Diode laser in secondary glaucoma in children – long-term results

Introduction
This paper presents effectiveness and safety of transscleral contact cyclophotocoagulation with diode laser (TSCPC) in secondary glaucoma in children. Fifteen eyes of 15 children at the age from 4 to 18 years were examined. Majority of patients was aphakic after congenital and traumatic cataract extraction. Microphtalmus, nystagmus and dysgenesis mesodermalis was observed. Eleven eyes had undergone at least one previous trabeculectomy, 9 eyes -cyclokrioaplication and 4 eyes perforate diathermy. In all patients diode laser transscleral cyclophotocoagulation has been performed. The number of procedures per one eye, intraocular pressure (IOP), visual acuity and complications after TSCPC was estimated. Follow-up ranged from 3 to 5 years, mean 4.13 years. TSCPC was performed once in 3 eyes, twice in 6 eyes, three times in 4 eyes and four times in 2 eyes, mean 2.33 procedures per eye. Before the treatment mean IOP was 34.0 mmHg. Decreasing of IOP was observed in 73.3% of eyes. The final mean postoperative IOP was 20.07 mmHg. Visual acuity before operation ranged from no light perception to 0.0001, mean 0.0081. After TSCPC no light perception was noted in 2 eyes. Visual acuity recovered in 1 eye. Mean Length of the eye globe before treatment was 24.48 mm. No changes of length after cyclophotocoagulation were noted.

Conclusions
cyclophotocoagulation by diode laser is a useful therapy for the treatment of secondary pediatric glaucomas with uncontrolled IOP in the long term.