Transscleral Diode Cyclophotocoagulation to Tackle Refractory Cases of Pediatric Glaucoma
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.