The UK National Cyclodiode Laser Survey

Abstract

To evaluate current practice of transscleral diode laser cyclophotocoagulation (cyclodiode) laser treatment among consultant ophthalmologists in the United Kingdom. A 31-question survey was emailed to all practising consultant ophthalmologists who were members of the Royal College of Ophthalmologists. All non-responders were sent a postal version of the questionnaire. This paper looked at cyclodiode practice patterns and consisted of questions on demographic data, transillumination, and power settings, factors influencing practice, post-operative care, and repeat treatment. A total of 510 participants (53.6%) responded. A total of 180 (35.3%) responders reported performing cyclodiode laser treatment, of which 84 (46.7%) were glaucoma subspecialists (GSS). Initial median power settings used were 1500 mW and 2000 ms. The average number of applications delivered per sitting was 25.5 ± 1.2 applications for GSS vs 20.6 ± 2.0 for non-GSS in a seeing eye (P = 0.0013). In all, 65% routinely transilluminated the globe of which 78% were GSS and 52.3% were non-GSS (P = 0.0009). In all, 43% of the GSS vs 17% of the non-GSS lowered power settings in uveitic glaucoma (P = 0.013). In blind eyes, 30% of the GSS vs 12% of the non-GSS increased energy levels (P = 0.0014). In all, 60% of the responders performed cyclodiode at any visual acuity, whereas 22% performed combined cyclodiode and cataract surgery. This survey highlights a wide variation in the use of cyclodiode laser treatment amongst GSS and non-GSS. However, the most frequently used practice may not be the optimal practice. A more individualised parameter according to the condition of the eyes may optimise the outcome.