Diode laser cyclophotocoagulation in refractory glaucoma

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.

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Micropulsed diode laser cyclophotocoagulation in recurrent pediatric glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672119858226 ◽

2019 ◽

Vol 30 (5) ◽

pp. 1149-1155 ◽

Cited By ~ 1

Author(s):

Eman M Elhefney ◽

Tharwat H Mokbel ◽

Sherein M Hagras ◽

Ahmed A AlNagdy ◽

Adel A Ellayeh ◽

...

Keyword(s):

Intraocular Pressure ◽

Diode Laser ◽

Congenital Glaucoma ◽

Secondary Outcome ◽

Cumulative Probability ◽

Pediatric Glaucoma ◽

Significant Difference ◽

The Mean ◽

Diode Laser Cyclophotocoagulation

Purpose: To evaluate the intermediate-term efficacy and safety of micropulsed diode laser cyclophotocoagulation in recurrent pediatric glaucoma. Patients and Methods: A prospective interventional study included children <16 years old diagnosed with recurrent glaucoma, attending Mansoura University, during the period from July 2017 to November 2017. Micropulsed diode laser sessions were performed in all the cases. The main outcome was the intraocular pressure reduction with monitoring of complications as secondary outcome. The mean follow-up period was 15.08 ± 1.1 (mean: 12–16) months. Results: A total of 36 eyes of 29 patients were included (62% males) with median age of 24 months. Primary congenital glaucoma represented 47.2% of the initial diagnoses. At the 15th month, the mean intraocular pressure dropped significantly from 37.5 ± 11.3 mmHg at baseline to 20.03 ± 2.7 mmHg (p < 0.001) with 37.15% reduction. The mean number of glaucoma medications decreased significantly from 2.6 ± 0.5 pretreatment to 1.7 ± 0.6 at the 15th month (p < 0.001). A total of 24 eyes (66.7%) required second session of treatment with mean number of 1.7 ± 0.5 sessions per eye. The cumulative probability of qualified success was 69.4%, 58.3%, 52.8%, 47.2%, and 41.7% at 1, 3, 6, 12, and 15 months after treatment. Qualified success was achieved in 61% at 15 months without statistically significant difference between the initial diagnoses (p = 0.61). None of the eyes developed any major ocular complications throughout the follow-up period. Conclusion: Micropulsed diode laser was proved to be a safe approach with relative effectiveness in controlling intraocular pressure in children with recurrent glaucoma.

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

European Journal of Ophthalmology ◽

10.1177/1120672119877586 ◽

2019 ◽

pp. 112067211987758 ◽

Cited By ~ 3

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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Effect of diode laser cyclophotocoagulation in treatment of patients with refractory glaucoma

Vojnosanitetski pregled ◽

10.2298/vsp1501016c ◽

2015 ◽

Vol 72 (1) ◽

pp. 16-20 ◽

Cited By ~ 3

Author(s):

Vladimir Canadanovic ◽

Ljiljana Tusek-Ljesevic ◽

Aleksandar Miljkovic ◽

Sava Barisic ◽

Tatjana Bedov ◽

...

Keyword(s):

Diode Laser ◽

Panretinal Photocoagulation ◽

Safe Procedure ◽

Refractory Glaucoma ◽

Group I ◽

Clinical Center ◽

The Mean ◽

Group Ii ◽

Novi Sad ◽

Diode Laser Cyclophotocoagulation

Background/Aim. Refractory glaucoma is glaucoma resistant to conventional management (maximally tolerated medical therapy, one or more glaucoma surgeries) and glaucoma in cases of neovascularisation after panretinal photocoagulation or cryoablation. The aim of the study was to determine the intraocular pressure (IOP) lowering efficacy of transscleral diode laser cyclophotocoagulation (DCPC) treatment in the management of pain and IOP in patients with refractory glaucoma. Methods. This nonrandomized, retrospective study, included 95 patients (95 eyes) with refractory glaucoma treated at the University Eye Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia, between November 2007 and November 2012 in accordance with the established protocols (16-18 spots, 270?, up to 5J of energy). All the eyes were treated with transscleral DCPC (Iris Medical OcuLight SLx, Iridex Co, Mountain View, USA). Patient's symptoms, bests corrected visual acuity and IOP were recorded 7 days, and 1, 3 and 6 months after the DCPC treatment. Results. Out of 95 patients (95 eyes) enrolled in this study 24 (25.2%) were with primary (the group I), and 71 (74.5%) with secondary (the group II) glaucoma. The mean baseline IOP in these two groups was similar: 36.08 ? 8.39 mmHg for the first group and 37.36 ? 8.19 mmHg in the second group. Measurement of the mean IOP in the group I showed the following results: on the day 7 it was 13.96 ? 8.30 mmHg (62.1% decrease of the baseline value), on the day 30 it was 18.44 ? 8.85 mmHg (48.9% decrease regarding the baseline value), after 3 months it was 22.44 ? 7.36 mmHg (37.8% decrease regarding the baseline value), and after 6 months it was 25.92 ? 7.65 mmHg (28.2% decrease regarding the baseline value). Measurement of IOP in the group II showed the following results: on the day 7 it was 15.77 ? 9.73 mmHg (57.8% decrease of the baseline value), on the day 30 it was 20.14 ? 10.20 mmHg (46.1% decrease regarding the baseline value), after 3 months it was 23.46 ? 9.83 mmHg (37.2% decrease regarding the baseline value) and after 6 months it was 27.23 ? 9.87 mmHg (27.2% decrease regarding the baseline value). Pain was the main symptom in 70 (73.6%) patients before the treatment and it persisted in only 4 (4.2%) of our patients. Other complaints (burning, stinging, foreign body sensation) were experienced by 39 (41%) of the patients, postoperatively. A total of 52 (54.7%) patients had no complaints after the treatment. Conclusion. Our study confirmed that transscleral DCPC is a useful, effective and safe procedure with predictable amount of IOP decrease, which makes it the treatment of choice for refractory glaucoma.

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

BioMed Research International ◽

10.1155/2013/371951 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 16

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.

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Micropulse Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

Ophthalmology Glaucoma ◽

10.1016/j.ogla.2019.08.009 ◽

2019 ◽

Vol 2 (6) ◽

pp. 402-412 ◽

Cited By ~ 3

Author(s):

Giancarlo A. Garcia ◽

Christine V. Nguyen ◽

Aleksandr Yelenskiy ◽

Goichi Akiyama ◽

Brett McKnight ◽

...

Keyword(s):

Diode Laser ◽

Refractory Glaucoma ◽

Diode Laser Cyclophotocoagulation

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COMBINED TRANSSCLERAL DIODE LASER CYCLOPHOTOCOAGULATION AND TRANSSCLERAL RETINAL PHOTOCOAGULATION FOR REFRACTORY NEOVASCULAR GLAUCOMA

Retina ◽

10.1097/00006982-199616020-00016 ◽

1996 ◽

Vol 16 (2) ◽

pp. 164-165 ◽

Cited By ~ 8

Author(s):

JAMES C. TSAI ◽

PHILIP A. BLOOM ◽

WENDY A. FRANKS ◽

PENG T. KHAW

Keyword(s):

Diode Laser ◽

Neovascular Glaucoma ◽

Diode Laser Cyclophotocoagulation ◽

Retinal Photocoagulation

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Visual Loss After Transscleral Diode Laser Cyclophotocoagulation for Primary Open-Angle and Neovascular Glaucoma

Ophthalmic Surgery Lasers and Imaging ◽

10.3928/15428877-20080101-09 ◽

2008 ◽

Vol 39 (1) ◽

pp. 22-29 ◽

Cited By ~ 23

Author(s):

Russell Pokroy ◽

Yoel Greenwald ◽

Ayala Pollack ◽

Amir Bukelman ◽

Miriam Zalish

Keyword(s):

Diode Laser ◽

Visual Loss ◽

Neovascular Glaucoma ◽

Open Angle ◽

Diode Laser Cyclophotocoagulation

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Efficacy and safety of single Ultrasound Cyclo-Plasty to treat refractory glaucoma: Results at 1 year

European Journal of Ophthalmology ◽

10.1177/1120672120973605 ◽

2020 ◽

pp. 112067212097360

Author(s):

Zhou Longfang ◽

Hu Die ◽

Lan Jie ◽

Liu Yameng ◽

Lv Mingyuan ◽

...

Keyword(s):

Success Rate ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Neovascular Glaucoma ◽

Angle Closure ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Ocular Complications ◽

The Mean ◽

Main Complication

Purpose: To evaluate clinical efficacy and safety of single Ultrasound Cyclo-Plasty (UCP) in the treatment of advanced refractory glaucoma. Methods: From January 2018 to August 2018, 25 patients (25 eyes) with refractory glaucoma and intraocular pressure (IOP) not controlled by drugs or conventional filtering surgery were included in the study. All subjects (neovascular glaucoma [ n = 12], secondary glaucoma [ n = 6], angle closure glaucoma [ n = 6], and primary open angle glaucoma [ n = 1]) underwent 8-sector Ultrasound Cyclo-Plasty. Patients were followed-up at Day 1, Week 1, and at 1, 3, 6, and 12 months, during which the IOP, the number of IOP lowering drugs and the occurrence of ocular complications were recorded. Clinical outcomes were IOP reduction, success rate, and ocular complications. According to the glaucoma type, patients were divided into a neovascular group (NVG) and a non-NVG group for sub-analysis. Results: All patients underwent a single UCP procedure and mean IOP reduced significantly from 39.7 ± 6.1 mmHg before UCP to 27.1 ± 11.0 mmHg at 1 year ( p < 0.01) corresponding to a mean IOP reduction of 29.6%. The mean number of IOP-lowering drugs used was 2.4 ± 1.2 at baseline and 2.3 ± 1.0 at 12 months. Success rate after a single UCP procedure was achieved in 41.7% patients at 1 year, with a higher success rate in non-NVG than in the NVG group. No major postoperative complications were reported. The main complication was conjunctival congestion, anterior chamber inflammation, scleral ring congestion, and scleral inprint. Of these, scleral ring congestion and scleral imprint are relatively rare complications, which can still be observed 12 months after UCP treatment. Conclusion: UCP for refractory glaucoma is effective in reducing IOP and has a good safety profile. Success rate is lower after a single UCP in NVG than for other types of glaucoma.

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