Limited transscleral cyclophotocoagulation for silicone oil-induced glaucoma in eyes with good visual potential

doi:10.12998/wjcc.121479

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Cases. Jul 26, 2026; 14(21): 121479
Published online Jul 26, 2026. doi: 10.12998/wjcc.121479

Limited transscleral cyclophotocoagulation for silicone oil-induced glaucoma in eyes with good visual potential

Rashmi Krishnamurthy, Akash Belenje, Sirisha Senthil, Padmaja Kumari Rani

Rashmi Krishnamurthy, Sirisha Senthil, Kalathur Venugopal Reddy Glaucoma Institute, L V Prasad Eye Institute, Hyderabad 500034, India

Akash Belenje, Padmaja Kumari Rani, Srimati Kannuri Santhamma Centre for Vitreo-Retinal Diseases, Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad 500034, India

Author contributions: Krishnamurthy R and Belenge A conducted the research; Krishnamurthy R drafted the manuscript; Krishnamurthy R and Rani PK designed the study, analyzed the data; Senthil S and Rani PK critically reviewed and revised the manuscript; and all authors read and approved the final manuscript.

AI contribution statement: The authors assume full responsibility and accountability for the integrity, accuracy, originality, and scientific validity of the manuscript and all submitted materials. We confirm that AI tools were not used during manuscript preparation.

Supported by Hyderabad Eye Research Foundation.

Institutional review board statement: This study was approved by the Medical Ethics Committee of L V Prasad Eye Institute, approval No. LEC-BHR-R-03-2026-394.

Informed consent statement: Due to the retrospective nature of this study and the de-identified nature of the data, involving minimal risk of identification, informed consent was deemed unnecessary by the local Ethics Committee.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: Data is available from the corresponding author upon reasonable request to: Padmaja Kumari Rani, MS, Head, Network Associate Director, Teleophthalmology (LVPEI network) Consultant, Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Banjara Hills, Hyderabad 500034, India or rpk@lvpei.org.

Corresponding author: Padmaja Kumari Rani, MS, FRCS, Network Associate Director, Teleophthalmology, Srimati Kannuri Santhamma Centre for Vitreo-Retinal Diseases, Anant Bajaj Retina Institute, L V Prasad Eye Institute, Banjara Hills, Hyderabad 500034, India. rpk@lvpei.org

Received: March 30, 2026
Revised: May 13, 2026
Accepted: June 23, 2026
Published online: July 26, 2026
Processing time: 117 Days and 21.2 Hours

Abstract

BACKGROUND

Silicone oil-induced glaucoma is a complex form of secondary glaucoma that develops after vitreoretinal surgery and is often refractory to conventional treatment. The role of limited transscleral cyclophotocoagulation (TSCPC) in eyes with preserved visual potential remains inadequately defined.

AIM

To evaluate the outcomes of limited TSCPC in patients with silicone oil-induced glaucoma and good visual potential.

METHODS

This retrospective study included eyes with visual acuity better than 20/400 and refractory silicone oil-induced glaucoma treated with limited TSCPC (180° treatment, 16-18 laser applications) between 2015 to 2019. Primary outcome measures were visual acuity and intraocular pressure (IOP). Visual acuity success was defined as maintenance of baseline acuity or loss of fewer than two lines. Qualified IOP success was defined as an IOP > 5 mmHg and ≤ 21 mmHg with anti-glaucoma medications (AGMs). Secondary outcomes included the number of AGMs required and treatment-related complications.

RESULTS

Twelve patients (12 eyes) were included, of which three eyes had silicone oil in situ at the time of TSCPC. The median age at presentation was 28.3 years, and the median interval from silicone oil removal (n = 9) to TSCPC was 3.4 months. The median follow-up duration was 21.5 months. Stable or improved visual acuity was observed in 75% of eyes. Median IOP significantly decreased from 29.5 mmHg to 17 mmHg at 3 months and 16 mmHg at 1 year. The median number of AGMs decreased from four to two within 1 year. Mean percentage IOP reduction was 66.7% at 3 months and 46.7% at 6 months and was maintained up to 2 years. Repeat surgery for IOP control was required in 50% of cases. No major adverse events, including hypotony, phthisis bulbi, or severe inflammation, were observed.

CONCLUSION

Limited TSCPC appears to be a moderately effective and safe option for IOP control in patients with silicone oil-induced glaucoma and preserved visual potential, supporting its role as a possible treatment strategy in this challenging condition.

Keywords: Transscleral cyclophotocoagulation; Silicone oil induced glaucoma; Limited transscleral cyclophotocoagulation; Refractory glaucoma; Post vitreoretinal surgery

Core Tip: Silicone oil-induced glaucoma is a challenging secondary glaucoma with limited surgical options, particularly in eyes with preserved visual potential. This study evaluated limited transscleral cyclophotocoagulation (TSCPC) as a minimally invasive treatment approach in this subset of patients. Limited TSCPC provided moderate intraocular pressure control, reduced anti-glaucoma medication burden, and preserved visual acuity in most eyes, with a favorable safety profile. However, the need for repeat interventions underscores the refractory nature of the disease. Limited TSCPC may represent a useful adjunctive treatment option when conventional surgical approaches are not feasible and warrants further evaluation in larger controlled studies.