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J.A. Brooks, D.E. Neely, D.A. Plager; Long Term Safety Profile of Endocyclophotocoagulation in the Management of Refractory Pediatric Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5468.
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Our experience with endoscopic diode laser cyclophotocoagulation in pediatric patients is continuing to grow. We initially started performing the procedure in 1994–95 in 10 eyes of 8 patients, many of whom were end stage eyes that had failed multiple other procedures. 6 of those eyes were aphakic. We now report the long term safety profile of this surgical technique in the initial treatment group of 10 eyes.
Retrospective review of 12 endoscopic diode laser cyclophotocoagulation procedures performed on 10 eyes of 8 pediatric patients. Postoperatively, patients have a minimum of 75 months of follow up to assess long–term intraocular pressure response and occurrence of any subsequent complications.
At 110.58 ± 22.91 months of follow–up an average of 1.20 ± 0.42 endolaser treatments to a total arc of 243.00 ± 57.36 degrees of ciliary body were performed. Baseline mean pretreatment intraocular pressure was 36.10 ± 9.94 mm Hg. Final IOP was 23.30 ± 11.96 mm Hg at last follow up. None of these eyes had a total arc of treatment equaling 360 degrees. 2 eyes of different patients were retreated at least once. In the immediate post–operative period 1 eye had an episode of transient hypotony which subsequently resolved. Long term complications included progression of vision loss in 1 eye. No other long–term complications such as hypotony, retinal detachment, endophthalmitis or cataract formation occurred.
Treatment of pediatric glaucomas with endoscopic diode laser cyclophotocoagulation has shown to have a favorable safety profile compared to other forms of cyclodestruction.
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