Authors
Yakovlev R.A.1, Gorbunova N.Yu.1, 2, Voskresenskaya A.A.1, 2, Pozdeyeva N.A.1, 2
1 Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Cheboksary
2 State Autonomous Continuing Education Institution «Institute for Advanced Medical Training» of the Ministry of Health of the Chuvash Republic, Cheboksary
Abstract
Relevance: сurrently, micropulse transscleral cyclophotocoagulation is widely used for the treatment of refractory glaucoma. It has a high safety profile and can be applied to eyes with high visual potential. Continuous-wave cyclophotocoagulation has a more pronounced hypotensive effect; however, it is accompanied by a significant number of complications. During transscleral cyclophotocoagulation, it is suggested to use a standard position for the sensor, though the position of the ciliary processes may vary.
Purpose: to analyze the effectiveness and safety of the combined cyclophotocoagulation technique using transillumination.
Materials and Methods: the study included 22 patients (22 eyes) who underwent combined cyclophotocoagulation with transillumination. The observation period was 6 months, with control examinations conducted at 1, 3, and 6 months. At each visit, refractokeratometry, visual acuity assessment, ultrasound examination (B-scan), tonometry using the Maklakov method were performed. There was one case of postoperative uveitis in the form of iridocyclitis.
Results: after six months, intraocular pressure decreased by 45% from the baseline level-from 35.5 (34–38.5) mm Hg to 20 (20–21) mm Hg. The number of hypotensive therapy drops was also reduced-from 7 (5.75–7) to 4 (3.25–4) drops per day.
Conclusion: combined cyclophotocoagulation with transscleral transillumination demonstrated a stable hypotensive effect over 6 months, with no significant complications such as prolonged hypotony, phthisis bulbi, or persistent refractory uveitis, which are commonly seen with continuous-wave cyclophotocoagulation. Thus, this technique may become an effective alternative to standard methods of cyclophotocoagulation.
Keywords: glaucoma, cyclophotocoagulation, transillumination.
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