Background:

Transscleral Cyclophotocoagulation (TSCPC) is a cyclodestructive procedure used to control elevated Intra Ocular Pressure (IOP) in refractory glaucoma. Recent literature suggests that cyclophotocoagulation is increasingly performed as the primary surgery for various types and stages of glaucoma, even in patients with good vision.

We set out to analyze efficacy and safety of TSCPC in refractory glaucoma at our hospital.

Methods:

Data was collected retrospectively from patients who underwent TSCPC at our hospital between January 2013 and August 2015. All patients were symptomatic on maximal medical therapy. Primary outcome measure was reduction in IOP and the secondary outcome measures were relief of symptoms and incidence of complications.

Results:

42 patients underwent TSCPC of which 27 were included for analysis. 16men and 11women with mean age 61.81±12.98years and visual acuity ranging from 6/24 to no perception of light were included.

Mean IOP decreased from 46.04±8.6 mmHg (range:26-58 mmHg) pre-procedure to 16.7±13.44 mmHg (p<0.001) at last follow up. Complete success was achieved in 22.2%, qualified success in 18.5%, 29.6% eyes had hypotony and 29.6% failed. Mean glaucoma medications decreased from 3.15±1.30 to 0.89±1.16 (p<0.001). Patients were asymptomatic; complications were phthisis and vitreous hemorrhage which resolved (one case each).

Conclusion: 

Transscleral cyclophotocoagulation is a simple, safe, cost effective method of controlling intra ocular pressures in refractory glaucoma where other methods have high risk of failure. It is repeatable, may not be restricted to eyes with poor vision potential and a symptom free patient is often the end result.