Dataset Information

Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria.

ABSTRACT:

Importance

To investigate the safety, effectiveness and follow-up rates after transscleral diode laser cyclophotocoagulation as primary treatment for seeing eyes with primary open angle glaucoma in Bauchi, Nigeria.

Background

There is a high prevalence of primary open angle glaucoma in Africa where adherence to medical treatment and acceptance of surgery are poor.

Design

Prospective case series.

Participants

New glaucoma patients where surgical intervention was recommended.

Methods

A diode 810?nm laser G-probe was used under retrobulbar anaesthesia to deliver approximately 20 shots for 2000?ms, titrating the power. If both eyes were treated the first was the study eye. Repeat treatment offered if the intraocular pressure (IOP) was >21?mmHg on two consecutive visits.

Main outcome measures

IOP?Results201 out of 204 eyes with complete data analysed. Mean age 52?years, 17 (8.3%) eyes were re-treated. Mean pre-treatment IOP was 39 (SD 11) mmHg. 106 (53%) attended at 12?months when the mean IOP was 19 (7-45) mmHg; 77 (73%) had IOP < 22?mmHg. VAs were better in 13 (12.3%) and worse in 23 (21.7%) eyes. Postoperative complications included mild uveitis (5.5%), corneal oedema (2.5%), severe uveitis (0.5%) and transient hypotony (2.0%). No hypotony at 12?months.

Conclusions and relevance

Transscleral diode laser cyclophotocoagulation controlled IOP in almost three quarters of eyes at 12?months with short-term preservation of vision and minimal complications. Poor follow-up in this setting highlights the need for an effective, safe and acceptable treatment where regular follow-up is less critical.

SUBMITTER: Abdull MM

PROVIDER: S-EPMC6585748 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria.

Abdull Mohammed M MM Broadway David C DC Evans Jennifer J Kyari Fatima F Muazu Fatima F Gilbert Clare C

Clinical & experimental ophthalmology 20180617 9

<h4>Importance</h4>To investigate the safety, effectiveness and follow-up rates after transscleral diode laser cyclophotocoagulation as primary treatment for seeing eyes with primary open angle glaucoma in Bauchi, Nigeria.<h4>Background</h4>There is a high prevalence of primary open angle glaucoma in Africa where adherence to medical treatment and acceptance of surgery are poor.<h4>Design</h4>Prospective case series.<h4>Participants</h4>New glaucoma patients where surgical intervention was recom ...[more]

PMID: 29808573

Similar Datasets

Project description:PurposeThe outer stent lumen can be located either deeper (in or under Tenon's layer) or more superficially in the conjunctival stroma after the transscleral XEN Glaucoma Gel Microstent (XEN-GGM; Allergan Plc., USA) implantation. The present study aimed to investigate the effect of the postoperative conjunctival implant position on surgical success and intraocular pressure (IOP) after XEN-GGM.MethodsProspective data from 66 consecutive open-angle glaucoma eyes of 54 patients were collected preoperatively and 1 and 2 weeks, and 1, 6 and 12 months postoperatively. The layer of implantation was determined in the first month postoperatively as intra- and subtenon or intraconjunctival depending on the location of the outer lumen of the stent in OCT (Visante OCT; Zeiss, Germany). Primary outcome measures were differences in relative IOP reduction at 12 months between the two groups. Further, complete and qualified surgical success, number of secondary needlings and number of IOP-lowering medications and absolute IOP were assessed.ResultsRelative IOP reduction was higher in intra- and subtenon group (n = 37/66, 56%) at week 1 (-54% versus -19%, p < 0.001), week 2 (-39% versus -21%, p = 0.02), month 1 (-42% versus -28%, p = 0.035) and month 12 (-39% versus -24%, p = 0.024). The mean absolute IOP was lower in intra- and subtenon group at week 1 (10.8 [95%CI, 8.8-14.1] versus 16.6 [95%CI, 14.1-19.0] mmHg, p < 0.001) and months 12 (13.9 [95%CI, 12.4-15.4] versus 16.7 [95%CI, 14.6-18.8] mmHg, p = 0.041). At month 6, a lower burden for IOP-lowering medication was shown for the intra- and subtenon group (0.2 ± 0.5 versus 1.0 ± 1.1, p = 0.034). The mean number of secondary needlings, which were done in 47/66 (71%) of the eyes, was lower in the intra- and subtenon group in the first year (1.9 ± 1.7 versus 1.2 ± 1.2, p = 0.03). Qualified surgical success was higher in the intra- and subtenon group (90% versus 61%, p = 0.01) after 1 year.ConclusionThe present study demonstrates a higher efficacy achieved with lower secondary needling rates in deeper implant positions in conjunctiva after XEN-GGM.

Dataset Information

Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria.

Importance

Background

Design

Participants

Methods

Main outcome measures

Conclusions and relevance

Publications

Safety and effectiveness of primary transscleral diode laser cyclophotoablation for glaucoma in Nigeria.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure