Relevance of long-term follow-up of cyclocryocoagulation

Abstract

In spite of the availability of cyclocryodestructive laser therapy there still appears to be an indication for cyclocryotherapy in different kinds of glaucoma. Cyclocryotherapy very often appears to be the operation of choice in cases of progressive functional visual loss if a patient is not sufficiently helped with the maximum tolerated medical therapy. We investigated long-term IOP effects and possible complications in our group of patients undergoing cyclocryotherapy. Cyclocryotherapy was performed on 109 eyes of 97 patients from 1988 to 1994. Cyclocryotherapy was performed as follows: 67 of 109 eyes were controlled for IOP for an average of 10 months (3-41 months). We applied cryotherapy six times 3-4 mm behind the limbus for an average duration of 50 to 60 s over half of the circumference. We achieved satisfactory IOP control (IOP < or = 22 mm Hg) in 40 eyes, however, with 30 additional operations. One eye developed phthisis bulbi, and 3 other eyes became blind because of complications in neovascular glaucomas. Neovascular glaucoma cases responded the least. Cyclocryotherapy produced a statistically significant IOP reduction in eyes with primary open-angle glaucoma or secondary glaucoma. Close long-term follow-up appears advisable in order to check the eyes for possible increase in IOP or complications of surgery.