Long-term results after transscleral diode laser cyclophotocoagulation in refractory posttraumatic glaucoma and glaucoma in aphakia

Schlote, Torsten; Grüb, Matthias; Kynigopoulos, Myron

doi:10.1007/s00417-007-0708-0

Cited by 34 publications

(30 citation statements)

References 20 publications

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“…This study comprised dark-skinned pigmented Asians of North India and the 58.5 % reduction in IOP attained was very similar to success rate of 59 % documented in a recent study done on the darker pigmented races of South India [17]. This would indicate that although the effectivity varies from 34 to 87 % between lighter pigmented Caucasian race and darker pigmented Asian race [16,[18][19][20], minor alterations in brown-skinned races do not translate into significant difference in the effect of laser on the ciliary epithelium.…”

Section: Discussionsupporting

confidence: 84%

“…The various disabling complications noted after DLCP in the literature [16,[19][20][21] namely phthisis, chronic hypotony, corneal graft decompensation, macular pucker, cystoid macular edema, vitreous hemorrhage, loss of visual acuity, retinal detachment, uveitis, malignant glaucoma [22], and corneal edema [23] did not occur in this series over the entire follow-up. The lower laser parameters used avoidance of horizontal 3 and 9 o'clock meridian could be a factor which accounted for no sight threatening or severe complications in this series.…”

Section: Discussionmentioning

confidence: 75%

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Diode laser cyclophotocoagulation in Indian eyes: efficacy and safety

2016

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Diode laser cyclophotocoagulation (DLCP) has emerged as a time-tested procedure for end-stage glaucoma with fewer complications. By means of this study, we have evaluated its wide indications, its efficacy, and safety in darkly pigmented Asian Indian eyes. Ninety-one eyes with uncontrolled glaucoma presenting to glaucoma clinic of a tertiary care center over a period of 6 years were scheduled for DLCP. The semiconductor diode laser with a G probe was used with laser energy delivered about 1.5 mm behind the surgical limbus. The extent of clock hours of laser application was determined by pretreatment intraocular pressure (IOP) and superior area was spared in cases where future filtration surgery was contemplated. The DLCP was repeated earliest at 1 month in case of non-response and a maximum of three laser procedures were performed for any patient. Ninety-one eyes of 89 patients (40 males, 49 females) were included. Common indications included secondary glaucoma (37.3 %), failed trabeculectomies (27.4 %), angle closure glaucoma (17.5 %), etc. Laser power delivered ranged from 990 to 1800 mW, (mean 1396 + 182.14 mW) with an average of 17 spots. Patients improved from pretreatment IOP of 38.18 + 8.96 mmHg (range 20.6-64) to post treatment IOP of 17.86 + 7.75 mmHg (range 10-42). Qualified success was defined as final IOP of 20 mm Hg or less on topical medications that could be achieved in 70 % eyes with one or repeat treatment. Pre op visual acuity ranged from PL+ to 6/18 showing a slight improvement to PL+ to 6/12 post op. A 58.5 % reduction of IOP was noted. No incidence of serious complications was noted during follow-up ranging from 9 months to 3 years. DLCP is an effective and safe tool to be used in Indian population for control of IOP. It can be safely used as a primary modality to bring IOP to permissible levels before trabeculectomy.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 75%

Diode laser cyclophotocoagulation in Indian eyes: efficacy and safety

2016

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“…Numerous publications have reported significant ocular hypotensive effects in various types of glaucoma using diode TSCPC; furthermore, fewer complications have been encountered compared to previous modalities 13-17. By and large, TSCPC has been studied as a treatment option for glaucoma refractory to medical and/or surgical means, but a small and growing number of investigations are giving promising results for TSCPC as a primary surgical method 18-20…”

Section: Introductionmentioning

confidence: 99%

Intermediate Term Safety and Efficacy of Transscleral Cyclophotocoagulation After Tube Shunt Failure

Ness

Khaimi

Feldman

et al. 2011

Journal of Glaucoma

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Purpose To determine the efficacy and safety of diode transscleral cyclophotocoagulation (TSCPC) after tube shunt failure. Patients and Methods The patient population consisted of 32 eyes of 31 patients with uncontrolled glaucoma. Each eye had a previously implanted aqueous tube shunt and was currently on maximally tolerated medication. Each eye also underwent TSCPC treatment using the Iridex (Mountain View, CA) diode laser with a maximum of 360 degrees of treatment. All 31 charts were reviewed for data pertaining to demographics, treatment, ocular history, and follow-up clinical examinations. Safety was evaluated by complication data. Efficacy was evaluated in terms of TSCPC treatment parameters (number of laser applications, laser power, application duration, and degrees of ciliary body treated), intraocular pressure (IOP), number of hypotensive medications, and any further treatment required. Results With a mean (SD) follow-up of 17.1 (16.3) (median = 11.7) months from the last treatment, the mean IOP decreased from 28.6 (10.2) mmHg to 16.8 (7.5) mmHg (35% reduction) at 3 months (n = 30, p < 0.0001) and to 14.7 (7.9) mmHg (43% reduction) at 1 year (n = 13, p < 0.0001). Complications included hypotony (n = 4), hyphema (n = 2), failed corneal transplant (n = 1), and loss of light perception (n = 5). Conclusions TSCPC has a significant ocular hypotensive effect on glaucoma refractory to both tube shunt and medical therapy. The safety of this intervention remains unclear in this high risk patient population and warrants further study.

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“…Scholte et al reported that TDCP was less effective in younger patients with refractory glaucoma. 27 Our study showed no significant correlation between age and mean IOP reduction. The study also found a significant correlation between baseline IOP and mean IOP reduction.…”

Section: Discussionmentioning

confidence: 44%