The Study On The Relationship Between Treatment Parameter Of TSCP And IOP Or Ciliary Body Morphologic Change

Objectives: To investigate the relationship amongst the parameters oftransscleral photocoagulation (TSCP) laser treatment and postoperative IOP orciliary morphological changes, and to guide the clinical choice of the shootingpoints and points of blasting during the surgery of TSCP.Methods: Retrospective analysis of the patients who admitted to ourhospital and diagnosed as refractory glaucoma from August2010to November2011. All these patients underwent the surgery of TSCP. A total of65caseswere enrolled in this study. Forty-one patients (forty-one eyes) out of these65cases were followed up regularly and were used for statistic analysis. Theintraocular pressure (IOP), anterior segment parameters before and threemonths after surgery were measured by using the tonometer and ultrasoundbiomicroscopy (UBM), respectively. All these data were used to analysis therelationship between the change of IOP or morphological change and theparameters of the surgery of TSCP.Results:1. A total of41cases, including41eyes, were enrolled in this study. TheIOP were58.91±3.618mmHg and27.27±16.019mmHg before and threemonths after surgery, respectively. Compared with the IOP before surgery, theIOP of three months after surgery were decreased significantly (P<0.05). TheIOP of the patients who diagnosed as IOP out of control after trabeculectomydecreased much less compared with other patients (17.5±5.44mmHg)(P<0.05).Compared with the results before surgery, the ciliary process number (CPN),the transscleral angle (θ), alpha angle change significantly three months aftersurgery (P <0.05). 2. The relationship between IOP and morphologic change of ciliary body.As the decrease of IOP, the angle of (θ)(r=0.925, P<0.05), the angle of A(r=0.848, P<0.05), the angle of alpha (r=0.949, P<0.0), and the number of CPN(r=0.687, P <0.05) are all decreased correspondingly. However, the thick ofCPT did not show the same change.3. The relationship between IOP and treatment parameters of TSCP. As theincrease of firing points or blasting points, the IOP will decreased significant atthree months after surgery (r=0.656, P<0.05for firing point; r=0.554, P<0.05for blasting points).Conclusion:1. TSCP is an efficacy, relatively easy, safety, and economic treatment forthe refractory glaucoma. Among the different types of refractory glaucoma, theoutcome of the TSCP for primary angle-closure glaucoma is much better.However, the patients with IOP out of control after trabeculectomy can not getmuch better outcome.2. The degree of IOP decrease shows a positive relationship withmorphologic change after the surgery of TSCP. The larger the morphologic ofciliary change, the more the IOP decreased.3. We found a significantly relationship between the decrease of IOP andthe firing points or blasting points. As the increase of firing points or blastingpoints, the IOP decrease correspondingly.4. During the surgery of TSCP, we should choose the firing points andblasting points based on the level of IOP before surgery. For the patients withhigher IOP, we should increase the number of firing points and blasting points.