Efficacy of Transscleral Diode Laser Cyclophotocoagulation in Patients with Good Visual Acuity

Ghosh, Saurabh; Manvikar, Sridhar; Ray-Chaudhuri, Neeta; Birch, Michael

doi:10.5301/ejo.5000389

Cited by 32 publications

(31 citation statements)

References 20 publications

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“…() and Ghosh et al. () both studied patients with Snellen VA ≥ 0.3 and showed high success rates although their definition of success differed from ours as previously discussed.…”

Section: Discussionmentioning

confidence: 55%

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Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients

Rasmuson

Lindén

Lundberg

et al. 2019

Acta Ophthalmologica

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Purpose: To retrospectively evaluate the efficacy and safety of all transscleral cyclophotocoagulation (TCP) treatments performed during a 5-year period. Methods: Medical records of all patients, who had undergone TCP treatment between 2010 and 2014 at Ume a University Hospital, Sweden, were evaluated. Clinical data including intraocular pressure (IOP), visual acuity (VA), number of topical glaucoma medications, use of oral acetazolamide, retreatments and complications during a 2-year follow-up were registered. Global success was defined as IOP 6-18 mmHg with or without glaucoma medication. Results: Three hundred patients underwent TCP during the time period. Mean IOP at baseline was 29.3 AE 11.0 (mean AE standard deviation) mmHg (n = 297) with a mean reduction of 11.5 (AE12.0) mmHg at 1 year (n = 258; p < 0.001) and 12.6 (AE12.0) mmHg at 2-year follow-up (n = 245; p < 0.001). Global success at 2 years was 64%, achieved by a mean of 1.2 treatments (n = 257). The number of topical glaucoma medications at baseline was 3.1 (AE1.0; n = 296) and was reduced by 0.9 (AE1.0) medications at 2 years (n = 244; p < 0.001). Use of oral acetazolamide decreased from 30% (n = 90) at baseline to 5.3% (n = 13) at 2 years. In eyes with Snellen VA ≥ 0.1, the mean VA at baseline was 0.55 (AE0.3) logarithm of the minimum angle of resolution (logMAR; n = 132) and 1.1 (AE0.9) logMAR (n = 76) at 2 years (p < 0.001). No cases of phthisis bulbi were found. Conclusion: This study displays a substantial and long-term reduction of IOP following TCP with a decrease in topical and oral glaucoma medications. The treatment appears to be safe but the decrease in VA during follow-up is a concern that needs further evaluation.

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“…() and Ghosh et al. () both studied patients with Snellen VA ≥ 0.3 and showed high success rates although their definition of success differed from ours as previously discussed.…”

Section: Discussionmentioning

confidence: 55%

“…; Ghosh et al. ), but in these, the definition of success only included an upper IOP boundary and not a lower IOP limit, consequently including patients with potential hypotony in the reported success rates. An exception is Rotchford et al.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients

Rasmuson

Lindén

Lundberg

et al. 2019

Acta Ophthalmologica

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“…Forty-six eyes were treated, 52% had POAG and the mean pre-treatment IOP was 24 (12-35 mmHg). At 2 years, 80% of eyes had an IOP of <22 mmHg with or without additional topical treatment: 23.9% of eyes lost more than two lines of VA. 30 In another UK study, 49 seeing eyes were treated for uncontrolled glaucoma and at 5 years IOP was controlled (6-21 mmHg) in 79.6% of eyes; 30.6% lost ≥ 2 lines of VA. 31 Primary TDLC treatment has been reported in several studies (Tables S1 and S2). For example, a study in Germany recruited individuals who refused surgery or where follow-up could not be guaranteed: among the 25 eyes treated, re-treatment was required in three eyes.…”

Section: Introductionmentioning

confidence: 99%

Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria

Abdull

Broadway²,

Evans

et al. 2018

Clinical Exper Ophthalmology

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“…Cyclophotocoagulation, or laser destruction of the ciliary body, has been found to be an effective modality for lowering IOP by decreasing aqueous humor production in humans, dogs, and horses . The target of diode laser energy is the pigmented epithelium (PE) of the ciliary processes.…”

Section: Introductionmentioning

confidence: 99%

“…8 Difficulties with the medical management of equine glaucoma include the relatively high cost of long-term medications, and the limited ability of owners or trainers to treat affected eyes at the recommended frequency. Treatment with dorzolamide is most effective when administered every 8 h. 9 Cyclophotocoagulation, or laser destruction of the ciliary body, has been found to be an effective modality for lowering IOP by decreasing aqueous humor production in humans, 10 dogs, [10][11][12] and horses. 2,4,13 The target of diode laser energy is the pigmented epithelium (PE) of the ciliary processes.…”

Section: Introductionmentioning

confidence: 99%

The location of sites and effect of semiconductor diode trans‐scleral cyclophotocoagulation on the buphthalmic equine globe

Gemensky-Metzler

Wilkie

Weisbrode

et al. 2014

Veterinary Ophthalmology

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Purpose To determine appropriate location and energy settings for transscleral cyclophotocoagulation (TSCPC) for buphthalmic equine globes. Animals Eleven horses with a buphthalmic eye blinded by glaucoma presented for enucleation. Methods Globe and corneal dimensions were measured via ultrasonography and calipers and TSCPC was performed under general anesthesia immediately prior to enucleation. Part 1: In 9 globes, sixty sites were lasered 4 mm posterior to the limbus in the dorsotemporal and ventrotemporal quadrants at settings of 1500 milliwatts and 1500 milliseconds. Globes were processed and sectioned sagitally over the temporal aspect in two blocks, each with 5 histologic sections examined by light microscopy. A digital imaging system was used to determine the location and length of the pars plicata on one slide from each block. Part 2: Based on results in Part 1, two globes were measured and lasered using the same time and energy settings at the following distances posterior to the limbus: 8 mm dorsally, 6 mm dorsotemporally, 5 mm ventrotemporally, 5 mm ventrally. Results Globe and corneal dimensions exceeded normal values in all globes. Part 1: In all 9 globes photocoagulation affected the anterior ciliary processes and iris base and in 8/9 coagulation of the pectinate ligaments was noted. Part 2: In both globes, coagulation was confined to the pars plicata. Conclusions The previously recommended TSCPC sites are located too far anteriorly for a buphthalmic globe. Buphthalmic equine globes should have TSCPC performed at the following distances posterior to the limbus: 6-8 mm dorsally, 5-6 mm dorsotemporally, 4-5 mm ventrotemporally and 4-5 mm ventrally.

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Efficacy of Transscleral Diode Laser Cyclophotocoagulation in Patients with Good Visual Acuity

Abstract: This study suggests a role of TSDLC as an effective, safe, and rapid method of treatment in patients with good vision over a 24-month period. The loss of VA in some patients is similar to previously reported studies in patients having cyclodiode, trabeculectomy, or tube surgery.

Cited by 32 publications

References 20 publications

Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients

Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients

Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria

The location of sites and effect of semiconductor diode trans‐scleral cyclophotocoagulation on the buphthalmic equine globe

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