Abstract
PURPOSE: Reporting treatment outcomes of slow coagulation transscleral cyclophotocoagulation (TSCPC) as an initial surgical intervention in pseudophakic patients with glaucoma.
DESIGN: Retrospective case series.
METHODS: This single academic center study reviewed 74 pseudophakic patients who had a diagnosis of glaucoma and no previous glaucoma surgeries (mean age 82.6 ± 12.5 years; mean follow-up 18.7 ± 9.1 months). The intervention used was slow coagulation continuous wave TSCPC (1250-mW power and 4-second duration). The primary outcome measure was surgical success defined as an intraocular pressure (IOP) of 6-21 mm Hg with a ≥20% reduction from baseline, no reoperation for glaucoma, and no loss of light-perception vision. Secondary outcome measures included glaucoma medication use, visual acuity (VA), and complications.
RESULTS: IOP decreased from 27.5 ± 9.8 mm Hg preoperatively to 16.1 ± 6.3 mm Hg postoperatively (P < .001). The preoperative number of glaucoma medications was 4.1 ± 0.9 and 3.1 ± 1.3 post-TSCPC (P < .001). The cumulative probabilities of success at 1 and 2 years were 60.6 % and 58.5%, respectively. When patients were divided into 2 groups based on their baseline IOP being >21 mm Hg (high group) or ≤21 mm Hg (low group), success rates at 2 years were 64.9% and 45.5%, respectively (P = .144). The mean logarithm of the minimum angle of resolution VA changed from 0.70 ± 0.64 to 1.04 ± 0.87 at the last follow-up visit (P = .01). No serious complications were observed and most of the complications were mild and transient.
CONCLUSIONS: Slow coagulation TSCPC has good efficiency, especially in patients with baseline IOP >21 mm Hg, and safety profile as an initial surgical intervention in pseudophakic patients with glaucoma.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 90-99 |
| Number of pages | 10 |
| Journal | American journal of ophthalmology |
| Volume | 229 |
| Early online date | Apr 20 2021 |
| DOIs | |
| State | Published - Sep 2021 |
| Externally published | Yes |
Bibliographical note
Funding Information:Funding/Support: Supported by a National Eye Institute Center Core Grant to the University of Miami (P30 EY014801), an unrestricted grant from Research to Prevent Blindness, and the Camiener Family Glaucoma Research Fund. The funding organizations had no role in the design or conduct of this research. Financial Disclosures: R.K.L. is supported by the Walter G. Ross Foundation. The other authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2021 Elsevier Inc.