Transscleral Diode Cyclophotocoagulation to Tackle Refractory Cases of Pediatric Glaucoma

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Ahmad K. Khalil, MD, PhD, Research Institute of Ophthalmology, Giza, Egypt

Narrative Responses:

Purpose
to study the effectiveness of trans-scleral diode cyclophotocoagulation on refractory cases of pediatric glaucoma.

Methods
46 eyes of 41 children with refractory glaucoma were included in the study. Diagnosis of cases: recurrent early onset developmental glaucoma (EODG) after 2 or more surgeries (23 eyes) Aphakic/pseudophakic glaucoma (16 eyes), advanced anterior segment dysgenesis (7eyes). Trans-scleral diode cyclophotocoagulation was carried out using 25-35 applications per eye. IOP and ocular inflammation were monitored postoperatively for a minimum of 1 year.

Results
IOP was lowered below 20 mm Hg with no medications in 38 eyes (83%), the remaining eyes needed 1-2 medications to keep IOP at that level. Marked hypotony was observed in 24 eyes(52%) within 3 days postoperatively, with IOP building up afterwards to its plateau of below 20 within 6 weeks. Various degrees of transient extra/intraocular inflammation were observed in almost all eyes starting the secnd postoperative day, and disappeared 1-6 weeks postoperatively

Conclusion
 Trans-scleral diode cyclophotocoagulation can be a viable option in managing refractory cases of pediatric glaucoma.