Anterior segment and corneal changes in patients undergoing transscleral cyclophotocoagulation

Objective: In cases of refractory glaucoma where medical and surgical treatment methods fail to provide intraocular pressure control, it was aimed to examine the changes in intraocular pressure and anterior segment corneal parameters after transscleral diode laser cyclophotocoagulation treatment. Materials and Methods: Cases who underwent transscleral diode laser cyclophotocoagulation due to refractory glaucoma in our clinic between June 2024 and December 2024 were analyzed. Patients were followed up at postoperative week 1, month 1, and month 3. During follow-ups, visual acuity, anterior segment evaluation (corneal topography, ocular biometry, corneal endothelial cell count, density, hexagonality, etc.) and dry eye tests (tear break-up time, Schirmer test) were performed. Changes in anterior segment corneal parameters and findings in terms of dry eye were examined. Results: Twelve (40%) of the patients were female, and eighteen (60%) were male, and it was determined that the participants were between 21 and 75 years of age, with a mean age of 53.7. The preoperative mean intraocular pressure was 43.47, the postoperative 1st-week mean was 29.8, the postoperative 1st-month mean was 22.47, and the postoperative 3rd-month mean was 17.03. It was observed that the mean intraocular pressure decreased statistically significantly in all follow-up examinations compared to each other. In the tests performed for dry eye in the patients, it was seen that the measurements did not differ statistically significantly between the evaluated periods. The changes in corneal and ocular biometric parameters in the patients were examined. It was determined that the variables in the evaluated parameters did not differ statistically significantly between the measurement periods. Only the anterior chamber depth variable showed a difference, and it was observed that the postoperative 1st-month and postoperative 3rd-month values decreased statistically significantly compared to the preoperative value. The changes in visual acuity in the patients were also examined. It was observed that visual acuity did not differ statistically significantly. Among the patients followed within the scope of our study, a decrease in visual acuity was detected in three cases. In two of these cases, the progression of cataract was identified as the underlying reason, while in the last case, an epithelial defect developing after the laser was recorded as the responsible factor. Conclusion: In cases of refractory glaucoma, for intraocular pressure that cannot be controlled with medical and surgical treatments, transscleral diode laser cyclophotocoagulation constitutes an important treatment alternative with its proven effectiveness and reliability. Keywords: Glaucoma, intraocular pressure, cornea, transscleral diode laser cyclophotocoagulation