Five Cases of Laser Goniopuncture after Deep Sclerectomy with Collagen implant.

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

Case Report

Journal of the Korean Ophthalmological Society 2002;43(1):219-224.
Published online January 1, 2002.

Five Cases of Laser Goniopuncture after Deep Sclerectomy with Collagen implant.

Jun Il Hyun, Chan Yun Kim, Young Jae Hong

The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. KCYEYE@yumc.yonsei.ac.kr

심층공막절제술 및 콜라겐 삽입술 후 레이저 전방각천자 5예

현준일 ( Jun Il Hyun ) , 김찬윤 ( Chan Yun Kim ) , 홍영재 ( Young Jae Hong )

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.

Key Words: Deep sclerectomy with collagen implant (DSCI);Laser goniopuncture