Long-term results of noncontact neodymium:yttrium–aluminum–garnet cyclophotocoagulation in neovascular glaucoma1☆
Presented as a poster at the American Academy of Ophthalmology, New Orleans, Louisiana, November 2001.
Received 24 December 2001; accepted 18 September 2002.
Abstract
Purpose
To determine the long-term efficacy and safety of noncontact transscleral neodymium:yttrium–aluminum–garnet (Nd:YAG) cyclophotocoagulation (CP) for the treatment of neovascular glaucoma (NVG).
Design
Retrospective, noncomparative, interventional case series.
Participants
One hundred fifteen eyes of 111 subjects treated from December 1987 to January 2001.
Methods
Eyes with uncontrolled NVG underwent noncontact Nd:YAG CP. Treatment parameters and pretreatment and posttreatment intraocular pressures (IOP) were reviewed. Preoperative and postoperative IOP were compared using a paired Student’s t test. Success was defined as an IOP ≤22 mmHg, with or without medications, in the absence of phthisis bulbi, and without having undergone further surgical procedures. Results were subjected to a Kaplan–Meier life-table analysis.
Results
Mean follow-up was 27.0 ± 34.3 months (range, 1–148 months). Mean preoperative IOP was 47.4 ± 11.1 mmHg (range, 26–70 mmHg). Mean postoperative IOP was 18.3 ± 12.2 mmHg (range, 0–44 mmHg). The mean number of treatment sessions was 1.4 ± 0.7 (range, 1–6), with 82 eyes (71.3%) having only one treatment. Kaplan–Meier survival analysis showed a probability of continued success at 1 year of 65.0%, at 3 years of 49.8%, and at 6 years of 34.8%. Phthisis developed in 8.6% of the eyes.
Conclusions
Noncontact Nd:YAG CP provides long-term IOP reduction in eyes with medically uncontrolled NVG. This can be associated with complications that include inflammation, visual loss, and hypotony. Repeat treatment may be necessary.
1Glaucoma Research & Education Group, San Francisco, California, USA
2PharmaLogic Development, Inc., San Rafael, California, USA
Reprint requests to Christopher J. Dickens, MD, 490 Post Street, Suite 644, San Francisco, CA 94102, USA.
ABSTRACT