Transscleral diodelaser cyclophotocoagulation in micropulse mode in patients with refractory glaucoma

Abstract

The aim of the work was to study clinical efficacy of micropulsed transscleral diode laser cyclophotocoagulation (MTDСFC) in patients with refractory glaucoma. Material and methods. After careful standard ophthalmologic eye examination, 60 patients underwent mTDGFC to compensate the intraocular pressure (IOP) and stabilize the visual and functional indices. Results. Immediately on the next day after the procedure a brightening of the cornea and a decrease of the degree of perilymphalic congestion were observed. IOP level decreased from 42.0 ± 1.2 to 20.97 ± 1.12 in 47.6% of cases, and in a year – to 18.85 ± 0.7. In 40% of cases (n = 24) the visual acuity improved from 0.03 ± 0.01 to 0.06 ± 0.05 which was statistically significant (p < 0,05). In 16.7% of cases (n = 10) there was an increase in the visual field boundaries by an average of 5 degrees. In 15 eyes (25.0%) it became possible to observe fundus. An important advantage of mTDFC was a 52.4% decrease in the number of hypotensive drugs used by the end of follow-up: from 3.0 ± 0.5 to 1.0 ± 0.5 drugs (p < 0.05). In the early postoperative period subconjunctival hemorrhages in 5 (8.3%) patients, hyphema 1 mm in 1 (1,7%) patient were among the available complications; they dissolved after hematase and dexamethasone injection. Conclusions. mTDFC should be performed in patients at earlier stages of refractory glaucoma, providing compensation for varying degrees of elevated IOP. This procedure contributes to the elimination or significant reduction of pain syndrome, which preserves eye function, improves patients'quality of life, and is an alternative to laser treatment of refractory glaucoma. Keywords: refractory glaucoma, surgical treatment, laser cyclophotocoagulation, micropulse cyclophotocoagulation, transscleral cyclophotocoagulation