| Background/aims: The main aims of this study were to compare the outcomes of two protocol for transscleral cyclophotocoagulation(TSCPC)in glaucoma and to evaluate possible predictive factors that would help establish optimum treatment parameters.Patients and Methods: Data were collected retrospectively on patients with glaucoma who underwent TSCPC in Lanzhou University second hospital.Compare the outcomes of patient demographics,intraocular pressure(IOP),visual acuity(VA),antiglaucoma medications and complications and analysis of influencing factors.Data were analyzed using SPSS version 22.0.Results: A total of 356 patients(362 eyes)were treated with TSCPC from January 2012 to May 2018,and 237 patients(240 eyes)were included in the analysis after final follow-up,in which 115 eyes from114 patients and 125 eyes from124 patients in the new protocol treatment and traditional protocol treatment groups,respectively.For new protocol treatment,a starting power of 1.25 W and a 4.0-second or 4.5-second duration were used.Conversely,for the traditional protocol treatment group,a starting power of 2.0 W and a 2.0-second duration were used.Then,the laser power was adjusted depending on the occurrence of an audible “pop.”The IOP was significantly decreased from preoperative to postoperative in both groups(P < 0.001).The difference in reduction of IOP between preoperative and postoperative was 18.77±11.48 mmHg vs 20.33 ± 11.89 mmHg and 41.81%(SD20.79)VS 42.33%(SD20.91).There was no significant difference in reduction of IOP between the two groups after treatment(P=0.772).There were 52(45.2%)eyes in the new protocol group and 47(37.6%)eyes in the traditional protocol group(P=0.231)where the IOP decreased to normal(6-21 mmHg)on the first day after surgery.The effect of reducing IOP on first day after treatment was equivalent.The initial VA waspoor,there are 80(69.57%)eyes and 104(83.20%)eyes blind in new and traditional groups(P=0.108).At final follow-up,there were 96(83.47%)eyes and122(97.60%)eyes blind in new and traditional groups.The mean total energy delivered per eye was 140.53±26.24 J in new group and 102.42±27.00 J in traditional group(range 64.80to191.25J)(P< 0.001).The follow-up periods were 13.75±7.167 and39.06 ± 13.852 months for the new and traditional groups,respectively(P <0.001).IOP remained between6-21 mmHg in 77(66.96%)eyes of new protocol TSCPC patients and 80(64.00%)eyes of traditional TSCPC patients,in additional,IOP of more than21 mmHg was recorded in 36(31.30%)eyes in new group and 44(35.20%)eyes in traditional group and 2(1.74%)and 1(0.80%)eyes occurred hypotony in new and traditional group at the last follow-up visit(P = 0.638).Overall,30(26.09%)eyes required at least two retreatments in new protocol group and36(28.80%)in traditional group(P=0.638).The use of anti-glaucoma medication was reduced in 60(52.17%)eyes and 69(55.20%)eyes before treatment to after final follow up in new protocol group and traditional group,and at the final follow up there only60(52.17%)and 69(55.20%)eyes need antiglaucoma eye drops in two groups(p=0.103).In addition,complications were also comparable.At the final follow-up,31(26.96%)eyes of the new protocol group had at least one complication,compared with 60(48.00%)of the eyes in the traditional protocol group(P = 0.001),and the mean number of atrophy of eyeball was higher in the traditional group26(22.61%)eyes versus the new protocol group 53(42.40%)eyes(P=0.001)Conclusions: In our study,both new protocol treatment and traditional protocol treatment effectively lowered IOP at postoperative and final follow up and there is no significantly difference between two groups.The complication profiles of the techniques also were comparable and traditional treatment appeared to result in a high incidence in atrophy of eyeball. |
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