Acta clinica Croatica, Vol. 60. No. 2., 2021.
Original scientific paper
https://doi.org/10.20471/acc.2021.60.02.01
Efficacy of Cyclocryotherapy and Transscleral Diode Laser Cyclophotocoagulation in the Management of Refractory Glaucoma
Aleksandar Miljković
orcid.org/0000-0003-1509-5041
; Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia; Eye Department, Clinical Centre of Vojvodina, Novi Sad, Vojvodina, Serbia
Nikola Babić
orcid.org/0000-0002-4733-5786
; Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia; Eye Department, Clinical Centre of Vojvodina, Novi Sad, Vojvodina, Serbia
Vladimir Čanadanović
; Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia; Eye Department, Clinical Centre of Vojvodina, Novi Sad, Vojvodina, Serbia
Sofija Davidović
orcid.org/0000-0002-7597-0437
; Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia; Eye Department, Clinical Centre of Vojvodina, Novi Sad, Vojvodina, Serbia
Jelena Ljikar
; Eye Department, Clinical Centre of Vojvodina, Novi Sad, Vojvodina, Serbia
Marija Vasin
; Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia
Abstract
Treating advanced glaucoma often requires numerous therapeutic modalities in
order to achieve the desired intraocular pressure (IOP) reduction. The purpose of this study was to
evaluate the IOP lowering efficacy of both cyclocryotherapy (CCT) and transscleral diode laser cyclophotocoagulation
(TS-DCPC) in the management of refractory primary open-angle glaucoma. This
prospective, randomized, controlled clinical trial included 40 patients (40 eyes) with refractory glaucoma
treated at the Eye Department, Clinical Center of Vojvodina, Novi Sad, Serbia, between January
2016 and June 2019. Twenty patients underwent CCT (group 1), while another twenty patients were
treated with TS-DCPC (group 2). Each patient underwent complete eye examination on the treatment
day, as well as follow-up eye examinations 7 days and 1, 6 and 12 months after the intervention,
when IOP and number of anti-glaucoma drugs used were recorded. The median baseline IOP was
36.50 mm Hg (IQR, 28.75-42.00) in group 1 and 27.00 mm Hg (IQR, 22.00-35.00) in group 2.
Follow-up measurements of IOP in group 1 showed the following results: 16.50 mm Hg (IQR, 7.75-
20.00) (60% decrease from the baseline value), 12.00 mm Hg (IQR, 9.25-18.00) (67% decrease from
the baseline value), 9.00 mm Hg (IQR, 2.00-13.75) (73% decrease from the baseline value), and 9.50
(IQR, 2.50-12.00) (75% decrease from the baseline value) after 7 days, 1, 6 and 12 months, respectively.
Follow-up measurements of IOP in group 2 showed the following results: 16.00 mm Hg (IQR,
10.00-17.00) (48% decrease from the baseline value), 14.00 mm Hg (IQR, 10.00-16.00) (56% decrease
from the baseline value), 14.00 mm Hg (IQR, 12.25-16.50) (43% decrease from the baseline
value) and 14.00 mm Hg (IQR, 11.25-15.75) (53% decrease from the baseline value) after 7 days, 1,
6 and 12 months, respectively. The mean number of antiglaucoma drugs used decreased from 4 to
0.65±0.81 and 2.25±1.07 in groups 1 and 2, respectively. In conclusion, study results confirmed the
CCT and TS-DCPC to have a rapid and statistically significant ocular hypotensive effect in eyes with
refractory glaucoma at one-year follow-up.
Keywords
Refractory glaucoma; Cyclocryotherapy; Diode laser cyclophotocoagulation; Intraocular pressure
Hrčak ID:
263317
URI
Publication date:
1.6.2021.
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