Aims Transscleral diode laser cyclophotocoagulation (TSCP) is widely accepted in the treatment of refractory glaucoma especially in eyes with poor vision. However, until recently, there has been a reluctance to extend its use to eyes with good visual acuity (VA). The aims of this study were to evaluate the long-term efficacy and safety of TSCP for a range of glaucoma conditions, with particular emphasis on post-treatment VA in seeing eyes. Methods A retrospective analysis of case notes of 74 treated eyes was conducted over a period of 4-30 months (mean 12.5 months). Results Mean (SD) intraocular pressure (IOP) was reduced by 43% from 40.3 (6.7) to 21.1 mmHg (5.4) at the final index visit. Of all patients, 58% had a reduction in glaucoma drops and all discontinued oral Acetazolamide; 9% experienced complications. Mean VA was preserved in the subgroups with good vision, although 3/23 (13%) patients with primary open-angle glaucoma (POAG) lost vision due to cataract and glaucoma progression. There were no cases of hypotony (IOPp5 mmHg) or phthisis and only one eye required re-treatment. Conclusions TSCP is highly effective and safe for various types of glaucoma, and its use can be extended to eyes with good vision.

Aim To investigate the incidence and ethnic distribution of patients with symptomatic acute primary angle closure (APAC) who presented to a UK hospital serving a multicultural conurbation by a populationwide case series investigation. Methods Case series chart review of patients aged 30 years and above, who required laser peripheral iridotomy (LPI) for a primary acute angle closure event over a 7-year period. Demographic data for cases were compared to the local resident census data. Results A total of 46 local residents aged X30 years required LPI for APAC. In all, 96% of patients were Caucasian compared to the local resident population of 89% Caucasian. The overall annual APAC rate for Bolton was 4.14 cases per 100 000 population (95% CI 3.03-5.52). The standardised incidence ratio for the South Asian population was 0.78 (95% CI 0.02-4.34) and 26.6 (95% CI 0.67-148.40) for the Chinese population. Conclusions APAC incidence in South Asians was similar to that among Caucasians. The incidence of APAC patients treated in this UK department is consistent with international experience. Individuals of Chinese ethnicity were at an enhanced risk of APAC. However, these results should be interpreted with caution, as patient numbers are small.

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