Transscleral red laser cyclophotocoagulation for the treatment of therapy-resistant inflammatory glaucoma.

PURPOSE: To evaluate in a retrospective study the long-term usefulness of red 647 nm krypton and 670 nm diode laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy-resistant inflammatory glaucoma. METHODS: The authors treated 48 eyes of 38 consecutive patients (mean age 36.8 years, range 6-81 years) with therapy-resistant inflammatory glaucoma secondary to chronic uveitis (45/48), chronic scleritis (1/48), or combined scleritis with keratouveitis (2/48) using transscleral red 647 nm Krypton or 670 nm Diode laser. All eyes had failed maximum tolerated medical therapy and 19/48 (40%) eyes also previous antiglaucoma surgery. Laser power at the scleral surface was 0.35 to 0.45 W and the application time 10 seconds each. The follow-up was 42.8+/- 40.0 (range 2-145) months. RESULTS: The mean preoperative intraocular pressure (IOP) of 35.6+/-8.1 mmHg fell to 6-21 mmHg level in 75% after one or repeated CPC. Among adult patients this was achieved in 85%, among children in 54%. More than one treatment was needed in 52%. No cases of hypotony, phthisis bulbi, or other devastating complications occurred. CONCLUSIONS: Transscleral CPC using red 647 nm krypton or 670 nm diode laser is an effective and well-tolerated procedure for the treatment of therapy-resistant inflammatory glaucoma in adults. CPC can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken.

The participation of health professionals in a smoking-cessation programme positively influences the smoking cessation advice given to patients.

This study assessed the degree of smoking cessation advice given by health professionals, before and after their participation in a smoking cessation study using bupropion-sustained release (bupropion SR, Zyban). A total of 690 physicians and nurses who had smoked an average of 10 cigarettes/day over the previous year and were motivated to quit smoking, were randomised in a double-blind manner to receive bupropion SR (days 1-3, 150 mg/day; days 4-49, 150 mg twice daily) or placebo for 7 weeks, with follow-up to week 52. All subjects received regular follow-up and brief motivational support throughout the study. Questions regarding their smoking cessation advice formed part of the study, with the aim of determining whether study participants became more proactive with their smoking cessation advice. A positive shift from baseline to end of study was observed with respect to the advice and support they gave to their smoking patients. These changes were not related to study treatment or current smoking status. An increase in advising patients to quit smoking and in offering cessation counselling was observed. Participation in a smoking-cessation study by physicians and nurses who smoke has a positive effect, regardless of study medication, in smoking cessation advice and counselling given to their patients.