Introduction: Transscleral diode laser cyclophotoco-agulation is new
cyclodestructive procedure for the treatment of refractory, advanced
glaucoma. Comparing to other cyclophotocoagulation it is more safe and
selective. Aim of the study: To evaluate the efficacy and safety of
transscleral diode laser cyclophotocoagulation in treatment of refractory
glaucoma. Material: A retrospective cohort study included 35 patients (36
eyes) with refractory glaucoma treated in Centre for Sight "Oftalmika", form
March 2008 to February 2012. All patients were treated by transscleral diode
laser cyclophotocoagulation. The mean age was 68.8 ? 16.8 years. Most
prevalent type was the neovascular glaucoma (23 ili 65.7%). The treatment
consisted of 16-20 applications of 1.5-2.0 W energy applied for 1.5-2.0
seconds. Results: The average IOP reduction was 33.4mmHg or 63,1%. The best
treatment result was achieved in the neovascular glaucoma, where IOP
reduction 6 months after the procedure was 71,2 %. The poorest results were
obtained in congenital glaucoma (28,5%). Prior ciclodestructive procedures
and/or filtration glaucoma procedures did not influence laser treatment
results. In only 5,7% patients repeated procedures were indicated. Overall
complication rates was 22,8%, and the most prevalent complications were
hyphema and reversible keratopathy (8,6% eyes). Postoperative hypothonia had
one patient. Number of antiglaucoma medications, 6 months after the
treatment, was reduced by 1,1 (45,7%). Medication reduction was most
prevalent in the case of seconday glaucoma 1,4 (52,6%), and the least
prevalent in congenital glaucoma 0,5 (14,3%). Only one patient had occasional
pain after the procedure. Conclusion: Transscleral diode laser
cyclophotoco-agulation is safe and effective procedure in the treatment of
refractory glaucoma. The best treatment result was achieved in the
neovascular glaucoma, and the poorest in congenital glaucoma. Effect of the
procedure on pain relif is unequivocal.
Combined diode laser cyclophotocoagulation and intravitreal bevacizumab (Avastin) in neovascular glaucoma
