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Purpose: This study aimed to evaluate the clinical efficacy of contact diode trans-scleral cyclophotocoagulation (TSCPC) for treatment of refractory glaucomas., Method: Fifty two eyes of 52 patients, (post-penetrating keratoplasty glaucoma: 16 eyes; adherent leucoma with secondary glaucoma: 8 eyes; aphakic glaucoma: 6 eyes; neovascular glaucoma: 6 eyes; narrow angle glaucoma: 6 eyes; and other secondary glaucomas: 10 eyes) were followed up from 3.5-18 months (average 12 months) after TSCPC. The treatment parameters using the contact G probe were--energy: 3-4J; area: 40 spots spread over 360 degrees; site: 1.2-1.5 mm posterior to limbus. Retreatments (22 eyes; 42%) were given whenever intraocular pressure (IOP) exceeded 22 mmHg despite maximum tolerable topical therapy., Results: IOP decreased from a baseline of 44.7 (+/- 7.3) mmHg to 15 (+/- 3.7) mmHg at first week and was 15.2 +/- (8.2) mmHg at the last follow up. Successful control of IOP (< 22 mmHg) occurred in 30 (58%) eyes after a single treatment and in 48 (92%) eyes following retreatment. Complications included reduction in visual acuity from light perception (LP) only to no light perception (NLP) in two eyes and phthisis bulbi in one eye., Conclusion: Contact trans-scleral diode laser cyclophotocoagulation is effective in lowering IOP in eyes with intractable glaucoma with few side effects in Indian subjects.

Purpose: To evaluate the effectiveness and safety of diode laser contact transscleral cyclophotocoagulation in Asian patients with refractory glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body., Methods: This prospective clinical study included consecutive Asian patients with dark irides and confirmed for glaucoma. Only one eye of each patient was treated. Diode laser contact transscleral cyclophotocoagulation treatment was performed with the center of the probe placed 1.5 mm behind the limbus. About 30 pulses of 810-mm laser radiation (power, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraocular pressure levels and postoperative complications were recorded. The relation between patient and disease characteristics, total laser energy delivered, and intraocular pressure effects were analyzed., Results: Thirty-three patients were studied, with a mean follow-up period of 9.4 months. An average 56% of patients showed a 30% or greater drop in intraocular pressure. About 38% of patients achieved sustained intraocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis., Conclusions: In Asian patients with refractory glaucoma or painful glaucomatous eyes with poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser contact transscleral cyclophotocoagulation by means of the glass ball probe is relatively effective and safe.