Diode Laser Cyclophotocoagulation Research Articles

The potential of a fixed combination of brimonidine and timolol in achieving safe intraocular pressure levels after micropulse laser cyclophotocoagulation

PURPOSE. To evaluate the clinical effectiveness and safety of using a fixed combination — hypotensive drug Brimonidine Duo (brimonidine tartrate 2 mg/mL + timolol maleate 5 mg/mL) to reduce intraocular pressure in patients with advanced stages of primary open-angle glaucoma (POAG) in cases when achieving target pressure failed after laser micropulse transcleral diode laser cyclophotocoagulation (mCPC).METHODS. MCPC was performed with individually chosen parameters in 100 patients (104 eyes) aged 35 to 86 with POAG, of them 54.17% were men and 45.83% were women. The follow-up period lasted 3 months, the results were evaluated on the 1st, 7th and 14th days, then after 1 and 3 months. In 23.08% of cases (24 patients) subjects were prescribed antihypertensive combination drug Brimayza Duo due to intraocular pressure (IOP) remaining uncompensated.RESULTS. The average IOP level after 7 days was 23.54± 4.8 mm Hg. After 3 months, IOP values were 18.11±2.04 mm Hg, which is 4–5 mm Hg lower than in the early postoperative period. After 30 days of follow-up, an additional antihypertensive drug Latanoprost 0.005% was added for 5 patients (20.83%). Repeated surgery was recommended and performed in 4 patients (16.67%), of which 1 patient underwent surgical intervention of the penetrating type, 3 patients underwent repeat mCPC with individually chosen parameters.CONCLUSION. MCPC is a safe and effective tool for reducing intraocular pressure in patients with advanced stages of POAG. The noninvasive nature of this technique makes it possible to speed up the recovery time after surgery, as well as reduce the number of postoperative complications. Among patients who failed to achieve target pressure after surgery, the use of Brimayza Duo was effective in 62.5% of cases.

Comparison of GATT versus micropulse transscleral diode laser cyclophotocoagulation combined with GATT in patients with advanced glaucoma.

To compare the efficacy of gonioscopy-assisted transluminal trabeculotomy (GATT) versus micropulse transscleral diode laser cyclophotocoagulation(MP-TDLC) combined with GATT in the treatment of advanced glaucoma. This retrospective comparative study study included 82 patients (82 eyes) with a diagnosis of advanced glaucoma: 36 patients underwent GATT, and 46 underwent GATT + MP-TDLC. Intraocular pressure (IOP) changes in patients who underwent GATT and GATT MP-TDLC were analyzed retrospectively at regular intervals during the 6-month follow-up period. For the 82 patients included in this study, the mean ± SD IOPs before the procedures were 27.2 ± 8.5 mmHg in the GATT group and 26.6 ± 6.9 mmHg in the GATT + MP-TDLC group (p = 0.866), and the numbers of glaucoma medications used were 3.41 ± 0.5 in the GATT group and 3.36 ± 0.4 in the GATT + MP-TDLC group (p = 0.605). The mean IOP after GATT was 13.6 ± 3.9 mmHg at day 1, 13.9 ± 3.7 mmHg at week 1, 14.6 ± 4.0 mmHg at month 1, 15.3 ± 4.3 mmHg at month 3, and 14.7 ± 3.3 mmHg at month 6. In the GATT + MP-TDLC group, the postoperative day 1, week 1, month 1, month 3, and month 6 IOP values were 12.4 ± 2.5, 11.8 ± 1.8, 12.1 ± 2.0, 11.8 ± 1.09, and 11.8 ± 1.5 mmHg, respectively. GATT was found to be effective in the treatment of patients with advanced glaucoma, and results closer to the targeted low teens IOP values were obtained with GATT + MP-TDLC.

Clinical Presentation and Treatment Outcomes of Pupillary Block Glaucoma Following Vitreoretinal Surgery

ABSTRACT Purpose To describe the clinical presentation and treatment outcomes of pupillary block glaucoma (PBG) following vitreoretinal surgery (VR surgery). Material and Methods Retrospective observational study of 6941 patients, who underwent VR surgery at a tertiary eye care centre in South India between January 2015 and December 2019. Amongst them, clinical data of 61 patients who developed PBG were taken for statistical analysis. Results Mean (SD) age was 53.90 (13.4) years and the incidence of PBG was .87%. Median (IQR) time of onset of PBG following VR surgery was 3.33 (1.1–6.6) months and majority were pseudophakic (75%). PBG resolved with Nd:YAG laser peripheral iridotomy (LPI) alone in 50 (82%) patients, whereas 11(18%) patients required additional interventions like surgical iridectomy, trabeculectomy or diode laser cyclophotocoagulation (CPC) either as a stand-alone procedure or in combination with silicone oil removal (SOR). Mean (SD) intraocular pressure at the onset of PBG was 41.61 (14.5) mmHg, which reduced drastically following LPI to 24.28 (14.9) mmHg which further dropped significantly at 6 months follow up to 20.34 (13.9) mmHg. Conclusions Incidence of secondary PBG after VR surgery was .87%, and we observed diabetes mellitus, combined cataract and VR surgery, use of 1000cs SO endotamponade, intraoperative endolaser and multiple VR surgical interventions as common associations. Majority of the patients with PBG after VR procedures resolved with LPI and medical management. Few individuals (18%) required additional laser or surgical intervention for IOP control.

Long-Term Results of Transscleral Diode Laser Cyclophotocoagulation in Glaucoma: A Real-Life Study.

Transscleral diode laser cyclophotocoagulation is effective and safe in a large population and different types of glaucoma, but is least effective in NVG group. We aimed to investigate the clinical outcomes of transscleral diode laser cyclophotocoagulation (TDLC) in a large cohort of patients with different types of refractory glaucoma. Using patient charts, we retrospectively analyzed the success and complications of TDLC performed on eyes categorized in 6 groups: primary glaucoma (116 eyes), trauma (41 eyes), neovascular glaucoma (NVG, 84 eyes), post-vitreoretinal surgery (post-VRS, 79 eyes), penetrating keratoplasty (PK, 47 eyes), and miscellaneous (40 eyes). Failure was defined as intraocular pressure (IOP) >22mmHg or <5mmHg, the need for further glaucoma surgery, and the loss of light perception during follow-up. Overall, the mean follow-up time was 33.4±17.4 months, the mean total energy delivered was 109.2±56.5 J, and the mean IOP reduction rate was 41.8%. Total energy delivered and IOP reduction rates were similar between the groups (all P >0.05). The probability of success at 36 months was 71.5%, 70.7%, 55.9%, 77.2%, 72.3%, and 72.5% in the primary glaucoma, trauma, NVG, post-VRS, PK, and miscellaneous groups, respectively. The NVG group showed a significantly lower success rate (P=0.009) than the other groups. Significant complications consisted of phthisis bulbi in 1 eye (0.2%) in the NVG group and chronic hypotony in 7 eyes (1.7%) in the NVG (3 eyes), trauma (2 eyes), post-VRS (1 eye), and primary glaucoma (1 eye) groups. Although TDLC was found to be a safe, effective method in the long term, it was least effective in eyes with NVG.

The outcomes of diode laser transscleral cyclophotocoagulation in refractory primary angle-closure glaucoma in a South Indian population.

The surgical intervention of refractory primary angle-closure glaucomas (PACGs) is a big challenge to any ophthalmologist since the efficacy of lens extraction in eyes with a long duration of angle closure is limited. Also, trabeculectomy in such eyes is not without vision-threatening complications. To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation (CPC) in eyes with refractory PACG. A retrospective study analyzing all patients who underwent CPC for refractory PACG in the year 2019 was conducted. Out of the 68 patients recruited, 56 PACG patients fulfilled the study criteria. The mean age of the participants was 58.5 years. The mean (standard deviation [SD]) intraocular pressure (IOP) at baseline was 38.91 (14.86) mmHg, and it ranged from 21 to 74 mmHg. Participants' mean (SD) follow-up duration was 11.87 (7.83) months. Almost 90.9% of eyes showed IOP reduction from baseline during the follow-up period. There was also a reduction in the mean antiglaucoma medications (AGM) to 2.67 (1.29) in the final follow-up visit compared to the baseline of 3.30 (0.81). Chronic hypotony was noted in four eyes, out of which phthisis bulbi occurred in one eye. Six eyes underwent additional incisional surgical procedures. The outcomes from our study support the role of transscleral diode laser CPC in the interim optimization of IOP in PACG eyes refractory to other modalities. This is emerging as a primary treatment option to optimize IOP to safer limits before any planned incisional procedure. Though complications like chronic hypotony occur as anticipated, vision-threatening complications are rare.

Транссклеральная диод-лазерная циклофотокоагуляция в микроимпульсном режиме у пациентов с рефрактерной глаукомой

The aim of the work was to study clinical efficacy of micropulsed transscleral diode laser cyclophotocoagulation (MTDСFC) in patients with refractory glaucoma. Material and methods. After careful standard ophthalmologic eye examination, 60 patients underwent mTDGFC to compensate the intraocular pressure (IOP) and stabilize the visual and functional indices. Results. Immediately on the next day after the procedure a brightening of the cornea and a decrease of the degree of perilymphalic congestion were observed. IOP level decreased from 42.0 ± 1.2 to 20.97 ± 1.12 in 47.6% of cases, and in a year – to 18.85 ± 0.7. In 40% of cases (n = 24) the visual acuity improved from 0.03 ± 0.01 to 0.06 ± 0.05 which was statistically significant (p &lt; 0,05). In 16.7% of cases (n = 10) there was an increase in the visual field boundaries by an average of 5 degrees. In 15 eyes (25.0%) it became possible to observe fundus. An important advantage of mTDFC was a 52.4% decrease in the number of hypotensive drugs used by the end of follow-up: from 3.0 ± 0.5 to 1.0 ± 0.5 drugs (p &lt; 0.05). In the early postoperative period subconjunctival hemorrhages in 5 (8.3%) patients, hyphema 1 mm in 1 (1,7%) patient were among the available complications; they dissolved after hematase and dexamethasone injection. Conclusions. mTDFC should be performed in patients at earlier stages of refractory glaucoma, providing compensation for varying degrees of elevated IOP. This procedure contributes to the elimination or significant reduction of pain syndrome, which preserves eye function, improves patients'quality of life, and is an alternative to laser treatment of refractory glaucoma. Keywords: refractory glaucoma, surgical treatment, laser cyclophotocoagulation, micropulse cyclophotocoagulation, transscleral cyclophotocoagulation

Proliferative Vitreoretinopathy Following Transscleral Diode Cyclophotocoagulation.

Transscleral diode laser cyclophotocoagulation may trigger the development of proliferative vitreoretinopathy. Our article demonstrates one such case leading to tractional macula off retinal detachment in a child with aphakic glaucoma. The purpose of this article is to describe a case of proliferative vitreoretinopathy (PVR) developing subsequent to transscleral diode laser cyclophotocoagulation (cyclodiode) in a pediatric patient with aphakic glaucoma. PVR most commonly occurs following rhegmatogenous retinal detachment (RRD) repair however, to the best of our knowledge, has never been reported to appear after cyclodiode. Retrospective evaluation of case presentation and intraoperative findings. A 13-year-old girl with aphakic glaucoma presented four months after cyclodiode of the right eye with a retrolental fibrovascular membrane and anterior PVR. The PVR extended posteriorly over the next month after which the patient developed a tractional macula off retinal detachment. Pars Plana vitrectomy was performed confirming dense anterior and posterior PVR. Review of the literature suggests an inflammatory cascade, similar to that seen in PVR development following RRD, may occur from the destruction of the ciliary body by cyclodiode. As a result, fibrous transformation may occur, likely accounting for the cause of PVR development in this case. The pathophysiology of PVR development remains unclear. This case demonstrates that PVR may occur following cyclodiode and should be considered during post-operative monitoring after this procedure.

Ultrasound cycloplasty: a case series examining the efficacy on a local Malaysian cohort of patients

Introduction: Ultrasound cycloplasty (UCP) is commercially available in Europe. It has been shown to have less side effects than its trans-scleral diode laser cyclophotocoagulation counterpart in reducing intraocular pressure (IOP) in refractory glaucoma patients.&#x0D; Case presentation: This retrospective case series followed seven patients treated with UCP for refractory glaucoma at the Ophthalmology Clinic, Hospital Universiti Kebangsaan Malaysia. Patients were aged 52–80 years, with baseline IOP 14–27 mmHg. All patients received sequential activation of the transducers lasting 8 seconds. Postoperatively, patients were followed-up at 1 week, 1 month, and 3 months. No complications or changes in best-corrected visual acuity were recorded postoperatively. One patient underwent a trabeculectomy 3 months post-procedure, whilst the others continued regular medication. At 1-month postoperative, there was IOP reduction of 6–10 mmHg in six patients. At the 3-month follow-up, IOP returned to the preoperative levels. Conservative power and duration of the shots were used to ensure patients safety.&#x0D; Conclusion: Most studies on UCP safety and efficacy have been conducted on Caucasian populations. A longer duration of UCP may be necessary in the Asian population. Further studies are required to determine the efficacy of UCP in the Asian population.

Comparison of Aqueous Flare Values after Micropulse Transscleral Laser Treatment and Continuous Wave Transscleral Cyclophotocoagulation

ABSTRACT Purpose The purpose of this study was to analyse the changes in flare values after Micropulse Transscleral Laser Treatment for Glaucoma (MP-TLT) in patients with refractory glaucoma and to compare with the outcomes of patients who underwent continuous wave (CW) diode laser cyclophotocoagulation (CW-TSCPC). Methods In this single-centre study, we reviewed the medical records of 54 patients who underwent MP-TLT and 35 patients who underwent CW-TSCPC at Ankara University Faculty of Medicine, Department of Ophthalmology. Aqueous flare values were measured by laser flare photometry. Results The mean laser flare values in both groups (MP-TLT/CW-TSCPC) increased after surgery from 20.85 ± 8.74/22.14 ± 7.39 ph/ms at baseline to 48.52 ± 18.23/57.38 ± 20.08 ph/ms (P = .001) on day 1 and then progressively decreased to 44.13 ± 18.32/52.24 ± 20.56 in week 1, 40.5 ± 18.5/48.24 ± 19.23 week 2 and 35.28 ± 17.09/41.11 ± 16.7 month 1 (all p < .05) and returned to similar levels to baseline at month 3 and month 6 (both p > .05). Patients who achieved treatment success had significantly higher flare values than patients who failed on post-operative day 1, week 1 and week 2 in both groups. The flare values were significantly lower in the MP-TLT group than the CW-TSCPC group on post-operative day 1, week 1, week 2 and month 1 (all p < .05). There were no cases of prolonged post-operative inflammation or serious complications in both groups. Conclusion Intraocular inflammation, quantified by aqueous flare, may be a contributing factor to the IOP lowering effect of transscleral diode laser cyclophotocoagulation in the early post-operative period.

The outcome of Concurrent Diode Laser Cyclophotocoagulation and Bevacizumab for Treatment of Neovascular Glaucoma

The outcome of Concurrent Diode Laser Cyclophotocoagulation and Bevacizumab for Treatment of Neovascular Glaucoma

Surgical management of glaucoma following different keratoplasty techniques.

To investigate the results of surgical management of glaucoma following different keratoplasty techniques. Medical records of 628 cases who underwent keratoplasty were reviewed. One hundred and eighty-eight patients (29.9%) who developed post-keratoplasty glaucoma were evaluated. Patients who could not be controlled with maximal medical treatment and underwent glaucoma surgery were included in this study. Trabeculectomy, Ahmed glaucoma valve (AGV) implantation or diode laser cyclophotocoagulation (DLC) were applied. Glaucoma surgery was performed in 55 (29.3%) patients who had uncontrolled post-keratoplasty glaucoma. In penetrating keratoplasty group (n = 42), DLC was applied to 30 (71.4%) eyes, AGV to 11 (26.2%) eyes, and trabeculectomy in 1 (2.4%) eye. InDescemet'smembrane endothelial keratoplasty group (n = 8), DLC was applied to 4 (50%) eyes, trabeculectomy for 3 (37.5%) eyes and AGV for 1 (12.5%) eye. In deep anterior lamellar keratoplasty group (n = 5), DLC was applied to 2 (40%) eyes, trabeculectomy to 2 (40%) eyes and AGV to 1 (20%) eye. While a statistically significant decrease was found in intraocular pressure (IOP) and anti-glaucomatous medication after surgery (p < 0.05 for each), no significant difference was found in best corrected visual acuity (BCVA). During follow-up, DLC was applied as re-glaucoma surgery in 19 (34.5%) cases. A significant reduction in IOP together with number of anti-glaucomatous medications was found with re-operation; however, a significant decrease in BCVA was noted (p < 0.05 for each). Glaucoma surgeries after keratoplasty are effective in decreasing IOP and the number of anti-glaucomatous medication. While BCVA doesn't change after the first glaucoma surgery, after re-operation significant decrease may occur.

Low-energy transscleral diode laser cyclophotocoagulation: is it effective?

Low-energy transscleral diode laser cyclophotocoagulation: is it effective?

Micropulse transscleral diode laser cyclophotocoagulation as a treatment modality for glaucoma patients

Aim To evaluate how micropulse transscleral diode laser cyclophotocoagulation (MP-TSCPC) is a safe and effective procedure, in reducing intraocular pressure (IOP) in different glaucoma patients among the Egyptian population.Study design Prospective, noncomparative interventional study.Patients and methods This study assessed the effect of MP-TSCPC laser on patients with different types of glaucoma. Forty eyes of 40 patients were included in our study. Patients were recruited from Benha University Hospital and Egyptian Eye Academy, and the procedure was done during the period between January 2020 and July 2021.Results The mean±SD baseline IOP was 27.72±8.6 mmHg, which showed significant reduction at postsurgical month 6, becoming 16.28±6.38 mmHg (P=0.001). The mean number of IOP-lowering agents was 2.35±1.03 preoperatively, which dropped significantly to 1.50±1.24 at 6 months. Postoperative logMAR best-corrected visual acuity was not significantly reduced from baseline. There was no development of significant postoperative complications.Conclusion MP-TSCPC is an efficient, safe, and simple technique with promising results in lowering IOP and can be used in patients with different types of glaucoma.

A review on technology and different probes in transscleral cyclophotocoagulation

Glaucoma is a chronic progressive optic neuropathy, characterised by retinal ganglion cell loss leading to optic nerve head changes and visual field defects. The control of intraocular pressure remains a key determinant factor in the management of glaucoma. Cyclodestructive procedures target the epithelium of ciliary processes, thereby reduces the aqueous formation. Cyclodestructive procedures have advanced from initial cyclodiathermy to micropulse diode laser cyclophotocoagulation (CPC). The various probes used in transscleral CPC (TSCPC) include G-probe delivery device and G-probe illuminate delivery device for continuous wave TSCPC and micropulse P3 probe for micropulse diode laser TSCPC. This review article provides details on design of probes and their technology.

Efficacy and safety of transscleral diode laser cyclophotocoagulation therapy in advanced glaucoma cases with good visual acuity

Efficacy and safety of transscleral diode laser cyclophotocoagulation therapy in advanced glaucoma cases with good visual acuity

A new approach for CW-TSCPC to improve its safety and efficacy in glaucoma treatment

The goal of our study was to compare the outcomes of transscleral diode cyclophotocoagulation using a new protocol with new settings. In fact, we targeted the ciliary body guided by transillumination, reduced the energy applied at each spot, and enlarged the treatment area posteriorly from the pars plicata to the pars plana. Data were collected retrospectively from two groups of glaucoma patients. The first group of patients underwent transscleral diode laser cyclophotocoagulation as usual, with one-row applications of a maximum of 1200mW of energy and a duration of 2000ms. The second group was treated in three rows, using the same settings as the first group. Transillumination was used continuously during all of our procedures, to focus accurately on the location of the ciliary body. Outcome measures included intraocular pressure (IOP) and visual acuity (VA) at baseline and at a minimum of 3 months postoperatively, as well as complications occurring up until last follow-up visit. Patients were considered successfully treated if their intraocular pressure was lowered by at least 25% compared to their baseline or if their intraocular pressure was less than 21mmHg after the procedure, with or without glaucoma medications. Sixty eyes were treated with the one-row protocol, followed by 508 eyes treated with the three-row protocol. The mean follow-up was 19 (range 3-31) months. Success rates were 62% and 86% for the one-row group and three-row group, respectively. The IOP decrease was 40.5% (a mean reduction from 37.5±8.1mmHg to 22.3±10.2mmHg) in the one-row group and 57.6% in the three-row group (mean reduction from 36.05±10.4mmHg to 15.7±7.3mmHg), which was statistically significant in each group (P=0.0001). Additionally, a significant improvement in efficacy was found in the 3-row compared to the 1-row group (P=0.0001) No significant difference was found in VA before or after the procedure or between the 2 groups. No serious complications were reported. Diode laser TSCPC is a practical, rapid and well-tolerated procedure. The treatment protocol used, with lower energy levels applied to the eye, guided systematically by transillumination and targeting a wider area, appears to be safer and more effective.

Anterior chamber laser flare photometry after diode laser cyclophotocoagulation

BackgroundThe aim of this study was to evaluate changes in intraocular inflammation according to energy delivered per eye during transscleral diode laser cyclophotocoagulation (TDLC) in refractory glaucoma using laser flare (LF) photometry and to investigate the relationship between the change in anterior chamber flare values ​​and the success of TDLC. MethodsPatients who underwent TDLC for refractory glaucoma and had LF photometry data were analyzed retrospectively. We recorded the best-corrected visual acuity, intraocular pressure (IOP) with Goldmann applanation tonometer, number of anti-glaucoma medications, LF photometry values (ph/ms) on pre-and postoperative days 1, 10 and 30. ResultsThe mean laser power applied during TDLC procedure was 2.45±0.35 W. The mean laser duration was 2.09±0.28 s. The mean total energy applied per eye was 114.69±16.13 J, the mean number of pulses was 22.43±4.3. While the mean LF value was 49.71±11.99 ph/ms preoperatively, it was 63.94±12.41 ph/ms at the postoperative 30th day.Possible predictors of success of TDLC were investigated using linear regression analysis (R adjusted 0.454 p = 0.001). The IOP decrease at postoperative 30th day was significantly related to the difference between the postoperative 1st day and the preoperative LF (p = 0.025, B/95% CI -0.358/-0.107- -0.008), and total cyclodiode energy delivered per eye (joules) (p = 0.016, B/95% CI -0.396/-0.287 to -0.031). ConclusionsAnterior chamber flare values increases after TDLC, though it does not regress to the preoperative level on the postoperative 30th day. Total cyclodiode energy delivered per eye and the difference between the postoperative 1st day and the preoperative LF can be used to predict TDLC response.

The Evaluation of the Effectiveness of the Optimized Technique of Transcleral Diodlaser Cyclophotocoagulation in Patients with Unstable Glaucoma

Objectives: To evaluate the effectiveness of the optimized technique of transcleral diode laser cyclophotocoagulation (DCPC) in patients with unstable glaucoma.Methods. The retrospective analysis of outpatient records of patients diagnosed with open-angle compensated glaucoma, who underwent transcleral diodlaser DCPC in continuous-wave mode, has been performed. Totally, 44 outpatient records (44 eyes) have been analyzed.Results. The course of the postoperative period, patients’ complaints, and the ophthalmological status have been evaluated. The level of intraocular pressure (IOP) was determined on the day after the procedure, a week, 1, 3, 6 and 12 months after the operation. 12 months after the operation, the level of IOP decreased by 42.9 %. The number of antihypertensive drugs used by the end of the follow-up period decreased by 66.6 %: from 2.75 ± 0.4 to 1.0 ± 0.7 drugs (p = 0.001). The frequency of side effects was low and comprised 11.3 %. In 40 % of patients, manifestations of toxic-allergic reactions of the ocular surface to antihypertensive drugs decreased due to the possibility to reduce the frequency of instillations. The MCVA indicators remained stable throughout the entire follow-up period.Conclusion. Thus, the results of the conducted clinical study indicate that transcleral DCPC is an effective and safe technique with a high predicted result, since it compensates for the level of IOP, which allows to stabilize the progression of the glaucoma process. The method of trascleral DCPC provides a reduction and (or) correction of the hypotensive regime by reducing the number of antihypertensive drugs used. In patients with a toxic-allergic reaction from the ocular surface developed due to a prolonged use of antihypertensive drugs, it allows to reduce the symptoms and clinical manifestations by canceling and (or) reducing the number of antihypertensive drugs used, indirectly significantly improving the quality of life.

Subliminal Diode Treatment of the Ciliary Bodies by Transscleral Cyclophotocoagulation with a 31.3% Duty Cycle in the Treatment of Refractory Glaucoma: Safety and Efficacy

Micropulse Transscleral diode laser cyclophotocoagulation (MP-TSCPC) is an established method of treatment for refractory glaucoma. This study evaluates the efficacy in terms of reduction in intraocular pressure and/or treatment amount, and safety and side effects of the ciliary bodies using a subthreshold laser with a duty cycle of 31.3% with Supra 810 nm Subliminal Quantel Medical, at one year in patients with refractory glaucoma.

The Results of Transscleral Diode Laser Cyclophotocoagulation in Micropulse Mode Treatment in Patients with Primary Subcompensated Open-Angle Glaucoma and Toxic-Allergic Syndrome of the Ocular Surface

Purpose: to analysis the results of microimpulse transscleral diode laser cyclophotocoagulation (DCPC) technique as a method of choice in patients with open-angle subcompensated glaucoma (OAG) with toxic allergic syndrome of the ocular surface (TASOS).Methods. The retrospective analysis of patients’ case reports with subcompensated open-angle glaucoma and TASOS was performed. Transscleral diode laser cyclophotocoagulation (DCPC) in a microimpulse mode was used in their treatment. A total of 19 patients’ case reports were analyzed.Results. In the postoperative period, its course, patient’s complaints, ophthalmological status, visual acuity indicators were determined. The level of intraocular pressure was measured. Almost all patients (84.2 %) reached the target level of IOP. The frequency of side effects was low. In 36.84 % of patients, symptoms of TASOS decreased in response to hypotensive treatment due to reduction of instillation frequency.Conclusion. The use of micro-pulse cyclophotocoagulation in patients with subcompensation form of OAG and toxic-allergic ocular surface syndrome (TASOS) reduces the intensity of the drop regime of antihypertensive drugs. As a result, the manifestations of TASOS are reduced, which increases the patients’ quality of life in the postoperative period. In addition, the use of DCPC in microimpulse mode leads to stabilization of functional and structural indicators, helps to prevent a decrease in visual functions. Thus, the described method is characterized by safety, high efficiency and a wide range of indications for its performance. It allows to compensate the IOP with a minimum percentage of complications and stable postoperative results.