Micropulse trans-scleral diode laser cyclophotocoagulation in refractory glaucoma: an initial experience in Indian eyes

2021 ◽  
Author(s):  
Murali Ariga ◽  
Nivean ◽  
Pratheeba Devi Nivean ◽  
V. G. Madanagopalan ◽  
Sujatha Mohan
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Open Angle Glaucoma ◽  
Small Sample Size ◽  
Small Sample ◽  
Initial Experience ◽  
Refractory Glaucoma ◽  
Surgical Success ◽  
Topical Medications ◽  
Diode Laser Cyclophotocoagulation

Abstract Purpose To evaluate the efficacy and safety of micro-pulse trans-scleral diode laser cyclophotocoagulation (MP-TSCPC) in Indian eyes with refractory glaucoma. Methods A prospective interventional short-term study was carried out with relatively small sample size of 55 eyes with refractory glaucoma. All eyes had visual acuity (VA) and intraocular pressure (IOP) measurements at baseline, 1 week (1w), 1 month (1 m) and 3 months (3 m). A single surgeon treated all eyes with recommended MP-TSCPC treatment settings. Surgical success was defined as achieving an IOP between 8–21 mmHg or achieving > 20% IOP reduction. Results The age of participants was 56.98 ± 15.74 years. Our study had more number of males. VA (in logMAR) at baseline was 1.38 ± 0.99. VA was 1.43 ± 0.93 at 1w, 1.47 ± 0.94 at 1 m and 1.47 ± 0.96 at 3 m (p > 0.05 for all). IOP (in mmHg) at baseline was 30.38 ± 10.70. IOP was 15.72 ± 6.85 at 1w, 16.98 ± 8.72 at 1 m and 17.60 ± 8.40 at 3 m (p < 0.001 for all). At 3 m, 49 (89.1%) eyes had surgical success. Surgical success was lesser in primary open angle glaucoma (p = 0.03). IOP at baseline showed significant correlation with percentage reduction in IOP at each review (p < 0.05). Use of glaucoma medication reduced from 2.94 ± 0.98 to 2.01 ± 1.16 at 3 m (p < 0.001). At 3 m, hypotony was noted in 4 (7.3%) eyes and reduction in visual acuity was seen in 15 (27.3%) eyes. Conclusion Initial experience in Indian eyes has shown that MP-TSCPC is safe and effective for refractory glaucoma. Patients can expect significant IOP lowering along with reduction in number of topical medications required for control of IOP.

scholarly journals A Comparison between Tube Surgery, ND:YAG Laser and Diode Laser Cyclophotocoagulation in the Management of Refractory Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Philip A. Bloom ◽  
Colin I. Clement ◽  
Anthony King ◽  
Baha Noureddin ◽  
Kamal Sharma ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Treatment Success ◽  
Treatment Modalities ◽  
Control Group ◽  
Refractory Glaucoma ◽  
Medium Term ◽  
Control Groups ◽  
Advanced Glaucoma ◽  
Diode Laser Cyclophotocoagulation

Purpose. To compare the results of intraocular pressure (IOP) reduction by 3 treatment modalities, (a) glaucoma tube implants, (b) noncontact YAG laser cyclophotocoagulation (cycloYAG), and (c) contact transscleral diode laser cyclophotocoagulation (cyclodiode), in cases of advanced glaucoma refractory to alternative treatments.Methods. A consecutive group of 45 eyes that received cycloYAG were matched against two control groups of patients who had received tube surgery or cyclodiode, each control group having been derived from a database of patients.Results. Mean pretreatment IOP improved from 41.3, 38.6, and 32.0 mmHg for the tube, cycloYAG, and cyclodiode groups, respectively, to 16.4, 22.1, and 19.3 mmHg, respectively. Treatment success was achieved in 78%, 69%, and 71% of the tube, cycloYAG, and cyclodiode groups, respectively. Visual acuity deteriorated 2 or more Snellen lines in 16%, 7%, and 9% of the patients in the tube, cycloYAG, and cyclodiode groups, respectively. Complications included retinal detachment, hypotony, and phthisis.Conclusions. All 3 methods provided acceptable IOP lowering in the short and medium term. Control of IOP was best in patients receiving tube surgery. Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP. Tube surgery was associated with a greater incidence of sight threatening complications.

Micropulse Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

2019 ◽  
Vol 2 (6) ◽  
pp. 402-412 ◽  
Author(s):  
Giancarlo A. Garcia ◽  
Christine V. Nguyen ◽  
Aleksandr Yelenskiy ◽  
Goichi Akiyama ◽  
Brett McKnight ◽  
...  
Keyword(s):  
Diode Laser ◽  
Refractory Glaucoma ◽  
Diode Laser Cyclophotocoagulation

scholarly journals Efficacy of Microwave Pulse Diode Laser and Argon Laser Trabeculoplasty in Patients with Primary Open Angle Glaucoma

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Asma Shams ◽  
Narain Das ◽  
Noman Rashid ◽  
M. Nasir Bhatti ◽  
Beenish Khan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Microwave Pulse ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Open Angle ◽  
Argon Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Group B

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.

Efficacy of Transscleral Diode Laser Cyclophotocoagulation in Patients with Good Visual Acuity

2014 ◽  
Vol 24 (3) ◽  
pp. 375-381 ◽  
Author(s):  
Saurabh Ghosh ◽  
Sridhar Manvikar ◽  
Neeta Ray-Chaudhuri ◽  
Michael Birch
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Good Visual Acuity ◽  
Diode Laser Cyclophotocoagulation

Transscleral diode laser cyclophotocoagulation for refractory glaucoma secondary to juvenile idiopathic arthritis: a short term follow-up

2012 ◽  
Vol 33 (4) ◽  
pp. 409-413 ◽  
Author(s):  
Anna I. Dastiridou ◽  
Sofia Androudi ◽  
Anna Praidou ◽  
Periklis Brazitikos ◽  
Catherine G. Brozou ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Diode Laser ◽  
Refractory Glaucoma ◽  
Short Term ◽  
Diode Laser Cyclophotocoagulation

scholarly journals Micropulse transscleral diode laser cyclophotocoagulation a safe treatment for recalcitrant glaucoma with good visual potential using different laser source on MicroPulse MP3 probe.

2019 ◽  
Author(s):  
Ammar Hamzeh ◽  
Azhar Annayef
Keyword(s):  
Visual Acuity ◽  
Diode Laser ◽  
Delivery System ◽  
Ocular Disease ◽  
New Combination ◽  
Laser Source ◽  
Safe Treatment ◽  
Good Visual Acuity ◽  
Visual Potential ◽  
Diode Laser Cyclophotocoagulation

Abstract Glaucoma is a challenging ocular disease with different but limited treatment approaches. Diode laser through sclera is a traditional way to decrease IOP in advanced glaucomatous eyes, but with micropulse (microsecond pulsing) delivery system it became safer and more effective. In this study we retrospectively summarized IOP changes in eyes that had been treated by micropulse transscleral diode laser cyclophotocoagulation. we focused on glaucomatous eyes that had relatively good visual acuity and we used a new combination of two devices from two different companies which were infrared 810 nm laser source from (LIGHTMED CORPORATION, Tuscan, TAIWAN) with different delivery system the MicroPulse MP3 handpiece probe from (Iridex, Mountain View, CA, USA) in this way we decrease cost and showed a comparable effectivity .

Micropulse transscleral cyclophotocoagulation using a standard protocol in patients with refractory glaucoma naive of cyclodestruction

2019 ◽  
pp. 112067211987758 ◽  
Author(s):  
Soufiane Souissi ◽  
Christophe Baudouin ◽  
Antoine Labbé ◽  
Pascale Hamard
Keyword(s):  
Intraocular Pressure ◽  
Diode Laser ◽  
Glaucoma Surgery ◽  
Refractory Glaucoma ◽  
Corrected Visual Acuity ◽  
Pressure Lowering ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
Diode Laser Cyclophotocoagulation

Purpose: To assess the efficacy and safety of a standardized micropulse transscleral diode laser cyclophotocoagulation procedure in refractory glaucoma. Methods: Retrospective, interventional study in a series of 37 consecutive patients with refractory glaucoma, cyclodestructive procedure-naive, who underwent micropulse transscleral diode laser cyclophotocoagulation from December 2016 to October 2017. A successful laser treatment was defined as (1) intraocular pressure between 6 and 18 mm Hg; (2) 20% of baseline intraocular pressure reduction; (3) no additional glaucoma medications; (4) no decrease in vision due to complications or change in intraocular pressure; and (5) no need for additional glaucoma surgery except micropulse transscleral diode laser cyclophotocoagulation retreatment. Results: Mean age was 60.2 years. Mean follow-up was 9.7 ± 3.9 months. The mean preoperative intraocular pressure (28.7 mm Hg) significantly decreased to 21.0 mm Hg at 1 month, 18.5 mm Hg at 3 months, 18.4 mm Hg at 6 months, and 18.5 mm Hg at 12 months ( p < 0.01 at all time points). The mean number of preoperative glaucoma medications (4.7) decreased to 4.0 at 1 month ( p = 0.14), 4.5 at 3 months ( p < 0.05), 3.9 at 6 months ( p < 0.05), and 3.6 at 12 months ( p < 0.05). At 1 year, the success rate was 35% with a mean intraocular pressure lowering of 36%. One patient had hypotony and a loss of best-corrected visual acuity. Mild transient postoperative inflammation was observed in 8% of the cases. Conclusion: Using a standardized procedure, micropulse transscleral diode laser cyclophotocoagulation allows a mild intraocular pressure decrease with a low rate of complications and thus achieves a relatively good profit risk benefit, mostly for moderately hypertensive refractory glaucoma.

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