Treatment Outcomes of Primary Transscleral Cyclophotocoagulation

Objective To report treatment outcomes of primary transscleral cyclophotocoagulation (TSCPC) in glaucomatous eyes. Design A retrospective non-comparative study. Subjects Forty-eight eyes with a diagnosis of glaucoma and no previous incisional ocular surgery. Intervention Continuous wave TSCPC was applied to the ciliary body to lower intraocular pressure (IOP). Main Outcome Measures The primary outcome measure was surgical success defined as an IOP ≤ 21 mmHg or reduced ≥ 20% from baseline, IOP > 5 mmHg, no reoperation for glaucoma, and no loss of light-perception vision. Secondary outcome measures include visual acuity (VA) and complications. Results Glaucoma eyes were stratified into two groups -1) those with pre-treatment IOP > 21mmHg (high group) and 2) those with pre-treatment IOP ≤ 21mmHg (low group). Mean±SD IOP at baseline was 30.2±6.0mmHg in the high group and 16.2±2.8mmHg in the low group. Mean±SD number of glaucoma medications at baseline was 4.0±0.9 in the high group and 3.6±1.1 in the low group. Based on our success criteria, the cumulative probability of success during the first year of follow-up was 58.3% in the high group and 28.1% in the low group (P=0.052). Post-operative mean IOP was significantly lower than baseline in the high IOP group at 1, 3, 6, 12, and 18 months post-operative visits (p Conclusions Continuous wave TSCPC was effective in lowering IOP in glaucoma patients without prior incisional ocular surgery who were recalcitrant to medical therapy, particularly those with baseline IOP > 21mmHg. Our minimally invasive surgical outcomes are comparable to those of conventional glaucoma surgical studies, such as the Ahmed Versus Baerveldt and Tube Versus Trabeculectomy studies.