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In cases experiencing a 2 line loss in acuity, the main causes were glaucoma progression (9 cases) and macula oedema (4 cases). Visual loss was unrelated to total treatment dose (mean 99.7J), initial acuity or initial IOP level. IOP was controlled at final follow-up in 39/49 (79.6%) with no cases of hypotony. 3Conclusions: The majority of these eyes with difficult to manage glaucoma retained their good visual acuity over long-term follow-up after undergoing diode laser cyclophotocoagulation. The proportion losing 2 Snellen lines is in line with that reported following trabeculectomy or tube surgery. These results suggest a possible role for the use of transscleral cyclodiode in selected eyes with significant visual potential. Further controlled prospective studies are required to better define this role.