CYCLOCRYOTHERAPY IN NEOVASCULAR GLAUCOMA AND NON-NEOVASCULAR GLAUCOMA

Background There are conflicting reports on the value of cyclocryother apy and it seems that the success rate is depending on glaucoma condit ions, the period of follow-up and the technique. This retrospective st udy was carried out to assess the efficacy and complication rate of cy clocryosurgery for advanced glaucoma with and without neovascularizati on. Patients and methods We induced 76 eyes of 75 patients with inadeq uately controlled glaucoma, which underwent cyclocryotherapy during th e period of 1993 and 1996 (treatment time 60 seconds with -80 degrees C, 6-12 applications (mean 9.8 +/- 2.3), 180-360 degree (median 270 de gree), diameter of the probe tip 2.5 mm, 1-2 mm distance from the limb us). Depending on the etiology we distinguished between neovascular (N VG) and non-neovascular glaucoma (nNVG). Pre- and postoperative data f rom all patients were studied retrospectively, for follow-up after 12- 36 months patients were examined. Results Intraocular pressure (IOP) d ecreased in all patients from 44.7 +/- 12.6 mm Hg preoperatively to 15 .6 +/- 6.5 mm Hg postoperatively after a follow-up of 12-36 months. In 88.2% IOP was lowered to less than or equal to 25 mm Hg. NVG showed a mean IOP reduction from 49.1 +/- 12.5 mm Hg before cyclocryotherapy t o 15.6 +/- 5.0 mm Hg at follow-up. In the nNVG group IOP was 40.5 +/- 11.3 mmHg and 15.7 +/- 7.6 mmHg after cyclocryotherapy. Pressure was c ontrolled (less than or equal to 25 mm Hg) for 83.8% of NVG and 92.3% of nNVG. A cyclocryotherapy-induced intense inflammation was seen more frequent in NVG (43.2%) than in nNVG (17.9%). 2 patients with NVG and 3 with nNVG developed phthisis postoperatively (total 6.7%). Conclusi ons Cyclocryosurgery is an effective method to reduce IOP in advanced, refractory glaucoma, when other methods have failed. The risk/success rate seems to be acceptable.