TRANSSCLERAL CONTACT KRYPTON LASER CYCLOPHOTOCOAGULATION FOR TREATMENT OF GLAUCOMA

Purpose: To evaluate the usefulness of the krypton laser for transscle ral contact cyclophotocoagulation. Methods: Transscleral contact krypt on laser cyclophotocoagulation was performed in 62 eyes of 57 patients with therapy-resistant glaucoma. A minimum follow-up for 6 months was obtained for 59 eyes. The krypton laser was delivered via a fiberopti c probe with compression of the sclera by the probe. The energy used w as 4 to 5 J per application at the tip of the probe with an exposure t ime of 10 seconds. Results: The intraocular pressure (IOP) decreased f rom the baseline mean of 34.8 +/- 11.0 mmHg to 20.4 +/- 8.3 mmHg withi n 10 days, to 22.6 +/- 12.5 mmHg at 1 month, to 21.3 +/- 11.3 mmHg at 3 months, and to 20.9 +/- 9.1 mmHg at 6 months postoperatively. Intrao cular pressures of 8 to 24 mmHg were obtained in 62% of the eyes at 1 month, 60% at 3 months, and 73% at 6 months postoperatively with one o r more cyclophotocoagulations but no other hypotensive procedures. The corresponding success rates after 6 months were 82% for eyes in which the procedure was performed to preserve vision anti 50% for eyes in w hich the procedure was performed to relieve pain. No clinical signs of scleral injury or cyclodestruction-related loss of vision were detect ed. Conclusions: Krypton laser cyclophotocoagulation appears to be an effective and well-tolerated means of lowering IOP in therapy-resistan t glaucoma. An advantage of the method is that standard retinal krypto n photocoagulators can be used for the procedure.