Modified CO2 Laser-assisted Sclerectomy Surgery in Chinese Patients With Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma: A 2-Year Follow-up Study.

Abstract

A modified CO2 laser-assisted sclerectomy surgery (CLASS) based on the characteristics of Chinese eyeball was carried out in Chinese patient and was confirmed to be effective and safe during long-term follow-up. The purpose of this study was to study the long-term efficacy and safety of modified CLASS in Chinese patients with primary open-angle and pseudoexfoliative glaucoma. We enrolled 25 medically uncontrolled primary open-angle and pseudoexfoliative glaucoma patients in this prospective, interventional case series. A combination of modified CLASS and preoperative laser iris management was administered to 29 eyes. Visual acuity, intraocular pressure (IOP), slit-lamp examinations, visual field, and gonioscopy were carried out at baseline and until 24 months postoperatively. Ultrasound biomicroscopy examinations were repeated at 3, 12, and 24 months postsurgically. Mean patient age was 53.92±12.08 years. Mean preoperative IOP was 30.66±10.41 mm Hg; and mean postoperative IOP was 8.17±3.76, and 13.25±2.73, 13.76±2.50, and 13.76±2.50 mm Hg at 1 day, and 6, 12, and 24 months, respectively. Proportional changes in IOP from baseline at 6, 12, and 24 months was 58.33%, 56.25%, and 58.97% (P<0.001), respectively. Complete postoperative success rates at 12 and 24 months were 62.07% and 48.28%. Qualified success rates at 12 and 24 months postoperatively were both 89.66%. Number of medications administered per patient reduced from 3 at baseline to 0 at 12 and 24 months (P<0.0001). Two patients demonstrated severe peripheral anterior synechiae (6.90%). Ultrasound biomicroscopy examination revealed a severe scleral lake diminution in 1 patient (3.40%) at 12 months and 2 patients (6.90%) at 24 months. Combination of modified CLASS and preventive laser iris management was effective and safe in the long-term treatment of primary open-angle glaucoma patients.