Individualized transscleral cyclophotocoagulation as the initial surgical intervention for medically uncontrolled glaucoma after blunt trauma

Abstract

Aim:

To investigate the safety and feasibility of individualized transscleral cyclophotocoagulation (TSCPC) as the initial non-incisional surgical intervention for medically uncontrolled glaucoma after blunt trauma.

Methods:

The therapy records were reviewed of medically uncontrolled traumatic glaucoma after blunt trauma treated with TSCPC in a single hospital between January 2014 and December 2018. Thirty-one patients (31 eyes) received individualized TSCPC after ultrasound biomicroscopy and gonioscopy examination to localize and quantify the injured quadrants of the anterior chamber angle. In addition to the number of IOP lowing drugs, visual acuity (VA), IOP, inflammation and hemorrhage in the anterior chamber were analyzed at 1 day, 3 weeks and 3 months after operation, respectively. Success was defined as the IOP was not more than 21 mmHg.

Results:

Compared with the data of pre-operation, constituent ratio of VA had no significant difference at 3 weeks (χ² = 0.56, p > 0.75). At 3 months the average IOP was 22.2 ± 6.8 mmHg, which was significantly lower than that of pre-operation (46.6 ± 5.6 mmHg) (t = 19.818, p < 0.001). No IOP lowing drug was needed in 12 eyes, and more than three kinds of drugs were still needed in five eyes. The average number of medications decreased to 1.2 ± 1.2 (χ² = 93.496, p < 0.001). The complete success rate was 38.7% and the relative success rate (combined with no more than two kinds of drugs) was 83.9% at 3 months.

Conclusions:

Individualized TSCPC could be applied as an initial non-incisional surgical intervention to treat traumatic glaucoma refractory to the medicine therapy.