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A comparison between tube surgery, ND:YAG laser and diode laser cyclophotocoagulation in the management of refractory glaucoma.

Bloom PA, Clement CI, King A, Noureddin B, Sharma K, Hitchings RA, Khaw PT - Biomed Res Int (2013)

Bottom Line: Control of IOP was best in patients receiving tube surgery.Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP.Tube surgery was associated with a greater incidence of sight threatening complications.

View Article: PubMed Central - PubMed

Affiliation: Western Eye Hospital, 153-173 Marylebone Road, London NW1 5QH, UK.

ABSTRACT

Purpose: To compare the results of intraocular pressure (IOP) reduction by 3 treatment modalities, (a) glaucoma tube implants, (b) noncontact YAG laser cyclophotocoagulation (cycloYAG), and (c) contact transscleral diode laser cyclophotocoagulation (cyclodiode), in cases of advanced glaucoma refractory to alternative treatments.

Methods: A consecutive group of 45 eyes that received cycloYAG were matched against two control groups of patients who had received tube surgery or cyclodiode, each control group having been derived from a database of patients.

Results: Mean pretreatment IOP improved from 41.3, 38.6, and 32.0 mmHg for the tube, cycloYAG, and cyclodiode groups, respectively, to 16.4, 22.1, and 19.3 mmHg, respectively. Treatment success was achieved in 78%, 69%, and 71% of the tube, cycloYAG, and cyclodiode groups, respectively. Visual acuity deteriorated 2 or more Snellen lines in 16%, 7%, and 9% of the patients in the tube, cycloYAG, and cyclodiode groups, respectively. Complications included retinal detachment, hypotony, and phthisis.

Conclusions: All 3 methods provided acceptable IOP lowering in the short and medium term. Control of IOP was best in patients receiving tube surgery. Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP. Tube surgery was associated with a greater incidence of sight threatening complications.

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Change in IOP (mmHg) following cycloYAG treatment.
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fig1: Change in IOP (mmHg) following cycloYAG treatment.

Mentions: Figures 1, 2, and 3 show the “raw data” for pretreatment IOP and IOP at last followup, for each treatment group. The mean pretreatment IOPs for the tube, cycloYAG, and cyclodiode groups, respectively, were 41.3 mmHg, 38.6 mmHg, and 32.0 mmHg (Figure 4 and Table 3, P < 0.00005 between groups). Following treatment there was an immediate IOP reduction in all groups, which reached a plateau about 1 month after treatment. After this, the IOP remained steady in the tube group whereas in the cycloYAG group there was a gradual rise to month 6 after which the level remained steady. In the cyclodiode group there was a further slight drop in IOP until month 6 after which the IOP remained steady (Figure 4).


A comparison between tube surgery, ND:YAG laser and diode laser cyclophotocoagulation in the management of refractory glaucoma.

Bloom PA, Clement CI, King A, Noureddin B, Sharma K, Hitchings RA, Khaw PT - Biomed Res Int (2013)

Change in IOP (mmHg) following cycloYAG treatment.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814063&req=5

fig1: Change in IOP (mmHg) following cycloYAG treatment.
Mentions: Figures 1, 2, and 3 show the “raw data” for pretreatment IOP and IOP at last followup, for each treatment group. The mean pretreatment IOPs for the tube, cycloYAG, and cyclodiode groups, respectively, were 41.3 mmHg, 38.6 mmHg, and 32.0 mmHg (Figure 4 and Table 3, P < 0.00005 between groups). Following treatment there was an immediate IOP reduction in all groups, which reached a plateau about 1 month after treatment. After this, the IOP remained steady in the tube group whereas in the cycloYAG group there was a gradual rise to month 6 after which the level remained steady. In the cyclodiode group there was a further slight drop in IOP until month 6 after which the IOP remained steady (Figure 4).

Bottom Line: Control of IOP was best in patients receiving tube surgery.Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP.Tube surgery was associated with a greater incidence of sight threatening complications.

View Article: PubMed Central - PubMed

Affiliation: Western Eye Hospital, 153-173 Marylebone Road, London NW1 5QH, UK.

ABSTRACT

Purpose: To compare the results of intraocular pressure (IOP) reduction by 3 treatment modalities, (a) glaucoma tube implants, (b) noncontact YAG laser cyclophotocoagulation (cycloYAG), and (c) contact transscleral diode laser cyclophotocoagulation (cyclodiode), in cases of advanced glaucoma refractory to alternative treatments.

Methods: A consecutive group of 45 eyes that received cycloYAG were matched against two control groups of patients who had received tube surgery or cyclodiode, each control group having been derived from a database of patients.

Results: Mean pretreatment IOP improved from 41.3, 38.6, and 32.0 mmHg for the tube, cycloYAG, and cyclodiode groups, respectively, to 16.4, 22.1, and 19.3 mmHg, respectively. Treatment success was achieved in 78%, 69%, and 71% of the tube, cycloYAG, and cyclodiode groups, respectively. Visual acuity deteriorated 2 or more Snellen lines in 16%, 7%, and 9% of the patients in the tube, cycloYAG, and cyclodiode groups, respectively. Complications included retinal detachment, hypotony, and phthisis.

Conclusions: All 3 methods provided acceptable IOP lowering in the short and medium term. Control of IOP was best in patients receiving tube surgery. Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP. Tube surgery was associated with a greater incidence of sight threatening complications.

Show MeSH
Related in: MedlinePlus