Incidence of hypotony and sympathetic ophthalmia following trans-scleral cyclophotocoagulation for glaucoma and a report of risk factors

Aujla, Jaskirat S., Lee, Graham A., Vincent, Stephen J. and Thomas, Ravi (2013) Incidence of hypotony and sympathetic ophthalmia following trans-scleral cyclophotocoagulation for glaucoma and a report of risk factors. Clinical and Experimental Ophthalmology, 41 8: 761-772. doi:10.1111/ceo.12088


Author Aujla, Jaskirat S.
Lee, Graham A.
Vincent, Stephen J.
Thomas, Ravi
Title Incidence of hypotony and sympathetic ophthalmia following trans-scleral cyclophotocoagulation for glaucoma and a report of risk factors
Journal name Clinical and Experimental Ophthalmology   Check publisher's open access policy
ISSN 1442-6404
1442-9071
Publication date 2013-11-01
Sub-type Article (original research)
DOI 10.1111/ceo.12088
Volume 41
Issue 8
Start page 761
End page 772
Total pages 12
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Language eng
Formatted abstract
Objective: To report the incidence and risk factors for hypotony and estimate the risk of sympathetic ophthalmia following diode laser trans-scleral cyclophotocoagulation (TSCPC).

Design: Retrospective study using data from a private tertiary glaucoma clinic and review of the literature. Participants: Seventy eyes of 70 patients with refractory glaucoma who received TSCPC treatment.

Methods: Review of the records of consecutive patients who underwent TSCPC by a single ophthalmic surgeon and review of the literature.

Main Outcome Measures: Hypotony (including phthisis bulbi), sympathetic ophthalmia.

Results: Seven eyes (10%; CI 5-19%) developed hypotony and included 4 eyes that developed phthisis. Higher total energy delivered during TSCPC treatment was associated with an increased risk of hypotony: eyes that developed hypotony received a mean total energy of 192.5±73.2 joules, compared to a mean of 152.9±83.2 joules in hypotony-free cases. The risk of sympathetic ophthalmia estimated from a review of the published literature and current series was one in 1512, or 0.07% (CI 0.03%-0.17%).

Conclusions: Total laser energy is one of several risk factors that act in a sufficient component cause-model to produce hypotony in an individual patient. The small sample size precluded inference for other individual putative risk factors but titrating laser energy may help decrease the occurrence of hypotony. The risk of sympathetic ophthalmia calculated from the literature is likely an overestimate caused by publication bias.
Keyword Cyclophotocoagulation
Diode laser
Glaucoma
Hypotony
Sympathetic ophthalmia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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