Change in Visual Acuity Following Trans-Scleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma

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.

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

European Journal of Ophthalmology ◽

10.5301/ejo.5000389 ◽

2014 ◽

Vol 24 (3) ◽

pp. 375-381 ◽

Cited By ~ 19

Author(s):

Saurabh Ghosh ◽

Sridhar Manvikar ◽

Neeta Ray-Chaudhuri ◽

Michael Birch

Keyword(s):

Visual Acuity ◽

Diode Laser ◽

Good Visual Acuity ◽

Diode Laser Cyclophotocoagulation

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

International Ophthalmology ◽

10.1007/s10792-012-9672-8 ◽

2012 ◽

Vol 33 (4) ◽

pp. 409-413 ◽

Cited By ~ 4

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

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

10.21203/rs.2.15190/v1 ◽

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 .

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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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