieved in 75 eyes (70.8%) after a single treatment and 31 eyes (29.2%) after multiple treatments (average 1.6 treatments), according to the study authors.

Hypotony was the most common adverse event, experienced in 4.7% of cases.

The study is published in the December issue of the Asian Journal of Ophthalmology.