Abstract
Purpose :
To determine and compare the efficacy of micropulse (MP-CPC) and continuous wave cyclophotocoagulation (CW-CPC) in pediatric patients diagnosed with glaucoma.
Methods :
A total of 28 patients (81 eyes) diagnosed with pediatric glaucoma (patients diagnosed with glaucoma less than 18 years of age) were reviewed retrospectively over the course of 12 months after either undergoing MP-CPC or CW-CPC. Several of the patients underwent multiple CPC treatment, in which a pre-operative intraocular pressure (IOP) was used as the new baseline IOP measurement. Laser settings including duration of treatment, power (mW) and total energy (J), and total quadrants treated were recorded. Patient IOP measurements, number of glaucoma medications, and the onset of complications were collected at baseline, 1-month, 3-month, 6-month, and 12-month intervals. Student t-tests were used to determine the changes in IOP from baseline for each laser modality as well as to compare the average IOP between modalities at the same treatment time.
Results :
All patients either undergoing MP-CPC or CW-CPC were matched for age (Mean ± SD; 1.76 ± 1.69 vs. 1.56 ± 2.49 years). Patients undergoing either MP-CPC or CW-CPC exhibited significant differences in their IOP at the 1, 3, and 6 month intervals. Patients that underwent MP-CPC, however, did not show a significant change in IOP at the 12-month interval when compared to baseline (30.90 ± 9.25 vs. 32.67 ± 6.89, p>0.05) while those patient that underwent CW-CPC did (36.88 ± 7.95 vs. 28.89 ± 11.24, p<0.05). When compared to MP-CPC, CW-CPC exhibited a significantly larger drop in IOP (0.89 ± 8.61 vs. 7.99 ± 7.95, p<0.05). There were no differences in total glaucoma medications at each visits between MP-CPC and CW-CPC patients. Eyes undergoing MP-CPC had significantly fewer complications with only 1 eye (5%) exhibiting a complication (corneal haze) and no complications of hypotony or phthisis bulbi. CW-CPC patients had more complications with 10 eyes (24%) exhibiting corneal haze and one eye (2%) suffering from phthisis bulbi. Similarly, to MPCPC, no patients that were treated with CWCPC experienced post-operative hypotony.
Conclusions :
Both MP-CPC and CW-CPC exhibit efficacy in lowering IOP in patients with pediatric glaucoma. While patients undergoing MP-CPC treatment did not have a sustained IOP decrease they did exhibit fewer complications when compared to CW-CPC.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.