UPDATE ON THE SUBCONJUNCTIVAL THC-YAG (HOLMIUM) LASER SCLEROSTOMY AB EXTERNO CLINICAL-TRIAL - A 4-YEAR REPORT

BACKGROUND AND OBJECTIVE: This is a follow-up report on 103 THC:YAG (h olmium) sclerostomies ab externo performed on 87 eyes of 81 patients. PATIENTS AND METHODS: The patients received pulse energies of 0.06 to 0.13 J (mean total energy 4.4 +/- 3.3 J, range 0.6 to 17.1 J). RESULTS : The estimated success rates with or without medication, and allowing a second procedure, were 44% at 2 years and 36% at 4 years. The mean preoperative intraocular pressure (IOP) was 29.7 +/- 11.4 mm Hg, and t he mean postoperative IOP in the successful patients was 13.6 +/- 4.6 mm Hg (P < .01). Hypotony and iris incarceration were the most frequen t early complications. CONCLUSIONS: Although holmium laser sclerostomy is a relatively straightforward procedure and offers some advantages over standard trabeculectomy in select cases, it currently has a numbe r of drawbacks that limit its use.