gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Diode laser cyclophotocoagulation critcally reviewed: indications, handling and complications

Meeting Abstract

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  • corresponding author M. Klemm - Klinik und Poliklinik für Augenheilkunde, Kopf- und Hautzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • E. T. Matthiessen - Klinik und Poliklinik für Augenheilkunde, Kopf- und Hautzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • O. Zeitz - Klinik und Poliklinik für Augenheilkunde, Kopf- und Hautzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.02.03

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog424.shtml

Veröffentlicht: 22. September 2004

© 2004 Klemm et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Treatment of patients with end-stage glaucoma is highly challenging. Conservative therapy with antiglaucomatous eye drops fails frequently or is limited due to allergic reaction against the compounds. Filtering surgery is associated with a rapid decrease of intraocular pressure to zero which can lead to a progression of visual field defects within a very short period of time. This presentations compares different techniques of diode laser cyclophotcoagulation. "Mild cyclophotocoagulation" is introduced as a novel minimal invasive concept to reach low target IOPs in end stage glaucoma patients.

Methods

Mild diode laser cyclophotocoagulation is applied in patients with end stage open angle glaucoma where no conservative therapy options are left or a reduction of eye drop frequency due to compliance problems is preferable. Initially 8 to 12 effects were applied in intravenous general anesthesia. 4 to 6 weeks later the success of the treatment is controlled in a 48h IOP analysis including IOP measurements in the night. If the the treatment was not successful, the procedure is repeated up to two times. Success of the treatment is defined as 1) reaching of target IOP und 2) reaching a previously set number of IOP lowering eye drops.

Results

More than 150 patients were treated after this concept in our clinic. Treatment was successful in 50% of the caes after one, in 75% after two and in 85% of the cases after three procedures. In the remaining cases treatment was not successful. Complications as known from a traditional diode laser cyclophotocoagulation, especially a persisting hypotonia, prolonged intraocular inflammation were observed in one case only. In some cases a transient increase of intraocular pressure was observed ("reactive hypertonia").

Conclusions

Mild cyclophotocoagulation appears as a suitable method for treatment of end stage open angle glaucoma.