Our results of conventional transscleral diode laser cyclophotocoagulation in patients with glaucoma

The aim of this study is to investigate effects of conventional (continuous wave) transscleral diode laser cyclophotocoagulation(TSDLC), which is a cyclodestructive treatment method, in regard to changes in intraocular pressure and changes in topical therapy among both low vision and good vision primary open-angle glaucoma, angle-closure glaucoma ,pseudoexfoliation glaucoma,congenital glaucoma and other secondary glaucoma types. 116 patients with primary open-angle glaucoma, angle-closure glaucoma, pseudoexfoliation glaucoma congenital glaucoma and secondary glaucoma were followed between September 2015 and December 2022 in Ankara University Ophthalmology Department were included in this study. TSDLS procedures were performed following retrobulbar or general anesthesia in operating room settings. IOPs were measured preoperatively and after 1 day,1 month,3 months, 6 months and 12 months postoperatively. Patients with visual acuity <0.1 were labeled group1, visual acuity between 0,1 and 0,3 were labeled group2, and visual acuity >0.3 were labeled group3. SPSS 22.0 package program was used in the statistical analysis of the study data. In the statistical analysis, independent groups t test, pair t test and chi square test were used. In group1 initial mean IOP measured was 33,22mmHg and following TSDLC treatment, mean IOP at 3 months was 17,5mmHg(p<0,001), at 6 months 14,9mmHg(p<0,001),and at 12 months 14,6mmHg (p=0,088). In group2 initial mean IOP measured was 33,05mmHg and following TSDL treatment , mean IOP at 3 months was 18,15mmHg(p<0,001), at 6 months 15,84mmHg(p<0,001), and at 12 months 14,81mmHg(p=0,066). In group3 initial mean IOP was 31,86mmHg and following TSDLC treatment, mean IOP at 3 months was 17,86mmHg(p<0,001), at 6 months 14,95mmHg(p<0,001),at 12 months 15,26mmHg. In all groups statistically significant IOP reduction was achieved 12 months after TSDLC treatment. Re-treatment was applied in %20 of patients with visual acuity lower than 0.1, %17 of patients with visual acuity of 0.1-0.3, %4.3 of patients with visual acuity greater than 0.3. There was no significant correlation between visual acuity and re-treatment (p=0,236). Mean number of topical agents used before TSDLC treatment was 3,77 and at both 1 month and 3 months following TSDLC treatment was 3.5(P<0,001). There has been no change in the number of drops used during the 6 months and 12 months. During follow-up 3 patient had decreased visual acuity due to corneal epitelial defect, cataract and diabetic retinopathy progression. After topical treatment, the epithelial defect was closed and visual acuity reached the same level. In this study, statistically significant IOP reduction was achieved in 12 months follow up. There were no complications observed other than visual acuity decrease in 3 patients. TSDLC shown significant effect in both IOP reduction and decrease in number of topical therapy agents. Keywords: Diode laser, Glaucoma, Cyclophotocoagulation, İntraokuler pressure, Ciliary body