Update on the subconjunctival THC:YAG (holmium) laser sclerostomy Ab externo clinical trial: a 4-year report.

BACKGROUND AND OBJECTIVE

This is a follow-up report on 103 THC:YAG (holmium) sclerostomies ab externo performed on 87 eyes of 81 patients.

PATIENTS AND METHODS

The patients received pulse energies of 0.06 to 0.13 J (mean total energy 4.4 +/- 3.3 J, range 0.6 to 17.1 J).

RESULTS

The estimated success rates with or without medication, and allowing a second procedure, were 44% at 2 years and 36% at 4 years. The mean preoperative intraocular pressure (IOP) was 29.7 +/- 11.4 mm Hg, and the mean postoperative IOP in the successful patients was 13.6 +/- 4.6 mm Hg (P < .01). Hypotony and iris incarceration were the most frequent early complications.

CONCLUSIONS

Although holmium laser sclerostomy is a relatively straightforward procedure and offers some advantages over standard trabeculectomy in select cases, it currently has a number of drawbacks that limit its use.