Background: Transscleral laser cyclophotocoagulation (TLC) has shown promising results in the treatment of refractory glaucoma and practically replaced cyclocryotherapy due to better outcomes, efficacy, increased safety, and tolerability. Two protocols of TLC have gained more popularity as effective modalities, TLC with the semiconductor diode laser and TLC with the Nd: YAG laser.
Aims: The aim of the study is to report the efficacy of
transscleral diode laser photocoagulation and compare outcomes between the
continuous wave (CW) and micropulse wave (MP) protocols for refractory glaucoma
in African eyes.
Methods: A non-randomized prospective comparative study of
patients who had transscleral diode laser photocoagulation for refractory
glaucoma between January 2021 and December 2021in Eye Foundation Hospital
Lagos, Nigeria was done.
Results: A total of 52 eyes of 52 patients were analyzed. The mean
age of patients was 66 ± 12.5 years. The mean preoperative intraocular pressure
(IOP) was 31.2 ± 11.9 mmHg. Overall post-operative mean IOP was 17.9 ± 8.6 mmHg
at 4 weeks, 21.0 ± 9.9 mmHg at 8 weeks and 20.6 ± 11.4 mmHg at 12 weeks. The
difference between mean preoperative and postoperative IOP measured at week 12
was statistically significant (p<0.001). Both continuous wave and micropulse
wave protocols were effective at reducing intraocular pressures, the micropulse
group had a mean difference between preoperative IOP and postoperative IOP at
week 12 of 7.5 ± 6.7 mmHg (p=0.001), while the continuous wave laser group had
a mean difference of 11.7 ± 13.7 mmHg (p<0.001). The micropulse group
achieved a higher percentage of success in 11 eyes (78.6%) compared with 24
eyes (63.2%) in the continuous wave group. This difference was not
statistically significant (p=0.341).
Conclusion: Both the continuous wave (CW) and micropulse wave (MP)
protocols of transscleral diode laser photocoagulation were found effective at
significantly reducing IOP in our study of African eyes with refractory
glaucoma. Although the MP group achieved a higher percentage of absolute
success, this was not statistically significant.
Author
(s) Details
Olufemi
Oderinlo
Eye Foundation Hospital, 27 Isaac John Street, GRA Ikeja, Lagos,
Nigeria.
Adunola
Ogunro
Eye Foundation Hospital, 27 Isaac John Street, GRA Ikeja, Lagos,
Nigeria.
Adekunle
Hassan
Eye Foundation Hospital, 27 Isaac John Street, GRA Ikeja, Lagos,
Nigeria.
Abiola
Oladeji
Eye Foundation Hospital, 27 Isaac John Street, GRA Ikeja, Lagos,
Nigeria.
Oyekunle
Idris
Eye Foundation Hospital, 27 Isaac John Street, GRA Ikeja, Lagos,
Nigeria.
Please see the book here:- https://doi.org/10.9734/bpi/msti/v8/4544
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