Safety and efficacy of micropulse in pediatric eyes with refractory glaucoma
Purpose: To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Design: Hospital-based prospective interventional study. Methods: Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and Ma...
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Published in | Indian journal of ophthalmology Vol. 73; no. Suppl 2; pp. S227 - S231 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
India
Wolters Kluwer - Medknow
01.03.2025
Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Wolters Kluwer Medknow Publications |
Edition | 2 |
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Online Access | Get full text |
ISSN | 0301-4738 1998-3689 1998-3689 |
DOI | 10.4103/IJO.IJO_1066_24 |
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Abstract | Purpose:
To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.
Design:
Hospital-based prospective interventional study.
Methods:
Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up.
Results:
A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study.
Conclusion:
MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. |
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AbstractList | Purpose:
To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.
Design:
Hospital-based prospective interventional study.
Methods:
Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up.
Results:
A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study.
Conclusion:
MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. Purpose:To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.Design:Hospital-based prospective interventional study.Methods:Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up.Results:A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study.Conclusion:MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.PURPOSETo analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.Hospital-based prospective interventional study.DESIGNHospital-based prospective interventional study.Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up.METHODSPatients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up.A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study.RESULTSA total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study.MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction.CONCLUSIONMP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Hospital-based prospective interventional study. A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study. MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Hospital-based prospective interventional study. Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up. A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study. MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. Purpose: To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Design: Hospital-based prospective interventional study. Methods: Patients less than 18 years of age, receiving MP-TSCPC between December 1, 2022 and May 31, 2023 with at least three follow-ups within 6 months period, were included in the study. Post-laser evaluation was done at day 1, 1 month, 3 months, and 6 months. Success outcomes were calculated at 1, 3, and 6 months follow-up. Results: A total of 23 eyes of 23 patients were included in the study. Mean intraocular pressure (IOP) lowering agents (P = 0.041) had significant change compared to the baseline value; however, the change was insignificant when eyes requiring additional IOP-lowering surgeries during the follow-up period were excluded. There was a significant reduction in IOP at each follow-up visit compared to the baseline (P = 0.000014). Two (8.6%) eyes required additional intervention within 1-month follow-up, another six eyes (26%) between 1-3 months, and three eyes (13%) between 3-6 months of MP-TSCPC. Total success was highest at 56.5% (13 eyes) at 1-month follow-up and at least 34.7% (8 eyes) at 6-month follow-up. No major complications were reported in our study. Conclusion: MP-TSCPC was found to be safe and effective in pediatric population. However, we observed a gradual reduction in the success with time, and thus, it can be individualized to patients with high risk for incisional surgery or those requiring immediate IOP reduction. Keywords: Childhood glaucoma, micropulse transscleral cyclophotocoagulation, pediatric glaucoma, refractory glaucoma |
Audience | Professional |
Author | Siddharth, Kumar Sivasubramanian, Raajaraajeshwari Rajendrababu, Sharmila Senthilkumar, Vijayalakshmi A Mani, Iswarya |
AuthorAffiliation | Department of General Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India 1 Department of Glaucoma, Aravind Eye Hospital, Madurai, Tamil Nadu, India 2 Department of Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India 3 Department of Biostatistics, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India |
AuthorAffiliation_xml | – name: 1 Department of Glaucoma, Aravind Eye Hospital, Madurai, Tamil Nadu, India – name: 3 Department of Biostatistics, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India – name: Department of General Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India – name: 2 Department of Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India |
Author_xml | – sequence: 1 givenname: Raajaraajeshwari surname: Sivasubramanian fullname: Sivasubramanian, Raajaraajeshwari – sequence: 2 givenname: Kumar surname: Siddharth fullname: Siddharth, Kumar – sequence: 3 givenname: Vijayalakshmi A surname: Senthilkumar fullname: Senthilkumar, Vijayalakshmi A – sequence: 4 givenname: Iswarya surname: Mani fullname: Mani, Iswarya – sequence: 5 givenname: Sharmila surname: Rajendrababu fullname: Rajendrababu, Sharmila |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39982084$$D View this record in MEDLINE/PubMed |
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Keywords | Childhood glaucoma micropulse transscleral cyclophotocoagulation pediatric glaucoma refractory glaucoma |
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References_xml | – volume: 99 start-page: e621 year: 2021 ident: R14-20250221 article-title: An update on continuous-wave cyclophotocoagulation (CW-CPC) and micropulse transscleral laser treatment (MP-TLT) for adult and paediatric refractory glaucoma publication-title: Acta Ophthalmol doi: 10.1111/aos.14661 – volume: 34 start-page: 235 year: 1997 ident: R16-20250221 article-title: Transscleral diode laser cyclophotocoagulation for refractory pediatric glaucomas publication-title: J Pediatr Ophthalmol Strabismus doi: 10.3928/0191-3913-19970701-11 – volume: 38 start-page: 266 year: 2010 ident: R20-20250221 article-title: Micropulse transscleral diode laser cyclophotocoagulation in the treatment of refractory glaucoma publication-title: Clin Exp Ophthalmol doi: 10.1111/j.1442-9071.2010.02238.x – volume: 133 start-page: 1030 year: 2015 ident: R8-20250221 article-title: Valved glaucoma drainage devices in pediatric glaucoma: Retrospective long-term outcomes publication-title: JAMA Ophthalmol doi: 10.1001/jamaophthalmol.2015.1856 – volume: 71 start-page: 140 year: 2023 ident: R31-20250221 article-title: Short-term outcomes of micropulse transscleral cyclophotocoagulation as a primary versus additional therapy in eyes with uncontrolled glaucoma publication-title: Indian J Ophthalmol doi: 10.4103/ijo.IJO_1289_22 – volume: 41 start-page: 2639 year: 2021 ident: R30-20250221 article-title: Micropulse trans-scleral diode laser cyclophotocoagulation in refractory glaucoma: an initial experience in Indian eyes publication-title: Int Ophthalmol doi: 10.1007/s10792-021-01697-1 – volume: 43 start-page: 40 year: 2015 ident: R22-20250221 article-title: Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: A randomized exploratory study publication-title: Clin Exp Ophthalmol doi: 10.1111/ceo.12360 – volume: 26 start-page: 401 year: 1995 ident: R12-20250221 article-title: Contact transscleral Nd:YAG laser cyclophotocoagulation for the treatment of refractory pediatric glaucoma publication-title: Ophthalmic Surg Lasers doi: 10.3928/1542-8877-19950901-05 – volume: 30 start-page: 1149 year: 2020 ident: R25-20250221 article-title: Micropulsed diode laser cyclophotocoagulation in recurrent pediatric glaucoma publication-title: Eur J Ophthalmol doi: 10.1177/1120672119858226 – volume: 9 start-page: 92 year: 2015 ident: R2-20250221 article-title: Review on the management of primary congenital glaucoma publication-title: J Curr Glaucoma Pract doi: 10.5005/jp-journals-10008-1192 – volume: 12 start-page: 179 year: 2023 ident: R27-20250221 article-title: Assessment of the effectiveness of glaucoma treatment using micropulse transscleral cyclophotocoagulation in patients with glaucoma who have previously undergone vitreoretinal surgery publication-title: Ophthalmol Ther doi: 10.1007/s40123-022-00598-5 – volume: 12 start-page: 379 year: 1998 ident: R10-20250221 article-title: Long-term follow-up of Molteno drains used in the treatment of glaucoma presenting in childhood publication-title: Eye (Lond) doi: 10.1038/eye.1998.90 – volume: 31 start-page: 393 year: 2016 ident: R19-20250221 article-title: Treatment outcomes of micropulse transscleral cyclophotocoagulation in advanced glaucoma publication-title: Lasers Med Sci doi: 10.1007/s10103-015-1856-9 – volume: 153 start-page: 804 year: 2012 ident: R23-20250221 article-title: Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up publication-title: Am J Ophthalmol doi: 10.1016/j.ajo.2011.10.024 – volume: 27 start-page: 900 year: 2018 ident: R26-20250221 article-title: Micropulse versus continuous wave transscleral cyclophotocoagulation in refractory pediatric glaucoma publication-title: J Glaucoma doi: 10.1097/IJG.0000000000001053 – volume: 30 start-page: 162 year: 2020 ident: R5-20250221 article-title: Factors associated with early and late failure after goniotomy for primary pediatric glaucoma publication-title: Eur J Ophthalmol doi: 10.1177/1120672118805872 – volume: 23 start-page: 773 year: 2000 ident: R32-20250221 article-title: La cyclophotocoagulation transsclérale au laser diode dans le traitement des glaucomes réfractaires du sujet jeune [Trans-scleral diode laser cyclophotocoagulation for the treatment of refractory pediatric glaucoma] publication-title: J Fr Ophtalmol – volume: 95 start-page: 427 year: 1983 ident: R6-20250221 article-title: Goniotomy vs external trabeculotomy for developmental glaucoma publication-title: Am J Ophthalmol doi: 10.1016/0002-9394(83)90260-X – volume: 105 start-page: 1921 year: 1998 ident: R11-20250221 article-title: Long-term outcome of cyclocryotherapy for refractory pediatric glaucoma publication-title: Ophthalmology doi: 10.1016/S0161-6420(98)91042-9 – volume: 140 start-page: 509 year: 2005 ident: R24-20250221 article-title: Standardization of uveitis nomenclature for reporting clinical data. 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To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.
Design:... To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Hospital-based... Purpose: To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Design:... To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma. Hospital-based... Purpose:To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory... To analyze the safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in pediatric eyes with refractory glaucoma.PURPOSETo analyze the... |
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SubjectTerms | Adolescent Care and treatment Child Child, Preschool childhood glaucoma Ciliary Body - surgery Development and progression Eye Female Follow-Up Studies Glaucoma Glaucoma - physiopathology Glaucoma - surgery Glaucoma in children Humans Infant Intraocular Pressure - physiology Laser Coagulation - methods Light coagulation Male Medical care Methods micropulse transscleral cyclophotocoagulation Original Original Article Patient outcomes Patients pediatric glaucoma Pediatrics Prospective Studies Quality management refractory glaucoma Sclera - surgery Success Surgery Tonometry, Ocular Treatment Outcome Visual Acuity |
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Title | Safety and efficacy of micropulse in pediatric eyes with refractory glaucoma |
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