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목적 : This study was conducted to evaluate the efficacy and safety of trans-scleral diode laser cyclophotocoagulation (TDCPC) and to identify predictive factors associated with non-response after TDCPC in refractory glaucoma.
방법 : Clinical data from 157 eyes of 156 patients who underwent TDCPC between 2003 and 2014 were retrospectively reviewed. Success was defined as final intraocular pressure (IOP) of 5 to 21 mmHg, or an IOP of 22 to 26 mmHg and pressure reduction of at least 30% compared with pretreatment, with or without medications. Hypotony was defined as IOP < 5 mmHg at the end of follow-up period. Response was defined as successful and hypotony eyes taken together. Multivariate analysis was used to identify possible predictive factors for non-response of TDCPC.
결과 : The mean follow-up period was 26.2 ± 31.1 months (range 12-120 months). Mean IOP decreased from 45.8 ± 9.6 mmHg pretreatment to 19.4 ± 13.7 mmHg at the end of follow-up (p<0.001). Mean number of total medications were reduced from 3.2 ± 0.7 to 1.7 ± 1.2 (p<0.05). Success was noted in 113 eyes (71.9%) and hypotony was found in 16 eyes (10.1%). Non-response occurred in 27 eyes (17.1%). The non-response was significantly associated with neovascular glaucoma and pretreatment IOP more than 40 mmHg (p<0.05). Phthisis bulbi was developed in 4 eyes (2.6%).
결론 : TDCPC is an effective method for the treatment of refractory glaucoma. Presence of neovascular glaucoma and a higher pretreatment IOP were associated with non-response.
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