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Robert J. Goulet, III, Ghasem Fakhraee, Juliana Almodin, Jonathan Myers, Martin Uram, George L. Spaeth; Use of Endoscopic Cyclophotocoagulation in Patients with Uncontrolled Refractory Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2618.
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To report the results of endoscopic cyclophotocoagulation in a series of patients with refractory glaucoma.
This was a retrospective, non-comparative, chart review study. Seventeen eyes of twelve patients with refractory glaucoma were treated with endoscopic cyclophotocoagulation by a single surgeon. The records of these patients were reviewed. Data collected included age, mechanism of glaucoma, lens status, preoperative and postoperative intraocular pressure (IOP), preoperative and postoperative glaucoma medications, and intraoperative and postoperative complications.
The mean age of the patients was 57 ± 14.86 years. Mechanisms of glaucoma included primary open-angle (n=8), chronic angle-closure (n=4), pigmentary (n=2), uveitic (n=2), and congenital (n=1). The mean number of previous glaucoma surgeries was 3 ± 1.29 per eye. One eye was phakic. All other eyes were pseudophakic. The mean follow up time was 17.53 ± 13.47 months (range 2-46). The mean preoperative and final postoperative IOP was 25.12 ± 6.36 mmHg and 10.53 ± 3.84 mmHg, respectively (p<0.001). The mean number of preoperative and final postoperative glaucoma medications per eye was 3.76 ± 1.30 and 0.94 ± 1.08, respectively (p<0.001). No significant intraoperative complications were noted. Postoperative complications included one case each of serous choroidal effusion, increased lens opacity, persistent fibrinous anterior chamber clot, dislocation of retained lens material into the vitreous, and macular hemorrhage.
Endoscopic cyclophotocoagulation appears to be a relatively safe and effective method of controlling IOP in patients with refractory glaucoma. This technique seems to be a reasonable therapeutic option in the treatment of patients with glaucoma who have failed more conventional approaches.
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