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Outcomes of micropulse cyclophotocoagulation for refractory glaucoma in children

Tomoyo Yoshida1, Tadashi Yokoi1, Hazuki Anzai1

  • 1Division of Ophthalmology, National Center for Child Health and Development, 2-10-1 O-kura, Setagaya-ku, Tokyo, 157-8535, Japan.

Japanese Journal of Ophthalmology
|April 16, 2026
PubMed

Insights

Micropulse transscleral cyclophotocoagulation (MP-CPC) effectively lowers intraocular pressure (IOP) in pediatric refractory glaucoma. This treatment demonstrated significant IOP reduction without inducing visual impairment or severe complications in children.

Area of Science:

  • Ophthalmology
  • Pediatric Glaucoma Treatment
  • Surgical Innovation

Background:

  • Refractory glaucoma in children presents significant challenges to vision preservation.
  • Established treatments often have limitations or severe side effects in pediatric populations.
  • Micropulse transscleral cyclophotocoagulation (MP-CPC) offers a potentially less invasive option for managing pediatric glaucoma.

Purpose of the Study:

  • To evaluate the efficacy and safety of MP-CPC in treating refractory glaucoma in pediatric patients.
  • To assess the impact of MP-CPC on intraocular pressure (IOP) and medication requirements.
  • To determine the complication profile and reoperation rates following MP-CPC in children.

Main Methods:

  • A retrospective study analyzed data from pediatric patients with refractory glaucoma who underwent MP-CPC.
  • Patient data included age, glaucoma type, surgical history, IOP, medication scores, visual acuity, and complications.
  • Follow-up was conducted for at least 3 months postoperatively, with specific assessments at 1, 3, and 6 months.

Main Results:

  • MP-CPC led to a significant mean IOP reduction of -9.8 mm Hg at 1 month, -7.5 mm Hg at 3 months, and -7.4 mm Hg at 6 months (P <.01).
  • The median medication score decreased postoperatively, indicating reduced reliance on glaucoma medications.
  • While effective, 65.5% of eyes required reoperation for glaucoma, with 58.6% needing reoperation within one year.

Conclusions:

  • MP-CPC is an effective treatment for reducing IOP in children with refractory glaucoma.
  • The procedure appears safe, with no reported visual impairment or serious complications.
  • Further investigation into reoperation rates and long-term outcomes is warranted.
Abstract

Keywords:
Micropulse transscleral cyclophotocoagulationPediatric glaucomaRefractory glaucoma

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