Cyclodiode Photocoagulation in the Management of Paediatric Glaucomas over a 15-Year Period
Eulee Seow, MD; Damien Chia Ming Yeo, MD; Jurgena Lukani; Patrick Watts, MD
University Hospital of Wales
Cardiff, Wales, United Kingdom
Introduction: Cyclodiode laser has a lower success rate in paediatric versus adult glaucoma. It may be used as a temporary measure or as an adjunct to surgery. We aim to report our experience with cyclodiode laser for children with secondary and congenital glaucoma.
Methods: Retrospective series in a tertiary centre. 25 eyes of 20 patients were included. Mean age 5.6 years (SD 5.5) with a median follow-up of 103 months (range 16-295 months)
Results: 7 eyes (28%) had aphakic glaucoma. 76% had undergone at least one previous procedure.|Patients underwent a mean of 1.92 (SD 1.4) treatments per eye. Following a single treatment, 40% had a clinically useful reduction in IOP ( <22 mmHg or by 30%), which increased to 68% with second cyclodiode. Of treatment failures, 20% had no useful IOP response. A single treatment of cyclodiode was curative (without medication or surgery) in 2 eyes. 11 (44%) patients went on to need drainage surgery. Cyclodiode treatment reduced the mean number of eye drops from 2.3 to 1.9. There were no complications from cyclodiode treatment.
Discussion: Aphakic and pseudophakic glaucoma were our most common diagnoses. Cyclodiode procedures may be used to reduce the intraocular pressures before surgery or after surgery has failed to control IOP. In a small number of children cyclodiode laser with medical treatment may help avoid invasive surgery.
Conclusion: Cyclodiode laser is a safe procedure and can be used as a temporising measure as well as in conjunction with medical or surgical therapy to control intraocular pressure in children.
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Sood S, Beck AD. Cyclophotocoagulation versus sequential tube shunt as a secondary intervention following primary tube shunt failure in pediatric glaucoma. Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus. 2009;13(4):379-383.