One-Year Results of Semiconductor Transscleral Cyclophotocoagulation in Patients With Glaucoma

Hawkins, Thomas

doi:10.1001/archopht.1993.01090040080035

Cited by 81 publications

(50 citation statements)

References 12 publications

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“…2 It is accepted as a safe treatment modality in complex and refractory glaucomas, with minimal pain and inflammation. [1][2][3]7 TSCP is quick, easy to learn and does not require a sterile operating room. 5 Ideally, any treatment should reduce IOP to a satisfactory level while preserving pretreatment visual function.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Recently it has gained attention as a modality for treatment of glaucoma cases with good vision, and even as a primary surgical treatment in some situations, [5][6] thereby establishing a broader role for TSCP. We report the long-term efficacy and safety data in a group of glaucoma patients, with particular emphasis on the long-term preservation of VA in those with ambulatory vision (6/36 or better) pretreatment.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…The combination of several advantages has encouraged several groups to study the various aspects of this treatment. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Some studies have made use of these facts to attempt even primary treatment of high-risk patients, 3,18 and to compare results of cyclophotocoagulation to better-established treatment options, such as filtering surgery, and drainage implants. Unfortunately, most of these studies were retrospective, with significant variability in the energy settings and in the number of applications making comparison and inference quite difficult.…”

Section: Discussionmentioning

confidence: 99%

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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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The chief drawback of these procedures as a group is a narrow therapeutic window, which implies that there is a very small safety zone in which it is effective without causing significant complications. Currently, transcleral laser cyclophotocoagulation (TSCPC) procedures appear to provide the best combination of effectiveness, portability, expense, and ease of use.…”

Section: Introductionmentioning

confidence: 99%

“…10 The most frequently used lasers for this modality of treatment are the 1064 nm Nd:Yag lasers [8][9][10][11] and 810 nm semiconductor diode. [12][13][14][15][16][17][18][19][20][21][22][23][24] Both wavelengths can produce thermal tissue damage, and there is evidence that the semiconductor diode laser with 810 nm wavelength exhibits less scleral transmission and considerably greater absorption by melanin compared to the 1064 nm Nd:Yag laser. 25 The clinically significant effect is that the energy needed to produce comparable lesions is less with the diode laser compared to that required by the Nd:YAG laser.…”

Section: Introductionmentioning

confidence: 99%

Lower energy levels adequate for effective transcleral diode laser cyclophotocoagulation in Asian eyes with refractory glaucoma

Kaushik

Pandav

Jain

et al. 2006

Eye

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Purpose To study the treatment parameters for diode laser cyclophotocoagulation (DLCP) in Asian Indian eyes using laser energy titrated to clinical response. Methods This prospective interventional longitudinal study included 66 eyes of 66 patients with varied aetiology refractory glaucoma, no previous cycloablation, and minimum 1 year follow-up. DLCP was performed using the Oculight s Diode laser system (IRIS & Medical Instruments Inc., CA, USA). Power used per spot was titrated according to the audible 'pops' indicating tissue microexplosion. The mean laser energy delivered, post-laser intraocular pressure (IOP) reduction, complications, and requirement of re-treatment in various subgroups were analyzed. Differences in energy delivered in each subgroup were assessed by analysis of variance with post hoc Bonferroni corrections. Linear regression analysis was used to identify possible predictive factors for failure of cyclodiode therapy. Results The mean total energy delivered per eye was 87.80731.8 J (range 105.4736.8 J in neovascular glaucoma (NVG) to 61.578.8 J in uveitic glaucoma (P ¼ 0.134)). Mean pre treatment IOP was 36.4710.7 mmHg, which reduced to 19.479.8 mmHg (Po0.001) at 1 week, and 15.676.6 mmHg at 1 year. At 1 year, 58 of 66 patients had IOPo22.0 mmHg (response rate 87.8%), and six patients had hypotony (success rate 78.8%). The uveitic glaucoma group had 100% success rate. NVG group required maximum re-treatments. Conclusions DLCP with a titrated energy protocol needs resulted in lower energy in Asian Indian eyes compared to that reported in literature, and different energy levels are needed for different diseases. 'Standard treatment parameters' for DLCP may be inappropriate for all diseases and all races.

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One-Year Results of Semiconductor Transscleral Cyclophotocoagulation in Patients With Glaucoma

Cited by 81 publications

References 12 publications

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

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

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

Lower energy levels adequate for effective transcleral diode laser cyclophotocoagulation in Asian eyes with refractory glaucoma

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