Long-term Results of Noncontact Transscleral Neodymium, YAG Cyclophotocoagulation

Dickens, Christopher J.; Nguyen, Ngoc Hung; Mora, Justin; Iwach, Andrew G.; Gafffney, Michelle M.; Wong, Pui-Mun; Tran, Henry

doi:10.1016/s0161-6420(95)30794-4

Cited by 45 publications

(21 citation statements)

References 17 publications

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“…A critical review of various laser energy sources used in cyclophotocoagulation and techniques and experimental work for cyclocoagulation is presented below [19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92]. …”

Section: Historymentioning

confidence: 99%

Cyclodestructive Procedures

Fankhauser

Kwasniewska

2004

Ophthalmologica

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Laser cyclophotocoagulation is an accepted method of cyclodestruction, such as cyclocryothermy and the application of cyclodiathermy, microwaves and ultrasound. These procedures may be considered as ultima ratios or ‘last-resort interventions’. Also, in cases where surgery is not possible, cyclodestruction may be the initial intervention. Among other lasers, the Nd:YAG and diode lasers are the energy sources of choice. Contact and noncontact methods have about the same clinical efficiency and risk. While immediate complications are transitory, other, late complications, mentioned in the world literature, such as sympathetic ophthalmia, malignant glaucoma and retinal detachment, are more serious but are rare, and their causal relationship with the cyclodestructive procedure is doubtful. However, they still merit our attention. The ultrastructural mechanisms related to cyclocoagulation have been studied. The study of aqueous flow may improve our understanding of cyclophotocoagulation techniques. Cyclophotocoagulation is considered an important cornerstone in glaucoma therapy. The uncertainty of its effect is no greater than that of any other therapeutic measure in the treatment of glaucoma.

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Section: Historymentioning

confidence: 99%

Cyclodestructive Procedures

Fankhauser

Kwasniewska

2004

Ophthalmologica

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“…This compares favourably with other studies, [1][2][3][4][5][6][7][8][9] although direct comparisons are difficult because of different study populations and treatment protocols. 4 Other cyclodestructive procedures (cyclocryotherapy, Nd:YAG cycloablation) are associated with reduction of IOP ranging between 43 and 51% with 12-30 months follow-up, 10,11 although there are more side-effects and vision loss with those methods. 12 It is encouraging that in the subgroups with good pre-laser vision, the mean VA post-TSCP was no worse than the pre-laser level, indeed slightly better in the case of POAG patients.…”

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confidence: 99%

Long-term efficacy and visual acuity following transscleral diode laser photocoagulation in cases of refractory and non-refractory glaucoma

Ansari

Gandhewar

2006

Eye

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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.

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“…Considerando a gravidade dos casos tratados, baixos índi-ces de complicações foram obtidos e, como esperado, casos de "phthisis" foram observados (15) . Em casos de reaplicação, utilizamos menor número e menor energia que a utilizada inicialmente, para diminuirmos a incidência de complicações (17) .…”

Section: I S C U S S ã Ounclassified

“…Após um ano de tratamento, alguns autores referem taxas de sucesso de 52% (14) . Devido à alta incidência de complicações, como irite, dor, hemorragia, hipotonia e "phthisis bulbi", recomenda-se que os pacientes sejam cuidadosamente selecionados e que apresentem acuidade visual baixa e sem possibilidade de submeter-se a outros tipos de terapia (1,12,15) .…”

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Ciclofotocoagulação com laser diodo em glaucoma refratário, resultado a longo prazo

Lima¹,

Mello²,

Prata³

2003

Arq. Bras. Oftalmol.

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Objetivo: Relatar experiência de longo prazo com ciclofotocoagulação com laser diodo em glaucomas refratários. Métodos: Foram selecionados casos de glaucomas refratários com indicação de ciclofotocoagulação com laser diodo acoplado a uma sonda G (Iris Medical). Todos os procedimentos foram realizados pelo mesmo cirurgião que realizou 20 aplicações (em média) com 2000 mW de potência em 270 graus de extensão, com a sonda colocada a 1,5 mm do limbo, por 2,0 a 2,5 s. Foram incluídos somente casos com pelo menos 6 meses de seguimento. Considerou-se sucesso ci-rúrgico Po final ≤ 24mmHg ou redução maior ou igual a 30% da Po inicial com remissão dos sintomas. Resultados: 133 casos tiveram acompanhamento médio de 18,1 ± 9,6 meses e observou-se sucesso em 116 (87,2%) casos e 17 (12,7%) casos de insucesso. A Po inicial média foi 48,20 ± 12,11mmHg e a final 19,93 ± 11,93mmHg (p < 0,0001), com uma redução média de -55,62 ± 29,37%. As principais complicações foram "phthisis bulbi" em 7 (5,2%) casos e hipotonia prolongada em 6 (4,5%) casos. Conclusão: Observaramse freqüência de sucesso e níveis de Po pós-operatório satisfatórios, com incidência relativamente baixa de complicações, considerando-se a refratariedade dos casos.Cyclophotocoagulation with diode laser in refractory glaucoma, long-term resultsRealizado na Universidade Federal de São Paulo -UNIFESP -Sub-Especialidade: Glaucoma

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Long-term Results of Noncontact Transscleral Neodymium, YAG Cyclophotocoagulation

Cited by 45 publications

References 17 publications

Cyclodestructive Procedures

Cyclodestructive Procedures

Long-term efficacy and visual acuity following transscleral diode laser photocoagulation in cases of refractory and non-refractory glaucoma

Ciclofotocoagulação com laser diodo em glaucoma refratário, resultado a longo prazo

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