Transscleral cyclophotocoagulation of the ciliary body is an effective technique to reduce intraocular pressure in case of glaucoma. Due to concerns over complications, the main indications for this second-line treatment are refractory glaucoma medication / surgery and low visual prognosis. The 2000 milliwatts (mW) for 2 seconds settings are used by the majority of researchers and clinicians according to the published literature. Some have proposed using 1250 mW for 4 seconds to improve the use of this medical procedure. The aim of this study is to determine how different parameters affect the efficacy of the treatment. This is a prospective double-blinded randomized controlled trial comparing two groups, the experimental group using 1250 mW for 4 seconds and the control group using 2000 mW for 2 seconds.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
44
* Intravenous route is installed * Retrobulbar anaesthesia : 50% xylocaine (2%) + 50% bupivicaine * Parameters set for laser treatment (1250mW-4seconds or 2000mW-2 seconds depending on the assigned group) * Pars plana measurement using transillumination (if needed) * Laser treatment applied approximately 1mm post to limbus * Dexamethasone 0,5 mg subconjunctival injection * Post-op regimen: Prednisolone 1% qid x 4 weeks, Atropine 1% bid x 2 weeks + Erythromycin ointment + patch x 6h
1250 mW for 4 seconds.
2000 mW for 2 seconds.
Centre universitaire d'ophtalmologie, Hôpital du Saint-Sacrement. CHU de Québec
Québec, Canada
Intraocular pressure (IOP) evolution
The intraocular pressure is measured to determine the efficacy of treatment during follow-up compared to the baseline IOP.
Time frame: 1h, 1 month, 6 months, 12 months, 18 months and 24 months post-op
Presence of complications
Assessment of complications (if applicable).
Time frame: During the intervention, 1 month, 6 months, 12 months, 18 months, 24 months post-op
Use of medication
Assessment of the topical and oral glaucoma medication at baseline and after treatment
Time frame: 1 month, 6 months, 12 months, 18 months and 24 months post-op
Retreatment
The clinician will assess the need for retreatment based on clinical experience.
Time frame: From the initial treatment up to the last visit (24 months)
Visual acuity
The visual acuity will be assessed at baseline and each subsequent visit
Time frame: 1 month, 6 months, 12 months, 18 months and 24 months post-op
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