2Doç. Dr., Ege Üniversitesi, Göz Hastalıkları, İzmir, Türkiye DOI : 10.37844/glau.cat.2023.18.19 Purpose: The purpose of this study is to evaluate the treatment results of transscleral diode laser cyclodestruction (DLC) in eyes with glaucoma resistant to medical and/or surgical treatment.
Materials and Methods: A retrospective chart review was performed for patients who underwent DLC due to intraocular pressure (IOP) >21 mmHg despite maximum medical and/or surgical anti-glaucoma treatment between September 2020-August 2022 in glaucoma unit. Data regarding demographic data, glaucoma types, previous glaucoma surgeries and medical anti-glaucoma treatments, IOP measurements before the DLC and on postoperative day 1, week 1 and months 1, 3, 6 and 12.
Results: Overall, 58 eyes [17 aphakic glaucoma, 10 penetrating keratoplasty glaucoma, 7 neovascular glaucoma, 5 exfoliative glaucoma, 4 primary angle closure, 3 primary open angle, 4 congenital, 3 iridocorneoendothelial syndrome, 2 Fuchs uveitis, 2 silicone oil, 1 glaucoma secondary to penetrating injury] of 53 (30 F, 23 M) patients were included. Mean age was 45.6±26.1 (1-81) years and mean follow-up period was 20.1 months. Fifty-four (93.1%) of the eyes received maximum topical anti-glaucoma medications, 14 (24.1%) received additional systemic acetazolamide and 4 (6.9%) pediatric patients were using maximum topical treatment except for alpha-2 agonists. Thirty-eight (65.5%) of the eyes had prior glaucoma surgery. Mean cup to disc (c/d) ratio was 0.92±0.18 and mean IOP was 31.3±9.1 mmHg before DLC. IOP was measured as 25.5±11.3 mmHg (p=0.001) on month 1 and 18.8±6.6 mmHg on month 12 (p<0.001). Re-treatment was needed in 19 (%32.7) eyes.
Conclusions: DLC is an effective method that may require repeated procedures (32.7%) in refractory glaucoma treatment.
Keywords : Cyclodestruction, Diode laser, Refractory glaucoma