CYCLODESTRUCTIVE PROCEDURES-TRANSSCLERAL AND ENDOPHOTOABLATION OF CILIARY BODY

J. Pilbauer,  J. Pasta, P. Nemec, S. Zapletalova and I. Hejdukova

Dept.of Ophthalmology, Central Military Hospital, Prague,

Czech Republic

Purpose:  To evaluate the clinical outcome of different methods of photoablation of ciliary body and to investigate whether endophotoablation offers specific advantages over transscleral one.

Methods:  668 patients, divided into two groups, were examined at one-and-half years postoperatively in our clinical study. First group of 635 patients underwent transscleral photoablation of CB (535 by Nd-YAG, 100 by diode laser). Second group - 33 patients – underwent endocyclophotoablation (argon laser). Postoperative IOP, necessity of repeat of photoablation, postoperative visual acuity, complications as well as changes in antiglaucomatous pharmacotherapy were evaluated on every 3rd months.

Results:

First group:

Mean preoperative IOP:32,4+/-8,1 mmHg.

Mean postoperative IOP:19,2+/-7,2 mmHg.  Photoablation had to be repeated in 28%. Without complications (18%), transient inflammation (67%), hyphema (12%).

Second group:

Mean preoperative IOP:35,1+/-6,3 mmHg.

Mean postoperative IOP:20,2+/-5,3 mmHg.  Need of second photoablation (33%), hyphema (12%),transient inflammation (55%), vitreous in the front chamber (9%) were observed postoperatively.

Conclusions:  Endophotoablation as a new technique of lasercoagulation of ciliary body gives good results and will be an alternative method to transscleral way of lasertreatment, especially in the aphakic /pseudophakic patients with glaucoma and in patients during cataract surgery.