Staging operation in the treatment of refractory glaucoma

Abstract

AIM:To analyze the clinical results of cyclophotocoagulation followed by other anti-glaucoma surgeries in the treatment of refractory glaucoma.METHODS:The clinical data of 30 patients(30 eyes)with refractory glaucoma were retrospectively analyzed from January 2013 to July 2014 in Beijing Huade Hospital, including 12 females and 18 males, with an average age of 56 years. Among the 30 eyes, there were 2 eyes with acute angle-closure glaucoma, 4 eyes with over mature cataract, 6 eye with intumescent cataract, 5 eyes with neovascular glaucoma,9 eyes with hard-to-controlled glaucoma even after surgeries,4 eyes with secondary glaucoma after vitrectomy. Diode laser transscleral cyclophotocoagulation was applied to all patients as the primary choice. If the intraocular pressure(IOP)was not well controlled, a secondary anti-glaucoma surgery was applied. RESULTS:During the follow-up period, all of the 30 eyes had satisfactory results, with no complications during or after the operations. The average pre-operative IOP was 62.79±5.59mmHg, which dropped to 32.84±8.16mmHg at 1wk after cyclophotocoagulation. Six of 30 eyes had totally normal IOP, the rest 24 cases underwent another anti-glaucoma operation, after which the IOP decreased to a normal range and in which no complication occurred.CONCLUSION:In the treatment of refractory glaucoma, applying cyclophotocoagulation first to control the IOP can greatly reduce risk of complications during the secondary surgeries. According to their original categories, further anti-glaucoma surgery can reduce the IOP to a safe and effective range.

Keywords

• refractory glaucoma
• diode laser
• transscleral cyclophotocoagulation