Journal des maladies et troubles oculaires

Abstrait

Treatment of the Refractory Glaucoma by the Micropulse Transcleral Diode Laser Cyclophotocoagulation

Mehdi Khamaily*, Imane Tarib, Yassine Mouzari, Joumany Brahim Salem, Taoufik Abdellaoui, Fouad El Asri, Karim Reda, Abdelbarre Oubaaz

Purpose: To describe our clinical experience with the efficacy and safety of micropulse transscleralcyclophoto coagulation as a alternative treatment for refractory glaucoma.
Methods: It is a prospective, non-comparative, longitudinal interventional study conducted on 26 eyes, which presented refractory glaucoma, treated and followed at the Mohammed V Military Teaching Hospital, for a period of one year, between January 2019 and January 2020. Eligible patients underwent a standardized cyclophoto coagulation treatment with micropulsed diode laser by placing the probe 1 mm from the limbus, for 90 seconds over 360 º while sparing the meridians of 3h and 9h to avoid the branches of the anterior ciliary artery and the posterior ciliary nerves, we used a power of 2000mw, a cycle of 35 ms.
Results: We included 18 men and 8 women in our study, the average age is 62.78 ± 6.33 years, 19 patients who were under an average of 3.21 ± 1.33 treatment molecules. 19 patients were on 4 or more treatment molecules and the visual acuity was between negative light perception and 3/10.The average IOP at 6 weeks postoperatively decreased with an average of 17.31 ± 4.91 mmHg which is a decrease of 56.08% .The decrease in IOP at 6 weeks as well as the number of therapies per patient experienced a significant drop with a p value <0.001 in comparison with the preoperative values.
Conclusion: The transcleral Micropulsecyclo coagulation proved good results in the management of refractory glaucoma, in comparison to the Nd: YAG laser technique. Certainly, further follow up for long-term results is essential.