Efficacy and safety of transscleral cyclophotocoagulation in Swedish glaucoma patients.

PURPOSE: To retrospectively evaluate the efficacy and safety of all transscleral cyclophotocoagulation (TCP) treatments performed during a 5-year period.

METHODS

Medical records of all patients, who had undergone TCP treatment between 2010 and 2014 at Umeå University Hospital, Sweden, were evaluated. Clinical data including intraocular pressure (IOP), visual acuity (VA), number of topical glaucoma medications, use of oral acetazolamide, retreatments and complications during a 2-year follow-up were registered. Global success was defined as IOP 6-18 mmHg with or without glaucoma medication.

RESULTS

Three hundred patients underwent TCP during the time period. Mean IOP at baseline was 29.3 ± 11.0 (mean ± standard deviation) mmHg (n = 297) with a mean reduction of 11.5 (±12.0) mmHg at 1 year (n = 258; p < 0.001) and 12.6 (±12.0) mmHg at 2-year follow-up (n = 245; p < 0.001). Global success at 2 years was 64%, achieved by a mean of 1.2 treatments (n = 257). The number of topical glaucoma medications at baseline was 3.1 (±1.0; n = 296) and was reduced by 0.9 (±1.0) medications at 2 years (n = 244; p < 0.001). Use of oral acetazolamide decreased from 30% (n = 90) at baseline to 5.3% (n = 13) at 2 years. In eyes with Snellen VA ≥ 0.1, the mean VA at baseline was 0.55 (±0.3) logarithm of the minimum angle of resolution (logMAR; n = 132) and 1.1 (±0.9) logMAR (n = 76) at 2 years (p < 0.001). No cases of phthisis bulbi were found.

CONCLUSION

This study displays a substantial and long-term reduction of IOP following TCP with a decrease in topical and oral glaucoma medications. The treatment appears to be safe but the decrease in VA during follow-up is a concern that needs further evaluation.