Document Detail


Diode laser cycloablation in adult glaucoma: long-term results of a standard protocol and review of current literature.
MedLine Citation:
PMID:  16872335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To study the long-term efficacy and safety of diode laser cycloablation under a standard protocol in refractory glaucoma. METHODS: A retrospective study involving 42 eyes (39 patients), observed for 36-84 (mean 65.7) months after cycloablation involving 14 burns of 2-W power and 2-s duration, over 270 degrees of the ciliary body. RESULTS: By final review, mean intraocular pressure (IOP) had dropped by 50.3% from 31.4 +/- 8.8 mmHg before treatment to 15.6 +/- 6.3 mmHg (P < 0.0001). Thirty-seven of the 42 eyes (88.1%) achieved IOP < 22 mmHg. Thirty-five of the 42 eyes (83.3%) eyes achieved IOP reduction > or = 30% from baseline levels. The mean number of antiglaucoma medications per eye dropped from 2.55 +/- 0.83 to 1.71 +/- 1.44 (P = 0.0004). The percentage of eyes requiring oral acetazolamide dropped from 92.9% to 11.9% (P < 0.0001). About 59.6% of eyes required multiple treatment sessions (mean 2.17). Twenty-seven (64.3%) eyes suffered deterioration, 11 (26.2%) maintained stability and 4 (9.5%) exhibited improvement of visual acuity. No relationship between the number of treatment sessions and visual outcome was evident. CONCLUSIONS: This conservative repeatable protocol affords delivery of the minimum dose of photocoagulation necessary to achieve a safe, long-term ocular hypotensive response, while minimizing the risk of serious adverse effects, and is valuable in the difficult treatment of refractory glaucoma.
Authors:
Stephen A Vernon; Joanne M Koppens; G Jayakrishna Menon; Anil K Negi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical & experimental ophthalmology     Volume:  34     ISSN:  1442-6404     ISO Abbreviation:  Clin. Experiment. Ophthalmol.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-28     Completed Date:  2006-09-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896531     Medline TA:  Clin Experiment Ophthalmol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  411-20     Citation Subset:  IM    
Affiliation:
Directorate of Ophthalmology, Queens Medical Centre, Nottingham, UK. stephen.vernon@nuh.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Acetazolamide / therapeutic use
Adolescent
Adult
Aged
Aged, 80 and over
Carbonic Anhydrase Inhibitors / therapeutic use
Ciliary Body / surgery*
Drug Utilization
Female
Glaucoma, Open-Angle / drug therapy,  physiopathology,  surgery*
Humans
Intraocular Pressure / physiology
Laser Coagulation / methods*
Male
Middle Aged
Retrospective Studies
Visual Acuity / physiology
Chemical
Reg. No./Substance:
0/Carbonic Anhydrase Inhibitors; 59-66-5/Acetazolamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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