Treatment of Refractory Glaucoma
Conditions
Brief summary
laucoma having bad prognosis after maximally tolerated medication,glaucoma that fails after filtering operations, neovascular glaucoma, glaucoma following vitrectomy and glaucoma secondary to uveitis etc. is collectively termed as refractory glaucoma. For such glaucoma patients, cyclodestructive procedures are often used to reduce IOP, as well as to relieve ocular and periocular pain. Recently,diode laser transscleral cyclophotocoagulation has proved to be an effective method for the treatment of refractory glaucoma and it has become a standard treatment for refractory glaucoma.(Yu, Q., Liang, Y., Ji, F. and Yuan, Z.,et al 2020. ) In previous articles, little is known about the long-term outcomes of micropulse diode laser cyclophotocoagulation and cyclocryotherapy. Discrepancies in the results of several large observational analyses have introduced further ambiguity on the role of micropulse diode laser cyclophotocoagulation and cyclocryotherapy.The mechanism of transcleral cyclophotocoagulation IOP lowering in refractory glaucoma is not well understood. In this study, we perform cyclocryoablation and micropulse diode laser cyclophotocoagulation in patients with refractory glaucoma and report the outcomes / mechanism of IOP control using this new surgical paradigm. The objective of our project is to assess the end result and outcome of the role of micropulse diode laser cyclophotocoagulation and cyclocryotherapy.We aim to evaluate the comparison between micropulse diode laser cyclophotocoagulation and cyclocryotherapy. Only those subjects will be recruited who provide written informed consent. Patients are diagnosed on bases of tonometry, gonioscopy, ophthalmoscopy, perimetry. Patients' age, gender, type of glaucoma, number of diode laser treatment sessions, postoperative complications, number of hypotensive medications required to control IOP, and best corrected visual acuity (BCVA) will be evaluated. The criteria for success will be defined as postoperative IOP \<21 mmHg or \>20% decrease in IOP with or without additional medical treatment.
Interventions
PROCEDUREMicropulse diode laser cyclophotocoagulation in treatment of refractory Glaucoma
Treatment of refractory Glaucoma by Micropulse diode laser cyclophotocoagulation
PROCEDURECyclocryoablation in treatment of refractory Glaucoma
Treatment of refractory Glaucoma by cyclocryoablation
Sponsors
University of Health Sciences Lahore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Positive diagnosis of refractory glaucoma * Poor visual acuity: Hand movements or less * Age ≥ 18 years * Intraocular pressure ≥ 21 mmHg * Signed informed consent
Exclusion criteria
* Eye surgery performed over the last 3 months * Eye inflammation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| postoperative complications | 1 year | Hypotony, Fibrinous uveitis, Cystoid macular edema |
| Reduced IOP | 1 year | Reduction in IOP to less than 21 mmHg medications required to control IOP |
| Decrease in number of hypotensive drugs | 1 year | — |
Countries
Pakistan
Contacts
Primary ContactMariam Noor, MBBS
Outcome results
None listed