Abstract
Purpose
Transscleral cyclodiode laser cyclophotocoagulation (TSCP) is often reserved for treatment of refractory glaucoma. This retrospective study investigates the safety and efficacy of TSCP among the Chinese population.
Methods
A retrospective review was performed on electronic patient records of all patients receiving TSCP between years 2009 to year 2016. Patient demographics, indication for laser, success and response rate, change in intraocular pressure (IOP), number of treatment sessions, laser energy, glaucoma medication, visual acuity, pain symptoms and complication rate were documented.
Results
The study included 126 patients: 81 patients were male and 45 were female, and the mean age was 66.6 ± 14.3 years old and the mean follow-up was 22.7 ± 14.1 months. The mean number of treatment sessions was 1.5 ± 0.8. The success rate was 67.3%. The mean IOP before TSCP was 67 ± 38.6 mmHg and 22.8 ± 14.2 mmHg after TSCP, the mean IOP reduction was 38.4%, which was statistically significant (P value < 0.001, Wilcoxon signed rank test). The mean laser energy used per eye was 72.7 ± 56.6 and 49.2 ± 22.9 J per individual treatment session. The mean number of laser shots was 15.0 ± 6.1. 71% of patients were able to reduce their glaucoma medication after TSCP, (P value < 0.01, Wilcoxon signed rank test). 86.1% of patients had improvement in pain symptoms after TSCP. The overall complication rate was 7.1%.
Conclusion
TSCP was found to be safe and effective among the Chinese population, with comparably low laser energy setting and complication rate. It was found to be most effective in treatment of glaucoma due to trauma, acute angle closure, uveitis and chronic angle closure.
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References
Kaushik S, Pandav SS, Jain R, Bansal S, Gupta A (2008) Lower energy levels adequate for effective transscleral diode laser cyclophotocoagulation in Asian eyes with refractory glaucoma. Eye (Lond) 22(3):398–405
Frezzotti P, Mittica V, Martone G, Motolese I, Lomurno L, Peruzzi S, Motolese E (2010) Longterm follow-up of diode laser transscleral cyclophotocoagulation in the treatment of refractory glaucoma. Acta Ophthalmol 88(1):150–155
Ansari E, Gandhewar J (2006) Long-term efficacy and visual acuity following transscleral diode laser photocoagulation in cases of refractory and non-refractory glaucoma. Eye 21(7):936–940
Murphy CC, Burnett CA, Spry PG, Broadway DC, Diamond JP (2003) A two centre study of the dose-response relation for transscleral diode laser cyclophotocoagulation in refractory glaucoma. Br J Ophthalmol 87(10):1252–1257
Pucci V, Tappainer F, Borin S, Bellucci R (2003) Long-term follow-up after transscleral diode laser photocoagulation in refractory glaucoma. Ophthalmologica 217(4):279–283
Iliev ME, Gerber S (2007) Long-term outcome of trans-scleral diode laser cyclophotocoagulation in refractory glaucoma. Br J Ophthalmol 91(12):1631–1635
Kirwan JF, Shah P, Khaw PT (2002) Diode laser cyclophotocoagulation: role in the management of refractory pediatric glaucomas. Ophthalmology 109(2):316–323
Rotchford AP, Jayasawal R, Madhusudhan S, Ho S, King AJ, Vernon SA (2010) Transscleral diode laser cycloablation in patients with good vision. Br J Ophthalmol 94(9):1180–1183
Cantor LB, Nichols DA, Katz LJ, Moster MR, Poryzees E, Shields JA, Spaeth GL (1989) Neodymium-YAG transscleral cyclophotocoagulation. The role of pigmentation. Invest Ophthalmol Vis Sci 30(8):1834–1837
Fankhauser F, van der Zypen E, Kwasniewska S, Rol P, England C (1986) Transscleral cyclophotocoagulation using a neodymium YAG laser. Ophthalmic Surg 17(2):94–100
Hawkins TA, Stewart WC (1993) One-year results of semiconductor transscleral cyclophotocoagulation in patients with glaucoma. Arch Ophthalmol 111(4):488–491
Wong EY, Chew PT, Chee CK, Wong JS (1997) Diode laser contact transscleral cyclophotocoagulation for refractory glaucoma in Asian patients. Am J Ophthalmol 124(6):797–804
Schlote T, Derse M, Rassmann K, Nicaeus T, Dietz K, Thiel HJ (2001) Efficacy and safety of contact transscleral diode laser cyclophotocoagulation for advanced glaucoma. J Glaucoma 10(4):294–301
Sivagnanavel V, Ortiz-Hurtado A, Williamson TH (2004) Diode laser trans-scleral cyclophotocoagulation in the management of glaucoma in patients with long-term intravitreal silicone oil. Eye 19(3):253–257
Kumar A, Dada T, Singh RP, Kedar S (2001) Diode laser trans-scleral cyclophotocoagulation for glaucoma following silicone oil removal. Clin Exp Ophthalmol 29(4):220–224
Riedel KG, Gabel V-P, Neubauer L, Kampik A, Lund O-E (1990) Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients. Graefes Arch Clin Exp Ophthalmol 228(1):19–23
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Cheung, J.J.C., Li, K.K.W. & Tang, S.W.K. Retrospective review on the outcome and safety of transscleral diode laser cyclophotocoagulation in refractory glaucoma in Chinese patients. Int Ophthalmol 39, 41–46 (2019). https://doi.org/10.1007/s10792-017-0782-1
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DOI: https://doi.org/10.1007/s10792-017-0782-1