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. 2013:2013:371951.
doi: 10.1155/2013/371951. Epub 2013 Oct 7.

A comparison between tube surgery, ND:YAG laser and diode laser cyclophotocoagulation in the management of refractory glaucoma

Philip A Bloom  1 , Colin I Clement, Anthony King, Baha Noureddin, Kamal Sharma, Roger A Hitchings, Peng T Khaw
Affiliations

A comparison between tube surgery, ND:YAG laser and diode laser cyclophotocoagulation in the management of refractory glaucoma

Philip A Bloom et al. Biomed Res Int. 2013.

Abstract

Purpose: To compare the results of intraocular pressure (IOP) reduction by 3 treatment modalities, (a) glaucoma tube implants, (b) noncontact YAG laser cyclophotocoagulation (cycloYAG), and (c) contact transscleral diode laser cyclophotocoagulation (cyclodiode), in cases of advanced glaucoma refractory to alternative treatments.

Methods: A consecutive group of 45 eyes that received cycloYAG were matched against two control groups of patients who had received tube surgery or cyclodiode, each control group having been derived from a database of patients.

Results: Mean pretreatment IOP improved from 41.3, 38.6, and 32.0 mmHg for the tube, cycloYAG, and cyclodiode groups, respectively, to 16.4, 22.1, and 19.3 mmHg, respectively. Treatment success was achieved in 78%, 69%, and 71% of the tube, cycloYAG, and cyclodiode groups, respectively. Visual acuity deteriorated 2 or more Snellen lines in 16%, 7%, and 9% of the patients in the tube, cycloYAG, and cyclodiode groups, respectively. Complications included retinal detachment, hypotony, and phthisis.

Conclusions: All 3 methods provided acceptable IOP lowering in the short and medium term. Control of IOP was best in patients receiving tube surgery. Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP. Tube surgery was associated with a greater incidence of sight threatening complications.

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Figures

Figure 1
Figure 1
Change in IOP (mmHg) following cycloYAG treatment.
Figure 2
Figure 2
Change in IOP (mmHg) following cyclodiode treatment.
Figure 3
Figure 3
Change in IOP following tube surgery.
Figure 4
Figure 4
Mean IOP control in the first year following treatment for all groups.
Figure 5
Figure 5
Change in Snellen visual acuity following treatment for Tube group.
Figure 6
Figure 6
Change in Snellen visual acuity following treatment for cycloYAG group.
Figure 7
Figure 7
Change in Snellen visual acuity following treatment for cyclodiode group.
Figure 8
Figure 8
Kaplan-Meier curves showing IOP control following treatment for all groups.
See this image and copyright information in PMC

References

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