 |
|
Diode Laser Transscleral Cyclophotocoagulation as a Primary Surgical Treatment for Primary Open-angle Glaucoma
Peter R. Egbert, MD;
Seth Fiadoyor, MD;
Donald L. Budenz, MD;
Patience Dadzie, RN;
Sally Byrd, MD
Arch Ophthalmol. 2001;119:345-350.
Objectives To evaluate the feasibility of diode laser transscleral cyclophotocoagulation
(TSCPC) as a primary surgical treatment for primary open-angle glaucoma and
to compare 2 laser energy settings used for treatment.
Methods In a prospective clinical trial in Cape Coast and Accra, Ghana, 1 eye
of each of 92 patients with primary open-angle glaucoma was treated by diode
laser TSCPC as a primary surgical treatment. Eyes were randomly assigned to
receive treatment by 20 applications of either 1.5 W applied for 1.5 seconds
or 1.25 W applied for 2.5 seconds.
Results Seventy-nine (86%) of 92 patients completed 3 months of follow-up; follow-up
was 13.2 ± 6.0 months (mean ± SD). Intraocular pressure decreased
in 53 (67%) of the 79 eyes. The drop in intraocular pressure was 20% or more
in 37 eyes (47%) and final intraocular pressure was 22 mm Hg or less in 38
eyes (48%). An atonic pupil was a previously unreported complication that
arose in 27 (28%) of 92 eyes. There were no serious complications of hypotony,
phthisis bulbi, or sympathetic ophthalmia. Visual acuity decreased in 18 (23%)
of 79 eyes treated by TSCPC and in 10 (23%) of 47 fellow eyes treated only
with glaucoma medications. There was no difference in outcomes between the
2 laser energy settings.
Conclusions Diode laser TSCPC is a practical, rapid, well-tolerated procedure that
may provide a modest and variable lowering of intraocular pressure. The treatment,
used with conservative energy levels applied to the eye, seems to have few
serious complications, although a previously unrecognized complication of
atonic pupil needs further evaluation. A moderate variation in laser energy
settings does not influence the results of treatment.
From the Department of Ophthalmology, Stanford University, Stanford,
Calif (Drs Egbert and Byrd); Cape Coast Christian Eye Clinic, Cape Coast,
Ghana (Dr Fiadoyor and Ms Dadzie); and the Department of Ophthalmology, Bascom
Palmer Eye Institute, University of Miami, Miami, Fla (Dr Budenz). The authors
have no financial interest in and no paid consulting arrangement with IRIS
Medical Instruments, Mountain View, Calif.
RELATED ARTICLE
A New Role for Diode Laser Transscleral Cyclophotocoagulation?
M. Roy Wilson
Arch Ophthalmol. 2001;119(3):424-425.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
A two centre study of the dose-response relation for transscleral diode laser cyclophotocoagulation in refractory glaucoma
Murphy et al.
Br. J. Ophthalmol. 2003;87:1252-1257.
ABSTRACT
| FULL TEXT
Glaucoma in west Africa: a neglected problem
Egbert
Br. J. Ophthalmol. 2002;86:131-132.
ABSTRACT
| FULL TEXT
A New Role for Diode Laser Transscleral Cyclophotocoagulation?
Wilson
Arch Ophthalmol 2001;119:424-425.
FULL TEXT
|
