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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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Kaplan-Meier curves showing IOP control following treatment for all groups.
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fig8: Kaplan-Meier curves showing IOP control following treatment for all groups.

Mentions: Kaplan-Meyer survival analysis shows IOP reduction to be maintained better with tube than with either cycloYAG or cyclodiode (Figure 8). Only the difference in IOP survival between the tube group and the cycloYAG group was statistically significant (P < 0.02).


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)

Kaplan-Meier curves showing IOP control following treatment for all groups.
© Copyright Policy
Related In: Results  -  Collection

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

fig8: Kaplan-Meier curves showing IOP control following treatment for all groups.
Mentions: Kaplan-Meyer survival analysis shows IOP reduction to be maintained better with tube than with either cycloYAG or cyclodiode (Figure 8). Only the difference in IOP survival between the tube group and the cycloYAG group was statistically significant (P < 0.02).

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