Abstract
Purpose :
Management of pediatric glaucoma is uniquely challenging. Surgical therapy is often the therapy of choice for long term control of intraocular pressure, with cyclodestructive procedures being the last option for many advanced refractory cases.
In this study, we retrospectively reviewed the outcomes of micropulse laser cyclophotocoagulation (lowering of intraocular pressure, use of glaucoma medications) as well as complications (rates of failure, hypotony, and increased ocular surface disease) in advanced cases of refractory pediatric glaucomas (primary congenital, juvenile open angle, aniridia, and glaucoma following cataract surgery) to study the efficacy and safety of this noninvasive procedure.
Results have been published in the adult literature, but this is the first study in the pediatric population.
Methods :
A retrospective data analysis was performed on all patients who underwent micropulse laser cyclophotocoagulation (MP-CPC) from January 2017 to November 2018.
Inclusion criteria:
Refractory glaucomawho underwent MP-CPC between January 2017 and October 2018.
Patient age: 0-18 years.
Surgery records was searched for eligible subjects who have undergone either MP-CPC in at least one eye within the described timeframe.
Data was collected from medical record review would include: demographics, diagnosis, medical history, surgical history, laterality, pre- and post- operative IOP, pre- and post- operative medications, surgical parameters including time and power of laser treatment, need for future medical or surgical intervention, and complications.
Results :
There were 20 eyes of 15 patients identified who fulfilled the inclusion criteria (refractory pediatric glaucoma and age 0-18). All 20 eyes achieved IOP lowering followng the procedure and decreased number of medications following the procedure. There were 6 eyes of 4 patients who required a subsequent glaucoma procedure to achieve target intraocular pressures. There were no other complications.
Conclusions :
Micropulse laser cyclophotocoagulation is a safe and efficacious procedure in cases of advanced refractory pediatric glaucomas.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.