Diode laser cyclophotocoagulation of secondary glaucoma caused by anterior, necrotizing scleritis

Patient A 60-year-old female patient presented with recurrent anterior, nec rotizing scleritis with inflammation and a newly developed secondary glauco ma in the right eye. Anterior uveitis occurred some years before. Severe sc leral thinning was circumferentially present and focal scleral ectasia was found. Physical examination revealed no systemic association of scleritis. Immunosuppressive therapy with metotrexate was initiated and control of scl eritis achieved. Intraocular pressure elevation persisted and was refractor y to glaucoma medication. Diurnal pressure curve showed IOP-values of 40 mm Hg despite the use of systemic carbonic anhydrase inhibitors. Visual acuit y was 20/50 in the right and 20/25 in the left eye. Method Diode laser cyclophotocoagulation (Oculight SLx 810 nm, Iris Medical Instruments Inc. California, USA) was performed under general anaesthesis using reduced parameters for application (12 laser spots, 1 second, 1,25 W) . No complications occurred during and after laser application. Postoperati vely, intraocular pressure was within normal range between 14 and 18 mm Hg. No reactivation of scleritis or uveitis was seen. Conclusion In our experience, diode laser cyclophotocoagulation is effectiv e and safe in treating secondary glaucoma associated with anterior, necroti zing scleritis with inflammation and uveitis using reduced parameters for a pplication.