Successfully treating ultra-refractory glaucoma patients

June 1, 2009

Examing endoscopic cyclophotocoagulation as a treatment for ultra-refractory glaucoma patients.

Key Points

High resistance rate in patients

IOP and visual acuity

Safety issues

Remarkable results

The results experienced in this cohort of patients were especially remarkable considering the poor prognosis associated with these refractory eyes. Historical norms indicate that the long-term success of tube implantation to be about 50%. A previously failed tube has a three-fold increase in the risk for failure. Tube implantation has a significant rate of serious complications. Further, the failure of a previous tube increases this risk of complications for subsequent tubes. Transcleral cyclophotocoagulation would be unthinkable in this desperate group of patients due to its high complication and low success rates along with the proclivity for visual loss.

ECP demonstrated a remarkable level of efficacy, while creating few difficulties in this challenging group of patients that otherwise would be faced with poor therapeutic options.