Trans-scleral diode laser cyclophotocoagulation for refractory glaucoma after high-risk penetrating keratoplasty
| Autor: | Luis Alonso Gonzalez-Gonzalez, Alejandro Rodríguez-García, J. Carlos Alvarez-Guzman |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Intraocular pressure medicine.medical_specialty Adolescent genetic structures medicine.medical_treatment Glaucoma Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Ciliary body Refractory Ophthalmology medicine Humans Longitudinal Studies Prospective Studies Child Prospective cohort study Antihypertensive Agents Intraocular Pressure Aged Laser Coagulation business.industry Secondary glaucoma Middle Aged medicine.disease eye diseases Surgery medicine.anatomical_structure Retreatment 030221 ophthalmology & optometry Female sense organs Lasers Semiconductor Phthisis bulbi business Laser coagulation Keratoplasty Penetrating 030217 neurology & neurosurgery |
| Zdroj: | International Ophthalmology. 36:373-383 |
| ISSN: | 1573-2630 0165-5701 |
| DOI: | 10.1007/s10792-015-0130-2 |
| Popis: | To analyze the intraocular pressure reduction, number of anti-glaucoma medications needed, and post-operative complications of trans-scleral diode laser cyclophotocoagulation (DCPC) in patients with high-risk penetrating keratoplasty (PKP) and secondary refractory glaucoma. Prospective interventional, longitudinal, non-comparative series of cases, including 16 eyes of 15 patient's post-PKP on maximal anti-glaucoma medical therapy with intraocular pressures above 22 mmHg. All patients received 18 shots, 360° peri-limbal (avoiding the long posterior ciliary nerves and arteries at 3 and 9 o'clock positions) of trans-scleral DCPC (2000 mW, time: 2.0 s/shot). There was a 55.5 % reduction (total of 14.0 mmHg) of the mean pre-operative IOP (31.5 mmHg) after the first diode laser application (p = 0.0020). Re-treatment was required in 31.2 % of eyes over a mean period of 10.7 months. In these five eyes, the mean pre-operative IOP was 40.4 mmHg, which decreased to 15.0 mmHg post-therapy, and a mean IOP reduction of 25.4 mmHg (p = 0.0218). There was a 51.0 % reduction in the mean number of medications used after the first, and a 57.1 % reduction after a second laser application. The incidence of failure (IOP ≥ 22 mmHg or need of additional medical therapy) from initial intervention to loss of follow-up was 1.3 % per person-month. DCPC effectively reduces the intraocular pressure and the number of anti-glaucoma medications with few complications in patients after high-risk PKP and secondary glaucoma. Only, one-third of the eyes needed a second intervention to control the intraocular pressure. Post-DCPC complications were limited to phthisis bulbi and endothelial dysfunction, one eye each. Please check and confirm the author names and initials are correct. Also, kindly confirm the details in the metadata are correct. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink