Five Cases of Laser Goniopuncture after Deep Sclerectomy with Collagen implant

Hyun, Jun Il; Kim, Chan Yun; Hong, Young Jae

Abstract

PURPOSE: To investigate the intraocular pressure-lowering efficacy of laser goniopuncture in 5 cases after hypertrophy of the trabecular-Descemet membrane resulting from deep sclerectomy with collagen implant (DSCI).
METHODS
Among the twenty-one patients (26eyes) who received DSCI, laser goniopuncture was performed in 5 patients (19%) by Nd:YAG laser at 5-10 mJ, 3 burst mode, and 2-10 times.
RESULTS
Of the 5 cases who received Nd:YAG laser goniopuncture, 2 cases showed a decrease in intraocular pressure after 1 session of treatment while 3 cases resulted in increase of intraocular pressure due to anterior synechiae of the iris. The anterior synechiae were resolved by Argon and Nd:YAG laser in 1 case, peripheral iridectomy and iridoplasty in 1 case but in the third case, patient refused to receive recommended further laser treatment such as peripheral iridectomy and iridoplasty.
CONCLUSIONS
In cases of increased intraocular pressure caused by hypertrophy of the trabecular-Descemet membrane after DSCI, laser goniopuncture is an effective method of treatment. However, iris prolapse and anterior synechiae may occur during the follow-up period which can be resolved by peripheral iridectomy and synechiolysis.