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N. Offor, I. Chu, A. Khouri, A. Cohen, R. Fechtner; Diode Laser Cyclophotocoagulation in Pseudophakic and Phakic Eyes With Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4429.
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© ARVO (1962-2015); The Authors (2016-present)
The role of the crystalline lens as a barrier to humoral factors between the posterior and anterior segments may have an effect on severity of neovascular glaucoma (NVG) and hence on treatment with diode laser cyclophotocoagulation (DCPC). We compared the effects of DCPC on intraocular pressure (IOP) and visual acuity in phakic and pseudophakic eyes with NVG.
A total of 71 eyes of 71 patients with NVG treated with DCPC were retrospectively studied. Based on the lens status at the time of DCPC, outcomes in phakic and pseudophakic eyes were analyzed. Data were collected on IOP and visual acuity. Differences in IOP and visual acuity were compared using a student’s T-test and a Fisher’s test respectively.
Intraocular Pressure: Mean preoperative IOP was 49.7 mmHg +/- 13.1 in the phakic group and 44.23 mm Hg +/- 12.2 in the pseudophakic group. The mean postoperative IOP at 2-8 weeks was 27.8 +/- 15.0 mm Hg for the phakic group and 23.2 +/- 15.0 mm Hg for the pseudophakic group (P = 0.196). At 9-12 months the mean postoperative IOP for the phakic and pseudophakic groups were 24.6 +/- 16.7 mm Hg and 20.5 +/- 7.4 mm Hg respectively (P = 0.510). Visual acuity: Postoperative decrease in visual acuity was noted in 10/40 patients (25.0%) and 7/29 (24.1%) in the phakic and pseudophakic groups respectively at 2-8 weeks. At 9-12 months, 11 out of 23 (47.8%) phakic patients and 6 out of 10 (60%) pseudophakic patients had a decrease in visual acuity.
Lens status does not statistically affect IOP reduction or changes in visual acuity after DCPC. This study corroborates exisiting literature that shows risk of visual compromise following DCPC. The role of the crystalline lens on the development and severity of NVG remains to be fully elucidated. A trend toward decreased visual acuity was noted among pseudophakic eyes at 9-12 months. A larger study with longer follow-up will further elucidate the effects of lens status on DCPC outcomes in eyes with NVG.
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