Purpose: To determine the factors associated with visual acuity loss following transscleral Nd:YAG cyclophotocoagulation (TYC).
Methods: The authors retrospectively studied 479 patients followed for a mean of 22 months after the initial TYC in one eye and analyzed the data with univariate and multivariate analysis for the factors associated with visual acuity loss. Data analyzed included age, race, sex, preoperative intraocular pressure (IOP) and visual acuity, type of glaucoma, total energy per treatment, number of retreatments, final IOP, and duration of follow-up.
Results: The preoperative factors associated with visual acuity loss after TYC as determined by both univariate and multivariate analysis were neovascular glaucoma (p = 0.001, odds ratio = 2.80) and black race (p = 0.044, odds ratio = 1.67). Postoperative hypotony and follow-up of > 6 months were also associated with visual acuity loss (p < 0.001, odds ratio = 6.68 and p = 0.046, odds ratio = 2.61, respectively).
Conclusions: Transscleral Nd:YAG cyclophotocoagulation is associated with a greater risk of visual acuity loss in patients with neovascular glaucoma and in the black population. Postoperative hypotony is associated with a poor visual outcome, whereas the association with longer follow-up duration suggests that other factors, related to the patient's underlying disease, are also significant factors.