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Paul Crichton, Isabella Irrcher, Delan Jinapriya; Modern Day Application of Trans Scleral Diode Laser Achieving Good Intraocular Pressure Control with Acceptable Risk Profile. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5622.
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© ARVO (1962-2015); The Authors (2016-present)
To report the outcomes of trans scleral diode (TSD) over a 7 year period at a tertiary care centre and to demonstrate that this intra-ocular pressure (IOP) lowering modality can be used safely and efficaciously to lower IOP, with a hypotony rate that is much lower than historically reported for this procedure.
Retrospective chart review of consecutive cases of TSDs performed by one glaucoma specialist in a tertiary care centre over a 6 year period (August 2009 to December 2015). Outcome measures were IOP lowering, change in vision, mean number of IOP lowering agents, and the number of hypotony events. The power, duration and number of shots for the TSD were recorded. This protocol received ethics approval from the Queen’s University Research and Ethics Board.
Total of 112 consecutive cases were evaluated from August 2009 to December 2015. Of these 91 were eligible and 21 were not. The ineligible charts were for not having data at the 1 month follow up or beyond. Mean age 73.53 SD 16.4; range 25-95. Mean number of shots: 16.13 SD 5. Mean power: 1991.89 SD 85.8. Mean pre-op IOP: 27.64 SD 12.4. Mean post-op IOP at 1 month: 13.61 SD 9.3 (p<0.05). At one month the number of hypotony (IOP <6) cases was 11 out of 91 cases (12.1%), however, these patients were still on IOP lowering meds and at the last follow up recorded, only 2 still had hypotony (2.2%). Mean number of IOP lowering agents per patient: 2.96 SD 1.3 pre and 2.36 SD 1.5 post. LogMar vision pre-op: 2.37 SD 2.0. LogMar vision at 1 month: 2.59 SD 2.0 (p=0.035). LogMar vision at 2 months: 2.17 SD 1.8.
Using the settings and number of shots used for TSDs at this tertiary care centre yielded a low rate of hypotony over a 6 year period. Furthermore, the average affect on vision was not significant. TSDs can be performed in a way that is both effective for IOP lowering and have minimal negative impact on vision.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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