Comparative study of two different techniques of diode laser transscleral cyclophotocoagulation in management of refractory glaucoma

Purpose The aim was to compare between two techniques of diode laser transscleral cyclophotocoagulation in treatment of refractory glaucoma, that is, standard titratable (audible pops' technique) versus slow coagulation technique, regarding and efficacy. Patients and methods In this prospective randomized study, 40 patients with refractory glaucoma were divided into two study groups: group A underwent standard technique of diode laser transscleral cyclophotocoagulation (audible pops technique), and group B underwent slow coagulation technique of diode laser transscleral cyclophotocoagulation. Patients were followed up at 1 week, 1 month, 3 month, and 6 month duration postoperatively, and changes in visual acuity, intraocular pressure (IOP), as well as postoperative complications were documented. Results The mean IOP was reduced significantly from 46.3 +/- 8.9 to 18.9 +/- 5.45 mmHg in patient of group A and from 42.8 +/- 8.53 to 20.05 +/- 8.28 mmHg in patient of group B at the end of 6-month follow-up (P<0.0001). The mean number of postoperative antiglaucoma drugs needed to control IOP was also reduced significantly in both groups. No serious complications such as hypotony were reported in the two study groups. Conclusion Both techniques of diode transscleral cyclophotocoagulation were of near equal safety and efficacy in treatment of refractory glaucoma with different underlying etiologies. Both had good efficacy in IOP lowering, reduced number of antiglaucoma medications used by patients, and relieved pain, with near equal incidence of postoperative complications.