Transscleral cyclophotocoagulation in the treatment of secondary glaucoma

Abstract

Background: The purpose of this study was to evaluate the results obtained by using transscleral cyclophotocoagulation (TSCPC) in the treatment of refractory secondary glaucoma. Our study attempted to assess the functional effects of TSCPC in different types of secondary glaucoma.

Material/methods: We studied 83 eyes in 81 patients: 52 men and 29 women, aged 9-88 years old (mean 52.8+/-21.85). Contact transscleral cyclophotocoagulation was performed with an OcuLight SLx photocoagulator using a G probe. The follow-up period was 12 months. All the eyes were photographed for documentation of details.

Results: The mean intraocular pressure (IOP) significantly decreased, from 46+/-12 mmHg at baseline to 18+/-6.4 mmHg (p<0.05) at the end of the 12-month observation period. Average visual acuity showed no statistically significant changes. The number of TSCPC procedures ranged from 1 to 4. The number of anti-glaucoma drugs decreased from 2.8+/-0.9 to 1.9+/-0.9 (p<0.05). The T/E coefficient was the lowest in pediatric secondary glaucoma (p<0.05). Most of the severe complications developed in neovascular glaucoma (p<0.05).

Conclusions: Contact transscleral cyclophotocoagulation effectively decreases intraocular pressure and the number of anti-glaucoma medications and also alleviates pain in the majority of patients with severe secondary glaucoma. Patients with neovascular glaucoma are at the highest risk of severe complications following TSCPC. TSCPC was the least effective in patients with refractory pediatric glaucoma. Since there is a risk of photocoagulative damage to the sclera and conjunctiva, areas of hyperpigmentation, hemorrhage and scleral thinning should be avoided.