Risk Factors for Hypotony After Transscleral Diode Cyclophotocoagulation

Ramli, Norlina; Htoon, Hla Myint; Ho, Ching Lin; Aung, Tin; Perera, Shamira A.

doi:10.1097/ijg.0b013e318207091a

Cited by 90 publications

(86 citation statements)

References 17 publications

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“…Ramli et al . in a recently published study investigated the risk factors for hypotony after TSCPC in an Asian population . With a comparatively high hypotony rate of 17.7%, they identified NVG as a significant risk factor.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of hypotony and sympathetic ophthalmia following trans‐scleral cyclophotocoagulation for glaucoma and a report of risk factors

Aujla

Lee

Vincent

et al. 2013

Clinical Exper Ophthalmology

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Total laser energy is one of several risk factors that act in a sufficient component cause-model to produce hypotony in an individual patient. The small sample size precluded inference for other individual putative risk factors but titrating laser energy may help decrease the occurrence of hypotony. The risk of sympathetic ophthalmia calculated from the literature is likely an overestimate caused by publication bias.

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Section: Discussionmentioning

confidence: 99%

“…The 27 TSCPC study groups included in the pooled analysis are summarized in Table . The mean pooled pretreatment IOP was 35.02 ± 6.11 (SD) mmHg (range 21–46 mmHg).…”

Section: Discussionmentioning

confidence: 99%

Incidence of hypotony and sympathetic ophthalmia following trans‐scleral cyclophotocoagulation for glaucoma and a report of risk factors

Aujla

Lee

Vincent

et al. 2013

Clinical Exper Ophthalmology

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“…When compared to Ahmed valve implantation in a randomized controlled trial, no significant difference was found in the success rate at 24 months between the diode cyclophotocoagulation (61.18 %) and Ahmed glaucoma valve implantation (59.26 %) in NVG treatment [91]. It is important to note, however, that the underlying diagnosis of NVG poses an increased risk for hypotony after transcleral-cyclophotocoagulation [94–97]. Endo-cyclophotocoagulation was also shown to be effective in NVG.…”

Section: Introductionmentioning

confidence: 99%

Neovascular glaucoma: a review

et al. 2016

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Neovascular glaucoma (NVG) is a secondary glaucoma generally associated with poor visual prognosis. The development of new vessels over the iris and the iridocorneal angle can obstruct aqueous humor outflow and lead to increased intraocular pressure. The underlying pathogenesis in most cases is posterior segment ischemia, which is most commonly secondary to proliferative diabetic retinopathy or central vein retinal occlusion. The neovascularization process in the eye is driven by the events that alter the homeostatic balance between pro-angiogenic factors, such as the vascular endothelial growth factor and anti-angiogenic factors, such as the pigment-epithelium-derived factor. Early diagnosis of this condition through slit lamp examination of the iris, iridocorneal angle and retina can help to avoid the development of goniosynechia and obstruction of aqueous humor outflow, with consequent intraocular pressure elevation. Historically, NVG treatment was focused on reducing the posterior segment ischemic process that caused the formation of new vessels, through panretinal photocoagulation. Recently, several studies have investigated the application of intravitreal anti-VEGF therapies in NVG. If clinical treatment with the use of hypotensive topical drops is not sufficient, laser and/or surgical procedures are required for intraocular pressure control.

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“…Many studies confirm the IOP-lowering ability of TSCPC [3–5] ; however, there is conflicting data on the complication rates of this procedure. Ramli et al [12] and Murphy et al [13] both reported that there was a significant risk of developing serious complications such as hypotony, while Osman et al [14] and Ansari and Gandhewar [15] reported no significant risk for development of these complications. This conflicting data, along with many reports of operative and postoperative pain associated with this procedure [16,17] merit consideration on how to maintain good outcomes while lowering complications and pain.…”

Section: Discussionmentioning

confidence: 99%

Observational report

Patterson¹

2017

Medicine

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The purpose of this article is to evaluate the improved safety and efficacy of transscleral cyclophotocoagulation (TSCPC) by performing it in the operating room.This is a retrospective review of 17 eyes of 16 patients who received TSCPC for uncontrolled glaucoma on maximum tolerated medication.Mean intraocular pressure (IOP) prior to surgery was 30.85 ± 6.24 mm Hg and was reduced to 14.48 ± 3.53 mm Hg after treatment for an average reduction in IOP of 48.56% at the final visit (P < .001). Visual acuity was measured at the final follow-up visit and was stable in 13 eyes (76.47%), improved in 2 eyes (11.75%), and decreased in 2 eyes (11.75%). Nine of the eyes (52.94%) saw a reduction in the number of medications taken, whereas 8 had no change. Two eyes had resolved complications of cystoid macular edema (CME) and subconjunctival hemorrhages. The overall success rate is determined to be 88%.TSCPC performed in the operating room may have greater safety and efficacy for patients with uncontrolled glaucoma.

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Risk Factors for Hypotony After Transscleral Diode Cyclophotocoagulation

Abstract: Underlying diagnosis of neovascular glaucoma is a significant risk factor for hypotony post TCP.

Cited by 90 publications

References 17 publications

Incidence of hypotony and sympathetic ophthalmia following trans‐scleral cyclophotocoagulation for glaucoma and a report of risk factors

Incidence of hypotony and sympathetic ophthalmia following trans‐scleral cyclophotocoagulation for glaucoma and a report of risk factors

Neovascular glaucoma: a review

Observational report

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