Treatment of glaucoma by use of transscleral neodymium:yttrium aluminum garnet laser cyclocoagulation in dogs.
Neodymium:yttrium aluminum garnet (Nd:YAG) laser energy was transsclerally applied to the ciliary body of 56 eyes of 37 dogs for treatment of glaucoma. Forty-four eyes were glucomatous at the time of treatment, and 12 normotensive eyes with ciliary cleft closure were treated prophylactically. Glaucoma was primary in 35 dogs and secondary in 2 dogs (1 eye in each dog). Energy was delivered by a general surgical Nd:YAG laser via a hand-held, 600-muc-diameter flexible quartz fiber. The mean (+/- SD) number of spots treated per eye was 35 (+/- 9.7), with mean energy per burst of 7.1 (+/- 2.6) J; mean total energy delivered to the eyes was 228 (+/- 81) J. Follow-up evaluation was available for 42 eyes from 2 to 4 weeks after treatment, and for 32 eyes from 12 to 24 weeks after treatment. Treatment success, defined as maintenance of intraocular pressure less than 25 mm of Hg, was achieved in 83% (20/24) of glaucomatous eyes evaluated between 12 and 24 weeks of treatment. Of 4 treatment failures, 3 were eyes devoid of uveal pigment. The consistent acute effects of treatment were conjunctival vascular congestion and blood-aqueous barrier disruption, recognized clinically by the presence of aqueous flare. Hyphema developed in 16% (9/56) of eyes; hyphema resolved without complication in all but 2 eyes. A common long-term complication of treatment was cataract formation, recognized in 37% (12/32) of eyes evaluated at 12 to 24 weeks. Cataracts were sufficiently dense to obstruct vision in 4 eyes. Phthisis bulbi was observed in 1 eye.(ABSTRACT TRUNCATED AT 250 WORDS)