Cyclocryotherapy for the treatment of advanced chronic glaucoma: an analysis of 185 cyclocryotherapies

Background For several years it has been discussed whether cyclocryotherapy is still an up-to-date treatment of resistant inadequately controlled glau coma. This retrospective study investigates the clinical aspects of 185 cyc locryotherapies between 1988 and 1997. Patients and Methods At the University Eye Clinic of Tubingen, 114 patients received in 119 eyes (64.3%) one cyclocryotherapy, and in 66 eyes (35.7%) multiple cyclocryotherapies. The standard surgical techniques for cyclocryo therapy can be summarized as followed: probe placements per eye, 4 to 6; lo cation of probe placement, inferior circumference (63.90/b); distance of th e applicator from limbus, 3 mm (50.7%); temperature of the probe tip, -70 d egrees C (34.2%); and time of the treatment, 60 seconds (89.9%). Results Intraocular pressure was on average 33.8 mmHg before treatment. In all analysed glaucoma types intraocular pressure was lowered to 10.2 mm Hg (30%). The most frequent type of glaucoma was the neovascular glaucoma (55% ). One year after treatment, this type showed on average, relative to all o ther types of glaucoma, the highest intraocular pressure (28.1 mm Hg) and a lowering of intraocular pressure by 8.3 mmHg (22.7%). Half a year after cy clocryotherapy, a highly significant (p<0.002) reduction of antiglaucomatou s medication was achieved in comparison to the preoperative medication. Conclusion Despite the fact that cyclocryotherapy is not always effective, it is an ambulant surgical technique easy to apply, non-invasive, cost-effe ctive and can be repeated to lower intraocular pressure in resistant chroni c glaucoma. We conclude that cyclocryotherapy will remain usefull until new techniques,like the diode laser cyclophototherapy (especially ultrasonic c ontrolled), are developed as alternative therapies.