Objective: The primary objective of the study is to determine the efficacy of diode laser cyclophotocoagulation in terms of the amount of intraocular pressure (IOP) drop achieved in glaucoma patients at Groote Schuur Hospital. The secondary objective is to determine the safety of the procedure by analysing the complications that arose as a result of the cyclodiode treatment. Methods: A retrospective file review was conducted on the diode laser cyclophotocoagulation (cyclodiode) procedures done at Groote Schuur Hospital Eye Clinic over a one year from 1 January 2014 to 31 December 2014. All the patients who received cyclodiode therapy at Groote Schuur Eye Clinic during this time period were included. There were no exclusion criteria. Data was collected on age, gender, laterality of procedure, pre-procedure visual acuity (VA), pre-procedure IOP, post-procedure VA at 3, 6 and 12 months, post-procedure IOP at 3, 6 and 12 months, medication pre- and post-procedure, type of glaucoma, prior glaucoma surgery, total number of laser spots applied, average laser power used (mW), number of laser sessions received and complications of the procedure documented at 3 months post procedure. Data analysis was performed using Microsoft Excel 2016. Results: There were 64 eyes treated over the 12-month period. Neovascular glaucoma was the most common glaucoma (44%). There was a significant difference between the pre- and the post-treatment IOP at each of three (p<0.00001), six (p=0.00026), and 12 months (p=0.0012) (paired samples t-test) with a mean IOP drop of 10mmHg. There was no significant difference between the visual acuity before and after treatment at three months (p=0.13) (paired samples t-test). There was a significant difference between the visual acuity before and after treatment at six months (p=0.0078) and at 12 months (p=0.0083) (paired samples t-test). Before treatment, 98% of patients were receiving anti-glaucoma medical treatment and at three months after treatment, the number of eyes on medical treatment had decreased to 90% of the patients. This decrease was not significant (p=0.06) (chi-squared test). The mean number of three anti-glaucoma medications being used remained unchanged but the number of patients receiving oral anti-glaucoma treatment decreased from 59% to 37% post-procedure. No complications were found in 60% at 3 months post-procedure. Conclusion: Transscleral cyclodiode is a safe procedure with a mean IOP decrease exceeding 10mmHg. Although this may not be enough to allow the cessation of all anti-glaucoma medication, it is often enough to allow the cessation of oral anti-glaucoma medication.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/29801 |
| Date | 18 February 2019 |
| Creators | Coetzee, Ingrid |
| Contributors | Du Toit, Nagib |
| Publisher | University of Cape Town, Faculty of Health Sciences, Division of Ophthalmology |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MMed |
| Format | application/pdf |
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