Treatment of the Refractory Glaucoma by the MicropulseTranscleral Diode Laser Cyclophotocoagulation
To describe our clinical experience with the efficacy and safety of micropulse transscleralcyclophoto coagulation as a alternative treatment for refractory glaucoma. Methods: It is a prospective, non-comparative, longitudinal interventional study conducted on 26 eyes, which presented refractory glaucoma, treated and followed at the Mohammed V Military Teaching Hospital, for a period of one year, between January 2019 and January 2020. Eligible patients underwent a standardized cyclophoto coagulation treatment with micropulsed diode laser by placing the probe 1 mm from the limbus, for 90 seconds over 360 º while sparing the meridians of 3h and 9h to avoid the branches of the anterior ciliary artery and the posterior ciliary nerves, we used a power of 2000mw, a cycle of 35 ms. Results: We included 18 men and 8 women in our study, the average age is 62.78 ± 6.33 years, 19 patients who were under an average of 3.21 ± 1.33 treatment molecules. 19 patients were on 4 or more treatment molecules and the visual acuity was between negative light perception and 3/10.The average IOP at 6 weeks postoperatively decreased with an average of 17.31 ± 4.91 mmHg which is a decrease of 56.08% .The decrease in IOP at 6 weeks as well as the number of therapies per patient experienced a significant drop with a p value.
Glaucoma is a major cause of irreversible blindness worldwide. Existing therapies aim either to increase the flow of aqueous humor or to decrease its production in order to decrease intraocular pressure and preserve the residual function of the optic nerve.
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