Diode laser cyclophotocoagulation as a primary surgical procedure
M. Becker, J. Funk
Background: Diode laser cyclophotocoagulation is widely accepted as the therapy of choice in worst glaucoma cases, especially after failure of other kinds of treatment. We wanted to know wether it is also suitable as a primary surgical procedure after failure of medical treatment.
Patients and methods: We retrospectively reviewed the charts of patients scheduled for cyclophotocoaculation as primary surgical treatment between February 1997 and May 1998. All patients had elevated intraocular pressure despite of maximum tolerated medical treatment. In most cases cyclophotocoagulation was performed because the patients refused filtering surgery. Usually 15 burns were applied (2000 mJ, 2,5 sec.) per treatment session.
Results: Alltogether 26 eyes of 21 patients could be enrolled. The mean age was 75.5+/- 7.4 years. The mean follow-up was 17.5 months. There was a mean reduction of the intraocular pressure from 29.9 mmHg preoperatively to 16.9 mmHg postoperatively. In 3 cases (11,5%) repeated treatment was necessary. The only complication was a mild to moderate Iritis in 4 cases (15,4%), while a shallow anterior chamber or an immediate postoperative elevation of intraocular pressure higher than 40 mmHg did not occur. We also did not find any severe visual loss.
Discussion: Diode laser cyclophotocoagulation lead to a reduction of intraocular pressure of 43.5% without any severe complications. So it can be recommended as an alternative to filtering surgery, particularly in older patients with mild to moderate glaucoma damage.
Augenklinik, Albert-Ludwigs-Universität, Killianstr. 5, D - 79106 Freiburg