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Long-term Follow-up of Intraocular Pressure after Cyclophotocoagulation in Different Kinds of Glaucoma
1Flamm C., 2Wiegand W.,
1Klinikum Nord-Heidberg, Augenabteilung (Hamburg)
2Klinikum Nord Heidberg, Augenklinik (Hamburg)
Purpose: Cyclophotocoagulation (CPC) with the diode laser has been established in glaucoma surgery in the last years. The initial reduction of IOP after single or repeated CPC has been confirmed earlier. Now, the 1-year follow-up of IOP should be investigated.
Method: In 150 eyes a single or repeated CPC with the diode laser (OcuLightSLx of Iris Medical, wavelength 810 nm, 2000 mW, 2000 ms, 20 spots) was performed. IOP was examined preop, 3 days postop, 6 month postop and 1 year postop in following kinds of glaucoma: neovascularization glaucoma (NG), glaucoma in pseudophakia (PG) and glaucoma with previous glaucoma surgery (SG). Complications and the number of repeated CPC were analyzed.
Results: Out of 150 eyes 93 were treated with CPC once, 42 eyes were treated twice, 9 eyes were treated 3 times and 6 eyes more than 3 times (until 7 times) with CPC. For NG (n=36) the mean preop IOP (mprIOP) was 32.5 mmHg and the mean postop IOP (mpoIOP) was 20.6 mmHg 3 days after CPC, 15.5 mmHg 6 month after CPC and 16.5 mmHg 1 year after CPC. In PG (n=41) mprIOP was 24.3 mmHg and mpoIOP was 16.0 mmHg 3 days after CPC, 15.2 mmHg 6 month after CPC and 17.0 mmHg 1 year after CPC. In SG (n=48) mprOP was 21.9 mmHg and mpoIOP was 14.5 mmHg 3 days after CPC, was 15.4 mmHg 6 month after CPC and 15.8 mmHg 1 year after CPC. Postop IOP showed high standard deviation (1.8-10.9 mmHg) in all kinds of glaucoma. The number of repeated CPC was 1.43 for the PG group 1.56 for the SG group and 1.61 for the NG group. Postoperative severe inflammatory reactions were observed in 10 eyes. 2 eyes showed postop. hypotonia.
Conclusions: In long time follow-up the reduction of IOP by CPC and the number of retreatments were not related to the type of glaucoma. 1 year after CPC the IOP showed a stabilization on a low level. The claims for successful glaucoma surgery - reduction of initial IOP of more than 30 % and IOP below 21mmHg - are fulfilled by CPC.