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Laser procedures significantly reduce IOP in eyes with refractory glaucoma
Eur J Ophthalmol. 2011;21(5):589-596
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Diode laser cyclophotocoagulation and cyclocryotherapy had similar results in the treatment of refractory glaucoma, a study found.
"Diode laser cyclophotocoagulation should be considered as the primary treatment option in refractory glaucoma using an individual treatment dosage," the study authors said.
The prospective, randomized study included 40 eyes of 40 patients with refractory glaucoma. Mean patient age was 74.3 years.
Twenty eyes underwent cyclophotocoagulation, and 20 eyes underwent cyclocryotherapy. Follow-up examinations were conducted on the first 3 days and subsequently at 1 week and 1, 3, 6 and 12 months after treatment. Investigators assessed and recorded complications and discomfort rates.
A visual analogue scale was used to score patient discomfort from 1 to 10. Complete surgical success was defined as IOP less than 22 mm Hg and greater than 5 mm Hg in all eyes with logMAR visual acuity greater than 0.05, or IOP reduction greater than 30% in eyes with visual acuity less than 0.05 without additional medication or additional glaucoma surgery. Relative success was defined by the same benchmarks but with the use of additional glaucoma medication.
Results showed that in the diode laser cyclophotocoagulation group, mean IOP dropped from 44.3 mm Hg preoperatively to 24.1 mm Hg at 3 months, 22.8 mm Hg at 6 months and 22.5 mm Hg at 12 months. The reduction was statistically significant (P < .05).
In the cyclocryotherapy group, mean IOP diminished from 46.5 mm Hg to 26.6 mm Hg at 3 months, 21.2 mm Hg at 6 months and 20.6 mm Hg at 12 months. The change was statistically significant (P < .05).
Mean postoperative pain was graded as 5.6 in the diode laser cyclophotocoagulation group and 5.7 in the cyclocryotherapy group. No complications were reported.