Cyclocryocoagulation In Secondary Neovascular Glaucoma And Our Results

Abstract

Purpose: To retrospectively evaluate the use of cyclocryocoagulation (CCC) in secondary neovascular glaucomas performed at the Department of Ophthalmology, Faculty of Medicine, Charles University and University Hospital Hradec Králové in the years 2016–2019. Material and methods: In a retrospective study, 30 procedures of 26 eyes of 24 patients were evaluated. All patients underwent CCC surgery. The main entry criteria were the presence of secondary neovascular glaucoma in diabetes or on the basis of occlusion of the retinal artery or vein and subsequent dispensarization of the patient in the 1st and 6th month after the operation. The parameters evaluated were: the best-corrected visual acuity (BCVA), intraocular pressure value (IOP), data of pain and change in the number of active substances of antiglaucoma therapy. Results: The mean age of patients at the time of the procedure was 62 years (range 22–85 years). The average number of procedures per eye was 1.15 out of a total of 30 procedures, 26 eyes were performed on 24 patients. The most common indication for CCC in secondary glaucoma-vascular complications in diabetes were in 21 procedures, vascular complications – after occlusion of the retinal vein or artery were in 9 cases. Two patients had both eyes operated on within one year. Three patients underwent two procedures on the same eye during the study period. One of them had two procedures on both eyes. The average value of the number of active substances of antiglaucoma drugs decreased from 3.10 to 2.87 after the 1st month (p = 0.318) and after 6 months it was 2.6 (p<0.05). The average IOP value decreased from 34.67 mmHg to 18.43 mmHg after the 1st month (p < 0.05) and after 6 months to 17.90 mmHg (p<0.05). The mean value of BCVA increased from 0.135 to 0.138 after the 1st month (p = 0.444) and after 6 months it decreased to 0.096 (p = 0.170). One month from the procedure, the average value of pain remained the same as the pre-surgery average value of the pain. No patients reported pain 6 months after the procedure. Conclusion: Our results correspond to the results of large clinical studies. We showed a statistically significant difference in the reduction of the number of active substances of antiglaucoma drugs and the reduction of intraocular pressure after 6 months after the procedure. All patients stopped reporting pain after the procedure.