Comparison of Outcome and Effectiveness Between Micropulse Diode Laser Cyclophotocoagulation and Cyclocryoablation in Treatment of Refractory Glaucoma

University of Health Sciences Lahore

Status: Enrolling

Conditions: Treatment of Refractory Glaucoma

Treatments: Procedure: Micropulse diode laser cyclophotocoagulation in treatment of refractory Glaucoma; Procedure: Cyclocryoablation in treatment of refractory Glaucoma

Study type: Interventional

Funder types: Other

Identifiers

NCT05437614

UniversityHSL786

Details and patient eligibility

About

laucoma having bad prognosis after maximally tolerated medication,glaucoma that fails after filtering operations, neovascular glaucoma, glaucoma following vitrectomy and glaucoma secondary to uveitis etc. is collectively termed as refractory glaucoma. For such glaucoma patients, cyclodestructive procedures are often used to reduce IOP, as well as to relieve ocular and periocular pain. Recently,diode laser transscleral cyclophotocoagulation has proved to be an effective method for the treatment of refractory glaucoma and it has become a standard treatment for refractory glaucoma.(Yu, Q., Liang, Y., Ji, F. and Yuan, Z.,et al 2020. ) In previous articles, little is known about the long-term outcomes of micropulse diode laser cyclophotocoagulation and cyclocryotherapy. Discrepancies in the results of several large observational analyses have introduced further ambiguity on the role of micropulse diode laser cyclophotocoagulation and cyclocryotherapy.The mechanism of transcleral cyclophotocoagulation IOP lowering in refractory glaucoma is not well understood. In this study, we perform cyclocryoablation and micropulse diode laser cyclophotocoagulation in patients with refractory glaucoma and report the outcomes / mechanism of IOP control using this new surgical paradigm. The objective of our project is to assess the end result and outcome of the role of micropulse diode laser cyclophotocoagulation and cyclocryotherapy.We aim to evaluate the comparison between micropulse diode laser cyclophotocoagulation and cyclocryotherapy.

Only those subjects will be recruited who provide written informed consent. Patients are diagnosed on bases of tonometry, gonioscopy, ophthalmoscopy, perimetry. Patients' age, gender, type of glaucoma, number of diode laser treatment sessions, postoperative complications, number of hypotensive medications required to control IOP, and best corrected visual acuity (BCVA) will be evaluated. The criteria for success will be defined as postoperative IOP <21 mmHg or >20% decrease in IOP with or without additional medical treatment.

Enrollment: 47 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Positive diagnosis of refractory glaucoma

• Poor visual acuity: Hand movements or less
• Age ≥ 18 years
• Intraocular pressure ≥ 21 mmHg
• Signed informed consent

Exclusion criteria

• Eye surgery performed over the last 3 months
• Eye inflammation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

47 participants in 2 patient groups

Treatment of refractory glaucoma using Micropulse diode laser cyclophotocoagulation

Active Comparator group

Treatment:

Procedure: Micropulse diode laser cyclophotocoagulation in treatment of refractory Glaucoma

Treatment of refractory glaucoma using cyclocryoablation

Active Comparator group

Treatment:

Procedure: Cyclocryoablation in treatment of refractory Glaucoma