Low-dose transscleral diode laser cyclophotocoagulation (TSCPC) as a potential single treatment for primary open-angle glaucoma (POAG) in Malawi?

Purpose: To compare the efficacy of the microwave pulse diode laser and argon laser trabeculoplasty in primary open angle glaucoma. Study Design: Quasi experimental study. Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Medical College Lyari and Sindh Government Lyari General Hospital, Karachi, from October, 2017 to March, 2018. Material and Methods: One hundred and sixty patients, between 42 to 61 years with visual acuity of perception of light to 6/36 were enrolled. Patients diagnosed with POAG were included and patients with intraocular pressure of more than 40 mm Hg, previous glaucoma surgery or laser treatment and narrow angle on gonioscopy were excluded. Ophthalmic examination included visual acuity, slit lamp examination, fundus examination and visual field status using Humphrey perimeter. Patients were divided into two groups. Group A received microwave pulse diode laser (810) and Group B received argon laser trabeculoplasty. Average follow up period was 6 months. Success was assessed objectively by measuring intra ocular pressure and subjectively by visual acuity. Results: The average time-period for each procedure was 15 ± 5 minutes. In Group A, mean IOP at first week, first month, third month and sixth month was 20.79, 16.34, 16.21and 16.09 mm Hg respectively. While in Group B, IOP at first week, first, third and sixth month was 16.52, 15.76, 13.62, and 12.54 mm Hg at (P < 0.001 in both groups). Conclusion: Both microwave pulse diode laser and argon laser trabeculoplasty are effective in lowering intra ocular pressures in patients with primary open angle glaucoma.

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Long-term Follow-up of Diode Laser Trabeculoplasty for Primary Open-angle Glaucoma and Ocular Hypertension

Ophthalmology ◽

10.1016/s0161-6420(93)31428-4 ◽

1993 ◽

Vol 100 (11) ◽

pp. 1614-1618 ◽

Cited By ~ 13

Author(s):

Anthony P. Moriarty ◽

J. Dominic A. McHugh ◽

Timothy J. ffytche ◽

John Marshall ◽

A.M. Peter Hamilton

Keyword(s):

Ocular Hypertension ◽

Diode Laser ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Open Angle ◽

Laser Trabeculoplasty ◽

Long Term Follow Up

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The Results of Transscleral Diode Laser Cyclophotocoagulation in Micropulse Mode Treatment in Patients with Primary Subcompensated Open-Angle Glaucoma and Toxic-Allergic Syndrome of the Ocular Surface

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-1-77-82 ◽

2021 ◽

Vol 18 (1) ◽

pp. 77-82

Author(s):

I. E. Shvailikova ◽

E. I. Belikova ◽

A. V. Korneeva

Keyword(s):

Diode Laser ◽

Postoperative Period ◽

Ocular Surface ◽

High Efficiency ◽

Antihypertensive Drugs ◽

Open Angle Glaucoma ◽

Case Reports ◽

Open Angle ◽

Wide Range ◽

Diode Laser Cyclophotocoagulation

Purpose: to analysis the results of microimpulse transscleral diode laser cyclophotocoagulation (DCPC) technique as a method of choice in patients with open-angle subcompensated glaucoma (OAG) with toxic allergic syndrome of the ocular surface (TASOS).Methods. The retrospective analysis of patients’ case reports with subcompensated open-angle glaucoma and TASOS was performed. Transscleral diode laser cyclophotocoagulation (DCPC) in a microimpulse mode was used in their treatment. A total of 19 patients’ case reports were analyzed.Results. In the postoperative period, its course, patient’s complaints, ophthalmological status, visual acuity indicators were determined. The level of intraocular pressure was measured. Almost all patients (84.2 %) reached the target level of IOP. The frequency of side effects was low. In 36.84 % of patients, symptoms of TASOS decreased in response to hypotensive treatment due to reduction of instillation frequency.Conclusion. The use of micro-pulse cyclophotocoagulation in patients with subcompensation form of OAG and toxic-allergic ocular surface syndrome (TASOS) reduces the intensity of the drop regime of antihypertensive drugs. As a result, the manifestations of TASOS are reduced, which increases the patients’ quality of life in the postoperative period. In addition, the use of DCPC in microimpulse mode leads to stabilization of functional and structural indicators, helps to prevent a decrease in visual functions. Thus, the described method is characterized by safety, high efficiency and a wide range of indications for its performance. It allows to compensate the IOP with a minimum percentage of complications and stable postoperative results.

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Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures

Clinical ophthalmology ◽

10.32364/2311-7729-2021-21-1-9-13 ◽

2021 ◽

Vol 21 (1) ◽

pp. 9-13

Author(s):

E.A. Korchuganova ◽

◽

A.Yu. Kazantzeva ◽

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Secondary Glaucoma ◽

Open Angle ◽

Uveoscleral Outflow ◽

Surgical Stimulation ◽

Diode Laser Cyclophotocoagulation ◽

Stimulation Of

Aim: to assess clinical efficacy and safety of surgical scleral rejection (SSR) vs. transscleral diode laser cyclophotocoagulation (TSCPC) in primary open-angle glaucoma (POAG) and secondary glaucoma (SG). Patients and Methods: study (prospective) group included 84 patients with POAG and SG after SSR. Control (retrospective) group included 80 patients after TSCPC. In addition, the patients were distributed by age and the stage and type of glaucoma, i.e., 128 patients were diagnosed with POAG and 36 patients were diagnosed with secondary thrombotic glaucoma. Follow-up was 24 to 36 months. IOP measurements, tonography (to assess the coefficient outflow facility / COF), ultrasound biomicroscopy of the anterior segment, visual acuity measurement, and visual field testing were performed. Results: no complications after SSR were reported in patients with POAG and SG. In contrast, postoperative complications (choroidal effusion, hyphema, and uveitis) were reported in 14% of patients after TSCPC. Long-term IOP-lowering efficacy of both procedures was similar (87% after SSR and 89% after TSCPC). In POAG, greater IOP reduction was seen after TSCPC (by 39.11%) compared to SSR (by 31.58%) (p<0.05). Meanwhile, in patients with SG, treatment outcomes were similar (IOP reduced by 36.78% after TSCPC and by 35.26% after SSR). In longterm follow-up, PVF reduced by 10.76% vs. baseline after TSCPC but increased by 11.19% vs. baseline after SSR (p≤0.05). Surgery resulted in the improvement or stabilization of visual functions. Ultrasonography has demonstrated that outflow pathways (intrascleral space and filtering bleb) remain functional after SSR in long-term follow-up. Conclusion: SSR is an alternative to cyclodestructive procedures in POAG and SG. Sclera being the final point of the uveoscleral outflow is a perspective entity to develop surgical approaches to glaucoma treatment. Keywords: surgical scleral resection, uveoscleral outflow, sclera, primary open-angle glaucoma, secondary glaucoma, glaucoma surgery, transscleral diode laser cyclophotocoagulation. For citation: Korchuganova E.A., Kazantzeva A.Yu. Surgical stimulation of uveoscleral outflow is an alternative to cyclodestructive procedures. Russian Journal of Clinical Ophthalmology. 2021;21(1):9–13. DOI: 10.32364/2311-7729-2021-21-1-9-13.

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