Transscleral diode laser cyclophotocoagulation for refractory pediatric glaucomas.

Published

Journal Article

PURPOSE: To evaluate the success of contact transscleral cyclophotocoagulation (TDC) in patients with refractory pediatric glaucomas. METHODS: Twenty-six eyes of 20 patients with therapy-resistant pediatric glaucomas were included in this retrospective study. Subgroup analysis was performed for patients 10 or younger and patients older than 10 at time of first TDC procedure. Diode laser cyclophotocoagulation was applied using a fiber optic G-probe. Follow up until time of failure or for a minimum of 6 months was obtained for all procedures in all eyes. Failure was defined as intraocular pressure (IOP) greater than 21 mm Hg, repeat of TDC due to clinically inadequate IOP control, progression to another procedure, or serious complication. RESULTS: Baseline mean pretreatment IOP was 34.2 +/- 10.4 mm Hg (range, 15 to 62 mm Hg). Ten of 26 eyes (38%) were successful 6 months after initial TDC. A mean decrease in IOP of 10.3 +/- 14.7 mm Hg was noted after the first procedure (P < 0.05). Eighteen eyes (70%) were retreated at least once. The mean decrease in IOP for all patients after all procedures was 12.9 +/- 13.4 mm Hg (P < 0.001). This represents a mean percent decrease in IOP of 33.2 +/- 6.9%. The overall success rate was 50%, including retreated patients. The younger and older subgroups did not differ with regard to overall success, time to failure, or retreatment rats. One patient suffered a retinal detachment. Visual loss was noted in 4 of 22 eyes with reliable visual acuity measurements. CONCLUSION: TDC is an effective means of decreasing IOP in some patients with refractory pediatric glaucomas. Although the retreatment rate is high, the procedure generally is well tolerated with few complications.

Full Text

Duke Authors

Cited Authors

  • Bock, CJ; Freedman, SF; Buckley, EG; Shields, MB

Published Date

  • July 1997

Published In

Volume / Issue

  • 34 / 4

Start / End Page

  • 235 - 239

PubMed ID

  • 9253738

Pubmed Central ID

  • 9253738

International Standard Serial Number (ISSN)

  • 0191-3913

Language

  • eng

Conference Location

  • United States