Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results
To evaluate the effectiveness in in-traocular pressure reduction and safety of micropulse trans-scleral diode cyclophotocoagulation in refractory glaucoma. We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral dio...
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| Veröffentlicht in: | Arquivos brasileiros de oftalmologia 2019-06, Vol.82 (5), p.381-388 |
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| creator | Jammal, Alessandro Adad Costa, Danilo Campos Vasconcellos, José Paulo Cabral Costa, Vital Paulino |
| description | To evaluate the effectiveness in in-traocular pressure reduction and safety of micropulse trans-scleral diode cyclophotocoagulation in refractory glaucoma.
We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral diode cyclophotocoagulation at 12-month follow-up. The total treatment time was at the discretion of the surgeon, considering baseline and target intraocular pressure and glaucoma diagnosis. Intraocular pressure, inflammation, visual acuity, and number of medications were monitored. Success was defined as intraocular pressure between 6 and 21 mmHg and/or 30% reduction from baseline intraocular pressure with or without the use of antiglaucoma medications. Visual acuity loss was defined as a loss of ≥2 lines of vision on the Snellen chart or a ≥2-level decrease in visual function in patients with nonmeasurable chart acuity.
The mean age was 61.04 ± 12.99 years, and 11 (52.4%) patients were male, with most (95%) patients showing low visual acuity at baseline (count fingers or worse). The mean intraocular pressure was 33.38 ± 15.95 mmHg, and the mean number of medications was 3.5 ± 1.1 at baseline. After 1, 3, 6, and 12 months, 76.19%, 57.14%, 55.56%, and 66.67%, respectively, of the patients were classified as treatment successes. Seven (33.3%) patients required new laser treatment and were considered treatment failures. The mean intraocular pressure reduction was 44.72% ± 29.72% in the first week and 41.59% ± 18.93% at the end of follow-up (p=0.006). The mean number of medications significantly dropped to 2.00 ± 1.7 at the 12-month visit (p=0.044). Complications included hypotony (4.8%), intraocular inflammation after 1 month (19%), and visual acuity loss (4.8%).
Micropulse transscleral diode cyclophotocoagulation was safe and effective for reducing intraocular pressure in eyes with refractory and advanced glaucoma, with reduced need for ocular antihypertensive medication. |
| doi_str_mv | 10.5935/0004-2749.20190076 |
| format | Article |
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We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral diode cyclophotocoagulation at 12-month follow-up. The total treatment time was at the discretion of the surgeon, considering baseline and target intraocular pressure and glaucoma diagnosis. Intraocular pressure, inflammation, visual acuity, and number of medications were monitored. Success was defined as intraocular pressure between 6 and 21 mmHg and/or 30% reduction from baseline intraocular pressure with or without the use of antiglaucoma medications. Visual acuity loss was defined as a loss of ≥2 lines of vision on the Snellen chart or a ≥2-level decrease in visual function in patients with nonmeasurable chart acuity.
The mean age was 61.04 ± 12.99 years, and 11 (52.4%) patients were male, with most (95%) patients showing low visual acuity at baseline (count fingers or worse). The mean intraocular pressure was 33.38 ± 15.95 mmHg, and the mean number of medications was 3.5 ± 1.1 at baseline. After 1, 3, 6, and 12 months, 76.19%, 57.14%, 55.56%, and 66.67%, respectively, of the patients were classified as treatment successes. Seven (33.3%) patients required new laser treatment and were considered treatment failures. The mean intraocular pressure reduction was 44.72% ± 29.72% in the first week and 41.59% ± 18.93% at the end of follow-up (p=0.006). The mean number of medications significantly dropped to 2.00 ± 1.7 at the 12-month visit (p=0.044). Complications included hypotony (4.8%), intraocular inflammation after 1 month (19%), and visual acuity loss (4.8%).
Micropulse transscleral diode cyclophotocoagulation was safe and effective for reducing intraocular pressure in eyes with refractory and advanced glaucoma, with reduced need for ocular antihypertensive medication.</description><identifier>ISSN: 0004-2749</identifier><identifier>ISSN: 1678-2925</identifier><identifier>EISSN: 1678-2925</identifier><identifier>DOI: 10.5935/0004-2749.20190076</identifier><identifier>PMID: 31271570</identifier><language>eng</language><publisher>Brazil: Conselho Brasileiro de Oftalmologia</publisher><subject>Adult ; Aged ; Ciliary Body - physiopathology ; Ciliary Body - surgery ; Female ; Glaucoma - physiopathology ; Glaucoma - surgery ; Glaucoma, Neovascular - surgery ; Humans ; Intraocular Pressure ; Laser Coagulation - methods ; Light Coagulation - instrumentation ; Light Coagulation - methods ; Male ; Middle Aged ; OPHTHALMOLOGY ; Prospective Studies ; Visual Acuity</subject><ispartof>Arquivos brasileiros de oftalmologia, 2019-06, Vol.82 (5), p.381-388</ispartof><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-64306fe71c3f7935b485f02c1718a986e3251d2a5fd673749b2786ec9998ad6a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31271570$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jammal, Alessandro Adad</creatorcontrib><creatorcontrib>Costa, Danilo Campos</creatorcontrib><creatorcontrib>Vasconcellos, José Paulo Cabral</creatorcontrib><creatorcontrib>Costa, Vital Paulino</creatorcontrib><title>Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results</title><title>Arquivos brasileiros de oftalmologia</title><addtitle>Arq Bras Oftalmol</addtitle><description>To evaluate the effectiveness in in-traocular pressure reduction and safety of micropulse trans-scleral diode cyclophotocoagulation in refractory glaucoma.
We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral diode cyclophotocoagulation at 12-month follow-up. The total treatment time was at the discretion of the surgeon, considering baseline and target intraocular pressure and glaucoma diagnosis. Intraocular pressure, inflammation, visual acuity, and number of medications were monitored. Success was defined as intraocular pressure between 6 and 21 mmHg and/or 30% reduction from baseline intraocular pressure with or without the use of antiglaucoma medications. Visual acuity loss was defined as a loss of ≥2 lines of vision on the Snellen chart or a ≥2-level decrease in visual function in patients with nonmeasurable chart acuity.
The mean age was 61.04 ± 12.99 years, and 11 (52.4%) patients were male, with most (95%) patients showing low visual acuity at baseline (count fingers or worse). The mean intraocular pressure was 33.38 ± 15.95 mmHg, and the mean number of medications was 3.5 ± 1.1 at baseline. After 1, 3, 6, and 12 months, 76.19%, 57.14%, 55.56%, and 66.67%, respectively, of the patients were classified as treatment successes. Seven (33.3%) patients required new laser treatment and were considered treatment failures. The mean intraocular pressure reduction was 44.72% ± 29.72% in the first week and 41.59% ± 18.93% at the end of follow-up (p=0.006). The mean number of medications significantly dropped to 2.00 ± 1.7 at the 12-month visit (p=0.044). Complications included hypotony (4.8%), intraocular inflammation after 1 month (19%), and visual acuity loss (4.8%).
Micropulse transscleral diode cyclophotocoagulation was safe and effective for reducing intraocular pressure in eyes with refractory and advanced glaucoma, with reduced need for ocular antihypertensive medication.</description><subject>Adult</subject><subject>Aged</subject><subject>Ciliary Body - physiopathology</subject><subject>Ciliary Body - surgery</subject><subject>Female</subject><subject>Glaucoma - physiopathology</subject><subject>Glaucoma - surgery</subject><subject>Glaucoma, Neovascular - surgery</subject><subject>Humans</subject><subject>Intraocular Pressure</subject><subject>Laser Coagulation - methods</subject><subject>Light Coagulation - instrumentation</subject><subject>Light Coagulation - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>OPHTHALMOLOGY</subject><subject>Prospective Studies</subject><subject>Visual Acuity</subject><issn>0004-2749</issn><issn>1678-2925</issn><issn>1678-2925</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9UU1r3DAUFKWlu0n7B3oIOvbizZNkWVZvZckXBFpochZaWU69yJajj8D--2jxZk8P3puZx8wg9IPAhkvGrwGgrqio5YYCkQCi-YTWpBFtRSXln9H6DFihixj3ALSWkn9FK0aoIFzAGqW_wcfZmjS8WWzftMs6DX7CvsfjYIKfs4sWp6CnGI2zQTvcDb6z2ByM8_N_n7zx-iW7hTZMONg-aJN8OOAXp7Pxo_6FCT5YHcotZpfiN_Sl10X3-2leoufbm6ftffX45-5h-_uxMqymqWpqBk1vBTGsF8Xwrm55D9QQQVot28YyyklHNe-7RrBic0dF2RopZau7RrNLtFl0oxms82rvc5jKQ_XvmIw6JrMkBxyAtaQQfi6EOfjXbGNS4xCNdU5P1ueoKOWMEWhqKFC6QEtIMRbTag7DqMNBEVDHetT5h_qop5CuTvp5N9ruTPnog70DA2mJvg</recordid><startdate>20190627</startdate><enddate>20190627</enddate><creator>Jammal, Alessandro Adad</creator><creator>Costa, Danilo Campos</creator><creator>Vasconcellos, José Paulo Cabral</creator><creator>Costa, Vital Paulino</creator><general>Conselho Brasileiro de Oftalmologia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope></search><sort><creationdate>20190627</creationdate><title>Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results</title><author>Jammal, Alessandro Adad ; Costa, Danilo Campos ; Vasconcellos, José Paulo Cabral ; Costa, Vital Paulino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-64306fe71c3f7935b485f02c1718a986e3251d2a5fd673749b2786ec9998ad6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ciliary Body - physiopathology</topic><topic>Ciliary Body - surgery</topic><topic>Female</topic><topic>Glaucoma - physiopathology</topic><topic>Glaucoma - surgery</topic><topic>Glaucoma, Neovascular - surgery</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Laser Coagulation - methods</topic><topic>Light Coagulation - instrumentation</topic><topic>Light Coagulation - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>OPHTHALMOLOGY</topic><topic>Prospective Studies</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jammal, Alessandro Adad</creatorcontrib><creatorcontrib>Costa, Danilo Campos</creatorcontrib><creatorcontrib>Vasconcellos, José Paulo Cabral</creatorcontrib><creatorcontrib>Costa, Vital Paulino</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><jtitle>Arquivos brasileiros de oftalmologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jammal, Alessandro Adad</au><au>Costa, Danilo Campos</au><au>Vasconcellos, José Paulo Cabral</au><au>Costa, Vital Paulino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results</atitle><jtitle>Arquivos brasileiros de oftalmologia</jtitle><addtitle>Arq Bras Oftalmol</addtitle><date>2019-06-27</date><risdate>2019</risdate><volume>82</volume><issue>5</issue><spage>381</spage><epage>388</epage><pages>381-388</pages><issn>0004-2749</issn><issn>1678-2925</issn><eissn>1678-2925</eissn><abstract>To evaluate the effectiveness in in-traocular pressure reduction and safety of micropulse trans-scleral diode cyclophotocoagulation in refractory glaucoma.
We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral diode cyclophotocoagulation at 12-month follow-up. The total treatment time was at the discretion of the surgeon, considering baseline and target intraocular pressure and glaucoma diagnosis. Intraocular pressure, inflammation, visual acuity, and number of medications were monitored. Success was defined as intraocular pressure between 6 and 21 mmHg and/or 30% reduction from baseline intraocular pressure with or without the use of antiglaucoma medications. Visual acuity loss was defined as a loss of ≥2 lines of vision on the Snellen chart or a ≥2-level decrease in visual function in patients with nonmeasurable chart acuity.
The mean age was 61.04 ± 12.99 years, and 11 (52.4%) patients were male, with most (95%) patients showing low visual acuity at baseline (count fingers or worse). The mean intraocular pressure was 33.38 ± 15.95 mmHg, and the mean number of medications was 3.5 ± 1.1 at baseline. After 1, 3, 6, and 12 months, 76.19%, 57.14%, 55.56%, and 66.67%, respectively, of the patients were classified as treatment successes. Seven (33.3%) patients required new laser treatment and were considered treatment failures. The mean intraocular pressure reduction was 44.72% ± 29.72% in the first week and 41.59% ± 18.93% at the end of follow-up (p=0.006). The mean number of medications significantly dropped to 2.00 ± 1.7 at the 12-month visit (p=0.044). Complications included hypotony (4.8%), intraocular inflammation after 1 month (19%), and visual acuity loss (4.8%).
Micropulse transscleral diode cyclophotocoagulation was safe and effective for reducing intraocular pressure in eyes with refractory and advanced glaucoma, with reduced need for ocular antihypertensive medication.</abstract><cop>Brazil</cop><pub>Conselho Brasileiro de Oftalmologia</pub><pmid>31271570</pmid><doi>10.5935/0004-2749.20190076</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Ciliary Body - physiopathology Ciliary Body - surgery Female Glaucoma - physiopathology Glaucoma - surgery Glaucoma, Neovascular - surgery Humans Intraocular Pressure Laser Coagulation - methods Light Coagulation - instrumentation Light Coagulation - methods Male Middle Aged OPHTHALMOLOGY Prospective Studies Visual Acuity |
| title | Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results |
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