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Refractory glaucoma – tube or diode?
Author(s) -
Malik Rizwan,
Ellingham Roger B,
Suleman Hanif,
Morgan William H
Publication year - 2006
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2006.01339.x
Subject(s) - medicine , intraocular pressure , glaucoma , surgery , refractory (planetary science) , ophthalmology , tube (container) , diode , anesthesia , mechanical engineering , physics , optoelectronics , astrobiology , engineering
A bstract Background: The aim of the present study was to assess the relative effectiveness of tube surgery and cyclodiode laser in terms of achieving intraocular pressure control. Methods: A retrospective study was undertaken to compare patients undergoing double plate Molteno tube implantation with patients undergoing diode cyclophotocoagulation. Intraocular pressure (IOP) was documented at 7 days prior to surgery and postoperatively at various time points. Surgical success was defined as a final IOP between 6 (inclusive) and 21 mmHg (inclusive), without the use of topical medication, while ‘qualified’ success was defined as IOP within the same range with the use of topical medication. Results: Twenty‐eight diode patients and 26 tube patients were included for the study. An average follow up of 150 weeks (range = 21–322 weeks) was available. Mean preoperative IOP was 37 ± 12 mmHg for the tube group and 39 ± 16 mmHg for the diode group ( t = 0.51, P = 0.61). The final IOP was 17 ± 12 mmHg for the tube group and 21 ± 13 mmHg for the diode group ( t = 0.35, P = 0.73). Surgical success was achieved in 46% of tube eyes and 11% of diode eyes, while qualified success was achieved in 81% of tube eyes compared with 64% of eyes in the diode group. Two eyes which underwent diode became phthisical. Conclusions: IOP control may be achieved in a greater number of patients with tube surgery. The possible benefits of IOP control in diode patients need to be weighed against the risks of long‐term visual loss and the need for multiple re‐treatments in this group.