NHMRC Glaucoma Guidelines - ANZGIG

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NHMRC GUIDELINES FOR THE SCREENING, PROGNOSIS, DIAGNOSIS, MANAGEMENT AND PREVENTION OF GLAUCOMA Chapter 10 – Laser therapy and surgery Table 10.1: Summary of indicators for surgical/laser treatments Surgery Source Contraindication Argon laser AOA (2002) Uveitic glaucoma trabeculoplasty RCO (2004) Young patients, especially children Narrow or closed angles Indications for use Benefits Drawbacks Reduces IOP in MOST eyes by an average of 30% Effect diminishes over time. May increase the chance of future surgical failure. Nd:YAG laser iridotomy RCO(2004) Caution required – watch for post-laser IOP rise in those with marked synechial angle closure In the absence of symptoms of intermittent angle closure Only effective with narrow but open drainage angles and some iris-trabecular contact Cyclodiode laser AOA (2002) Some uveitis Where other modalities have failed Incisional filtration Surgery AOA(2002) Contraindicated in eyes that are already blind or patients with severe systemic illness In NTG or POAG resistant to other forms of therapy Dramatic and stable reduction in POAG Many patients must remain on medication and may require additional filtration or other surgery Anti-fibrotic use AOA (2002) The elderly or those with frail conjunctiva Eye at risk of later failure due to scarring of the drainage bleb Caution required especially for those with high potency References American Academy of Ophthalmology [AAO] (2005a): Primary angle closure preferred practice pattern. San Francisco: American Academy of Ophthalmology. American Academy of Ophthalmology [AAO] (2005b): Primary open-angle glaucoma preferred practice pattern. San Francisco: American Academy of Ophthalmology. American Academy of Ophthalmology [AAO] (2005c): Primary open-angle glaucoma suspect preferred practice pattern. San Francisco: American Academy of Ophthalmology. American Optometric Association [AOA] (2002): Optometric clinical practice guideline: Care of the patient with open angle glaucoma (2nd edn.). St Louis: American Optometric Association. Burr J, Azuara-Blanco A, Avenell A (2004): Medical versus surgical interventions for open angle glaucoma. Cochrane Database of Systematic Reviews; 1. Doe EA, Budenz DL, Gedde SJ, Imami NR (2001): Long-term surgical outcomes of patients with glaucoma secondary to the iridocorneal endothelial syndrome. Ophthalmology; 108:1789–1795. National Health and Medical Research Council 153
NHMRC GUIDELINES FOR THE SCREENING, PROGNOSIS, DIAGNOSIS, MANAGEMENT AND PREVENTION OF GLAUCOMA Chapter 10 – Laser therapy and surgery European Glaucoma Society [EGS] (2003): Terminology and guidelines for glaucoma (2nd edn.). Savona, Italy: European Glaucoma Society. Friedman DS, Jampel HD, Lubomski LH, Kempen JH, Quigley H, Congdon N, Levkovitch-Verbin H, Robinson KA, Bass EB (2002): Surgical strategies for coexisting glaucoma and cataract: an evidencebased update. Ophthalmology; 109(10):1902-1913. Friedman DS, Vedula SS (2006): Lens extraction for chronic angle-closure glaucoma. Cochrane Database of Systematic Reviews; 3. Hong C, Arosemena A, Zurakowski D, Ayyala RS (2005): Glaucoma drainage devices: A systematic literature review and current controversies. Survey of Ophthalmology; 50(1):48-60. Japanese Glaucoma Society [JGS] (2004): Guidelines for glaucoma. Tokyo: Japanese Glaucoma Society. Minckler DS, Vedula SS, Li TJ, Mathew MC, Ayyala RS, Francis BA (2006): Aqueous shunts for glaucoma. Cochrane Database of Systematic Reviews; 2. Molteno ACB, Bevin TH, Herbison P, Houliston MJ (2001): Otago Glaucoma Surgery Outcome Study: Long-term follow-up of cases of primary glaucoma with additional risk factors drained by Molteno implants. Ophthalmology; 108(12):2193-2200. Nolan W, Foster P, Devereux J, Uranchimeg D, Johnson G, Baasanhu J (2000): YAG laser iridotomy treatment for primary angle closure in east Asian eyes. British Journal of Ophthalmology; 84(11):1255–1259. Ng WS, Ang GS, Azuara-Blanco A. (2008): Laser peripheral iridoplasty for angle-closure. Cochrane Database of Systematic Reviews; 3. Papadopoulos M (2001): What’s New in Primary Open Angle Glaucoma? Journal Community Eye Health; 14(39): 35-36. Royal College of Ophthalmologists [RCO] (2004): Guidelines for the management of open angle glaucoma and ocular hypertension. London: Royal College of Ophthalmologists. Saw SM, Gazzard G, Friedman DS (2003): Interventions for angle-closure glaucoma: an evidencebased update. Ophthalmology; 110:1869–1878. Sycha T, Vass C, Findl O, Bauer P, Groke I, Schmetterer L, Eichler H (2003): Interventions for normal tension glaucoma. Cochrane Database of Systematic Reviews; 1. The AGIS Investigators [AGIS] (2000): The Advanced Glaucoma Intervention Study 6 (AGIS). Effect of cataract on visual field and visual acuity. Archives of Ophthalmology; 118: 1639-1652. The AGIS Investigators [AGIS] (2002): The Advanced Glaucoma Intervention Study (AGIS) 11. Risk Factors for Failure of Trabeculectomy and Argon Laser Trabeculoplasty. American Journal of Ophthalmology; 134:481–498. Tuulonen A, Airaksinen PJ, Erola E, Forsman E, Friberg K, Kaila M, Klemetti A, Mäkelä M, Oskala P, Puska P, Suoranta L, Teir H, Uusitalo H, Vainio-Jylhä E, Vuori M (2003): The Finnish evidence-based guideline for open-angle glaucoma. Acta Ophthalmologica Scandinavica; 81(1): 3-18. Wilkins M, Indar A, Wormald R (2002): Intra-operative Mitomycin C for glaucoma surgery. Cochrane Database of Systematic Reviews; 3. Wormald RPL, Wilkins MR, Bunce C (2001): Post-operative 5-fluorouracil for glaucoma surgery. Cochrane Database of Systematic Reviews; 2. 154 National Health and Medical Research Council
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NHMRC Glaucoma Guidelines - ANZGIG

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