Martin Andreas Kotula1, Karsten Paust2, Arno Wirdemann3, Erick Msigomba4, Liberator Burusu5. 1. Augenzentrum am St. Franziskus-Hospital, Hohenzollernring 74, 48145, Münster, Deutschland. m.kotula@posteo.de. 2. Augenärztliche Gemeinschaftspraxis Bonner Augen, Bonn, Deutschland. 3. Augenärzte am Meer, Zweigpraxis Aurich, Aurich, Deutschland. 4. Ilembula Lutheran Hospital Eye Department, Njombe, Tansania. 5. Dr. Atiman Memorial Hospital, Sumbawanga, Tansania.
Abstract
BACKGROUND: Glaucoma is the leading cause of irreversible blindness worldwide. The prevalence of glaucoma is particularly high in rural regions of Tanzania. Poverty and an inadequate ophthalmic infrastructure increase the difficulty of glaucoma treatment. OBJECTIVE: Due to the limited access to eye drops or surgical therapy, the effectiveness of transscleral cyclophotocoagulation in micropulse technology (CPC-M) in advanced glaucoma was investigated in the present study. MATERIALS AND METHODS: We included n = 50 eyes of 35 adult patients with advanced glaucoma and a glaucoma-typical papillary excavation with cupdisc ratio (CDR) ≥ 0.9, regardless of the glaucoma entity. The mean intraocular pressure (IOP) prior to treatment was 34 mm Hg (± 14 mm Hg). The operation was performed under retrobulbar anesthesia with the A.R.C. FOX 810 diode laser (A.R.C. Laser, Nuremberg, Germany; mean energy 127 J ± 10 J). RESULTS: An IOP between 6 and 21 mm Hg or an IOP reduction by at least 20% of the initial value was defined as success. The success criteria were met by 71% of reevaluated eyes (n = 21) 3 months after treatment, and mean IOP was 19 mm Hg (± 13 mm Hg). Mean IOP 9 months postoperatively (n = 20) was 18 mm Hg (± 10 mm Hg) and the success criteria were met in 65% of cases. Seven eyes did not meet the success criteria: six eyes had a further increase in IOP and one eye showed intraocular hypotension. CONCLUSION: The CPC‑M represents a good, inexpensive, and easily accessible treatment option for advanced glaucoma in order to reduce the likelihood of blindness in a low-income setting.
BACKGROUND: Glaucoma is the leading cause of irreversible blindness worldwide. The prevalence of glaucoma is particularly high in rural regions of Tanzania. Poverty and an inadequate ophthalmic infrastructure increase the difficulty of glaucoma treatment. OBJECTIVE: Due to the limited access to eye drops or surgical therapy, the effectiveness of transscleral cyclophotocoagulation in micropulse technology (CPC-M) in advanced glaucoma was investigated in the present study. MATERIALS AND METHODS: We included n = 50 eyes of 35 adult patients with advanced glaucoma and a glaucoma-typical papillary excavation with cupdisc ratio (CDR) ≥ 0.9, regardless of the glaucoma entity. The mean intraocular pressure (IOP) prior to treatment was 34 mm Hg (± 14 mm Hg). The operation was performed under retrobulbar anesthesia with the A.R.C. FOX 810 diode laser (A.R.C. Laser, Nuremberg, Germany; mean energy 127 J ± 10 J). RESULTS: An IOP between 6 and 21 mm Hg or an IOP reduction by at least 20% of the initial value was defined as success. The success criteria were met by 71% of reevaluated eyes (n = 21) 3 months after treatment, and mean IOP was 19 mm Hg (± 13 mm Hg). Mean IOP 9 months postoperatively (n = 20) was 18 mm Hg (± 10 mm Hg) and the success criteria were met in 65% of cases. Seven eyes did not meet the success criteria: six eyes had a further increase in IOP and one eye showed intraocular hypotension. CONCLUSION: The CPC‑M represents a good, inexpensive, and easily accessible treatment option for advanced glaucoma in order to reduce the likelihood of blindness in a low-income setting.