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Laser cyclophotocoagulation reduces IOP in certain glaucomas, but vision loss may occur

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Transscleral diode laser cyclophotocoagulation may reduce IOP and the need for IOP-lowering medications in patients with either primary open-angle glaucoma or neovascular glaucoma, according to a study by researchers in Israel.

However, "patients should be warned that visual loss may occur, especially in end-stage glaucoma," the study authors said.

Russell Pokroy, MD, and colleagues at Hadassah Medical School in Jerusalem evaluated outcomes for 25 eyes of 23 patients with primary open-angle glaucoma (POAG) and 14 eyes of 14 patients with neovascular glaucoma. All cases were treated with transscleral diode laser cyclophotocoagulation using conservative laser settings, according to the study.

Follow-up averaged 22.4 months for the POAG group and 12.9 months for the neovascular glaucoma group.

At follow-up, IOP had decreased an average of 7.3 mm Hg (29.2%) for POAG patients and an average of 13.2 mm Hg (36.6%) for patients with neovascular glaucoma.

"One eye in each group had mild hypotony of 4 mm Hg, and no eyes became phthisical," the authors said.

Both groups also required significantly less treatment with oral acetazolamide. However, postoperative visual acuity decreased in both groups, with a greater loss among eyes with POAG despite better vision initially, they noted.

Nine eyes with POAG (36%) and eight eyes with neovascular glaucoma (50%) lost at least two lines of logMAR visual acuity, according to the study, published in the January/February issue of Ophthalmic Surgery Lasers & Imaging.