Presents 15 th Annual Resident and Fellow Research Day

Purpose:To evaluate the safety and efficacy of transscleral cyclophotocoagulation (TSCPC) in patients requiring additional intraocular pressure reduction following Baerveldt glaucoma implant (BGI) surgery. Methods: Twenty eyes that underwent TSCPC with the red (810nm) diode laser between April 2005 and January 2010 were retrospectively reviewed. All patients had previously undergone placement of a 250 mm(n=2), 350 mm(n=16) or 425 mm(n=2) BGI at an average of 34.65 +/24.23 months prior to the laser surgery. Aqueous flow into the drainage reservoir of the glaucoma implant was confirmed by clinical examination or by B-mode echography. An average of 11.55 +/2.3 laser applications was delivered with duration of 2500-3000 milliseconds and power of 1500-2500 milliwatts per application. A posterior sub-Tenon’s injection of 40 mg of triamcinolone acetonide was administered in all patients. Main outcome measureswere visual acuity, reduction in intraocular pressure (IOP), and reduction in the number of glaucoma medications. Success was defined as 5 mmHg ≤ IOP ≤ 14 mmHg at the two most recent follow up visits (at least 1 month apart), with or without medications, and without loss of light perception or need for additional glaucoma surgery. Results: The mean follow-up period was 25.6 +/17.4 months (range 2.3-56.5 months). Intraocular pressure (IOP) was reduced from a mean of 21.8 +/4.6 mmHg to 10.8 ± 3.2 mmHg at the most recent follow up which represents a 50.2% reduction in mean IOP. Successful postoperative IOP control was achieved in 16 (80%) of the 20 patients. The number of glaucoma medications decreased from 4.2 +/0.6 to 2.2 +/1.2. Postoperative complications included persistent corneal edema in 1 patient and both persistent corneal edema and cystoid macular edema in 1 patient. Both of these patients sustained a greater than 2 line reduction in Snellen visual acuity. Conclusion: TSCPC is safe and effective in the management of patients requiring additional intraocular pressure reduction following BGI surgery. Further i/nvestigation with a larger cohort of patients and longer follow-up is warranted. Question Which of the following are common complications post TSCPC (transcleral cyclophotocoagulation)?