Transscleral Diode Cyclophotocoagulation Research Articles

Rationale for early lens extraction in the treatment of primary angle closure disease

PURPOSE. To demonstrate the advisability of early lens extraction in the treatment of primary angle closure disease in clinical practice.METHODS. The study presents three clinical cases with patients at different stages of primary angle closure disease (PACD). The first one is related to the development of a bilateral acute attack of primary angle closure (PAC) that happened in the intensive care unit during treatment for acute respiratory distress syndrome (ARDS) associated with COVID-19 pneumonia in a patient with a previously undiagnosed PACD. The second case demonstrates the progression of glaucomatous optic neuropathy (GON) in early primary angle-closure glaucoma (PACG) after laser peripheral iridotomy (LPI) and delayed selective laser trabeculoplasty (SLT) in a patient with increased lens thickness. The third example illustrates the progression of advanced PACG in the right eye (OD) and moderate PACG in the left eye (OS) due to formation of goniosynechiae after bilateral LPI, which required transscleral diode cyclophotocoagulation (TSCP) in OD and trabeculectomy in OS. Subsequently, bilateral cataract phacoemulsification with intraocular lens implantation (CPE+IOL) and SLT were performed.RESULTS. In the first clinical case, advanced PACG developed in both eyes within 2 months. After bilateral LPI, trabeculectomy, compensation of intraocular pressure (IOP) was achieved, visual functions stabilized. In the second clinical case, 5.5 years after LPI and SLT, an increase in the thickness of the lens was revealed (in OD by 0.2 mm, in OS by 0.48 mm). GON did not progress in OD (thinning rate of the retinal nerve fiber layer was 0.94 µm/year, p=0.32) and the progression rate in OS was -1.04 µm/year (p=0.018). Taking into account the lens-involved mechanism of PACD progression, bilateral CPE+IOL was recommended. In the third clinical example, IOP remained elevated after bilateral LPI, TSCP in OD and trabeculectomy in OS as a result of goniosinechiogenesis, and therefore CPE+IOL also did not lead to its decrease. After bilateral SLT, compensation of IOP was achieved without local hypotensive therapy (IOP measured by Icare: OD 18.0 mm Hg, OS 15 mm Hg).CONCLUSION. In order to preserve visual functions, CPE+IOL is highly recommended at the very beginning of PACD, before the formation of GON and goniosynechiae. This is dictated by the dominant role of the lens-involved mechanism in PACD formation, as demonstrated in the described clinical examples.

Outcomes of Surgical Interventions in Primary Congenital Glaucoma Patients.

The aim was to report long-term surgical success of primary congenital glaucoma (PCG) patients in Thailand. PCG patients who underwent one of the following primary operations: trabeculotomy, goniotomy, trabeculectomy, combined trabeculotrabeculectomy (CTT) and diode transscleral cyclophotocoagulation (TSCPC) between January 1992 and January 2018 were reviewed. Surgical success was defined as intraocular pressure (IOP) between 5 and 21 mm Hg with or without antiglaucoma medications. Failure was defined as IOP ≤5 or ≥21 mm Hg for 2 consecutive visits, or when an additional glaucoma surgery was required to control IOP. Survival curves were analyzed using multilevel mixed-effect Weibull model. A total of 81 eyes from 55 PCG patients were included. Surgical procedures involved 20 goniotomies, 15 trabeculotomies, 16 trabeculectomies, 15 CTT, and 15 TSCPC. Median follow-up time was 24 months (interquartile range: 9 to 60 mo). Overall success rates were 68.8% at 1 year, 63.8% at 3 years, and 53.7% at 5 years. All types of surgery except TSCPC had comparable cumulative 1 year success rates ranging from 78.5% to 83.3%. Cumulative success rates of trabeculotomy (80.05%) and CTT (79.4%) were maintained at 3 and 5 years and were the highest among all procedures at 5 years. TSCPC had a significantly lower success rate compared with other types of surgery (hazard ratio: 7.4 to 13.1, all P=0.01). All patients receiving primary TSCPC showed no success at 48 months. Primary trabeculotomy and primary CTT demonstrated the highest long-term success rates in PCG patients.

Outcomes of Ahmed glaucoma valve and transscleral cyclophotocoagulation in neovascular glaucoma.

Purpose:To determine the outcomes of Ahmed glaucoma valve (AGV) and transscleral diode cyclophotocoagulation (CPC) in neovascular glaucoma (NVG).Methods:This was a single-center retrospective comparative case series involving chart review of consecutive patients who underwent AGV or CPC for treatment of NVG and had ≥6 months of follow-up. Surgical failure at 6 months, defined as an IOP of >21 or <6 mm Hg with hypotony maculopathy after 1 month, progression to no light perception (NLP) vision, glaucoma reoperation, or removal of AGV were the main outcome measures.Results:In total, 121 eyes of 121 patients were included (70 AGV and 51 CPC). Baseline demographics, visual acuity (VA), and intraocular pressure (IOP) were comparable between groups. At 6 months, failure was significantly higher in the CPC group than in the AGV group (43.1% vs. 17.1%, P = 0.020). Both groups had similar IOP and medication number at 6 months, but VA was significantly lower in the CPC group compared to the AGV group (2.4 ± 0.8 vs. 1.9 ± 1.0, P = 0.017). More CPC eyes required reoperation for glaucoma than AGV eyes (11.8% vs. 1.4%, P = 0.041). Multivariate regression analysis identified higher preoperative IOP (P = 0.001) and CPC surgery (P = 0.004) as independent predictors of surgical failure at 6 months. Age, sex, race, NVG etiology, bilaterality of the underlying retinal pathology, perioperative retina treatment, and prior or combined vitrectomy were not significantConclusion:AGV and CPC had comparable IOP and medication reduction in NVG eyes at 6 months. CPC was more frequently associated with failure, reoperation for glaucoma, and worse visual outcomes. High preoperative IOP and CPC surgery independently predicted surgical failure.

Role of trans-scleral diode cyclophotocoagulation in refractory glaucoma: A large retrospective study

Role of trans-scleral diode cyclophotocoagulation in refractory glaucoma: A large retrospective study

Secondary developmental glaucoma in eyes with congenital aphakia.

Purpose:To describe the clinical spectrum and management of glaucoma in congenital aphakia.Methods:The demographics and clinical spectrum of eyes with congenital aphakia with and without glaucoma were compared, and management outcomes of congenital aphakia cases with glaucoma were studied retrospectively between April 2000 and June 2020.Results:There were a total of 168 eyes (84 subjects) with a diagnosis of congenital aphakia, of which 29 eyes of 18 subjects were diagnosed with glaucoma. Corneal opacity was the presenting complaint in 26/29 eyes with glaucoma and 139/139 eyes without glaucoma. The (interquartile range (IQR)) horizontal corneal diameter was 10.5mm (IQR, 9.0-12.5) and 8mm (IQR, 5-10) in eyes with and without glaucoma (P = 0.01), respectively. The median (IQR) axial length was 17.5mm (IQR, 13.5-19.5) and 15mm (IQR, 14-16) mm in eyes with and without glaucoma (P = 0.03), respectively. Nineteen eyes with glaucoma had adequate intraocular pressure (IOP) control with one medication. Three eyes underwent transscleral diode cyclophotocoagulation and maintained IOP without medications. Three eyes underwent trabeculectomy and trabeculotomy, trabeculectomy followed by penetrating keratoplasty, and trabeculectomy, respectively, of which two eyes became phthisical. At the last follow-up, the median (IQR) IOP was 14 mm Hg (IQR, 14-17) Hg. The median (IQR) follow-up duration was 4.53 months (IQR, 2.03- 48.06).Conclusion:One-fifth of the eyes with congenital aphakia had secondary developmental glaucoma. The corneal diameter and axial lengths were higher in the eyes with glaucoma compared to eyes without glaucoma. Medical management is the preferred short-term mode of IOP control. Transscleral cyclophotocoagulation may be preferred over surgical intervention.

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.

Evolution of cyclodialysis cleft after transscleral diode cyclophotocoagulation on multimodal imaging

Evolution of cyclodialysis cleft after transscleral diode cyclophotocoagulation on multimodal imaging

Long-term results (>1 year) in 19 dogs treated with MicroPulse transscleral diode cyclophotocoagulation for refractory glaucoma.

To report the long-term (>1year) outcome of MicroPulse transscleral diode cyclophotocoagulation (MP-TSCP) in dogs. Client owned dogs that underwent MP-TSCP at a veterinary referral center. Retrospective study of 19 dogs treated with MP-TSCP. Dogs were evaluated at a median follow-up time of 30.5months postoperatively. Reported outcomes were intraocular pressure (IOP), retention or loss of vision, number of medications, and additional procedures performed. Variables associated with time to treatment failure were evaluated. Data from 19 dogs (24 eyes) was available. Median laser settings employed were 140s and 2200mW at 31.3% duty cycle. Long-term postoperative IOP was lower than preoperative IOP values (14mmHg (IQR=22mmHg, range: 4-52mmHg) versus 30mmHg (IQR=31mmHg, range: 8-62mmHg), respectively). Laser settings >2000mW were associated with a significantly longer time to reported failure. MP-TSCP was the sole therapy performed in 16/24 eyes resulting in long-term IOP control in 13/24 eyes and retention of vision in 6 of the 14 sighted eyes. Repeat MP-TSCP was performed in 10/24 eyes. Eight of 24 eyes required additional procedures with long-term IOP control in 4/8 eyes. MicroPulse transscleral diode cyclophotocoagulation can be an effective treatment for refractory glaucoma in select cases. Higher laser settings increased time to reported failure, whereas age, glaucoma type, and preoperative IOP did not affect survival. MP-TSCP as sole therapy or coupled with additional glaucoma procedures controlled the IOP in 70% of cases.

Efficacy and Safety of Repeated Micropulse Transscleral Diode Cyclophotocoagulation in Advanced Glaucoma.

Repeat micropulse transscleral cyclophotocoagulation (MPTCP) has some benefit in lowering intraocular pressure (IOP). There was a small risk of loss of vision, prolonged hypotony, and phthisis bulbi. This study aimed to determine the efficacy and safety of repeated MPTCP for an Asian population with refractory glaucoma. This is a retrospective case series of 43 eyes (43 patients) with severe glaucoma which underwent repeated MPTCP. Baseline parameters were taken from the visit just before the second MPTCP session. Success was defined as IOP of 6 to 21 mm Hg or ≥20% reduction in IOP without an increase in glaucoma medication from baseline, without further glaucoma reoperation, and ≤3 total MPTCP episodes. The IOP, number of IOP-lowering medications, and best-corrected visual acuity were documented preoperatively and postoperatively. Postoperative complications were also analyzed. The mean age±SD was 57.4±18.2 years with a mean follow-up duration of 28.9±27.5 months. Neovascular glaucoma was the most common type of glaucoma [18 eyes (41.9%)]. The success rates at postoperative years 1, 2, and 3, and the latest follow-up were 36.4%, 42.9%, 32.0%, and 39.5%, respectively. The median survival time of repeat MPTCP was 4.6 months. Compared with the preoperative mean IOP (35.2±11.0 mm Hg), the mean IOP at postoperative years 1, 2, and 3, and latest follow-up, was 27.8±13.7 mm Hg (P=0.004), 27.4±12.4 (P=0.003), 31.8±13.2 (P=0.35), and 27.1±13.8 mm Hg (P=0.002), respectively. The mean number of IOP-lowering medications was reduced from 3.3±0.9 preoperatively to 2.8±1.3 at the final follow-up (P=0.007). Postoperative complications included prolonged hypotony [3 eyes (7.0%)] and phthisis bulbi [2 eyes (4.7%)]. Repeated MPTCP is at best moderately effective in lowering IOP for eyes with advanced glaucoma.

Management of hypotony induced by transscleral diode cyclophotocoagulation in failed Ahmed glaucoma valve surgery

Management of hypotony induced by transscleral diode cyclophotocoagulation in failed Ahmed glaucoma valve surgery

Outcomes of Short and Long Duration Burns of Transscleral Diode Cyclophotocoagulation: A Retrospective Study

Outcomes of Short and Long Duration Burns of Transscleral Diode Cyclophotocoagulation: A Retrospective Study

EFFICACY AND SAFETY OF MICROPULSE TRANSSCERAL DIODE CYCLOPHOTOCOAGULATION IN PATIENTS WITH GLAUCOMA

• Glaucoma is the leading cause of irreversible blindness in the world, with approximately 8.4 million people blind from glaucomaSlowing disease progression and preservation of quality of life are the main goals for glaucoma treatment.• The only applied proven method to treat glaucoma is the reduction of intraocular pressure• Current glaucoma therapies include topical and systemic drugs, laser surgery, invasive glaucoma surgeries.• The new Micropulse Trans scleral Cyclophotocoagulation (MPTSCPC) is a non-incisional, noninvasive LASER treatment for glaucomaThe micropulse delivery mode includes on and cycles, allowing energy to build up in the targeted pigmented tissues, eventually reaching the coagulative threshold. The adjacent non-pigmented structures have time to cool during the off cycle, thus never reaching the coagulative threshold, which minimizes collateral tissue damageAim of workThe aim of this study is to evaluate the efficacy and safety of contact transscleral micropulse diode cyclophotocoagulation in patients with glaucoma.

Clinical Efficacy and Safety Outcomes of Micropulse Transscleral Diode Cyclophotocoagulation in Patients With Advanced Glaucoma.

Micropulse transscleral cyclophotocoagulation (MPTCP) is only moderately effective in lowering intraocular pressure (IOP) and is useful as an adjunct procedure to other glaucoma surgeries. There was a small risk of loss of vision, prolonged hypotony, and phthisis bulbi. The aim of this study was to determine the efficacy and safety of a single MPTCP treatment for an Asian population with advanced glaucoma. This is a retrospective single-center study of 207 eyes (207 patients) with advanced glaucoma which underwent first-time MPTCP between January 1, 2008, and March 31, 2018. Success was defined as IOP of 6 to 21 mm Hg or ≥20% reduction in IOP without an increase in glaucoma medication from baseline, and without glaucoma reoperation. The IOP, best-corrected visual acuity, and number of glaucoma medications were also analyzed. The mean (SD) age was 64.9±16.9 years. The mean follow-up duration was 18.7±16.2 months. The rate of success at postoperative years 1 and 2 follow-up was 44.1% and 32.6%, respectively. The median survival time of MPTCP was 9.0 months and 85 (40.9%) eyes received reoperation. The mean IOP decreased from 31.5±12.0 mm Hg preoperatively to 22.1±10.3 and 23.8±11.8 mm Hg at postoperative years 1 and 2, respectively (P<0.0001). The mean number of glaucoma medications was reduced from 3.3±1.0 preoperatively to 2.6±1.1 and 2.4±1.1 at postoperative years 1 and 2, respectively (P<0.0001). Significant complications included prolonged hypotony [1 eye (0.5%)], phthisis bulbi [7 eyes (3.4%)], and best-corrected visual acuity reduction [29 eyes (13.9%)]. Single first-time MPTCP for advanced glaucoma eyes was moderately effective in lowering IOP but >50% failed by 1 year.

Evaluation of ciliary body by ultrasound bio-microscopy after trans-scleral diode cyclo-photocoagulation in refractory glaucoma.

To evaluate the morphological changes of the ciliary body after diode laser trans-scleral cyclo-photocoagulation using ultrasound bio-microscopy in refractory glaucoma. This prospective, interventional, non-comparative, non-randomized, longitudinal study was performed on 40 eyes with refractory glaucoma, during the period between February 2016 and March 2018. All patients were treated with single session diode laser trans-scleral cyclo-photocoagulation. The intraocular pressure was obtained over a period of 3 months after the operation and morphological changes of the ciliary body were observed using ultrasound bio-microscopy. Trans-scleral cyclo-photocoagulation has achieved a reasonable success in reducing intraocular pressure to less than 22 mm Hg without increasing the number of glaucoma medication. The overall success rate was 40%, as the intraocular pressure decreased from a baseline mean value of 54.70 ± 12.27 to 42.45 ± 9.85 mm Hg 1 week after operation, 33.50 ± 8.00 mm Hg after 1 month, and 25.60 ± 6.62 after 3 months of operation. Ultrasound bio-microscopy detected reduction in the length and width of ciliary processes in addition to the ciliary muscle thickness of the treated quadrants. Intraocular pressure was more correlated to the width of the ciliary processes. Trans-scleral cyclo-photocoagulation is a rapid and effective procedure in treatment of refractory glaucoma with intraocular pressure reduction. Ultrasound bio-microscopy is a promising twin tool for cyclo-destructive procedures to detect ciliary body changes and can be used as a guide for re-treatment procedures.

Micropulse diode cyclophotocoagulation: A review of the literature

Transscleral diode cyclophotocoagulation (CPC) has conventionally been reserved for refractory glaucoma, where other surgery is not feasible. The newer micropulse cyclophotocoagulation (mpCPC) has become popular in recent times and is increasingly being used as a primary surgery for glaucoma in eyes with good vision. The available literature on mpCPC and its mechanism, histological changes caused in the eye, the technique of usage, efficacy, safety, potential applications, and comparison with continuous wave CPC and other surgeries have been reviewed. Varying criteria for inclusion and different definitions of success in studies make a direct comparison between studies difficult. The lack of definite evidence to prove superiority of mpCPC and the potential for rare but reported sight threatening complications should be kept in mind, especially before using this in nonrefractory cases of glaucoma when other time tested options are available.

Micropulse diode treatment in refractory neovascular glaucoma, high-energy level combined with adjunctive Ranibizumab

Introduction: Neovascular glaucoma is one of the highly refractory glaucoma types that mandates frequent modification of treatment. Micropulse diode cyclophotocoagulation may be a good option, but it may need an adjunctive and modification of parameters away from standard protocol. Design: A prospective, cohort, interventional case study. Purpose: To assess the safety and efficacy of high energy level of micropulse (MP) diode laser application after intravitreal injection of ranibizumab in the treatment of neovascular glaucoma refractory to medical treatment. Patients and Methods: This is a prospective, interventional, cohort, randomized case series study that included patients with neovascular glaucoma refractory to medical treatment. All patients underwent intravitreal injection of ranibizumab and then MP diode transscleral cyclophotocoagulation treatment in a high energy level. All patients were followed up for 24 months. The primary outcome measure was IOP reduction; the secondary outcome measure was stability and number of retreatment sessions; and the third outcome measure was complications. Results: This study included 50 eyes of 50 patients, 52% of them were male while 48% were female. Age of the studied patients ranged between 42 and 74 years with a mean of 60.8 ± 7.6 years. Cause of neovascular glaucoma was diabetes in 31 (62%), RVO in 8 (16%), and ocular ischemic syndrome in 3 (6%) of cases. The mean preoperative IOP was 41.2 ± 5.8 mmHg that decreased to 17.62 ± 2.01, 19 ± 4.05, 18.16 ± 1.96, 18.38 ± 1.96, 18.12 ± 1.98, and 18.3 ± 2.18 mmHg at 1, 3, 6, 12, 18, and 24 months, respectively (P

Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results.

To evaluate the effectiveness in in-traocular pressure reduction and safety of micropulse trans-scleral diode cyclophotocoagulation in refractory glaucoma. We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral diode cyclophotocoagulation at 12-month follow-up. The total treatment time was at the discretion of the surgeon, considering baseline and target intraocular pressure and glaucoma diagnosis. Intraocular pressure, inflammation, visual acuity, and number of medications were monitored. Success was defined as intraocular pressure between 6 and 21 mmHg and/or 30% reduction from baseline intraocular pressure with or without the use of antiglaucoma medications. Visual acuity loss was defined as a loss of ≥2 lines of vision on the Snellen chart or a ≥2-level decrease in visual function in patients with nonmeasurable chart acuity. The mean age was 61.04 ± 12.99 years, and 11 (52.4%) patients were male, with most (95%) patients showing low visual acuity at baseline (count fingers or worse). The mean intraocular pressure was 33.38 ± 15.95 mmHg, and the mean number of medications was 3.5 ± 1.1 at baseline. After 1, 3, 6, and 12 months, 76.19%, 57.14%, 55.56%, and 66.67%, respectively, of the patients were classified as treatment successes. Seven (33.3%) patients required new laser treatment and were considered treatment failures. The mean intraocular pressure reduction was 44.72% ± 29.72% in the first week and 41.59% ± 18.93% at the end of follow-up (p=0.006). The mean number of medications significantly dropped to 2.00 ± 1.7 at the 12-month visit (p=0.044). Complications included hypotony (4.8%), intraocular inflammation after 1 month (19%), and visual acuity loss (4.8%). Micropulse transscleral diode cyclophotocoagulation was safe and effective for reducing intraocular pressure in eyes with refractory and advanced glaucoma, with reduced need for ocular antihypertensive medication.

Comparative study of two different techniques of diode laser transscleral cyclophotocoagulation in management of refractory glaucoma

Purpose The aim was to compare between two techniques of diode laser transscleral cyclophotocoagulation in treatment of refractory glaucoma, that is, standard titratable (audible pops’ technique) versus slow coagulation technique, regarding and efficacy. Patients and methods In this prospective randomized study, 40 patients with refractory glaucoma were divided into two study groups: group A underwent standard technique of diode laser transscleral cyclophotocoagulation (audible pops technique), and group B underwent slow coagulation technique of diode laser transscleral cyclophotocoagulation. Patients were followed up at 1 week, 1 month, 3 month, and 6 month duration postoperatively, and changes in visual acuity, intraocular pressure (IOP), as well as postoperative complications were documented. Results The mean IOP was reduced significantly from 46.3±8.9 to 18.9±5.45 mmHg in patient of group A and from 42.8±8.53 to 20.05±8.28 mmHg in patient of group B at the end of 6-month follow-up (P Conclusion Both techniques of diode transscleral cyclophotocoagulation were of near equal safety and efficacy in treatment of refractory glaucoma with different underlying etiologies. Both had good efficacy in IOP lowering, reduced number of antiglaucoma medications used by patients, and relieved pain, with near equal incidence of postoperative complications.

Cyclodestructive procedures for non-refractory glaucoma.

Cyclodestructive procedures for non-refractory glaucoma.

Intraocular Pressure Outcomes Following Transscleral Diode Cyclophotocoagulation Using Long and Short Duration Burns.

The purpose of this study was to compare outcomes of transscleral diode cyclophotocoagulation using short duration (SD) versus longer duration (LD) treatment. Data were collected retrospectively on patients with glaucoma who underwent cyclophotocoagulation with LD (4000 ms) treatment with variable power ≤1000 mW versus SD using 1500 ms with variable power ≤2000 mW. The outcome measures included: intraocular pressure (IOP) at 12 months, decrease in number of antiglaucoma medications, complications and visual acuity (VA) at the final follow-up visit. There were 71 patients and 70 patients in the SD and LD groups, respectively. The mean IOP±SD pretreatment baseline was 33±10 versus 36±10 mm Hg for SD and LD groups, respectively (P>0.05). At 1 year postoperatively, the IOP decreased significantly in both groups (16.7 vs. 17.4 mm Hg for SD and LD, respectively; P<0.0001). This decrease in IOP was comparable between groups (P=0.5). The average number of IOP lowering medications were 2.5 and 2.9 at baseline in the SD and LD groups, respectively, and decreased to 1.3 in both groups (P=0.83). The mean LogMAR VA decreased significantly from 1.87 at baseline to 1.96 at 1 year in the SD group (P=0.276), and 2.03 to 2.3 (P≤0.001) in the LD group, this change was comparable (0.19; P=0.075) between the 2 groups. Complications were also comparable. Both LD and SD burns during cyclophotocoagulation effectively lowered IOP at 1 year. Neither treatment resulted in a greater reduction of IOP. LD treatment appeared to result in a decrease in VA and greater postoperative inflammation.