Diode Laser Trans-scleral Cyclophotocoagulation in the Management of Glaucoma in Patients with Long-term Intravitreal Silicone Oil

Aims: To analyse the results of contact trans-scleral cyclodiode photocoagulation (TSCPC) in reducing intraocular pressures (IOP) refractory to medical treatment in a group of patients with intravitreal silicone oil.

Methods: The medical records of 18 patients who received TSCPC were evaluated retrospectively. Success was evaluated primarily in terms of IOP control. Success was defined as a final IOP of less than 22 mmHg.

Results: In all, 18 eyes of 18 patients were followed up for an average of 21.8 months (range 6-36) (SD=8.6). The mean pre-treatment IOP was 39.6 mmHg (range 25-56 mmHg) (SD=9.3). This reduced to 20.0 mmHg (range 0-48, SD=13.5) after TSCPC, producing a mean reduction of 49% from mean pretreatment IOP levels. The overall success rate was 44% (eight eyes). Chronic hypotony occurred in two patients. IOP remained above that required to meet the IOP reduction criteria in eight patients.

Conclusion: Our results raise doubts about the efficacy of TSCPC in the management of glaucoma in eyes retaining silicone oil. This may relate to the long duration of silicone oil in our patients. Further studies are required to identify risk factors for treatment failure.