2Department of Ophthalmology, Istanbul Sultan Abdulhamid Han Training and Research Hospital, Uskudar, 34668 Istanbul, Turkey DOI : 10.37844/glauc.cat.2022.17.20 Purpose: To evaluate short-term effects of low-energy transscleral diode laser cyclophotocoagulation (TSCPC) in refractory glaucoma patients and compare the results with the literature.
Materials and Methods: Between October 2017 and May 2021, cases that underwent TSCPC for refractory glaucoma were retrospectively analyzed. Total energy application of 80J and lesser levels per eye are defined as low- energy and those eyes treated with low-energy included. Characteristics of the patients and eyes, preoperative and postoperative visual acuity, intraocular pressure levels (IOP), antiglaucomatous molecules, number of laser sessions, and laser settings were recorded. Preoperative and postoperative data compared with paired groups t-test and Wilcoxon signed-rank test.
Results: Low-energy TSCPC was applied to 23 eyes. Nineteen of patients were male (82.6%). In eyes undergoing TSCPC, visual levels were counting fingers at 1 meter in 1 patient (4.3%), hand movement in 7 (30.4%), light perception(+) in 8 (34.7%) and light perception (-) in 7 patients (30.4%). 17 patients (73.9%) had neovascular glaucoma and 7 patients (26.1%) had secondary glaucoma other than neovascular glaucoma. The mean preoperative IOP values of the patients were 34.3±6.7 mmHg, and the mean number of antiglaucomatous drugs used was 3.6 ±0.5. Mean total energy applied per eye was found to be 37.6±19.1 J (9.6-80). Postoperative 1st day, 1st week, and 2nd month mean IOP values were 31.9, 26.0, and 23.9 mmHg, respectively (p<0.05). The mean number of drugs in the postoperative 2nd month was 2.7±0.7(p<0.001).
Conclusion: Low energy TSCPC reduces IOP and drug exposure in eyes with refractory end-stage glaucoma.
Keywords : refractory glaucoma, transscleral cyclophotocoagulation, intraocular pressure