Biography
Biography: Melissa Morrison Toyos
Abstract
Aim: This project was undertaken to assess the clinical value of using a new trans-scleral cyclophotocoagulation device in patients with mild to severe glaucoma including those who have unsuccessfully undergone other procedures. This is a one year update of earlier reported data.
Method: This is a single site review of 26 eyes of 20 patients; four eyes were classified as mild glaucoma, five as moderate and 18 as severe or end stage glaucoma. Two eye of one patient were lost to follow up all eyes but three had previously undergone phacoemulsification and SLT or MLT. Four eyes had previously undergone trabeculectomy.
Results: Patients undergoing the procedure had an average IOP of 25.6 and were on an average of three IOP lowering meds. After the procedure, patients were started on difluprednate hourly for the first day then tapered over three weeks. Average IOP drop at POD 1 was 20% and 34% at POD 7 (using an average 1.3 IOP lowering meds). At POD 14, average IOP from baseline was 8% using one IOP lowering medication. At one month, IOP was down by 20% and average number of IOP reducing medications was 1.2. At 6-12 months, the average IOP lowering was 30% compared with baseline IOP on and average of 1.8 medications. There were no serious adverse events.
Conclusion: Patients with glaucoma of varying severities are able to safely undergo trans-scleral cyclophotocoagulation. On average, IOPs were reduced by 30% over one year time and number of IOP lowering medications was reduced by 60%. Further study is required to determine ideal treatment guidelines.