Efficacy and Safety of Repeated Micropulse Transscleral Diode Cyclophotocoagulation in Advanced Glaucoma
| Autor: | Lim K.A. Dawn, Loon Seng Chee, Aquino Maria Cecilia, J.Y. Edward Lim, T.C. Victor Koh, Sng Chelvin, Chew T.K. Paul, Lun W.X. Katherine |
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| Rok vydání: | 2021 |
| Předmět: |
Intraocular pressure
medicine.medical_specialty Visual acuity genetic structures Glaucoma medication business.industry medicine.medical_treatment Trans-scleral Glaucoma medicine.disease eye diseases Ophthalmology Refractory medicine Asian population sense organs Phthisis bulbi medicine.symptom business |
| Zdroj: | Journal of Glaucoma. 30:566-574 |
| ISSN: | 1057-0829 |
| DOI: | 10.1097/ijg.0000000000001862 |
| Popis: | Precis Repeat micropulse trans-scleral cyclophotocoagulation has some benefit in lowering intraocular pressure. There was a small risk of loss of vision, prolonged hypotony and phthisis bulbi. Aims To determine the efficacy and safety of repeated micropulse trans-scleral cyclophotocoagulation (MPTCP) for an Asian population with refractory glaucoma. Methods This is a retrospective case series of 43 eyes (43 patients) with severe glaucoma which underwent repeated MPTCP. Baseline parameters were taken from the visit just before the second MPTCP session. Success was defined as IOP of 6-21▒mmHg or ≥20% reduction in intraocular pressure (IOP) without an increase in glaucoma medication from baseline, without further glaucoma re-operation, and ≤3 total MPTCP episodes. The IOP, number of IOP-lowering medications and best-corrected visual acuity (BCVA) were documented pre and post-operatively. Post-operative complications were also analyzed. Results The mean age was 57.4±18.2 (standard deviation) years with a mean follow-up duration of 28.9±27.5 months. Neovascular glaucoma was the most common type of glaucoma (18 eyes [41.9%]). The success rates at post-operative years 1, 2 and 3, and latest follow-up was 36.4%, 42.9%, 32.0% and 39.5%, respectively. The median survival time of repeat MPTCP was 4.6 months. Compared to the pre-operative mean IOP (35.2±11.0▒mmHg), the mean IOP at post-operative years 1, 2 and 3, and latest follow-up, was 27.8±13.7▒mmHg (P =0.004), 27.4±12.4 (P=0.003), 31.8±13.2 (P =0.35) and 27.1±13.8▒mmHg (P=0.002), respectively. The mean number of IOP-lowering medications was reduced from 3.3±0.9 pre-operatively to 2.8±1.3 at the final follow-up (P=0.007). Post-operative complications included prolonged hypotony (3 eyes [7.0%]) and phthisis bulbi (2 eyes [4.7%]). Conclusion Repeated MPTCP is at best moderately effective in lowering IOP for eyes with advanced glaucoma. |
| Databáze: | OpenAIRE |
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