Intraocular Pressure Control After Contact Transscleral Diode Cyclophotocoagulation in Eyes with Intractable Glaucoma

Purpose: The effect of contact transscleral diode cyclophotocoagulation (TDC) on intraocular pressure (IOP) and its safety was determined in eyes with intractable glaucoma.

Methods: The charts of 41 consecutive patients (43 eyes) who underwent the laser procedure were reviewed. After surgery, data were collected from chart entries at I hour, 1 day, 4 to 6 weeks, 4 to 6 months, and at the final visit (6-24 months). Mean differences in IOP before and after treatment were compared using the paired Student t test. Associated complications also were assessed.

Results: The mean +/- standard deviation follow-up period was 11.9+/-5.3 months (range, 6-24 months). One patient who died after 1 month of follow-up and another patient with neovascular glaucoma who underwent an anterior chamber washout 1 week after laser to treat an uncontrolled IOP spike were excluded from the study. Repeat treatment was done in 12 (28%) eyes. At each follow-up visit postoperatively, a significant reduction from preoperative IOP was obtained (mean reduction of 50% at the final visit). At the final visit, 64% of patients achieved an IOP of <22 mmHg and a reduction of > or =20%. An IOP spike occurred in three (7%) eyes. Long-term complications included loss of vision (> or =2 lines) in eight (22%) patients, corneal decompensation in one (2%), phthisis bulbi in one (2%), and corneal graft rejection in one (2%).

Conclusion: Although effective IOP reduction was demonstrated in eyes with intractable glaucoma after TDC, a significant proportion (26%) of eyes had severe long-term complications.