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Transscleral Diode Laser Cyclophotocoagulation After Baerveldt Glaucoma Implant Surgery

Panarelli, Joseph F. MD*; Banitt, Michael R. MD, MHA*; Sidoti, Paul A. MD†,‡

doi: 10.1097/IJG.0b013e318279c957
Original Studies

Purpose: To evaluate the safety and efficacy of transscleral cyclophotocoagulation (TSCPC) in patients requiring intraocular pressure (IOP) reduction despite prior Baerveldt glaucoma implant (BGI) surgery.

Participants and Methods: Twenty eyes of 20 patients who had previously undergone BGI placement and subsequently underwent TSCPC with the red (810 nm) diode laser between April 2005 and January 2010 were retrospectively reviewed.

Results: All patients underwent BGI placement an average of 34.7±24.2 months before TSCPC. The mean follow-up period after TSCPC was 25.6±17.4 months (range, 2.3 to 56.5 mo). IOPs were reduced from a mean of 21.8±4.6 to 10.8±3.2 mm Hg at the most recent follow–up, which represents a 50.2% reduction in mean IOP. Successful postoperative IOP control was achieved in 16 (80%) of 20 patients. The number of glaucoma medications decreased from 4.2±0.6 to 2.2±1.2. The life-table success rate was 78.6% at 12, 24, and 36 months. Postoperative complications included persistent corneal edema in 1 patient and both persistent corneal edema and cystoid macular edema in another patient. Both patients sustained a >2 line reduction in Snellen visual acuity.

Conclusions: TSCPC is safe and effective in the management of patients requiring IOP reduction after BGI surgery. Although our sample size was limited, the safety profile of TSCPC after BGI seems promising.

*Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL

Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY

New York Medical College, Valhalla, NY

Presented at the American Academy of Ophthalmology Annual Meeting, October 2010.

M.R.B. is supported in part by NIH-NEI grant EY014957. P.A.S. is supported by grants from the David E. Marrus Glaucoma Research Fund and the Herman Peters Pediatric Glaucoma Research Fund. The Bascom Palmer Eye Institute is supported by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD-Grant#W81XWH-09-1-0675).

Disclosure: The authors declare no conflict of interest.

Reprints: Paul A. Sidoti, MD, Department of Ophthalmology, New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY (e-mail: psidoti@nyee.edu).

Received March 7, 2012

Accepted October 2, 2012

© 2014 by Lippincott Williams & Wilkins.