Longterm outcomes of cyclodiode treatment for patients with neovascular glaucoma

PurposeTo investigate the outcomes following cyclodiode treatment for patients with refractory neovascular glaucoma. Outcome measures were sustained IOP reduction, symptom relief, number of medications and progression to pthysis, over a 10 year period. Visual acuity data was also collected.MethodsA consecutive retrospective series of 15 eyes of 14 patients in a single eye unit, undergoing cyclodiode treatment between May 1999 to July 2005. Case notes were reviewed.ResultsFour patients died before completion of 10 year follow up but are included in the 5 year follow up data. Symptomatic relief was achieved in all eyes. Four eyes required a single further treatment with cyclodiode at 2 months to 3 years. Mean IOP prior to treatment was 42 mmHg. Following treatment, mean IOP was 18.5 mmHg at 1 month, 19.6 mmHg at 6 months, 15.33 mmHg at 1 year, 15.07 mmHg at 2 years, 12.92 mmHg at 3 years, 14.38 mmHg at 5 years and 10.1 mm/Hg at 10 years (75.95% reduction). 88% of eyes did not require any medication at 10 years. The mean reduction in number of medications used was 2 (2.8–0.8). Pthysis occurred in 5 eyes. In 3 eyes this occurred within 1 year of cyclodiode and in the remaining 2 eyes by 4 years. No patients progressed to evisceration or enucleation. 60% of eyes were NPL at 10 years, with pre‐cyclodiode acuities in this group of HMs to PL. One eye remained the same, with PL vision, and one eye improved from CF to 1/60. The vision in 2 eyes dropped from CF to HMs.ConclusionsCyclodiode laser treatment is effective for both pain control and maintaining IOP in the long term. It allowed a reduction in the number of topical treatments required.