Transscleral Diode Laser Cyclophotocoagulation: A Comparison of Slow Coagulation and Standard Coagulation Techniques

Eric R.H. Duerr, Mohamed S. Sayed, Stephen J. Moster, Timothy D. Holley, Jin Peiyao, Elizabeth A. Vanner, Richard K. Lee

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose: To compare the outcomes of standard pop-titrated transscleral cyclophotocoagulation (TSCPC) and slow-coagulation TSCPC in the treatment of glaucoma. Design: Retrospective case series. Participants: Seventy-eight eyes with glaucoma of any type or stage that underwent TSCPC as part of their treatment course. Methods: This study compared 52 eyes treated with slow-coagulation TSCPC with 26 eyes treated with standard pop-titrated TSCPC. Patient demographics, treatment course, surgical techniques, settings, and outcomes were assessed. Main Outcome Measures: Visual acuity (VA), intraocular pressure (IOP), and postsurgical complications. Results: The initial mean VA was 1.94 logarithm of the minimum angle of resolution (logMAR; standard deviation [SD], 0.73 logMAR) in the slow-coagulation TSCPC group and 1.71 logMAR (SD, 0.90 logMAR) in the standard TSCPC group (P = 0.507). Initial IOP was 37 mmHg (SD, 13 mmHg) in the slow-coagulation group and 39 mmHg (SD, 13 mmHg) in the standard group (P = 0.297). The follow-up periods were 16.36 and 24.68 months for the slow-coagulation and standard groups, respectively (P = 0.124). Visual acuity remained better than light perception in 71.1% of slow-coagulation TSCPC patients and 65.0% of standard TSCPC patients (P = 0.599). Intraocular pressure remained less than 20 mmHg in 46% of slow-coagulation TSCPC patients and 44% of standard TSCPC patients (P = 0.870). The mean number of complications was higher in the standard group (1.46; SD, 1.24) versus the slow-coagulation group (0.62; SD, 0.75; P = 0.002). The incidence of the need for a second procedure (slow-coagulation group, 28.8%; standard group, 23.1%; P = 0.588) and maximum number of medications needed to control IOP after surgery (P = 0.771) were similar between the 2 groups. Conclusions: In this case series, slow-coagulation TSCPC and standard pop-titrated TSCPC resulted in similar VA and IOP outcomes in the treatment of glaucomatous eyes. The complication profiles of the techniques also were comparable, although standard TSCPC showed a higher incidence of prolonged inflammation after surgery. This study suggests that slow-coagulation TSCPC may achieve equivalent control of IOP while reducing the incidence of prolonged postoperative inflammation—a feared complication of TSCPC—when compared with standard pop-titrated TSCPC.

Original languageEnglish (US)
Pages (from-to)115-122
Number of pages8
JournalOphthalmology. Glaucoma
Volume1
Issue number2
DOIs
StatePublished - Sep 1 2018

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

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