Long-term Outcome of Initial Ciliary Ablation with Contact Diode Laser Transscleral Cyclophotocoagulation for Severe Glaucoma

Kosoko, Omofolasade; Gaasterland, Douglas E.; Pollack, Irvin P.; Enger, Cheryl

doi:10.1016/s0161-6420(96)30508-3

Cited by 240 publications

(188 citation statements)

References 16 publications

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“…In 25% of the study patients vision improved by 2 or more Snellen lines; 13.8% suffered a comparable loss, while the rest remained unchanged. These are promising figures when compared to those in other studies, 14,17 and this may be partly related to the higher percentage of patients with relatively good visual acuity enrolled in this study. Only few painful eyes with very little vision were included.…”

Section: Eyesupporting

confidence: 55%

Diode laser transcleral cyclophotocoagulation for refractory glaucoma: a 1 year follow-up of patients treated using an aggressive protocol

Noureddin

Zein

Haddad

et al. 2005

Eye

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Purpose To prospectively evaluate the intraocular pressure (IOP) lowering ability, retreatment rate, and complications of transcleral Diode laser cyclophotocoagulation using a higher power setting than what is generally recommended. Patients and methods A total of 36 eyes of thirty six patients with refractory glaucoma, and who fitted our inclusion criteria underwent Diode cyclophotocoagulation. The laser power was set at 2250 mW, with a duration of 2000 ms, and a total number of 28 shots for the first treatment and 20 shots for any consequent one. The patients were followed up for 1 year with the following outcomes being analysed: IOP, visual acuity, change in the number of medications, and complications. Results The mean IOP decrease was 53% (Po0.05), and 72.2% of the patients maintained an IOP r21 mmHg for the whole duration of the study The number of medications necessary to control the pressure, significantly dropped from 2.8 to 0.89 (Po0.05), and 25% of the patients needed the treatment to be repeated only once. In all, 33% of the patients improved their visual acuity after the treatment, while 22% worsened, and the rest stayed the same. The most common treatment complications were conjunctival injection and corneal oedema, and these were both transient and reversible. Conclusion The use of the higher power setting of 2250 mW, resulted in a sustained lower IOP, less use of medications, less need for retreatment, relative preservation of visual acuity, and only reversible complications.

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Section: Eyesupporting

confidence: 55%

Diode laser transcleral cyclophotocoagulation for refractory glaucoma: a 1 year follow-up of patients treated using an aggressive protocol

Noureddin

Zein

Haddad

et al. 2005

Eye

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“…Trans-scleral cyclodiode photocoagulation (TSCPC) has been demonstrated as a safe and effective method of treating intractable glaucoma in eyes retaining silicone oil. [1][2][3] Below, we describe the effect on IOP of TSCPC based on the retrospective review of medical records of patients with intravitreal silicone oil and intractable glaucoma.…”

Section: Introductionmentioning

confidence: 99%

“…2 TSCPC has recently been reported as a safe and effective method of controlling glaucoma that is refractory to medical treatment in eyes with reasonable visual potential. [1][2][3] However, there are few detailed published reports of the use of TSCPC in silicone oilrelated glaucoma. One of the largest series reported is by Bloom et al who performed TSCPC in 210 eyes with various types of glaucoma uncontrolled on medical or surgical methods including previous cycloablative treatment.…”

mentioning

confidence: 99%

Diode laser trans-scleral cyclophotocoagulation in the management of glaucoma in patients with long-term intravitreal silicone oil

Sivagnanavel

Ortiz-Hurtado

Williamson

2004

Eye

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Aims To analyse the results of contact transscleral cyclodiode photocoagulation (TSCPC) in reducing intraocular pressures (IOP) refractory to medical treatment in a group of patients with intravitreal silicone oil. Methods The medical records of 18 patients who received TSCPC were evaluated retrospectively. Success was evaluated primarily in terms of IOP control. Success was defined as a final IOP of less than 22 mmHg Results In all, 18 eyes of 18 patients were followed up for an average of 21.8 months (range 6-36) (SD ¼ 8.6). The mean pretreatment IOP was 39.6 mmHg (range 25-56 mmHg) (SD ¼ 9.3). This reduced to 20.0 mmHg (range 0-48, SD ¼ 13.5) after TSCPC, producing a mean reduction of 49% from mean pretreatment IOP levels. The overall success rate was 44% (eight eyes). Chronic hypotony occurred in two patients. IOP remained above that required to meet the IOP reduction criteria in eight patients. Conclusion Our results raise doubts about the efficacy of TSCPC in the management of glaucoma in eyes retaining silicone oil. This may relate to the long duration of silicone oil in our patients. Further studies are required to identify risk factors for treatment failure.

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“…4,5 Previously described risk factors like trauma, contact lens wear, prior refractive surgery or exposure to contaminated water were absent in our patient. The only possible associated risk in this case was the use of topical steroids, leading to a localized immunosuppressed state, resulting in secondary infection by microsporidia.…”

mentioning

confidence: 61%

“…[1][2][3] Complications, such as uveitis, pupillary distortion, conjunctival burns, hyphema, chronic hypotony, cystoid macular oedema, retinal detachment, and phthisis bulbi, have been reported. 1,[4][5][6][7][8] Two cases of scleral perforation requiring suturing were described in the published literature. 9,10 We describe a case of scleral perforation during DLTSC in a patient with pre-existing scleral thinning, confirmed with ultrasound biomicroscopy.…”

Section: Sir Scleral Perforation Following Diode Laser Trans-scleralmentioning

confidence: 99%

Scleral perforation following diode laser trans-scleral cyclophotocoagulation

Kwong

Tham

Leung

et al. 2005

Eye

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microsporidia spores, which were confirmed by 1% acid-fast stain. Polymerase chain reaction (PCR) for microsporidia was performed using primers capable of identifying several Enterocytozoon and Encephalitozoon species of microsporidia. 3 A single B270 base pair fragment was observed on agarose gel electrophoresis and ethidium bromide staining of the PCR amplified patient sample (Figure 2b). Topical steroids were discontinued and he was treated with topical 0.3% ciprofloxacin eight times daily along with topical lubricants. After 10 days, all his lesions had disappeared (Figure 1b). The patient was seronegative for HIV by ELISA test.Bilateral punctate epithelial keratopathy and conjunctivitis has been described in immunocompromised 1,2 and more recently in immunocompetent patients as well. 4,5 Previously described risk factors like trauma, contact lens wear, prior refractive surgery or exposure to contaminated water were absent in our patient. The only possible associated risk in this case was the use of topical steroids, leading to a localized immunosuppressed state, resulting in secondary infection by microsporidia. In our patient, diagnostic debridement probably debulked the epithelium of the load of organisms and hastened resolution. Contrary to belief that debridement worsens the infection by driving the organisms into the stroma; we found that debridement actually hastens resolution. 2 CommentTo the best of our knowledge, this is the first report of keratoconjunctivitis caused by microsporidia in a corneal graft. As a result of local immunosuppression, this infection can occur in patients who have been grafted, which has not previously been described. The differential diagnosis of microsporidial keratitis should be considered in this subset of patients presenting with typical features of multiple epithelial lesions in the cornea.

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Long-term Outcome of Initial Ciliary Ablation with Contact Diode Laser Transscleral Cyclophotocoagulation for Severe Glaucoma

Cited by 240 publications

References 16 publications

Diode laser transcleral cyclophotocoagulation for refractory glaucoma: a 1 year follow-up of patients treated using an aggressive protocol

Diode laser transcleral cyclophotocoagulation for refractory glaucoma: a 1 year follow-up of patients treated using an aggressive protocol

Diode laser trans-scleral cyclophotocoagulation in the management of glaucoma in patients with long-term intravitreal silicone oil

Scleral perforation following diode laser trans-scleral cyclophotocoagulation

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