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Abstract #18269 Published in IGR 3-3
Transscleral contact krypton laser cyclophotocoagulation for treatment of glaucoma in children and young adults
Raivio VE; Immonen IJR; Puska PMOphthalmology 2001; 108: 1801-1807
PURPOSE: To evaluate the usefulness of the krypton laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of glaucoma in young patients. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Transscleral contact krypton laser CPC was performed in 27 glaucomatous eyes of 22 young patients (mean age, 10.5 ± 5.6 years; range, 11 months-19.4 years). METHODS: The treatment was delivered by means of a fiberoptic probe with compression of the sclera by the probe. The power used was 300-500 W per application at the tip of the probe with an exposure time of ten seconds. MAIN OUTCOME MEASURES: The primary outcome measure was a change in intraocular pressure (IOP). RESULTS: Of the patients who received CPC in both eyes, one eye was randomly chosen for statistical analysis. The mean overall follow-up time was 43.3 ± 25.3 (median, 36.5; range, 1-82) months after the initial CPC. Preoperatively, the mean IOP was 35.0 ± 7.9 mmHg (n = 22). After one or more CPCs, mean IOP had decreased to 21.5 ± 8.7 mmHg (n = 22) at one month (p < 0.001), to 23.4 ± 8.6 mmHg (n = 18) at three months (p < 0.001), to 25.0 ± 12.1 mmHg (n = 19) at six months (p < 0.01), to 22.1 ± 9.1 mmHg (n = 16) at one year (p < 0.01), and to 22.6 ± 10.3 mmHg (n = 11) at two years (p < 0.01). After one or more krypton CPCs, but no other glaucoma procedures, an IOP level of 8-21 mmHg or a decrease in IOP of more than 30% was obtained in 14 of 22 (64%) eyes at the last follow-up. No permanent hypotonia, phthisis bulbi, or devastating CPC-related complications were seen. CONCLUSIONS: Krypton laser CPC is a well-tolerated means of lowering IOP in young patients with glaucoma, but repeated treatments may be needed.
Dr V. Raivio, Helsinki University Eye Hospital, JP220, FIN-00029 HYKS, Helsinki, Finland. virpi.raivio@hus.fi
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)