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Therapy-resistant inflammatory glaucoma responds to transscleral red laser cyclophotocoagulation
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Transscleral red laser cyclophotocoagulation is an effective and well-tolerated procedure for treating therapy-resistant inflammatory glaucoma in adults, according to a study by researchers in Finland.
Päivi Puska, MD, and Ahti Tarkkanen, MD, of Helsinki University Eye Hospital reviewed outcomes for 48 eyes of 38 consecutive patients treated for inflammatory glaucoma with transscleral cyclophotocoagulation using either red 647 nm krypton or red 670 nm diode laser. Laser power at the scleral surface ranged from 0.35 W to 0.45 W, and the application time was 10 seconds each.
The patients averaged 36.8 years of age, with a range from 6 years to 81 years. In addition to glaucoma, 45 eyes had chronic uveitis, one had chronic scleritis and two had combined scleritis and keratouveitis. All of the eyes had failed maximum tolerated medical therapy, and 19 eyes (40%) had also failed previous antiglaucoma surgery, according to the study.
Follow-up time averaged 42.8 months and ranged from 2 months to 145 months.
After one or more cyclophotocoagulation treatments, IOP fell from a preoperative average of 35.6 mm Hg to a range of 6 mm Hg to 21 mm Hg in 75% of eyes. IOP reduction was achieved in 85% of adult patients and 54% of children, the authors reported.
More than one treatment was needed in 52% of eyes, but no cases of hypotony, phthisis bulbi or other complications occurred, they noted.
"[Cyclophotocoagulation] can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken," the authors said.
This study is published in the July-August issue of European Journal of Ophthalmology.