Clinical Observation Of Semiconductor Diode Laser Transscleral Ciliary Photocoagulation For Refractory Glaucoma

Purpose:To evaluate the efficacy and safety of semiconductor diode laser transscleral cyclophotocoagulation with refractory glaucoma.Method:To evaluate all the medical records of refractory glaucoma patients who were treated by transscleral diode laser cyclophotocoagulation from May 2019 to November 2020 at Second Affiliated Hospital of Nanchang University,a total of71cases(71 eyes).Clinical data were recorded,including intraocular pressure,visual acuity,glaucoma type,pain perception,postoperative inflammatory response,number of anti-glaucoma agents,retreatment during follow-up,and complications.The relationship between successful IOP control and various laser parameters(energy applied per eye,energy per laser application,power,exposure time and number of laser applications)was examined using the results of this study and previous investigations.Results:Three months after surgery,the success rate was 62.3%(n=69)with an average of1.04 treatments.The intraocular pressure decreased from 45.2(±12.0)mm Hg preoperatively to 18.1(±11.9)mm Hg postoperatively(P<0.05),the intraocular pressure and the amount of medication at 1 day,2 weeks,1 month and 3 months after surgery were significantly decreased than that of pre-operation.Complications occurred in 18 eyes,including conjunctival burn in 1 eye(1.4%),anterior chamber hemorrhage in 6 eyes(8.7%),choroidal detachment in 2eyes(2.9%).Combined analysis of the result of this study and previous studies reveals a linear,direct correlation(r=0.82)between the percentage of patients achieving a successful outcome and the energy delivered to the ciliary body during the treatment session.Conclutions:Transscleral diode laser cyclophotocoagulation is an effective and safe method for the treatment of refractory glaucoma.