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Purpose: This case report highlights scleral perforation as a complication of diode laser transscleral cyclophotocoagulation in the treatment of refractory primary open-angle glaucoma, as well as the management of this complication.
Observations: A 78-year-old woman with primary open-angle glaucoma refractory to medication had transscleral cyclophotocoagulation performed in her left eye. During the procedure, it was noted that conjunctival burns and scleral perforation had occurred, at which point the procedure was aborted. Limited peritomy and patch graft with split-thickness donor cornea was done in the area of the scleral thinning and perforation. The patient had a good outcome with an intraocular pressure of 8 mm Hg, appropriate integration of the patch graft, and no significant conjunctival inflammation at the 2-month post-operative visit.
Conclusions And Importance: This patient, without any known risk factors for scleral thinning or necrosis, experienced conjunctival burn as well as scleral perforation during transscleral cyclophotocoagulation, underscoring this possible complication of the procedure. Additionally, split-thickness donor cornea was used to patch graft the area of scleral thinning and perforation, which is a method of managing this complication that had not been previously reported.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10496012 | PMC |
http://dx.doi.org/10.1016/j.ajoc.2023.101893 | DOI Listing |
Am J Ophthalmol
September 2025
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Topic: The aim of this systematic review and meta-analysis is to evaluate best-corrected visual acuity (VA) outcomes following transscleral cyclophotocoagulation (TSCPC) in patients with refractory glaucoma.
Clinical Relevance: TSCPC is typically reserved for cases of refractory glaucoma, due to apprehension of negative affects on VA. Prior studies have reported the VA outcomes from TSCPC, but no comprehensive review of the literature has yet been conducted.
Can J Ophthalmol
September 2025
Département d'Ophtalmologie et d'Ophtalmologie et d'Oto-Rhino-Laryngologie-Chirurgie Cervico-Faciale, Faculté de Médecine, Université Laval, QC, Canada; Centre Universitaire d'Ophtalmologie, Hôpital du Saint-Sacrement, Centre Hospitalier Universitaire de Québec-Université Laval, QC, Canada.
Objective: To compare the efficacy of different settings in continuous-wave transscleral cyclophotocoagulation (CW-TSCPC).
Design: Prospective, randomized, triple-blind clinical trial in a single tertiary center.
Participants: Adult glaucoma patients who need continuous wave-transscleral cyclophotocoagulation to control intraocular pressure (IOP) or prevent or treat ocular pain/discomfort secondary to increased IOP.
Arq Bras Oftalmol
September 2025
Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Angle-closure glaucoma is a major cause of visual impairment worldwide, with Plateau iris syndrome presenting management challenges. We present a case report of a 58-year-old woman with advanced, uncontrolled angle--closure glaucoma and Plateau iris. Her history included laser peripheral iridotomy and three glaucoma medications in both eyes.
View Article and Find Full Text PDFClin Ophthalmol
August 2025
Department of Ophthalmology, University of Colorado School of Medicine, Sue Anschutz-Rodgers Eye Center, Aurora, CO, USA.
Purpose: To compare the acute structural changes of standard endoscopic cyclophotocoagulation (ECP), a novel ECP device (Leos™), and transscleral cyclophotocoagulation (TCP) on the ciliary processes and surrounding structures in human cadaveric eyes using scanning electron microscopy (SEM).
Patients And Methods: Three human cadaveric eyes were treated with standard ECP, Leos ECP, or TCP. Untreated areas served as controls.
Front Med (Lausanne)
August 2025
Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen Clinical Research Center for Eye Diseases, Xiamen Key Laboratory of Ophthalmology, Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Translat
Background: Autosomal recessive bestrophinopathy (ARB) comprises remarkable retinal dystrophy characterized by yellowish subretinal lesions scattered in the posterior pole and is always accompanied with refractory angle-closure glaucoma (ACG). The treatment of ACG patients with ARB is a major challenge for all ophthalmologists.
Case Presentation: A 12-year-old female child was diagnosed with ARB and ACG and presented with discrete, round, yellow-white deposits of variable sizes scattered in the retina, retinoschisis in the macular, shallow anterior chamber depth and angle closure with uncontrolled intraocular pressure (IOP).