Safety and Efficacy of Diode Laser Transscleral Cyclophotocoagulation in Eyes with Good Visual Acuity

Parth Shah, Amitabha Bhakta, Elizabeth A. Vanner, Krishna Kishor, David Greenfield, Arindel S Maharaj

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background/Aims: To evaluate the safety and efficacy of diode laser transscleral cyclophotocoagulation (TSCPC) in eyes with good visual acuity. Methods: A retrospective chart review identified patients that underwent TSCPC for uncontrolled intraocular pressure (IOP) from 2014 to 2016. Enrollment criteria included pre-treatment best-corrected Snellen visual acuity (BCVA) of 20/40 or better, and a minimum of 6 months of postoperative follow-up. Results: Thirty-three eyes of 33 patients (mean age 72.1±16.0y) were enrolled (mean follow-up 12.6±6.1mo). The mean (SD) IOP was reduced 48.3% from 27.1mmHg (7.8) at baseline to 13.1mmHg (4.2) at last follow-up. Reduction of 1 or more glaucoma medications was achieved in 17 eyes (51.5%) at last-follow-up. The cumulative probability of complete success (BCVA loss < 2 Snellen lines, 20% reduction IOP, no reoperation for glaucoma, no IOP <5mmHg) was 78.8% and 50% at months 6 and 12, respectively. The cumulative probability of qualified success (BCVA ≥2 lines with ≥20% reduction IOP, no reoperation for glaucoma, no IOP <5mmHg) was 90.1% and 81.3% at month six and one year respectively. Significant vision loss, defined as BCVA ≥2 lines, occurred in 33% of patients. The most common complications were post-operative iritis (56.3%)and cystoid macular edema (CME) (12.5%). Conclusions: TSCPC demonstrates a strong reduction in intraocular pressure and glaucoma medication use. However, with significant vision loss in 33% of patients, future prospective studies with a comparison group receiving traditional glaucoma surgery are needed to determine comparative safety and efficacy.

Original languageEnglish (US)
JournalJournal of Glaucoma
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • cyclodestruction
  • diode laser
  • transscleral cyclophotocoagulation
  • visual acuity

ASJC Scopus subject areas

  • Ophthalmology

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