Slow coagulation versus micropulse transscleral cyclophotocoagulation for refractory childhood glaucoma

• Published in: European journal of ophthalmology p. 11206721241236920
• Main Authors: Seixas, Regina Cele Silveira, Russ, Heloisa Helena Abil, Maestrini, Heloisa Andrade, Balbino, Marcos, Fernandes, Thatiana Almeida Pereira, Lima, Núbia Vanessa Dos Anjos, Lopes, Nara Lídia Vieira, Neto, Taurino Dos Santos Rodrigues
• Format: Journal Article
• Language: English
• Published: United States 01.11.2024
• Subjects: Childhood glaucoma; ciliary body ablation procedures; glaucoma medical therapies; childhood glaucoma procedures; laser surgery
• ISSN: 1724-6016
• DOI: 10.1177/11206721241236920

To compare the safety and efficacy of micropulse laser (MP-TSCP) and slow coagulation transscleral cyclophotocoagulation (TSCP) with a diode laser for reducing intraocular pressure (IOP) in patients with refractory childhood glaucoma (CG). Patients with CG and at least 12 months of medical chart data were included. Data on preoperative and postoperative outcomes were analyzed. The primary outcomes were an IOP of 6-21 mmHg and/or ≥ 20% reduction in the baseline value. A total of 17 eyes were included. The preoperative mean IOP was 28 mmHg in the MP-TSCP and 29.9 mmHg in the TSCP. The mean IOP decreased significantly to 17.26 ± 3.27 mmHg in the MP-TSCP and 14.68 ± 5.79 mmHg TSCP at the last medical record. Three anti-glaucoma meds were administered to the eyes preoperatively in both groups. A mean of 1.02 eye drops was administered to the MP-TSCP and 2.06 to the TSCP. The number of medications decreased by 2.38 ± 1.55 in the MP-TSCP and 0.82 ± 1.68 in the TSCP. The median preoperative visual acuity (logMAR) was 1.51 ± 1.06 in the MP-TSCP and 1.87 ± 0.74 in the TSCP. The variation in mean visual acuity (logMAR) was -0.027 ± 0.05 in the MP-TSCP and -0.40 ± 0.58 in the TSCP. The most frequent complication was corneal decompensation (one - MP-TSCP and two - TSCP). Both techniques were effective and relatively safe for reducing IOP. These techniques appear to extend the indications of cyclophotocoagulation in CG eyes and improve the functional prognosis.