Safety of low-does transscleral diode laser cyclophotocoagulation for the treatment of acute primary angle-closure glaucoma under persistent high intraocular pressure
Objective To analyze the safety of low-dose transscleral diode laser cyclophotocoagulation(TDCP)for the treatment of acute primary angle-closure glaucoma(APACG)under persistent high intraocular pressure(IOP).Methods A retrospective case series study.73 APACG with cataract patients(73 eyes)under persistent high IOP from January 2020 to February 2023 were retrospectively analyzed.The experimental group(35 eyes)was treated with low-dose TDCP followed by phacoemulsification combined with goniosynechialysis(2.49±0.26 w intervals).The control group(38 eyes)was treated with phacoemulsification combined with goniosynechialysis alone.IOP was compared between the two groups after nonoperative treatment,before phacoemulsification and 1day,1week,1month,3months after phacoemulsifica-tion.The incidence of intraoperative and postoperative complications was also compared between the two groups.Results There were no statistical differences in IOP between the two groups after nonoperative treatment and 1 week,1 month,3 months after phacoemulsification(all P>0.05).However,the IOP of the experimental group was lower than that of the control group before phacoemulsification and 1 day after phacoemulsification,there was a significant difference between the two groups(all P<0.05).The incidence of iris prolapse and transient high IOP,exudation in the pupil area,corneal edema after phacoemulsification in the experimental group was significantly lower than that in the control group(all P<0.05).But there was no statistical difference in the incidence of posterior capsular rupture between the two groups.Conclu-sions APACG under persistent high IOP can be treated with low-dose TDCP followed by phacoemulsification combined with goniosynechialysis after IOP reduction and intraocular inflammation was controlled.It can effectively control IOP and significantly reduce the incidence of intraoperative and postoperative complications.
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