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Purpose <p>To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TSCPC) in patients with refractory glaucoma using real-world clinical data from a tertiary referral center.</p> Methods <p>This retrospective study reviewed the medical records of 143 patients who underwent primary TSCPC for refractory glaucoma between December 2022 and January 2024. Data regarding intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of IOP-lowering medications, repeat treatments, and postoperative complications were collected. Surgical success was defined as achieving an IOP between 6 and 21&#xa0;mmHg with at least a 20% reduction from baseline, with (qualified success) or without (complete success) adjunctive medical therapy, in the absence of glaucoma-related phthisis bulbi, loss of light perception, or the need for additional glaucoma surgery other than repeat TSCPC.</p> Results <p>A total of 143 eyes from 143 patients (57.0% male) with a mean age of 62.0 ± 15.7&#xa0;years were included. Neovascular glaucoma was the most common diagnosis (62.0%). Mean IOP decreased significantly from 35.9 ± 11.0&#xa0;mmHg preoperatively to 16.2 ± 8.3&#xa0;mmHg at the 12-month follow-up (<i>p</i> &lt; 0.001). Overall surgical success was achieved in 65.8% of eyes, including 16.8% complete success and 49.0% qualified success. The mean number of antiglaucoma medications decreased from 2.8 ± 1.0 to 1.5 ± 1.1 (<i>p</i> &lt; 0.001). Postoperative complications occurred in 10.9% of eyes and were predominantly mild and transient. No cases of persistent hypotony or phthisis bulbi were observed.</p> Conclusions <p>In a real-world tertiary care setting, TSCPC was associated with significant IOP reduction and an acceptable safety profile over 12&#xa0;months in patients with refractory glaucoma. Despite the high proportion of neovascular glaucoma cases, no sight-threatening complications such as persistent hypotony or phthisis bulbi were observed during follow-up. However, longer-term studies are needed to confirm the durability and long-term safety of these outcomes.</p>

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Transscleral diode cyclophotocoagulation for refractory glaucoma: real-world efficacy and safety

  • 期刊论文

  • 发表日期：

    2026年4月22日

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  • Elif Ertan,
  • Merve Uran

摘要

Purpose

To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TSCPC) in patients with refractory glaucoma using real-world clinical data from a tertiary referral center.

Methods

This retrospective study reviewed the medical records of 143 patients who underwent primary TSCPC for refractory glaucoma between December 2022 and January 2024. Data regarding intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of IOP-lowering medications, repeat treatments, and postoperative complications were collected. Surgical success was defined as achieving an IOP between 6 and 21 mmHg with at least a 20% reduction from baseline, with (qualified success) or without (complete success) adjunctive medical therapy, in the absence of glaucoma-related phthisis bulbi, loss of light perception, or the need for additional glaucoma surgery other than repeat TSCPC.

Results

A total of 143 eyes from 143 patients (57.0% male) with a mean age of 62.0 ± 15.7 years were included. Neovascular glaucoma was the most common diagnosis (62.0%). Mean IOP decreased significantly from 35.9 ± 11.0 mmHg preoperatively to 16.2 ± 8.3 mmHg at the 12-month follow-up (p < 0.001). Overall surgical success was achieved in 65.8% of eyes, including 16.8% complete success and 49.0% qualified success. The mean number of antiglaucoma medications decreased from 2.8 ± 1.0 to 1.5 ± 1.1 (p < 0.001). Postoperative complications occurred in 10.9% of eyes and were predominantly mild and transient. No cases of persistent hypotony or phthisis bulbi were observed.

Conclusions

In a real-world tertiary care setting, TSCPC was associated with significant IOP reduction and an acceptable safety profile over 12 months in patients with refractory glaucoma. Despite the high proportion of neovascular glaucoma cases, no sight-threatening complications such as persistent hypotony or phthisis bulbi were observed during follow-up. However, longer-term studies are needed to confirm the durability and long-term safety of these outcomes.