Analysis of Pediatric Secondary Glaucoma Patients Treated with Micropulse Transscleral Cyclophotocoagulation...

Secondary glaucoma in children results from congenital or acquired ocular abnormalities, systemic diseases, or syndromes. These conditions impair aqueous humor outflow despite an open iridocorneal angle, causing elevated intraocular pressure (IOP). Micropulse transscleral cyclophotocoagulation (MP-TSCPC) reduces aqueous humor production by targeting the ciliary body and restores the aqueous humor's circulation balance. The aim of the study was to evaluate the safety and efficacy of MP-TSCPC in pediatric secondary glaucoma.

This retrospective study included 59 children who underwent MP-TSCPC procedures. The mean age was 7.2 years (range 4 months-17 years). Data on IOP, prior glaucoma treatments, medication use, and adverse events were analyzed. The mean follow-up was 10.4 months.

The mean preoperative IOP was 34.0 mmHg, which significantly decreased to 25.8 mmHg after MP-TSCPC, representing a mean reduction of 20.8% (p < 0.0001). Satisfactory IOP lowering was achieved in 69.6% of procedures. Eyes without prior glaucoma surgery showed a numerically greater IOP reduction (22%) compared to previously treated eyes (19%), though the difference was not statistically significant (p = 0.628). Among repeated MP-TSCPC treatments, 57.1% were successful, with a mean IOP reduction of 7.3%. The mean number of glaucoma medications decreased significantly from 2.42 to 2.02 (p = 0.0002). A sustained reduction in medication use was observed in 33.3% of cases.

MP-TSCPC effectively lowers IOP in pediatric secondary glaucoma and has a favorable safety profile. The option for repeated treatments and reduced medication needs supports its use as a less invasive alternative to conventional surgery.