Slow-Coagulation Transscleral Cyclophotocoagulation Laser Treatment for Medically Uncontrolled Secondary Aphakic Adult Glaucoma

Abstract

Précis: Slow-coagulation CW-TSCPC is an efficacious, relatively safe, and non-incisional laser treatment option as an initial surgical glaucoma management choice, in secondary aphakic adult glaucoma that is medically uncontrolled. Purpose: This study evaluates the outcomes of slow-coagulation continuous wave transscleral cyclophotocoagulation (CW-TSCPC) laser for treating secondary aphakic adult glaucoma after complicated cataract surgery as a primary surgical intervention. Materials and Methods: A retrospective chart review of adult aphakic eyes with medically uncontrolled glaucoma underwent slow-coagulation CW-TSCPC as a primary surgical glaucoma intervention was performed. Surgical success was the primary outcome measure. Success was defined as postoperative intraocular pressure (IOP) between 6 and 21 mm Hg with ≥20% reduction compared with baseline and no need for further glaucoma surgeries or development of vision-threatening complications. The secondary outcomes included changes in IOP, glaucoma medication numbers, visual acuity, and postoperative complications during the first year after laser treatment after laser treatment. Results: This study included 41 eyes of 41 patients. The mean age of study participants was 66.7±13.1 years, with a mean follow-up duration of 19±3.5 months. At one year, the success rate was 63.4%. A statistically significant reduction of the IOP was observed, with the mean IOP decreasing from 29.6±5.8 mm Hg with a mean of 3.9±1.0 medications at baseline to a mean of 19.0±6.4 mm Hg with a mean of 2.5±1.2 medications at 12 months (P<0.001). Four eyes received CW-TSCPC retreatment, and 2 eyes required incisional glaucoma surgeries. Reported postoperative complications included: visual acuity decline ≥2 lines in 7 eyes, iritis in 6 eyes, hyphema in 5 eyes, cystoid macular edema in 2 eyes, and transient hypotony in 1 eye. Conclusion: Slow-coagulation CW-TSCPC is an efficacious, relatively safe, and non-incisional laser treatment option as an initial surgical glaucoma management choice, in secondary aphakic adult glaucoma that is medically uncontrolled.