Long-term results of noncontact transscleral neodymium:YAG cyclophotocoagulation

Ophthalmology. 1995 Dec;102(12):1777-81. doi: 10.1016/s0161-6420(95)30794-4.


Purpose: To determine the long-term efficacy of noncontact transscleral neodymium:YAG (Nd: YAG) cyclophotocoagulation.

Methods: A retrospective analysis was made of 167 patients (173 eyes) with intractable glaucoma treated with noncontact Nd:YAG cyclophotocoagulation between December 1987 and November 1993, reviewing the treatment parameters, complications, and pre- and posttreatment intraocular pressure (IOP). The IOP was compared using a Student's t test, and the results were subjected to a Kaplan-Meier life-table analysis. Success was defined as an IOP of 22 mmHg or lower in the absence of phthisis and without having undergone any additional surgical procedures.

Results: Mean follow-up was 30.5 +/- 22.8 months. Mean preoperative IOP was 40.0 +/- 12.9 mmHg. Mean postoperative IOP was 19.8 +/- 11.4 mmHg (P < 0.05). The mean number of treatment sessions was 1.8 +/- 1.3 (range, 1-8) with 95 eyes (55%) having only one treatment. Kaplan-Meier survival analysis showed a probability of continued success at 3 years of approximately 73% and at 5 years of 45%. Complications included loss of two or more lines of Snellen visual acuity or one or more categories in the low-vision range (40%), phthisis (6.9%), epithelial defects (1.9%), and hyphema (0.6%).

Conclusion: This study suggests that Nd:YAG transscleral cyclophotocoagulation provides a useful long-term reduction of IOP in eyes with advanced or complicated glaucoma, but there is a significant risk of visual loss associated with the procedure.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Ciliary Body / physiopathology
  • Ciliary Body / surgery*
  • Female
  • Follow-Up Studies
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure
  • Laser Coagulation*
  • Life Tables
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Visual Acuity