Higher power diode setting may be useful for glaucoma treatment

Using a higher power setting than generally recommended in cyclophotocoagulation can result in lower IOP, fewer medications for the patient and relative preservation of visual acuity, according to a study.

B.N. Noureddin and colleagues at the American University in Beirut studied 36 eyes of 36 patients with refractory glaucoma who were undergoing diode cyclophotocoagulation. For these eyes, the laser was set at 2,250 mW, for a duration of 2,000 ms and a total number of 28 shots for the first treatment and 20 shots for any subsequent treatments. Main outcome measures included IOP, visual acuity, change in the number of medications and complications. Follow-up was 1 year.

According to the study, the overall mean IOP decrease was 53%; 72.2% of the patients maintained an IOP of less than 21 mm Hg for the duration of the study. Patients went from a mean of 2.8 medications preoperatively to 0.89 medications postoperatively. The treatment needed to be repeated once in 25% of the patients, authors said.

One-third of the patients improved their visual acuity after the treatment, while 22% had a decline in their VA. Common treatment complications included conjunctival injection and corneal edema. Both the complications were transient and reversible, the authors said.

The study is published in the March issue of Eye.