Browsing by Author "Thomas, Jason Peter"

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    The efficacy and safety of diode laser cycloablation in the treatment of refractory glaucoma in a South African population
    (Stellenbosch : Stellenbosch University, 2022-04) Thomas, Jason Peter; Smit, Derrick; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Ophthalmology
    ENGLISH SUMMARY: The development of a safe and effective protocol for trans-scleral cyclophotocoagulation in a Southern African population presenting with refractory glaucoma to a tertiary eye care centre. prospective, non-randomised, observational study of patients attending the Eye Clinic at Tygerberg Hospital, Cape Town, South Africa between March 2018 and January 2020. 119 eyes of 105 eligible patients were treated during the study period. The mean laser power was 1766 ± 187 milliwatt per burn for a mean of 15.6 ± 2.9 burns per eye. Mean total delivered energy per eye was 55.28 ± 12.61 Joule. 64% of the patients who followed up for the entire six-month period had an intraocular pressure reduction of ≥ 30% and 42.2% of those followed up had an IOP of ≤ 22 mmHg. The pain scores reported by patients decreased significantly between pre-operatively and three months (coefficient -1.752, p<0.001) and between pre-operatively and six months (coefficient -1.498, p=0.002). There was not a statistically significant effect on the change in topical medication from pre-operatively to three months (coefficient = -0.089, p=0.186), nor from pre-operatively to six months (coefficient = -0.003, p=0.946). Oral acetazolamide use decreased from 50.4% of patients at the date of their initial cyclophotocoagulation treatment to 9.3% at three months and further to 7.8% at six months. One eye had a scleral perforation at the time of initial treatment; no further complications arose. An individualized, “pop-titrated” cyclophotocoagulation protocol is safe and effective for use in a Southern African population. Retreatment should be considered at three months if intraocular pressure is not adequately controlled.