Efficacy of Cyclocryotherapy and Transscleral Diode Laser Cyclophotocoagulation in the Management of Refractory Glaucoma

Miljković, Aleksandar; Babić, Nikola; Čanadanović, Vladimir; Davidović, Sofija; Ljikar, Jelena; Vasin, Marija

doi:10.20471/acc.2021.60.02.01

Cited by 4 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ten respondents (27.8%) have difficulty watching movies, sporting events or playing games. These findings from our questionnaire represent evidence of the minimal impact of cyclocryopexy on vision, the feeling of pain or discomfort from the patient's point of view, and the overall post-surgery comfort of the patient in the post-surgery period, as described in the work of Miljiković et al [17] from 2021. According to the questionnaire, 16 respondents underwent trabeculectomy (25%).…”

Section: Discussionsupporting

confidence: 69%

Analysis of subjective signs in patients after secondary glaucoma surgeries

Sekac

Popov

et al. 2023

Oftalmol Zh

View full text Add to dashboard Cite

Purpose Implementation of quality-of-life standards for patients with secondary glaucoma after surgery. Material and methods Data analysis included secondary surgical glaucoma patients with a time interval of 4 years. Patients were followed up to 3 years after surgery to answer questions related to subjective perceptions after the surgical intervention (pain, discomfort, near vision, distance vision, intermediate vision, and normal activity). We were also interested in the overall quality of life and the effect on the patient's psyche when performing certain surgical techniques. Results As part of the questionnaire, patients were asked 36 questions. Responses were received from 98 patients. Thirty-five respondents (97.2%) of patients who underwent cyclocryopexy reported tolerable, minimal, or no pain during and immediately after surgery, with the majority of patients reporting minimal pain. Twenty-one patients (58.3%) did not complain of pain until one year after surgery. According to the survey, 16 respondents (25%) had undergone trabeculectomy. Most respondents reported tolerable pain during surgery, minimal pain for 2 weeks after surgery, and no or minimal pain 2 years after surgery. Eleven respondents (68.8%) answered that their eyesight improved in daily life, but the majority of nine (56.3%) did not notice any change in their vision during short-distance movement, short-distance work, or reading. Most serious problems had patients after cyclocryocoagulation or enucleation of the eye globe. Conclusion Secondary glaucoma surgery for every patient should be personalized and tailored to the patient's every need, taking into account the patient's current health status, knowledge and skills as well as socioeconomic circumstances.

show abstract

Section: Discussionsupporting

confidence: 69%

Analysis of subjective signs in patients after secondary glaucoma surgeries

Sekac

Popov

et al. 2023

Oftalmol Zh

View full text Add to dashboard Cite

show abstract

“…A further 11 studies were later excluded: four because they were conference abstracts, two because there was no available outcome data, one because the study population was unqualified, and four because the TSCPC was conducted with an Nd: YAG laser. Thus, the meta‐analysis included nine articles for data extraction and analysis, including four (RCTs) (Liu & Tang, 2008; Miljkovic et al, 2021; Tzamalis et al, 2011; Wang et al, 2021) and five retrospective clinical controlled trials (Freigassner & Eckhardt, 2003; Goldenberg‐Cohen et al, 2005; Gorsler et al, 2015; Waibel et al, 2020; Zhang, 2010).…”

Section: Resultsmentioning

confidence: 99%

“…Even though there was no statistically significant difference between two procedures after 1 year, the mean difference in IOP decrease favoured the CCT group. However, only three studies provided information for 1 year (Freigassner & Eckhardt, 2003; Miljkovic et al, 2021; Tzamalis et al, 2011), and one study evaluated the IOP for more than 1 year postoperatively (Freigassner & Eckhardt, 2003), so the long‐term IOP‐lowering effect of the two procedures could not be systemically evaluated. Since the additional efficacy assessment in terms of antiglaucoma agent reduction, success rate, and retreatment rate did not differ significantly between the two groups, our study demonstrated that TSCPC and CCT appeared to provide comparable efficacy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transscleral cyclophotocoagulation versus cyclocryotherapy in the treatment of intractable glaucoma: A systematic review and meta‐analysis

Wang,

Yen,

Kuo

et al. 2023

Acta Ophthalmologica

View full text Add to dashboard Cite

To perform a meta‐analysis to compare the efficacy and safety of diode laser transscleral cyclophotocoagulation (TSCPC) and cyclocryotherapy (CCT) in the treatment of intractable glaucoma. Systemic searches of the Ovid MEDLINE, EMBASE, and Cochrane Library databases yielded experimental and observational comparative studies. TSCPC and CCT efficacy and safety outcomes were compared. Subgroup analyses of participant ethnicity, preoperative intraocular pressure (IOP) level, and underlying causes of glaucoma were conducted. The pooled effects were computed using the random‐effects model. The meta‐analysis included nine studies totalling 668 eyes. There was no statistically significant difference between the TSCPC and CCT groups in the IOP reduction (IOPR%), decrease in antiglaucoma medications, the operative success rate with or without medications, or retreatment rate in the efficacy analysis. In the subgroup analysis, CCT had a better IOP‐lowering effect among non‐Asian participants and a non‐inferior IOPR% to TSCPC among Asian participants. TSCPC and CCT were associated with similar rates of deterioration in visual acuity, postoperative visual analog scale, and other analysed postoperative complications in the safety analysis. In both groups, severe complications were uncommon. Diode laser TSCPC and CCT had nearly equivalent clinical efficacy in treating intractable glaucoma, while CCT demonstrated a better IOP‐lowering effect in non‐Asian. Both cyclodestructive procedures have a comparable safety profile.

show abstract

Possibilities of using regional anesthesia with diode-laser transscleral cyclophotocoagulation in children: description of clinical cases

Bersenev,

Konyaeva,

Yurchenko

2023

Regional Anesthesia and Acute Pain Management

View full text Add to dashboard Cite

BACKGROUND: Diode-laser transscleral cyclophotocoagulation (DLTCPC) is one of the most commonly used treatment options for intraocular pressure reduction in refractory glaucoma in adult and pediatric patients. To achieve the necessary effect, these operations often have to be repeated. Repeated general anesthesia inductions increase the risk of cognitive disorders in children and sometimes do not provide sufficient postoperative analgesia. OBJECTIVE: To analyze the results of transscleral DLTCPC in children under regional anesthesia and identify factors predisposing to the choice of this anesthesia method. MATERIALS AND METHODS: The study included 33 children aged 1017 years who had undergone 57 transscleral DLTCPCs in IRTC Eye Microsurgery Ekaterinburg Center between 01.09.2017 to 31.08.2022. In each case, the anesthesia method was selected individually according to the principle of reasonable sufficiency. RESULTS: Of 57 operations, 36 (73%) were performed under regional and 21 (37%) were under general anesthesia. Factors that favor regional anesthesia include (1) psycho-emotional maturity of the patient, (2) older age, and (3) greater number of previous operations. An algorithm for the selection of the anesthesia method is presented, as well as a plan for the conversation with the patient and his / her legal representatives. Regional anesthesia provides good intra- and postoperative anesthesia and prophylaxis of postoperative cognitive disorders in children who are emotionally stable and suitable for this type of anesthesia. CONCLUSION: Considering the psycho-emotional features of children, general anesthesia remains the main method in ophthalmic anesthesiology. Nevertheless, following the principle of reasonable sufficiency and accounting for the short duration of DLTCPC and the large extent of general anesthesia survived by these children previously, regional anesthesia can be successfully used in a portion of these children.

show abstract

Efficacy of Cyclocryotherapy and Transscleral Diode Laser Cyclophotocoagulation in the Management of Refractory Glaucoma

Cited by 4 publications

References 20 publications

Analysis of subjective signs in patients after secondary glaucoma surgeries

Analysis of subjective signs in patients after secondary glaucoma surgeries

Efficacy and safety of transscleral cyclophotocoagulation versus cyclocryotherapy in the treatment of intractable glaucoma: A systematic review and meta‐analysis

Possibilities of using regional anesthesia with diode-laser transscleral cyclophotocoagulation in children: description of clinical cases

Contact Info

Product

Resources

About