Efficacy and Safety of Transscleral Diode Laser Cyclophotocoagulation Therapy in Advanced Glaucoma Cases with Good Visual Acuity.

Purpose: To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TSDLC) in advanced glaucoma patients with hest-corrected visual acuity (BCVA) of 0.3 Snellen unit or better. Materials and Methods: Patients with BCVA of 0.3 Snellen unit or better who underwent TSDLC for uncontrolled intraocular pressure (IOP) and followed up regularly for at least 12 months were evaluated retrospectively. The primary end-point was the decrease of one or more Snellen lines in BCVA, secondary end-point was the IOP control with or without medications. Results: Thirty-six eyes of 36 patients were included and followed for a mean of24.1+26.4 months. The mean IOP was reduced from 28.3±6.0 mmHg at baseline to 14.4±5.0 mmHg (p<0.001). The average number of antiglaucoma medications was significantly reduced from 3.7±0.5 at baseline to 3.0±0.87 (p<0.05) at last follow-up. BCVAremained constant in 24 (66.7%) eyes, improved in 4 (11.1%), and deteriorated by one line or more in 8 (22.2%). The vision loss was attributed to TSDLC in only 3 patients who had cystoid macular edema, central retinal vein occlusion and post-laser hypotony. Conclusion: TSDLC is an effective, safe, and technically easy procedure for controlling the IOP in advanced glaucoma cases with good visual acuity. TSDLC may be considered both as primary treatment and as an alternative treatment after failed filtration procedures instead of invasive glaucoma surgeries. [ABSTRACT FROM AUTHOR]