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Laser goniopuncture lowers IOP after deep sclerectomy but may have complications
Acta Ophthalmologica. 2010;88(1):110-115.
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After a single Nd:YAG laser goniopuncture procedure following deep sclerectomy, IOP was reduced to lower than 15 mm Hg and remained lower for 2 years or longer in approximately 50% of cases, a study found.
However, there were complications after laser goniopuncture, the study authors reported. Those complications included peripheral anterior synechiae, hypotony, late acute IOP increase, delayed bleb leak and blebitis.
The study looked at 258 eyes of 258 consecutive patients who had deep sclerectomy or deep sclerectomy combined with phacoemulsification. In 192 eyes (74.4%), mitomycin C was administered during surgery.
Laser goniopuncture was performed in 173 eyes (67%). After deep sclerectomy, mean follow-up was 40 ± 11 months, and after laser goniopuncture, mean follow-up was 31 ± 12 months. A mean interval of 10.3 ± 8.7 months separated laser goniopuncture and deep sclerectomy procedures in the study.
"At 2 years after laser goniopuncture, the probability of maintaining IOP less than 15 mm Hg with a 20% decrease from the pre-laser IOP and no further glaucoma procedure or medication was 49.7%," the study authors said. "Regular gonioscopy is recommended following [laser goniopuncture] to detect any occlusion of the goniopuncture by the iris."
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