Contact diode laser cyclo-photocoagulation for refractory glaucoma. A pilot study.

Initial experience with non-contact diode cyclo-photocoagulation for refractory glaucoma has shown positive results. Diode laser irradiation applied via a contact probe results in greater transmission through the sclera and delivery of more energy to the ciliary body. A trial was performed to evaluate the effects of contact diode cyclo-photocoagulation. A total of 12 patients with glaucoma due to conditions such as central retinal vein occlusion were treated. A mean of 22 pulses (810 nm) with powers of up to 2 W and of 2 s duration were applied via a fibre-optic delivery system and a contact probe. The mean intra-ocular pressure dropped from 42.3 to 13.6 mmHg over 3 months. Four patients required retreatment. Three patients had side effects that included hyphaema, anterior fibrinous uveitis and pupil block. In conclusion, contact diode cyclo-photocoagulation had a significant ocular hypotensive action in the treatment of refractory glaucoma. As compared with non-contact diode cyclo-photocoagulation, the contact modality produced more marked non-therapeutic side effects.