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Low-dose transscleral diode laser cyclophotocoagulation (TSCPC) as a potential single treatment for primary open-angle glaucoma (POAG) in Malawi?

  • Glaucoma
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Abstract

Purpose

To investigate if low-dose 810 nm transscleral cyclophotocoagulation (TSCPC) can be used as single treatment in Malawian glaucoma patients.

Methods

Forty-seven eyes of 28 patients with primary open-angle and pseudoexfoliation glaucoma were treated with TSCPC using 12 spots with 900 mW, 2,000 ms (1.8 J per spot); six spots in the upper half, six in the lower by sparing the 3 and 9 o’clock positions ±20°. Intraocular pressure (IOP) and uncorrected visual acuity (UVA) were measured by an independent examiner preoperatively, on the first postoperative day, after 2 weeks, and after 3 months.

Results

Twenty-four (86 %) and 18 (64 %) of 28 patients (31 of 47 eyes; 66 %) completed follow-up at 2 weeks and at 3 months respectively. After a single treatment session, IOP decreased by at least 25 % in 88 % (21 of 24) after 2 weeks, and in 50 % (nine of 18) of patients after 3 months. Mean IOP was 38.5 mmHg before TSCPC, 23.5 mmHg (p < 0.001) after 1 day, 24.5 mmHg (p < 0.001) after 2 weeks, and 35.6 mmHg (p = 0.37) after 3 months. In three patients, however, IOP increased after 3 months to levels significantly higher than before TSCPC.

Conclusion

Low-dose TSCPC caused a significant IOP lowering for up to 2 weeks (15 mmHg less from baseline) in most patients. After 3 months, this effect was stable in 50 % of patients; in the other half, IOP nearly returned back to baseline.

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Acknowledgments

We thank Professor Klauss for sponsoring this study through his price money he won from Fondation L’Occitane.

We thank the whole team that was involved in data collection. We thank Else–Kröner–Fresenius Stiftung for supporting the College of Medicine, Blantyre, Malawi.

Competing interests

None.

Funding statement

This study has been supported by Fondation L’Occitane, France, through funds originating from the Sight Award donated to Professor Volker Klauss in 2011.

Authorship according to ICMJE guidelines

M Schulze Schwering & M Spitzer & V Klauss: designed study

K Kalua & P Kayange: collected data

M Schulze Schwering & M Spitzer: did study analysis

M Schulze Schwering: edited manuscript for submission.

M Schulze Schwering & M Spitzer & V Klauss: Reviewed manuscript before submission

M Schulze Schwering, P Kayange; V Klauss; K Kalua; M Spitzer: agreed to manuscript being published.

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Authors and Affiliations

  1. University Eye Hospital Tübingen, Tübingen, 72076, Germany

    Markus Schulze Schwering & Martin S. Spitzer

  2. Lions Sight First Eye Hospital, Blantyre, Malawi

    Markus Schulze Schwering, Petros Kayange & Khumbo Kalua

  3. College of Medicine, University of Malawi, Blantyre, Malawi

    Markus Schulze Schwering, Petros Kayange, Khumbo Kalua & Martin S. Spitzer

  4. University Eye Hospital Munich, Munich, Germany

    Volker Klauss

Authors
  1. Markus Schulze Schwering
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  2. Petros Kayange
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  3. Volker Klauss
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  4. Khumbo Kalua
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  5. Martin S. Spitzer
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Corresponding author

Correspondence to Markus Schulze Schwering.

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Schulze Schwering, M., Kayange, P., Klauss, V. et al. Low-dose transscleral diode laser cyclophotocoagulation (TSCPC) as a potential single treatment for primary open-angle glaucoma (POAG) in Malawi?. Graefes Arch Clin Exp Ophthalmol 251, 2389–2393 (2013). https://doi.org/10.1007/s00417-013-2441-1

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  • DOI: https://doi.org/10.1007/s00417-013-2441-1

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