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<p>Effectiveness and Safety of Long Duration versus Short Duration Diode Laser Transscleral Cyclophotocoagulation</p>
摘要： Purpose: To compare the efficacy and safety of diode laser transscleral cyclophotocoagulation using either the long duration or short duration protocol. Methods: Retrospective series of 23 consecutive patients with glaucoma who underwent continuous-wave diode laser transscleral cyclophotocoagulation from August 2016 to July 2018 at a tertiary hospital in Hong Kong. Laser pulse duration for the long and short duration protocols was defined as 3.0–4.0 and 1.5–2.0 s, respectively. Results: There were 15 male and 8 female Chinese subjects (23 eyes), age 49–90 (71.3 ± 2.7), with 10 subjects that underwent long duration cyclophotocoagulation (power 1239.2 ± 78.3 mW, spots 13.9 ± 1.4) and 13 subjects that had short duration cyclophotocoagulation (mean power 1817.3 ± 85.7 mW, spots 14.4 ± 1.0). Six months after long and short duration cyclophotocoagulation, intraocular pressure decreased significantly from 29.9 ± 7.8 to 21.1 ± 6.5 (p < 0.01), and from 35.4 ± 2.7 to 24.1 ± 3.4 (p = 0.04), respectively, while glaucoma medications decreased significantly by 1.4 ± 0.5 (p = 0.02) in the long duration group only. Reduction of medications after short duration cyclophotocoagulation was less and did not reach statistical significance (0.9 ± 0.9, p = 0.15). There was no significant difference of visual deterioration and complication rates. Conclusion: Both types of cyclophotocoagulation were equally effective in lowering intraocular pressure by 6 months, but the short duration protocol, using higher laser power, was able to achieve a greater and earlier reduction, at 3 months. However, the long duration protocol, using less laser power, appears better at reducing medication requirement by 6 months.
关键词： g-probe,cycloablation,cyclodiode,cyclodestructive,cyclodestruction
更新于2025-09-19 17:13:59
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Safety and Efficacy of Diode Laser Transscleral Cyclophotocoagulation in Eyes With Good Visual Acuity
摘要： The main aim of this study was to evaluate the safety and efficacy of diode laser transscleral cyclophotocoagulation (TSCPC) in eyes with good visual acuity. A retrospective chart review identified patients who underwent TSCPC for uncontrolled intraocular pressure (IOP) from 2014 to 2016. Enrollment criteria included pretreatment best-corrected visual acuity (BCVA) of 20 of 40 or better, and a minimum of 6 months of postoperative follow-up. Thirty-three eyes of 33 patients(mean age, 72.1 ± 16.0 y) were enrolled (mean follow-up 12.6 ± 6.1 mo). The mean (SD) IOP was reduced 48.3% from 27.1 mm Hg (7.8) at baseline to 13.1 mm Hg (4.2) at last follow-up. Reduction of ≥ 1 glaucoma medications was achieved in 17 eyes (51.5%) at last follow-up. The cumulative probability of complete success (BCVA loss <2 Snelling lines, 20% reduction IOP, no reoperation for glaucoma, no IOP < 5 mm Hg) was 78.8% and 50% at months 6 and 12, respectively. The cumulative probability of qualified success (BCVA ≥ 2 lines with ≥ 20% reduction IOP, no reoperation for glaucoma, no IOP < 5 mm Hg) was 90.1% and 81.3% at month 6 and 1 year, respectively. Significant vision loss, defined as BCVA ≥ 2 lines, occurred in 33% of patients. The most common complications were postoperative iritic (56.3%) and cystoid macular edema (12.5%). TSCPC demonstrates a strong reduction in IOP and glaucoma medication use. However, with significant vision loss in 33% of patients, future prospective studies with a comparison group receiving traditional glaucoma surgery are needed to determine comparative safety and efficacy.
关键词： transscleral cyclophotocoagulation,diode laser,visual acuity,cyclodestruction
更新于2025-09-16 10:30:52