Contact Transscleral Continuous Wave Neodymium:YAG Laser Cyclophotocoagulation

Joel S. Schuman, Carmen A. Puliafito, R. Rand Allingham, C. Davis Belcher, A. Robert Bellows, Mark A. Latina, Bradford J. Shingleton

Research output: Contribution to journalArticlepeer-review


Advanced glaucoma in 140 eyes of 136 patients was treated with contact transscleral continuous wave neodymium:YAG (Nd:YAG) laser cyclophotocoagulation (CYC) with a sapphire-tipped probe. The anterior edge of the probe was placed 0.5 to 1.5 mm posterior to the limbus, using 7 to 9 W of power for 0.7 seconds with 32 to 40 applications, sparing the 3 and 9 o'clock meridians. Patients were studied prospectively. The mean preoperative intraocular pressure (IOP) of 36.7 ± 0.97 mmHg decreased to 21.2 ± 0.99 mmHg (P = 0.004) after treatment (mean follow-up, 3.2 ± 0.35 months) for a mean decrease in IOP of 15.5 ± 1.21 mmHg and a mean percent decrease of 39%. Forty-one eyes were followed 6 or more months (mean, 6.7 ± 0.25 months). The CYC reduced IOP to 25 mmHg or less in 71 % of eyes, to 22 mmHg or less in 62% of eyes, and to 19 mmHg or less in 49% of eyes. Maximum lowering of IOP occurred 1 week to 1 month after treatment and remained at that level through 6 months of follow-up. Retreatment was required in 11% of patients; only one patient was retreated more than once. Four patients treated with 9 W of power developed IOPs below 5 mmHg; two of these patients had an IOP of 0 mmHg. Other complications of therapy were minimal, and patients had little pain. There was no significant change in visual acuity. Early results of this newly available therapy are encouraging.

Original languageEnglish (US)
Pages (from-to)571-580
Number of pages10
Issue number5
StatePublished - 1990

ASJC Scopus subject areas

  • Ophthalmology


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