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Abstract #15804 Published in IGR 2-3
Contact transscleral diode laser cyclophotocoagulation for the treatment of refractory pediatric glaucoma
Hamard P; May F; Quesnot S; Hamard HJournal Français d'Ophtalmologie 2000; 23: 773-780
PURPOSE: To evaluate the success rate of contact diode transscleral cyclophotocoagulation (TSCPC) in pediatric refractory glaucoma. PATIENTS AND METHOD: Twenty-eight eyes of 28 patients (age range, five months to 26 years) with medical and surgical refractory pediatric glaucoma due to primary congenital glaucoma (group 1, 20 eyes) or aphakic congenital glaucoma (group 2, eight eyes), were included in this retrospective study. All eyes underwent one or more TSCPC with the diode laser (Oculight SLX, Iris Medical) with a minimal follow-up of two months. Success was defined as intraocular pressure (IOP) between 6 and 20 mmHg after one or more procedures, with no increase in medical hypotensive therapy, and no progression to another hypotensive procedure. RESULTS: Mean baseline IOP was 29.4 ± 7.8 mmHg (range, 25-60 mmHg) and mean follow-up was 10.3 ± 6.9 months (range, 2-26 months). Success rates evaluated at six and 12 months (Kaplan Meier survival curves) were 54.4% and 27.7%, respectively, with one-third of the eyes being retreated at least once. These success rates were similar in both groups with a mean baseline IOP decrease of 38.9 ± 15.9%. Postoperative uncontrolled hypertony occurred in the first three months in six (21.4%) eyes, leading to surgical IOP management. Other complications were decrease in visual acuity (14.3%), inflammation (25.5%), and phthisis (3.5%). CONCLUSIONS: TSCPC with the diode laser is a disappointing procedure for the management of refractory pediatric glaucoma, with poor mid-term IOP control and high incidence of complications including severe uncontrolled IOP increase. For these reasons, this cyclodestructive procedure should be considered as a last resort therapy in patients with refractory pediatric glaucoma.LA: French
Dr. P. Hamard, Centre du Glaucome, CHNO des Quinze-Vingts, 75012 Paris, France
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)