[Transscleral cyclophotocoagulation as primary surgical intervention in glaucoma]

Abstract

Background: The gold standard of surgical interventions in medically uncontrolled glaucoma is trabeculectomy. Cyclophotocoagulation is often performed only as a secondary/tertiary surgery. Since trabeculectomy demands a high degree of postsurgical compliance to achieve satisfying results, some patients do not qualify for trabeculectomy.

Patients and methods: During cyclophotocoagulation, the ciliary processes were coagulated using a transscleral diode laser. 49 eyes of 47 patients (25 women and 22 men) were included in our study. Patients were regularly followed up for 24 months. During follow-up, IOP, best corrected visual acuity and number of antiglaucoma drugs were recorded.

Results: The mean age was 69.27 ± 14.45 years. The diagnosis was open-angle glaucoma in 15 eyes, pseudoexfoliative glaucoma in 12 eyes, secondary rubeotic glaucoma in 7 eyes and secondary glaucoma without further specification in 15 eyes. On average, cyclophotocoagulation reduced intraocular pressure by 14.45 ± 11.77 mmHg (-42.7%, p < 0.001). Medication could be reduced by 1.31 ± 1.27 (-52%, p < 0.001). On average, visual acuity deteriorated by 0.383 LogMAR (± 0.848, p = 0.004).

Conclusion: For selected glaucoma patients, cyclophotocoagulation could be an option as primary surgical intervention to lower intraocular pressure.