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S.A. Vernon, J. Koppens, J. Menon, A. Negi; Diode Laser Cyclophotocoagulation – Long Term Results of a Standard Protocol . Invest. Ophthalmol. Vis. Sci. 2005;46(13):126.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To study the long–term efficacy and safety of diode laser cycloablation under a standard protocol in refractory glaucoma. Methods: A prospective study involving 42 eyes (39 patients), observed for 36 – 84 (mean 65.7) months after cycloablation involving fourteen burns of 2W power and 2seconds duration, over 270° of the ciliary body. Results: By final review, mean intraocular pressure had dropped by 50.3% from 31.4 (+/–8.8) mmHg pre–treatment to 15.6 (+/– 6.3) mmHg (p<0.0001). 37/42 (88.1%) eyes achieved IOP <22mmHg. 35/42 (83.3%) eyes achieved IOP reduction ≥30% from baseline levels. The mean number of anti–glaucoma medications per eye reduced from 2.55 (+/–0.83) to 1.71 (+/–1.44) (p < 0.05). The percentage of eyes requiring oral acetazolamide dropped from 92.9% to 16.7%. 59.6% of eyes required multiple treatment sessions (mean 2.17). 27 (64.3%) eyes suffered deterioration, 11 (26.2%) maintained stability and 4 (9.5%) eyes exhibited improvement of visual acuity. No relationship between the number of treatment sessions and visual outcome was evident. Conclusions: This conservative repeatable protocol affords delivery of the minimum dose of photocoagulation necessary to achieve a safe, long–term ocular hypotensive response, whilst minimising the risk of serious adverse effects, and is valuable in the difficult treatment of refractory glaucoma.
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