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Impressum
Dose-effect relation following cyclophotocoagulation with the Diode laser
Flamm C., Wiegand W.
Eye Dept., Klinikum Nord-Heidberg, Tangstedter Landstr. 400, 22413 Hamburg
Objective: Although the cyclophotocoagulation (CPC) is nowadays
a frequent surgical intervention in glaucoma surgery, a clear dose recommendation
is still missing. We examined the dose-effect relation of a single CPC
in different indication groups.
Methods: In 125 eyes a CPC with the Diode laser (OcuLightSLx from
Iris Medical, wave length 810 nm, 2000 mW, 2000 ms, 20-40 spots) was performed.
The reduction of intraocular pressure was investigated between the first
and third postoperative day for different types of glaucoma: neovascularization
glaucoma (NV), glaucoma in pseudophakia (PG), and therapy resistent glaucoma
with previous glaucoma surgery (ZG).
Results: The NV group (n=36) showed a mean reduction of intraocular
pressure (mrIOP) of 9.1 mmHg on the first and of 11.9 mmHg on the third
postop day with a mean preoperative IOP of 32 mmHg. In the PG group (n=41)
the mrIOP was on the first postop day 6.0 mmHg and on the third postop
day 8.3 mmHg with a mean preop IOP of 24.3 mmHg. In the ZG group (n=48)
the mrIOP was 5.1 mmHg on the first and 7.5 mmHg on the third postop day
with a mean preop IOP of 21.9 mmHg. However, the postoperative course
of the IOP showed considerable high standard deviations (4.6-7.8 mmHg).
A postoperative inflammatory reaction in 10 eyes (8%) was observed, one
eye showed postop hypotension.
Conclusion: The IOP reduction of a single CPC seems to depend more
on the preoperative IOP than on the type of glaucoma. The highest reduction
of IOP was already observed on the first postoperative day. The predictability
of the effect of a CPC, however, is difficult because of large interindividual
differences. The rate of complications of a CPC is relatively low.