Transscleral Diode Laser Photocoagulation in Refractory Glaucoma

Abstract

Background and Objective: Patients with glaucoma refractory to medical or surgical treatment are difficult to treat. The aim of this study was to evaluate the effect of contact transscleral diode laser cyclophotocoagulation (DLPC) on these patients’ intra-ocular pressure (IOP) and visual acuity. Patients and Methods: 37 eyes of 36 patients who suffered from refractory glaucoma and who had undergone DLPC, were followed at the Eye Clinic of Verona University for an average of 14 ± 4 months. The average age was 54 ± 26 years. IOP, visual acuity and ocular complications were analysed. Results: A total of 71 treatments were given. More than 1 treatment was given in 22 eyes (59%). The mean pretreatment IOP was 33.1 ± 3.3 mm Hg. At the last follow-up, the mean IOP was 21 ± 1.6 mm Hg. Mean total medications were reduced from 4.4 ± 0.5 to 2.4 ± 0.3. No serious complications occurred in 71 treatments. Visual acuity remained stable in 25 eyes (67.5%), improved in 6 eyes (16.2%) and decreased in 6 eyes (16.2%). Conclusions: DLPC is effective in lowering IOP in eyes with refractory glaucoma. It also serves to reduce the number of antiglaucoma medications. This procedure is relatively safe. Nevertheless, multiple DLPC applications may be needed.