Effect of diode laser contact transscleral pars plana photocoagulation on intraocular pressure in glaucoma

Authors: Ho, Ching Lin¹; Wong, Edmund YM¹; Chew, Paul TK²

Source: Clinical & Experimental Ophthalmology, Volume 30, Number 5, October 2002 , pp. 343-347(5)

Publisher: Wiley-Blackwell

Abstract:

Purpose: To evaluate the efficacy of diode laser contact transscleral pars plana photocoagulation (CTPPP) for intraocular pressure (IOP) control in glaucoma and its clinical application.

Method: A prospective, non-randomized hospital-based pilot study was conducted. Fourteen patients with poor visual acuity (VA worse than 6/60) and medically uncontrolled, refractory glaucoma were recruited, and CTPPP was performed after informed consent.

Results: Mean preoperative IOP was 41.0 mmHg (SD 12.6, range 27−70, n = 14). At 1 week postoperatively, IOP was reduced in 12 of 14 (86%) patients to a mean of 28.6 mmHg (SD 15.8, range 3−55, n = 14). This represented a mean decrease of 12.4 mmHg. Mean IOP was 34.0 mmHg (SD 17.4, range 5−71, n = 14) and 31.6 mmHg (SD 13.4, range 5−22, n = 12) at 4 and 12 weeks, respectively. The IOP reduction was significant at 1 week (P = 0.001, paired t-test) and at 12 weeks (P = 0.04, paired t-test). The two patients with preoperative pain reported abolition of pain after the procedure. Seven of 13 patients on preoperative antiglaucoma eye drops did not require eye drops postoperatively.

Conclusions: Diode laser CTPPP was found to significantly reduce IOP in the majority of patients at 1 week postoperatively, with less but still significant effect at 12 weeks. Its potential application as a procedure for short-term IOP reduction in medically uncontrolled glaucoma requiring filtering surgery needs to be further investigated.

Keywords: diode laser; transscleral cyclophotocoagulation; intraocular pressure; uveoscleral outflow

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1442-9071.2002.00553.x

Affiliations: 1: Singapore National Eye Centre and 2: Department of Ophthalmology, National University Hospital, Singapore

Publication date: 2002-10-01

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