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Study: Transscleral diode cyclophotocoagulation lowers IOP, risk for adverse events
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Sequential glaucoma drainage device implantation and transscleral diode cyclophotocoagulation both reduce IOP after failure of a primary drainage device, but cyclophotocoagulation may carry less risk for adverse events, according to a study.
The retrospective study included 32 patients who underwent sequential glaucoma drainage device (GDD) implantation and 21 patients who underwent transscleral diode cyclophotocoagulation (CPC) at Emory Eye Center, Atlanta, Georgia.
Investigators assessed efficacy of IOP reductions and major complications. Success was defined as no loss of light perception, no need for subsequent glaucoma surgery and IOP between 6 mm Hg and 21 mm Hg as measured at two consecutive office visits after 3 months. Mean follow-up was 37.9 months in the sequential GDD group and 46.3 months in the CPC group.
CPC yielded a greater reduction in IOP than sequential GDD implantation (P = .0172), with IOP decreasing an average of 40.7%, from 27.8 mm Hg to 16.5 mm Hg in the sequential GDD group (P < .0001), and an average of 56.3%, from 33.2 mm Hg to 14.5 mm Hg in the CPC group (P < .0001).
The probability of surgical success at 5 years was greater in the sequential GDD group: 65.3% vs. 58% in the CPC group. The between-group difference was statistically insignificant.
The probability of corneal failure in eyes that did not have corneal edema preoperatively was 31.6% in the sequential GDD group and 6.7% in the CPC group (P = .0828) at 3 years.
Two cases of endophthalmitis were reported in the GDD group, whereas no cases were reported in the CPC group.
“CPC after primary GDD failure warrants further investigation for use in eyes with preserved central vision as it may provide similar IOP-lowering effects with a lower risk of serious adverse events,” the researchers wrote. – by Matt Hasson
Disclosure: The study authors report no relevant financial disclosures.
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J Glaucoma. 2015;doi:10.1097/IJG.0000000000000370.
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