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Abstract：
BACKGROUND: The long-term safety and efficacy of repeated applications of subliminal transscleral cyclophotocoagulation (SL-TSCPC) with a focus on cumulative energy was evaluated in glaucoma patients.
METHODS: In this retrospective, multicentric study the data of a total of 82 eyes with various causes of glaucoma that were treated with a single or multiple applications of SL-TSCPC were collected. Treatments were performed under general or local anesthesia with an 810 nm diode laser. Power was 2000 mW; duty cycle, 31.3%; total treatment duration, 80-320 s; equaling a total energy of 50-200 J per treatment session. Fifty-five eyes (55 patients) presented for all follow-ups, and these eyes were selected for further statistical analysis. The mean age was 60.0 ± 17.1 years, and 22 (40%) of the patients were female. Intraocular pressure (IOP) and dependence on further glaucoma medication were evaluated at 12 months following the initial treatment.
RESULTS: Eyes underwent 1 or 2 consecutive SL-TSCPC treatments. Median (min-max) baseline IOP of 34 (13-69) decreased to 21.5 (7-61), 22 (8-68), 20 (9-68), and 19.5 (3-60) mmHg at the 1, 3, 6, and 12-month postoperative timepoints respectively. The mean (± SD) IOP decrease at 12 months was 26 ± 27%, 39 ± 32%, and 49 ± 33% in the low (below 120 J, n = 18), medium (120-200 J, n = 24), and high (above 200 J, n = 13) cumulative energy groups respectively. At the 12-month timepoint, oral carbonic anhydrase use was discontinued in ¾ of the cases.
CONCLUSIONS: It was found that the repeated application of SL-TSCPC safely and efficiently decreases IOP in a Caucasian population with heterogenous causes of glaucoma, eyes with silicone oil responded to a greater extent. Inclusion of cumulative energy scales may contribute to better addressing repeated procedures in a standardized fashion.
METHODS: In this retrospective, multicentric study the data of a total of 82 eyes with various causes of glaucoma that were treated with a single or multiple applications of SL-TSCPC were collected. Treatments were performed under general or local anesthesia with an 810 nm diode laser. Power was 2000 mW; duty cycle, 31.3%; total treatment duration, 80-320 s; equaling a total energy of 50-200 J per treatment session. Fifty-five eyes (55 patients) presented for all follow-ups, and these eyes were selected for further statistical analysis. The mean age was 60.0 ± 17.1 years, and 22 (40%) of the patients were female. Intraocular pressure (IOP) and dependence on further glaucoma medication were evaluated at 12 months following the initial treatment.
RESULTS: Eyes underwent 1 or 2 consecutive SL-TSCPC treatments. Median (min-max) baseline IOP of 34 (13-69) decreased to 21.5 (7-61), 22 (8-68), 20 (9-68), and 19.5 (3-60) mmHg at the 1, 3, 6, and 12-month postoperative timepoints respectively. The mean (± SD) IOP decrease at 12 months was 26 ± 27%, 39 ± 32%, and 49 ± 33% in the low (below 120 J, n = 18), medium (120-200 J, n = 24), and high (above 200 J, n = 13) cumulative energy groups respectively. At the 12-month timepoint, oral carbonic anhydrase use was discontinued in ¾ of the cases.
CONCLUSIONS: It was found that the repeated application of SL-TSCPC safely and efficiently decreases IOP in a Caucasian population with heterogenous causes of glaucoma, eyes with silicone oil responded to a greater extent. Inclusion of cumulative energy scales may contribute to better addressing repeated procedures in a standardized fashion.
摘要：
背景：在青光眼患者中评估了重复应用以累积能量为重点的经巩膜下睫状体光凝（SL-TSCPC）的长期安全性和有效性。
方法：在本回顾性研究中，多中心研究收集了一次或多次应用SL-TSCPC治疗的82只眼的各种青光眼的数据。在全身麻醉或局部麻醉下用810nm二极管激光进行治疗。功率为2000mW；占空比，31.3%；总治疗持续时间，80-320秒；相当于每次治疗的总能量为50-200焦耳。55只眼睛（55名患者）进行所有随访，选择这些眼睛进行进一步的统计学分析。平均年龄为60.0±17.1岁,22例（40%）患者为女性。初始治疗后12个月评估眼压（IOP）和对进一步青光眼药物的依赖性。
结果：眼睛接受1或2次连续SL-TSCPC治疗。基线眼压中位数（最小-最大）34（13-69）降至21.5（7-61），22(8-68)20（9-68）术后1、3、6和12个月时间点分别为19.5（3-60）mmHg。12个月时平均(±SD)眼压下降26±27%，39±32%,低点为49±33%(低于120焦耳，n=18),中型（120-200J，n=24),和高(高于200J，n=13)个累积能量组。在12个月的时间点，在3个病例中，口服碳酸酐酶的使用已停止。
结论：发现重复应用SL-TSCPC可以安全有效地降低青光眼异质性高加索人群的IOP，眼睛用硅油反应的程度更大。包含累积能量标度可能有助于以标准化方式更好地解决重复程序。
方法：在本回顾性研究中，多中心研究收集了一次或多次应用SL-TSCPC治疗的82只眼的各种青光眼的数据。在全身麻醉或局部麻醉下用810nm二极管激光进行治疗。功率为2000mW；占空比，31.3%；总治疗持续时间，80-320秒；相当于每次治疗的总能量为50-200焦耳。55只眼睛（55名患者）进行所有随访，选择这些眼睛进行进一步的统计学分析。平均年龄为60.0±17.1岁,22例（40%）患者为女性。初始治疗后12个月评估眼压（IOP）和对进一步青光眼药物的依赖性。
结果：眼睛接受1或2次连续SL-TSCPC治疗。基线眼压中位数（最小-最大）34（13-69）降至21.5（7-61），22(8-68)20（9-68）术后1、3、6和12个月时间点分别为19.5（3-60）mmHg。12个月时平均(±SD)眼压下降26±27%，39±32%,低点为49±33%(低于120焦耳，n=18),中型（120-200J，n=24),和高(高于200J，n=13)个累积能量组。在12个月的时间点，在3个病例中，口服碳酸酐酶的使用已停止。
结论：发现重复应用SL-TSCPC可以安全有效地降低青光眼异质性高加索人群的IOP，眼睛用硅油反应的程度更大。包含累积能量标度可能有助于以标准化方式更好地解决重复程序。
