In reply

The correspondence confirms what we said our article: “There is wide disagreement among surgical ophthalmologists as to the value of this treatment.”

For this reason, the American Academy of Ophthalmology has set up a working group that is tasked with defining the indications for laser cyclophotocoagulation in detail (1).

Laser cyclophotocoagulation is recommended, for example, after failed filtration surgery or glaucoma implant surgery, when no visual function exists, and when intraocular pressure needs to be lowered—for example, because of pain—as well as in patients who refuse to have other procedures (for example, filtration surgery or glaucoma implants) or who are not eligible for such procedures because of other reasons (such as their general condition).

The US working group explicitly mentions the lack of evidence provided by the published data, which makes a comparison of individual modifications of laser cyclophotocoagulation difficult.

As things stand, this includes the modification of controlled cyclophotocoagulation mentioned by our correspondents.

Mr Preussner deserves much praise for having developed a tool—in the shape of a controlled laser system that is particularly adapted to patients with strongly pigmented skin—that can be used in the surgical treatment of glaucoma, especially by doctors in medically underprovided developing countries.
DOI: 10.3238/arztebl.2010.0140b

Prof. Dr. med. Thomas S. Dietlein
Zentrum für Augenheilkunde
Universität zu Köln
Kerpener Str. 62
50937 Köln, Germany
Thomas.Dietlein@uk-koeln.de

Conflict of interest statement
The authors of both contributions declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.