Holmium Laser Sclerectomy: Success and Complications

Joel S. Schuman, William G. Stinson, B. Thomas Hutchinson, A. Robert Bellows, Carmen A. Puliafito, Robert Lytle

    Research output: Contribution to journalArticle

    Abstract

    Purpose: To investigate the safety and efficacy of holmium YAG laser sclerectomy, a new laser filtration procedure. Methods: The authors performed holmium YAG laser sclerectomy on 49 eyes of 46 patients (mean follow-up, 12.3 ± 1.1 months). Results: Mean preoperative intraocular pressure (IOP) was 26.9 ± 1.3 mmHg; postoperative mean IOP on last follow-up visit was 19.7 ± 1.6 mmHg. Thirty (61%) of 49 eyes achieved a final IOP of 5 to 22 mmHg, 29 (59%) of 49 had a final IOP of 5 to 19 mmHg, and 21 (43%) of 49 had a final IOP of 5 to 15 mmHg. Sixteen (73%) of 22 eyes treated postoperatively with 5-fluorouracil (5-FU) had a final IOP of 21 mmHg or less. Twenty-seven percent of eyes lost one or more lines of vision, and 36% of eyes gained one or more lines of vision; there was no median change in visual acuity. Complications included suprachoroidal hemorrhage in 7 (14%) of 49 eyes and intraoperative vitreous hemorrhage in 2. Seventeen (35%) of 49 eyes required a second IOP-lowering procedure. Conclusion: Holmium YAG laser sclerectomy is an effective means to perform glaucoma filtration surgery. This is a full-thickness filtering procedure, with all of the risks attendant.

    Original languageEnglish (US)
    Pages (from-to)1060-1065
    Number of pages6
    JournalOphthalmology
    Volume100
    Issue number7
    DOIs
    StatePublished - 1993

    ASJC Scopus subject areas

    • Ophthalmology

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    Schuman, J. S., Stinson, W. G., Hutchinson, B. T., Bellows, A. R., Puliafito, C. A., & Lytle, R. (1993). Holmium Laser Sclerectomy: Success and Complications. Ophthalmology, 100(7), 1060-1065. https://doi.org/10.1016/S0161-6420(93)31538-1