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Ultrasound Cyclo Plasty in Eyes with Glaucoma
05:05

Ultrasound Cyclo Plasty in Eyes with Glaucoma

Published on: January 26, 2018

[Cyclodestructive procedures in secondary glaucoma in children]

Bronisława Koraszewska-Matuszewska1, Rafał Leszczyński, Elzbieta Samochowiec-Donocik

  • 1Kliniki Okulistyki Dzieciecej Slaskiej Akademii Medycznej w Katowicach.

Klinika Oczna
|October 30, 2004
PubMed

Insights

Transscleral contact cyclophotocoagulation with diode laser (TSCPC) is more effective than cyclocryocoagulation for lowering intraocular pressure in children. However, TSCPC is associated with more severe complications than cyclocryocoagulation.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology

Background:

  • Pediatric glaucoma management often requires interventions to control intraocular pressure (IOP).
  • Cyclodestructive procedures are utilized when other treatments fail.
  • Comparison of cyclocryocoagulation and transscleral contact cyclophotocoagulation (TSCPC) in pediatric populations is crucial for treatment selection.

Purpose of the Study:

  • To compare the effectiveness and safety of cyclocryocoagulation versus diode laser transscleral contact cyclophotocoagulation (TSCPC) in pediatric patients.
  • To evaluate intraocular pressure (IOP) reduction and complication rates for both procedures.

Main Methods:

  • Sixty-nine eyes of 60 children (4 months to 16 years) underwent either cyclocryotherapy (40 eyes) or TSCPC (29 eyes).
  • Patients included those aphakic post-cataract extraction, with aniridia, Sturge-Weber disease, or ROP complications.
  • Intraocular pressure (IOP), visual acuity, and complications were assessed in early and late postoperative periods with a mean follow-up of 23 months.

Main Results:

  • TSCPC required fewer procedures per eye (1.14) compared to cyclocryotherapy (1.3).
  • IOP reduction was significantly greater with TSCPC (57.9% of eyes) than cyclocryotherapy (39% of eyes) (p=0.0003).
  • Long-term IOP below 22 mmHg was achieved in 79% of eyes after TSCPC versus 60% after cyclocryotherapy; however, TSCPC had more severe complications including uveitis and transient hypotony.

Conclusions:

  • Diode laser TSCPC demonstrates superior efficacy in lowering IOP in children compared to cyclocryocoagulation.
  • While effective, TSCPC is associated with a higher incidence of more severe complications than cyclocryotherapy.
  • Treatment choice requires careful consideration of efficacy versus potential adverse events in pediatric glaucoma management.
Abstract

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