Transscleral Contact Krypton Laser Cyclophotocoagulation for Treatment of Posttraumatic Glaucoma

PURPOSETo evaluate the usefulness of the krypton laser for transscleral contact cyclophotocoagulation in the treatment of posttraumatic glaucoma. PATIENTS AND METHODSA total of 18 eyes of 18 patients with therapy-resistant posttraumatic glaucoma treated with krypton laser cyclophotocoagulation from 1991 to 1996 were included in this review. The krypton laser was delivered by a fiberoptic probe with simultaneous compression of the sclera. The energy used was 3 to 5 J per application at the tip of the probe, with an exposure time of 10 seconds. The treatment covered 90 to 360° of the ciliary body with approximately 10 applications per quadrant. RESULTSWith one or more cyclophotocoagulation treatments, the intraocular pressure decreased from the baseline mean (± standard deviation) of 32.6 ± 12.8 mm Hg to 23.6 ± 10.3 mm Hg (n = 17) at 1 month, to 21.8 ± 7.5 mm Hg (n = 13) at 3 months, to 22.5 ± 7.6 mm Hg (n = 13) at 6 months, and to 19.6 ± 10.5 mm Hg (n = 18) at the last control visit (mean, 19.4 months; range, 3 weeks to 73 months) after cyclophotocoagulation but no other glaucoma procedure. At baseline, 17 (94%) of 18 patients were taking glaucoma medication, as were 15 (83%) of 18 patients at the last control visit. One (6%) case of phthisis occurred. CONCLUSIONSKrypton laser cyclophotocoagulation is an effective and reasonably well tolerated means of lowering intraocular pressure in posttraumatic glaucoma. Because of the refractory nature of the disease, repeated treatments may be needed.