Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria

Abdull, Mohammed M; Broadway, David C; Evans, Jennifer R; Kyari, Fatima; Muazu, Fatima; Gilbert, Clare

doi:10.1111/ceo.13328

Cited by 12 publications

(9 citation statements)

References 37 publications

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“…However, the effect of TSCPC on IOP was unpredictable and the side effect of an atonic pupil problematic in a sunny climate. This is in contrast with other studies, showing that TSCPC is an effective and safe method as a primary procedure in the United States and Nigeria 17,18. To our knowledge, there were no African cost-analysis studies relating to TSCPC.…”

contrasting

confidence: 84%

“…This is in contrast with other studies, showing that TSCPC is an effective and safe method as a primary procedure in the United States and Nigeria. 17 , 18 To our knowledge, there were no African cost-analysis studies relating to TSCPC. Controlled cyclophotocoagulation, a modified technique of TSCPC, and the newer micropulse TSCPC offer a potential for first-line intervention; however, limited or no trials have been performed in a non-Caucasian setting.…”

mentioning

confidence: 99%

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COVID-19 and the Rationale for Primary Selective Laser Trabeculoplasty and Diode Laser Transscleral Cyclophotocoagulation in Africa

Milad

Mikhail

Lenzhofer

et al. 2022

Journal of Glaucoma

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The recent COVID-19 pandemic has affected ophthalmologists' practices worldwide. Consequent global drug shortages and the limitations of medical glaucoma treatments in sub-Saharan Africa have highlighted the need for innovation in global ophthalmology to provide accessible, affordable, and effective glaucoma care. The role of lasers rather than medications for glaucoma patients in developing nations is emerging. Since lasers are easier to master than glaucoma surgery, it is pertinent to discuss the primary use of lasers in treating glaucoma in such nations. In particular, selective laser trabeculoplasty and diode laser transscleral cyclophotocoagulation seem to present a promising future for the treatment of glaucoma in Africa. In this report, we provide an evidence-based discussion exploring the emerging role of lasers in Africa.

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confidence: 84%

mentioning

confidence: 99%

COVID-19 and the Rationale for Primary Selective Laser Trabeculoplasty and Diode Laser Transscleral Cyclophotocoagulation in Africa

Milad

Mikhail

Lenzhofer

et al. 2022

Journal of Glaucoma

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“…Although CPC has been studied in the early stages of glaucoma (Egbert et al 2001; Kramp et al 2002; Singh et al 2017b; Abdull et al 2018), its complications remain common enough to limit its use to the treatment of glaucoma refractory to conventional surgical treatments (Michelessi et al 2018; Hasan et al 2019; Paul et al 2019) (Table 3). Moreover, the inflammatory (mostly CD4 T‐cell lymphocytic infiltrates) and fibrotic histological conjunctival lesions induced by the procedure are likely to impair future filtration blebs (Tan et al 2019).…”

Section: Cw‐tscpc and Ecpmentioning

confidence: 99%

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Souissi¹,

Mer²,

Metge³

et al. 2020

Acta Ophthalmologica

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Purpose Continuous‐wave cyclophotocoagulation (CW‐CPC) is often preferred to medical and surgical treatments for managing refractory glaucoma. This review summarizes diode CW‐CPC indications, history, histopathology, methods, efficacy and safety. It also provides an overview of the latest data available on micropulse transscleral laser treatment (MP‐TLT) that uses repetitive micropulses of diode laser energy in an off‐and‐on cyclical fashion. Methods A literature review was conducted on transscleral CW‐CPC (CW‐TSCPC), endoscopic CPC (ECP) and MP‐TLT. Relevant series of adult and paediatric patients were included for assessing the procedures. Results Regarding CW‐TCPC, highly variable success rates are reported in the literature, depending on the definition of success, type of underlying glaucoma, energy settings, follow‐up duration and retreatment rates. CW‐CPC often needs to be repeated, especially in paediatric patients. CW‐CPC exposes to risks of inflammation and chronic ocular hypotony or phthisis with irreversible visual loss. CW‐TSCPC has mainly been used in very severe forms of glaucoma, in painful eyes with limited visual potential or after filtering surgery failure. Published data on ECP are more limited but overall good success rates have been reported. Through the direct visualization of the targeted ciliary body in anatomically abnormal eyes, ECP is the preferred surgical procedure in paediatric refractory glaucoma. Complication rates are relatively low after ECP; however, large studies with long‐term follow‐up are needed. ECP may be used in difficult, refractory cases, but it is often used earlier when combined with cataract surgery. Despite limited data on the exact mechanism of action of MP‐TLT and a lack of standardization of laser settings, the first data from heterogeneous case series shows that it has a similar efficacy and a better safety profile compared to CW‐TSCPC in the medium term. Conclusion Although they may lead to sight‐threatening complications, both CW‐TSCPC and ECP seem effective. ECP appears to be superior to CW‐TSCPC in paediatric refractory glaucoma. Unlike ECP combined with cataract surgery, evidence supporting a wider use of CW‐TSCPC and MP‐TLT in earlier stages of neuropathy is lacking. While it now appears that the safety profile of MP‐TLT is superior to that of CW‐CPC, robust prospective comparative studies including homogeneous and well‐defined cohorts of patients are still needed to confirm an at least comparable efficacy in the long term.

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“…To our knowledge, there are no other studies of MPCPC other than those reported in this paper, although we did find the study of Abdull et al. [ 14 ], who investigated the safety and effectiveness of continuous CPC in Nigeria (Africa). In this large cohort of 201 eyes, 11 cases of mild anterior uveitis and one case of severe uveitis have been reported as complications.…”

Section: Discussionmentioning

confidence: 72%

“…Furthermore, it is important to remember that Abdull et al. [ 14 ] analyzed patients treated by continuous CPC and not micropulse CPC like our patient.…”

Section: Discussionmentioning

confidence: 97%

Intermediary inflammatory reaction after micropulse cyclophotocoagulation diode therapy: a case report

2022

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Introduction Of the many types of laser cyclophotocoagulation procedures, micropulse cyclophotocoagulation diode is praised as a noninvasive, safe, and effective procedure with few complications. In this case report, we describe a rare complication that, to the best of our knowledge, has not been previously reported. Case report We report on the case of a 66-year-old African man with a history of end-stage primary open-angle glaucoma. One week after undergoing micropulse cyclophotocoagulation diode therapy in both eyes, he developed severe intermediary inflammation in one eye, associated with decreased visual acuity. The intraocular pressure had significantly decreased after the procedure and was well controlled with intraocular-pressure-lowering medications. Slit lamp examination revealed a moderate anterior chamber inflammation, anterior vitritis, and a large inflammatory membrane attached to the posterior surface of the intraocular implant. A vitrectomy was finally performed in the left eye because of the persistent intermediary inflammation despite the use of high doses of topical and subconjunctival corticosteroids. Conclusion Intermediary uveitis is a rare complication after micropulse cyclophotocoagulation diode therapy. To the best of our knowledge, there have been no reports of vitritis after a noncomplicated micropulse cyclophotocoagulation diode in primary open-angle glaucoma.

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Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria

Cited by 12 publications

References 37 publications

COVID-19 and the Rationale for Primary Selective Laser Trabeculoplasty and Diode Laser Transscleral Cyclophotocoagulation in Africa

COVID-19 and the Rationale for Primary Selective Laser Trabeculoplasty and Diode Laser Transscleral Cyclophotocoagulation in Africa

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Intermediary inflammatory reaction after micropulse cyclophotocoagulation diode therapy: a case report

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