Controlled Cyclophotocoagulation for the Therapy of Primary Open-angle Glaucoma in African Eyes
Holbach M., Fiadoyor S., Preußner P.-R.
Dept. of Ophthalmology, Mainz University
Purpose: Controlled cyclophotocoagulation is a glaucoma therapy known since a few years. The probability of unwanted pop-effects is reduced by 1-2 orders of magnitude despite higher tissue selectivity, as compared to standard transscleral cyclophotocoagulation. In case of highly pigmented (e.g. african) eyes, the method, however, failed so far (excess pop effects).
Method: Two laser wavelengths (810nm, 940nm) and two optical designs with different flux densities but same power of 5W were compared to each other in african cadaver eyes in Kpando, Ghana. With the best of the four resulting combinations 32 eyes with chronic open angle glaucoma were treated within 10 days. Further patients are currently treated by one of the authors (S.F.).
Results: The 940nm laser and the optic with the lower flux density were clearly superior, in coincidence with previous physical considerations. Mean exposure time of 0.2s and mean energy of 1.0J are even smaller than with the 810nm laser in European eyes (0.3s, 1.5W). Complications could not be observed. Postoperative inflammation was lower than in European eyes. Local steroids and cycloplegia therefore were needed only in about 1/4 of the cases for more than one day. Short-term pressure reduction (one week) was more than a factor of two, without postop values below 10mm Hg. However, in some of the eyes pressure increased again significantly durin
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