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J GlaucomaSeptember 20160 citations

Intraocular Pressure Outcomes Following Transscleral Diode Cyclophotocoagulation Using Long and Short Duration Burns.

Alzuhairy Sultan, Albahlal Abdullah, Aljadaan Ibrahim, Owaidhah Ohoud, Al Shahwan Sami, Craven Earl Randy, Mousa Ahmed, Edward Deepak P


AI Summary

This study found both short and long duration cyclophotocoagulation effectively lowered glaucoma eye pressure, but long duration treatment may worsen vision and inflammation, favoring shorter burns clinically.

Abstract

Purpose

The purpose of this study was to compare outcomes of transscleral diode cyclophotocoagulation using short duration (SD) versus longer duration (LD) treatment.

Patients and methods: Data were collected retrospectively on patients with glaucoma who underwent cyclophotocoagulation with LD (4000 ms) treatment with variable power ≤1000 mW versus SD using 1500 ms with variable power ≤2000 mW. The outcome measures included: intraocular pressure (IOP) at 12 months, decrease in number of antiglaucoma medications, complications and visual acuity (VA) at the final follow-up visit.

Results

There were 71 patients and 70 patients in the SD and LD groups, respectively. The mean IOP±SD pretreatment baseline was 33±10 versus 36±10 mm Hg for SD and LD groups, respectively (P>0.05). At 1 year postoperatively, the IOP decreased significantly in both groups (16.7 vs. 17.4 mm Hg for SD and LD, respectively; P<0.0001). This decrease in IOP was comparable between groups (P=0.5). The average number of IOP lowering medications were 2.5 and 2.9 at baseline in the SD and LD groups, respectively, and decreased to 1.3 in both groups (P=0.83). The mean LogMAR VA decreased significantly from 1.87 at baseline to 1.96 at 1 year in the SD group (P=0.276), and 2.03 to 2.3 (P≤0.001) in the LD group, this change was comparable (0.19; P=0.075) between the 2 groups. Complications were also comparable.

Conclusions

Both LD and SD burns during cyclophotocoagulation effectively lowered IOP at 1 year. Neither treatment resulted in a greater reduction of IOP. LD treatment appeared to result in a decrease in VA and greater postoperative inflammation.


MeSH Terms

AdultCiliary BodyFemaleGlaucomaHumansIntraocular PressureLaser CoagulationMaleMiddle AgedPostoperative PeriodRetrospective StudiesScleraTime FactorsTonometry, OcularTreatment OutcomeVisual Acuity

Key Concepts5

Transscleral diode cyclophotocoagulation using short duration (1500 ms, variable power ≤2000 mW) and long duration (4000 ms, variable power ≤1000 mW) burns both significantly lowered intraocular pressure (IOP) at 1 year postoperatively (P<0.0001 for both groups) in patients with glaucoma.

TreatmentCohortRetrospective Cohort Studyn=71 patients (SD group), 70 patients (…Ch28Ch44

The decrease in intraocular pressure (IOP) at 1 year post-treatment was comparable between transscleral diode cyclophotocoagulation using short duration burns (16.7 mm Hg) and long duration burns (17.4 mm Hg) in patients with glaucoma (P=0.5).

Comparative EffectivenessCohortRetrospective Cohort Studyn=71 patients (SD group), 70 patients (…Ch28Ch44

The average number of intraocular pressure (IOP) lowering medications decreased from baseline (2.5 in SD group, 2.9 in LD group) to 1.3 in both groups at 1 year post-treatment with transscleral diode cyclophotocoagulation using short duration and long duration burns in patients with glaucoma, with comparable reduction between groups (P=0.83).

TreatmentCohortRetrospective Cohort Studyn=71 patients (SD group), 70 patients (…Ch28Ch29Ch44

Transscleral diode cyclophotocoagulation using long duration burns appeared to result in a decrease in visual acuity and greater postoperative inflammation compared to short duration burns in patients with glaucoma.

TreatmentCohortRetrospective Cohort Studyn=71 patients (SD group), 70 patients (…Ch28Ch44

The mean LogMAR visual acuity decreased significantly from 2.03 at baseline to 2.3 (P≤0.001) at 1 year in patients with glaucoma who underwent transscleral diode cyclophotocoagulation with long duration burns.

TreatmentCohortRetrospective Cohort Studyn=70 patients (LD group)Ch6Ch44

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