Scleral perforation following trans-scleral cyclodiode

Editor,—In recent years, the diode laser utilising 810 nm wavelength has emerged as an increasingly popular and effective tool for treating severe cases of glaucoma which are resistant to other conservative or surgical therapeutic options.1 2 The desired effect (as with other lasers used in this field) is thermal heating and coagulation necrosis of the ciliary epithelium (laser cyclophotocoagulation). However, the laser scleral transmission is increased by the contact method (compared with the non-contact method), allowing for less total energy application while obtaining the same desired effect.3 The side effects of trans-scleral cyclodiode laser range from common ones such as mild iritis4 to rare ones including phthisis bulbi.1 To the best of our knowledge, there has only been one reported case of scleral perforation due to trans-scleral diode cyclophotocoagulation. This was following contact delivery of the laser using the original quartz G-probe (diameter 600 μm) and settings of 2 W for 2 seconds per application.5 The patient in question had scleral thinning following previous cataract surgery. It was thought that the sharp edge of the probe had …