April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Outcomes of Diode Laser Cyclophotocoagulation in the Treatment of Refractory Glaucoma
Author Affiliations & Notes
  • S. S. Dewundara
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • B. A. Hughes
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • A. Goyal
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • M. S. Juzych
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • M. Y. Alexander
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • S. Ali
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • D. A. Feldman
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • O. Warritay
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • C. Kim
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • Footnotes
    Commercial Relationships  S.S. Dewundara, None; B.A. Hughes, None; A. Goyal, None; M.S. Juzych, None; M.Y. Alexander, None; S. Ali, None; D.A. Feldman, None; O. Warritay, None; C. Kim, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4433. doi:
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      S. S. Dewundara, B. A. Hughes, A. Goyal, M. S. Juzych, M. Y. Alexander, S. Ali, D. A. Feldman, O. Warritay, C. Kim; Outcomes of Diode Laser Cyclophotocoagulation in the Treatment of Refractory Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4433.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : This study was conducted to evaluate the outcomes and complications of diode laser cyclophotocoagulation (DLCP) in refractory glaucoma.

Methods: : This retrospective study analyzed 70 eyes in 68 patients with glaucoma refractory to conventional medical and/or surgical management and thereafter treated with DLCP. Patients studied had chronic open-angle glaucoma (n = 29), chronic angle-closure glaucoma (n = 20), neovascular glaucoma (n = 14) or other (n = 7) forms of glaucoma including congenital glaucoma. Patients received one treatment session per eye. Success was defined as IOP measured between 5-22 mmHg with no increase in number of antiglaucoma medications and no additional diode or incisional surgery.

Results: : Mean patient age was 63 ± 18 years (range 24 - 88 years). Thirty-six males (51%) and 34 females (49%) were studied. With respect to race, there were 47 African-Americans (67%), 15 Caucasians (21%), and 8 other (11%). Mean follow-up was 12 ± 11 months. Total laser energy delivered per eye was 38 ± 14 Watts. Patients received 20 ± 6 laser applications per session, each lasting 2 seconds in duration, ranging from 180 - 360 degrees. Mean pretreatment IOP was 37 ± 12 mmHg and mean post-treatment IOP at 24 months was 19 ± 9 mmHg (P=0.002). Mean number of antiglaucoma medications used decreased from 3.1 ± 1.1 to 2.2 ± 0.4 by 24 months (P<0.05). A success of 42% was noted at median follow up of nine months. There was no difference with respect to type of glaucoma and success of treatment (P>0.05). Median pretreatment visual acuity was hand motion and median post-treatment visual acuity was light perception at 9 months follow up (P=0.025). Persistent hypotony developed in four eyes (5.7%) within one month post-treatment.

Conclusions: : With significant reductions in IOP and number of medications, DLCP is a safe and effective alternate treatment for refractory glaucoma. However, visual acuity may be affected nine months post-treatment. Type of glaucoma did not impact success of treatment. Hypotony is the most common complication and developed within one month post-treatment.

Keywords: inflow/ciliary body • intraocular pressure • laser 
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