Transscleral Cyclophotocoagulation in the Treatment of Secondary Glaucoma

R. Leszczyński, A. Gierek-Lapiñska and I. Filipecka

1st Department of Ophthalmology, Medical University of Silesia, Katowice

Purpose

This study aimed to evaluate the results of TSCPC in the treatment of refractory secondary glaucoma, including its functional effects in different types of secondary glaucoma.

Material and methods

Eighty-three eyes in 81 patients (52 men and 29 women aged 9-79 y. mean 58±21 y) diagnosed 1-10 y. earlier were studied. Contact transscleral cyclophotocoagulation was performed with an OcuLight SLx photocoagulator (IRIS Medical Instrument).

Results

In a 12-month follow-up period, intraocular pressure (IOP) decreased

from 46±12 mmHg to 18± 6.4 mmHg (p<0.05) and visual acuity showed no significant changes. The number of TSCPC procedures was 1.7±1.7 (range1-4). 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 secondary

pediatric glaucoma (p<0.05). Severe complications developed mainly in

neovascular glaucoma.

Conclusions

1.Contact transscleral cyclophotocoagulation effectively decreases

intraocular pressure and the number of antiglaucomatous medications and

alleviates pain in most patients with severe secondary glaucoma.

2.Patients with neovascular glaucoma are at the highest risk of severe

complications following TSCPC.

3.TSCPC was the least effective in patients with refractory pediatric

glaucoma.

4.It is recommended to avoid areas of hyperpigmentation, hemorrhage and scleral thinning because of the risk of photocoagulative scleral and

conjunctival damage.