PURPOSE: To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation (DLTSC) to control intraocular pressure (IOP) in keratoprosthesis patients with uncontrolled glaucoma. PATIENTS AND METHODS: Between 1993 and 2007, 18 eyes of 18 patients underwent DLTSC, either before (n=3), during (n=1), or after (n=14) keratoprosthesis surgery. Keratoprosthesis type I was used in 72%. All but one of these patients received an Ahmed Glaucoma Valve, either with or after the keratoprosthesis placement. Best-corrected visual acuity, IOP (assessed by digital palpation), number of medications, and complications were recorded preoperatively, at day 7, at 1, 3, and 6 months then every 6 months postoperatively. RESULTS: Mean follow-up was 26.6+/-19.6 months (mean+/-SD) and mean age was 50.1+/-15.6 years. Glaucoma was identified in 11 eyes before keratoprosthesis surgery and in 7 eyes after. Mean postoperative IOP was significantly reduced at 6, 12, 24, 36, and 48 months after DLTSC. DLTSC was repeated in 6 eyes. At final visit, mean best-corrected visual acuity was not decreased and there were no statistically significant differences in the number of glaucoma medications. Two patients had complications after DLTSC: a conjunctival dehiscence and a fungal endophthalmitis. CONCLUSIONS: DLTSC has beneficial long-term effects in the control of IOP and can be considered in the management of keratoprosthesis patients with refractory glaucoma.
PURPOSE: To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation (DLTSC) to control intraocular pressure (IOP) in keratoprosthesis patients with uncontrolled glaucoma. PATIENTS AND METHODS: Between 1993 and 2007, 18 eyes of 18 patients underwent DLTSC, either before (n=3), during (n=1), or after (n=14) keratoprosthesis surgery. Keratoprosthesis type I was used in 72%. All but one of these patients received an Ahmed Glaucoma Valve, either with or after the keratoprosthesis placement. Best-corrected visual acuity, IOP (assessed by digital palpation), number of medications, and complications were recorded preoperatively, at day 7, at 1, 3, and 6 months then every 6 months postoperatively. RESULTS: Mean follow-up was 26.6+/-19.6 months (mean+/-SD) and mean age was 50.1+/-15.6 years. Glaucoma was identified in 11 eyes before keratoprosthesis surgery and in 7 eyes after. Mean postoperative IOP was significantly reduced at 6, 12, 24, 36, and 48 months after DLTSC. DLTSC was repeated in 6 eyes. At final visit, mean best-corrected visual acuity was not decreased and there were no statistically significant differences in the number of glaucoma medications. Two patients had complications after DLTSC: a conjunctival dehiscence and a fungal endophthalmitis. CONCLUSIONS: DLTSC has beneficial long-term effects in the control of IOP and can be considered in the management of keratoprosthesis patients with refractory glaucoma.
Authors: Allister Gibbons; Ella H Leung; Luis J Haddock; Carlos A Medina; Viviana Fernandez; Jean-Marie A Parel; Heather A Durkee; Guillermo Amescua; Eduardo C Alfonso; Victor L Perez Journal: Clin Ophthalmol Date: 2018-02-15
Authors: Claes H Dohlman; Fabiano Cade; Caio V Regatieri; Chengxin Zhou; Fengyang Lei; Alja Crnej; Mona Harissi-Dagher; Marie-Claude Robert; George N Papaliodis; Dongfeng Chen; James V Aquavella; Esen K Akpek; Anthony J Aldave; Kimberly C Sippel; Donald J DʼAmico; Jan G Dohlman; Per Fagerholm; Liqiang Wang; Lucy Q Shen; Miguel González-Andrades; James Chodosh; Kenneth R Kenyon; C Stephen Foster; Roberto Pineda; Samir Melki; Kathryn A Colby; Joseph B Ciolino; Demetrios G Vavvas; Shigeru Kinoshita; Reza Dana; Eleftherios I Paschalis Journal: Cornea Date: 2018-02 Impact factor: 3.152