Résumé
Purpose: the aim of this pilot study was to compare efficacy and safety of endocyclophotocoagulation (ECP) and transscleral cyclophotocoagulation (TS-CPC) in the treatment of refractory glaucoma. Methods: we conducted a retrospective, monocentric, interventional case series of patients with a diagnosis of refractory glaucoma (resistant to maximal medical therapy). They underwent either transscleral cyclophotocoagulation or endocyclophotocoagulation. The primary outcome measure was 3-month surgical success, defined as an intraocular pressure (IOP) between 6 and 21mmHg with a 20% IOP reduction from baseline, no major complications (light perception loss, phthisis bulbi, choroidal or retinal detachment, fibrinous exudation, endophthalmitis), and no additional cyclodestructive or filtering procedure. Secondary outcome measures included glaucoma medication use and complications. Results: a total of 33 patients (45.4% women, mean age 69.7 years) were included. Mean (SD) follow- up was 3.6 (2.1) months. Three-month surgical success was observed in 33.3% in both groups (p>0.99). IOP decreased by 40.0% and 40.5% in ECP and TS-CPC groups respectively (p<0.01 in both groups). Glaucoma medication use decreased in the TS-CPC group (p=0.02). We found a trend toward less major complications in the ECP group (p=0.21).Conclusion: three-month surgical success of ECP and TS-CPC were similar in refractory glaucoma patients. Glaucoma medication decrease was more important in TS-CPC group, but fewer major complications were observed in ECP group.