Comparative study of the safety and efficacy of two techniques of diode laser transcleral cyclophotocoagulation for refractory glaucoma

Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : A.Matsou UK

Co Author(s): :    M. Dermenoudi   A. Tzamalis   E. Anastasopoulos                 

Abstract Details

Purpose:

To prospectively compare the safety and efficacy of the standard pop-titrated diode laser transcleral cyclophotocoagulation technique (TSCPC) versus the fixed, lower power and larger duration settings technique (slow burn).

Setting:

2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece

Methods:

Patients with refractory glaucoma were prospectively enrolled to receive diode laser TSCPC. Subjects in Group A received the standard pop-titrated technique (2sec burn duration, 1500mW starting power increased until pop sound produced and then decreased one step to avoid further pops). Group B received the slow coagulation technique with fixed settings based on iris pigmentation (dark/brown irises: 1250mW- 4.5sec duration burns/ lightly pigmented irises 1500mW- 4.5sec duration). Visual acuity, intraocular pressure (IOP) and anterior chamber inflammation were recorded at baseline, week-1, month-1 and month-3 after the procedure. Pain score was documented at first post-operative day using a 0-10 pain scale.

Results:

Baseline IOP did  not differ significantly between groups; Group A (n=14) patients had an average IOP of 38mmHg and Group B (n=21) 41.2mmHg (p=0.39). No significant differences were detected in IOP measurements and anterior chamber inflammation in either of the three follow-up timepoints. Subjects in both groups demonstrated an adequate and similar reduction in IOP at month 3; Group A 20.2mmHg and Group B 21.2mmHg (p=0.84). Pain score as reported by patients on the first post-operative day was higher for patients in the slow coagulation group (Group A 2.9 Vs Group B 4.8) without however reaching statistical significance (p=0.12).

Conclusions:

In our study, both the standard pop-titrated and the slow burn TSCPC techniques demonstrated an adequate and similar IOP reduction at all timepoints. The complication profiles of the two methods were also comparable with anterior chamber inflammation being similar in both groups up to month 3 as was the pain score at day one. Our results suggest that the slow coagulation technique which does not require any modifications in power settings during the procedure, is equally safe and efficacious in achieving IOP reduction in eyes with refractory glaucoma

Financial Disclosure:

None