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Abstract #9818 Published in IGR 5-3
Long-term results of transscleral cyclophotocoagulation in refractory pediatric glaucoma patients
Autrata R; Rehurek JOphthalmologica 2003; 217: 393-400
The authors evaluated efficacy and complications of diode laser cyclophotocoagulation in pediatric patients with refractory glaucomas. The retrospective study comprised 69 eyes of 53 pediatric patients with uncontrolled refractory glaucoma treated by transscleral diode laser cyclophotocoagulation. Mean age was 6.1 ± 4.29 (range, 0.9-15) years. The main parameters evaluated were: intraocular pressure (IOP), visual acuity, and complications. The mean follow-up period was 5.6 ± 2.8 (range, 2.2-9.5) years. Treatment success was defined as a postoperative IOP of 21 mmHg, with or without adjunctive glaucoma medications. The baseline mean pretreatment IOP was 34.08 ± 7.13 (range, 24-47) mmHg. The final mean postoperative IOP was 20.81 ± 6.38 (range, 12-33) mmHg after a mean of 2.13 ± 1.47 (range, 1-6) laser procedures. After one treatment session, 66% of the eyes had a successful reduction in IOP (21 mmHg), but this had fallen to 41% by one year. With repeat cyclophotocoagulation, 79% of the eyes had a clinically effective reduction in IOP (21 mmHg) for one year (mean 7.1-month interval between treatments). Postoperative complications included choroidal detachment in four eyes and retinal detachment in two eyes, with progression of vision loss. All these complications occurred in aphakic patients. Cyclophotocoagulation by diode laser is a useful therapy for the treatment of refractory pediatric glaucomas with uncontrolled IOP. Cyclodiode repeated treatment can provide effective control of IOP with a low risk of severe complications. Aphakic patients may have an increased risk of postoperative complications.
Dr. R. Autrata, Department of Pediatric Ophthalmology, Faculty of Medicine, Masaryk University, Cernopolni 9, CZ-613 00 Brno, Czech Republic. RAutrata@seznam.cz
Classification:
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
