DIODE-LASER CONTACT TRANSSCLERAL CYCLOPHOTOCOAGULATION FOR REFRACTORYGLAUCOMA IN ASIAN PATIENTS

PURPOSE: To evaluate the effectiveness and safety of diode laser conta ct transscleral cyclophotocoagulation in Asian patients with refractor y glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body. M ETHODS: This prospective clinical study included consecutive Asian pat ients with dark irides and confirmed for glaucoma. Only one eye of eac h patient was treated, Diode laser contact transscleral cyclophotocoag ulation treatment was performed with the center of the probe placed 1. 5 mm behind the limbus, About 30 pulses of 810-nm laser radiation (pow er, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraoc ular pressure levels and postoperative complications were recorded. Th e relation between patient and disease characteristics, total laser en ergy delivered, and intraocular pressure effects were analyzed. RESULT S: Thirty three patients were studied, with a mean follow up period of 9.4 months. An average 56% of patients showed a 30% or greater drop i n intraocular pressure. About 38% of patients achieved sustained intra ocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis. CONCLUSIONS: In Asian patients with refractory glaucoma or painful glaucomatous eyes w ith poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser con tact transscleral cyclophotocoagula tion by means of the glass ball probe is relatively effective and safe .