Noncontact thermal mode Nd:YAG laser transscleral cyclocoagulation in the treatment of glaucoma. Intermediate follow-up.

Noncontact transscleral Nd:YAG laser thermal mode cyclocoagulation is known to reduce intraocular pressure (IOP). Thirty-five eyes were treated at a mean of 2.5 Joules and followed for a mean of 28 months. The mean preoperative IOP of 39.8 mmHg (standard deviation, 11.7) was consistently decreased by 45% to 55% over the follow-up period (standard deviation, 19.9 to 30.8), along with a significant reduction of medical therapy. This effect is comparable with that obtained by investigators using much higher energy levels. Successful control was defined as IOP between 5 and 21 mmHg for eyes with visual acuity of counting fingers or better, between 5 and 25 mmHg for eyes with hand motions to light perception, and as control of ocular pain for eyes with no light perception; 71% to 75% of the eyes were successfully controlled for up to 3 years. The use of lower energy levels appears to be associated with a lower incidence of vision loss and, therefore, merits further controlled investigation.