Evaluation of repeated micropulse cyclophotocoagulation in patients with refractory glaucoma

PURPOSE. To evaluate the efficacy and safety of repeated micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with previously operated refractory glaucoma.MATERIALS AND METHODS. We examined 89 patients aged 74.2±7.3 years with moderate (16), advanced (58) and terminal (15) stages of uncompensated primary openangle glaucoma (POAG) before and within 12 months after the first MP-TSCPC (SUPRA 810, “Quantel Medical”, France) using standard laser parameters — 100 J. Indications for repeated MP-TSCPC were determined for 23 patients in 3 (1 patient), 6 (14 patients), 9 (8 patients) months after the first procedure. Repeated MP-TSCPC was carried out with higher impact energy — 125 J.RESULTS. After the first procedure, the hypotensive effect was achieved in 66 (74.2%) patients with refractory glaucoma lasting up to 12 months of follow-up. Repeated MP-TSCPC in 23 patients reduced the IOP by 31.2% in moderate, 31.8% in advanced, and 22.9% in terminal stages (p<0.05) by 6 months of follow-up. As a result, during 12 months of observation, MP-TSCPC (single and double) led to stabilization of the IOP in 83.1% of cases.CONCLUSION. Single and repeated micropulse TSCPC with laser energies of 100 J and 125 J is an effective and safe method of treating patients with refractory glaucoma. A single MP-TSCPC with laser energy of 100 J was effective in 66 (74.2%) patients by 12 months of observation, and single followed by repeated (laser energy of 125 J) — in 74 (83.1%) patients. It is possible to revise the basic parameters of the MP-TSCPC procedure from 100 to 125 J to achieve a longer and at the same time safe hypotensive effect in patients with refractory glaucoma.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v3 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software. Results After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05). And there were no significant differences in other complications between the two groups (P>0.05). Conclusions Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v1 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background: To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in Chinese population. Methods: We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in this two groups underwent a corresponding procedure during June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, use of anti-glaucoma agents and complications were reviewed and compared between the two groups. Results: After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents, which were used postoperatively in the two groups were both lower than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1d after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05), while there were no significant differences in other complications between the two groups (P>0.05).Conclusions: Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of ultrasound cycloplasty and transscleral cyclophotocoagulation for refractory glaucoma in Chinese population

BMC Ophthalmology ◽

10.1186/s12886-020-01655-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods We retrospectively compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software. Results After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P < 0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P>0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P < 0.05). And there were no significant differences in other complications between the two groups (P > 0.05). Conclusions Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v4 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background: To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods: We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software.Results: After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P<0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P＞0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05). And there were no significant differences in other complications between the two groups (P>0.05).Conclusions: Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v2 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

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Ahmed valve implantation results in children with uveitic glaucoma

Russian Ophthalmological Journal ◽

10.21516/2072-0076-2021-14-1-30-34 ◽

2021 ◽

Vol 14 (1) ◽

pp. 30-34

Author(s):

L. A. Katargina ◽

E. V. Denisova ◽

I. N. A. Bahaaeddin ◽

M. A. Khrabrova

Keyword(s):

Intraocular Pressure ◽

Surgical Treatment ◽

Hypotensive Effect ◽

Open Angle ◽

Anterior Chamber Angle ◽

Safe Method ◽

Ahmed Valve ◽

Valve Implantation ◽

Chamber Angle

The purpose is to evaluate the effectiveness and safety of Ahmed valve implantation in children with refractory postuveitic glaucoma (PUG).Material and methods. Ahmed valve was implanted to 10 children aged 7 to 17 years (10 eyes) with open-angle or mixed PUG uncompensated even by a maximum antihypertensive mode. Previously, all patients had undergone an average of 2.1 ± 0.9 surgeries aimed at normalizing the intraocular pressure (IOP) (predominantly, sinus trabeculectomy). 6 eyes were pseudophakic, 2 phakic, 2 aphakic. Ahmed valves were implanted according to the generally accepted technique. At the time of surgery IOP was 30.50 ± 4.35 mm Hg on average. The follow-up postsurgical period ranged from 3.9 to 23.6 months (averagely, 14.1 ± 6.5).Results. A stable hypotensive effect of the intervention was achieved in 90 % of cases, of which 3 patients had no hypotensives while 6 patients received hypotensive drugs even though their quantity was significantly smaller than before surgery (1.7 ± 1.49, p=0.028). At the end of the follow-up the average IOP was 18.1 ± 5.34 mm Hg, (significantly lower than before surgery, p = 0.008). During surgery, 1 patient experienced bleeding from the vessels of the anterior chamber angle after paracentesis, which was stopped by tamponade with sterile air. In other cases, the surgery as well as the immediate and distant postoperative period showed no complications.Conclusion. Ahmed valve implantation is an effective and safe method of the surgical treatment of refractory PUG in children and can be recommended in cases when previous antiglaucomatous operations proved ineffective, including patients with pseudophakia and aphakia.

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Longterm follow-up of diode laser transscleral cyclophotocoagulation in the treatment of refractory glaucoma

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2008.01354.x ◽

2010 ◽

Vol 88 (1) ◽

pp. 150-155 ◽

Cited By ~ 32

Author(s):

Paolo Frezzotti ◽

Vincenzo Mittica ◽

Gianluca Martone ◽

Ilaria Motolese ◽

Luca Lomurno ◽

...

Keyword(s):

Diode Laser ◽

Refractory Glaucoma ◽

Transscleral Cyclophotocoagulation

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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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Clinical Efficacy and Safety Profile of Micropulse Transscleral Cyclophotocoagulation in Refractory Glaucoma

Journal of Glaucoma ◽

10.1097/ijg.0000000000000934 ◽

2018 ◽

Vol 27 (5) ◽

pp. 445-449 ◽

Cited By ~ 35

Author(s):

Alice L. Williams ◽

Marlene R. Moster ◽

Kamran Rahmatnejad ◽

Arthur F. Resende ◽

Teresa Horan ◽

...

Keyword(s):

Clinical Efficacy ◽

Safety Profile ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Transscleral Cyclophotocoagulation

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Micropulse transscleral cyclophotocoagulation in glaucoma treatment. Preliminary results

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-2-48-51 ◽

2021 ◽

pp. 48-51

Author(s):

O.Y. Kukleva ◽

◽

K.P. Zhukov ◽

A.K. Drakon ◽

D.D. Dement'ev ◽

...

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Neovascular Glaucoma ◽

Open Angle ◽

Refractory Glaucoma ◽

Preliminary Results ◽

Average Decrease ◽

Micropulse Laser ◽

Transscleral Cyclophotocoagulation

Objective. To evaluate the preliminary results after micropulse cyclophotocoagulation in patients with primary open-angle refractory glaucoma (POAG) and neovascular glaucoma. Methods. Retrospective study of adult patients with glaucoma, with at least 6 months follow-up after the only one session of micropulse laser therapy. The study included 16 patients, 17 eyes with refractory primary open-angle glaucoma (POAG) and neovascular glaucoma. Follow up period was 6 months. The same surgical technique was used in all cases. The wavelength of the laser beam was 810 nm, the total exposure was 160 s, the energy was 2000 mJ, 31,3% of active cycle, the pulse duration was 0.5 ms, the period was 1.1 ms. Results. The average decrease in IOP was 26.6%. No complications identified Conclusions: micropulse transscleral cyclophotocoagulation has been shown to be safe and effective in lowering IOP in patients with refractory glaucoma. However, further study of this method is required. Key words: micrоpulse transscleral cyclophotocoagulation, glaucoma, intraocular pressure.

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