مقايسه سايكلوكرايوتراپي با سايكلوفوتوكواگولاسيون با ليزر دايود از روي اسكلرا در بيماران مبتلا به گلوكوم مقاوم به درمان

Cyclocryotherapy Versus Transscleral Diode Laser Cyclophotocoagulation for Uncontrolled Intraocular Pressure

Background and objectives: Refractory glaucoma is characterized by pain and medically uncontrolled intraocular pressure. To compare the effectiveness and safety of cyclocryotherapy and diode transscleral cyclophotocoagulation(TSCPC) in refractory glaucoma. Materials and Methods: This clinical trial have been carried out in 100 eyes (100 patients) with refractory glaucoma randomly treated with either cyclocryotherapy (I group) or diode transscleral cyclophotocoagulation (II group). Only Eighty –eight patients after 6 months examined in follow up periods. Intraocular pressure, corrected visual acuity, and complications was assessed in the early and late postoperative period. Follow-up ranged from 6 months to 11 months, mean 34.6±9.5 weeks. Data were analyzed using SPSS version 14 and chi-squared testing was used for categorical variables and a non-paired t -test for Continuous variables. Results: There was a statistically significant decrease in intraocular pressure after both cyclocryotherapy and diode transscleral cyclophotocoagulation at each time period. Before treatment IOP mean 45.82 ± 9.19 mmHg in the I group and mean 48.4±12.59 mmHg in the II group. There were no significant differences in postoperative visual acuity change in cyclocryotherapy. After TSCPC visual function increased in 27.2 % of eyes (0.0005). After cyclocryotherapy only conjunctival oedema was observed in majority of cases. In the early postoperative period after TSCPC uveitis occurred in 2 eyes (4.2%), transient hypotony in 1 eyes, hyphaema in one eye. Conclusion: Diode cyclophotocoagulation decreases IOP more effective than cyclocryotherapy in refractory glaucoma but complications after TSCPC are more severe than after cyclocryotherapy