[Diode laser cyclophotocoagulation as the primary surgical intervention in glaucoma].

BACKGROUND: Diode laser cyclophotocoagulation is widely accepted as the therapy of choice in severe glaucoma cases. It is especially performed after failure of other kinds of treatment. We wanted to know whether it is also suitable as a primary surgical procedure after failure of medical treatment. PATIENTS AND METHODS: We retrospectively evaluated the charts of patients scheduled for cyclophotocoagulation as a primary surgical treatment between February 1997 and May 1998. Usually 15 burns (2000 mW, 2.5 s) were applied per treatment session. The mean age was 75.5 +/- 7.4 years (range: 63-86). The mean follow-up was 17.5 months (range: 6-32).
RESULTS: Altogether 25 eyes of 20 patients could be included in the study. There was a mean reduction of the intraocular pressure from 29.9 mmHg preoperatively to 17.4 mmHg postoperatively = 41.6%. In three cases (12%) repeated treatment was necessary. No severe complications such as endophthalmitis or phthisis bulbi were observed. No acute postoperative elevation of intraocular pressure > or = 40 mmHg occurred. Visual acuity remained stable during the follow-up in all eyes with a preoperative measurement of 20/60. DISCUSSION: Diode laser cyclophotocoagulation is suitable as a primary surgical procedure. We mostly perform it instead of filtering procedures when the patient refuses the filtering operation or when the patient is not able to visit an ophthalmologist for regular aftercare.