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Abstract
Purpose
To examine the influence of irradiation methods on the long-term results of contact transscleral Nd:YAG laser cyclophotocoagulation and to evaluate the factors that affect changes in intraocular pressure (IOP) and occurrence of ocular hypotony after cyclophotocoagulation.
Methods
In this retrospective study, 36 refractory glaucomatous eyes of 36 patients were observed for at least one year after a cyclophotocoagulation procedure. Contact transscleral Nd:YAG laser cyclophotocoagulation was performed with 7 to 10 Watts of power, a duration of 0.7 seconds, with one or two rows, and ranges of either greater or less than 180 degrees. The change in IOP, the success rate of the procedure, and the occurrence rate of hypotony were analyzed with regard to the methods of cyclophotocoagulation.
Results
In this series of patients with refractory glaucoma, the final IOP and success rate were not significantly influenced by the laser application method or by the total energy used. The eyes with ocular hypotony showed significantly decreased IOP one year after cyclophotocoagulation when compared with eyes without ocular hypotony. The IOP percent reduction in the patients with ocular hypotony tended to decrease more rapidly than did that of the patients without hypotony, beginning three months after the operation.
References
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Figure 1.
Changes in intraocular pressure (IOP) and percent IOP reduction from preoperative IOP. The difference of all postoperative intraocular pressure is statistically significant when compared with the pre-operative intraocular pressure (p<0.05).
Figure 2.
Changes in IOP and % reduction according to the range of laser performed. There was statistically significant difference between different laser range groups at preoperative time (a), and significant difference in IOP % reduction at 3, 6 months between different laser range groups (b).
Figure 3.
Changes in IOP and % reduction according to row of laser performed. There was no significant difference between different laser row groups in IOP (a) and IOP % reduction (b).
Figure 4.
IOP changes and % reduction between groups with or without ocular hypotony. Intraocular pressures became statistically different between 2 groups after 1 year (a). The percent reduction of IOP was significantly higher from 3 months after the procedure in the eyes with hypotony (b).
Table 1.
Baseline characteristics of the study population
Table 2.
Demographic findings according to range and rows of laser performed
Table 3.
Postoperative changes of success rate and energy used
| 1 month | 3 months | 6 months | 1 year | Last visit | Energy used | ||
|---|---|---|---|---|---|---|---|
| Overall |
63.6% (21/33) |
51.5% (17/33) |
55.6% (15/27) |
52.0% (13/25) |
30.6% (11/36) |
228.7±95.7 J | |
|
Range of laser performed |
≤180° |
44.4% (4/9) |
33.3% (3/9) |
25.0% (2/8) |
33.3% (3/9) |
33.3% (3/9) |
159.8±62.5 J* |
| ＞180° |
70.8% (17/24) |
58.3% (14/24) |
68.4% (13/19) |
62.5% (10/16) |
29.6% (8/27) |
251.7±94.6 J* | |
| Rows of laser performed | 1 row |
62.5% (15/24) |
60.9% (14/23) |
57.9% (11/19) |
52.9% (9/17) |
28.0% (7/25) |
225.6±103.7 J |
| 2 rows |
66.7% (6/9) |
30.0% (3/10) |
50.0% (4/8) |
50.0% (4/8) |
36.4% (4/11) |
235.8±78.8 J |
Table 4.
Analyses of the factors that can affect the occurrence rate of ocular hypotony
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