Abstract
Purpose :
To evaluate the effect of continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) using the slow coagulation parameters on the corneal endothelium in the early postoperative periods.
Methods :
A retrospective study of glaucomatous patients who underwent slow coagulation CW-TSCPC (1250 mv power and 4-second duration). The exclusion criteria were previous ocular surgery except for cataract surgery, any corneal disease, the presence of anterior chamber intraocular lens, aphakia, previous ocular inflammation. In addition to intraocular pressure (IOP) measurements, specular microscopy values were obtained using a Konan Noncon Robo Pachy Sp-9000 noncontact-type specular microscope preoperatively, at week 1 (W1), month 1 (M1), and month 3 (M3) after TSCPC. Corneal endothelial cell density (CECD), percent hexagonality, coefficient of variation in cell area (CV), and central corneal thickness (CCT) were assessed in the central corneal area.
Results :
The study included 34 eyes of 34 patients. Mean age of the patients was 69.8±11.1 years, 19 (55.9%) patients were females, and 17 (50%) were Hispanic. Primary open angle glaucoma was the most common glaucoma type in 82.4% of the cohort. Twenty-three (67.6%) patients were pseudophakic. Treated patients received 19.1 ± 1.5 laser spots.
After TSCPC, IOP decreased from 19.2±6.5 mmHg at baseline to 13.6±5.2 mmHg at W1 (p<0.001), 14.1±3.7 mmHg at M1 (p<0.001), and 13.9±5.5 mmHg at M3 (p<0.001).
CECD changed from 2517.2±147.1 cell/mm2 at baseline to 2590.2±151.7 cells/mm2 at W1, 2443.3±314.3 cell/mm2 at M1, and 2394.0±560.6 cell/mm2 at M3 (p=0.58, p= 0.507, p=0.882 respectively). CV values were 38.3±7.4% at baseline, 37.4±6.6% at W1, 53.0±44.9 at M1, and 51.1±40.9 at M3 (all p>0.05). No statically significant changes in the percentage of hexagonal cells were noted during the follow up period (p=0.192 at W1, p=0.977 at M1 and p=0754 at M3). CCT changed from 515.9±37.7 μm at baseline to 561.1±56 μm at W1(p=0.006), 538±48.7μm at M1 (p=0. 21) and 532.5±44.8 μm at M3(p=0.356).
No major complications were reported during the study.
Conclusions :
Slow coagulation TSCPC is an efficient and relatively safe procedure with no significant corneal changes noted in patients during the early postoperative period. Studies with longer follow up periods are required for further evaluation of the long-term effect of cyclophotocoagulation treatment on the cornea.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.