Transscleral Nd: YAG laser cyclophotocoagulation versus cyclocryotherapy.

The post-operative course of intraocular pressure (IOP) after transscleral Nd: YAG laser cyclophotocoagulation (TSYLC) in refractory glaucoma was studied using the life-table method and retrospectively compared with that of cyclocryotherapy. In all, 36 eyes of 36 patients who underwent TSYLC for the first time and 80 eyes of 75 patients who underwent cyclocryotherapy for the first time were included in the present study. The follow-up averaged 9.2 months (range, 1-21 months) in patients receiving cyclocryotherapy. In patients with a preoperative visual acuity of greater than or equal to 0.01, the successful control of IOP was represented by a value of less than 21 mmHg that was obtained without additional medication, and that in patients who had a visual acuity of less than 0.01 was represented by a decrease in IOP of at least 25%, also obtained without additional medication. The success rate of the TSYLC-treated group at 21 months after treatment was 45.2% +/- 11.7%, whereas that of the group receiving cyclocryotherapy was 38.9% +/- 6.1%. The difference between these success rates was not statistically significant (P greater than 0.05). Complications such as phthisis bulbi, hypotony, hemorrhage in the anterior chamber or swelling of the eyelids were less frequent in the TSYLC-treated group than in the group given cyclocryotherapy. TSYLC is thought to be as effective as cyclocryotherapy in lowering IOP, but with fewer complications.