|
KMID : 1813520160050010001
|
|
Journal of the Korean Glaucoma Society
2016 Volume.5 No. 1 p.1 ~ p.5
|
|
|
Is the Transscleral Diode Laser Cyclophotocoagulation Safe for the Patients with Retained Visual Potential?
|
|
Kim Chang-Sik
|
|
|
Abstract
|
|
|
Purpose : To evaluate the effects of trans-scleral diode laser cyclophotocoagulation (TSDLC) on best corrected visual acuity (BCVA) in patients with refractory glaucoma with and without retained visual potential.
Methods : The medical records of 148 eyes (148 patients) with refractory glaucoma who were followed-up > 6 months after TSDLC were analyzed retrospectively. Among them, 49 eyes (49 subjects) who had BCVA > no light perception (NLP) before TSDLC were classified as Group 1 and the other 99 eyes (99 patients) who had NLP vision were classified as Group 2. The outcomes of TSDLC including change in BCVA following treatment were analyzed for all patients and 49 subjects in group 1 who had retained visual potential before treatment, separately.
Results : The mean follow-up period in Group 1 was 19.1 ± 13.5 months and 16.7 ± 12.7 months in Group 2. The intraocular pressure (IOP) and the number of IOP lowering medications decreased in both groups (both p < 0.001). In all subjects, there was no significant difference between BCVA before surgery and at the last follow-up (2.4 ± 0.9 logMAR and 2.5 ± 0.8 logMAR, respectively, p = 0.612). However, in Group 1, BCVA was decreased from 1.4 ± 1.0 to 1.9 ± 1.1 logMAR after the TSDLC (p < 0.001). In those patients, visual loss ≥ 0.2 logMAR was found in 31 eyes (63.3%) and light perception was lost in 15 eyes (30.6%). After treatment, corneal edema developed in 5 eyes (3.4%), phthisis bulbi and chronic hypotony occurred in 3 eyes each (2%) and iridocyclitis occurred in 2 eyes (1.4%).
Conclusions : TSDLC in patients with refractory glaucoma showed an efficient reduction in IOP and the number of IOP-lowering medications. However, there was a loss in BCVA in significant number of patients who had retained visual potential before treatment. Therefore, for patients with retained visual potential, surgical options other than cyclodestructive surgery should be first considered, and the patients should be warned of possible visual acuity deterioration resulting from this treatment.
|
|
|
KEYWORD
|
|
|
Glaucoma, Diode lasers, Cyclophotocoagulation, Visual acuity
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|