Immediate results of micropulse cyclophotocoagulation in glaucoma in children

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Abstract

AIM: This study aimed to investigate the efficacy and safety of micropulse cyclophotocoagulation (MP-CPC) in the treatment of various types of glaucoma in children.

MATERIAL AND METHODS: The study included 14 children (15 eyes) with uncompensated glaucoma of various etiologies, who underwent MP-CPC using the Cyclo G6 laser system (IRIDEX, USA). The intervention was considered absolutely effective when IOP reached 8 to 25 mm Hg without medications and without signs of progression of glaucoma, relatively effective, when the same criteria are achieved with hypotensive medications.

RESULTS: The average age of children at the time of intervention was 8.5±1.5 yr (from 7 months to 17 yr). The average level of IOP before surgery was 28.5±1.1 mm Hg, 3 days after MP-CPC (18.87±1.04 mm Hg), while the absolute efficiency was 14.3%, relative — 100%. By the end of the observation period (1–6 months; on average, 2.5±0.4 months), the average IOP was 24.4±1.31 mm Hg (average decrease, 14.3%), with absolute efficiency of 0% and relative of 66.7%. The average number of hypotensive medications received in instillations did not change significantly before and after MP-CPC and amounted to 3.45±0.22 and 2.91±0.39, respectively (p=0.167). Complications after MP-CPC were detected in six eyes (40%); in all cases, the appearance or increase of the inflammatory reaction in the anterior chamber was observed. In addition, in two eyes (13.3%). In addition, a slight mydriasis (4–5 mm) developed.

CONCLUSION: MP-CPC is a safe and effective treatment for glaucoma in children with various etiologies. Further research is needed to evaluate the effectiveness of intervention in the long term and the safety of repeated procedures to achieve normal IOP and to develop individual schemes of MP-CPC.

About the authors

Anna Yu. Panova

Helmholtz National Medical Research Center of Eye Diseases

Email: annie_panova18@mail.ru
ORCID iD: 0000-0003-2103-1570
SPIN-code: 9930-4813

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Lyudmila A. Katargina

Helmholtz National Medical Research Center of Eye Diseases

Email: katargina@igb.ru
ORCID iD: 0000-0002-4857-0374

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Ekaterina V. Denisova

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: deale_2006@inbox.ru
ORCID iD: 0000-0003-3735-6249
SPIN-code: 4111-4330

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Aleхаndеr A. Sorokin

Helmholtz National Medical Research Center of Eye Diseases

Email: a.a.sorokin@inbox.ru
ORCID iD: 0000-0002-8213-8518

Graduate Student

Russian Federation, Moscow

References

  1. Drobysheva IS. Our Experience in Treating Refractory Terminal Glaucoma. Tambov University Reports Series: Natural and Technical Sciences. 2016;21(4):1525–1528. (In Russ). doi: 10.20310/1810-0198-2016-21-4-1525-1528
  2. Kramp K, Vick HP, Guthoff R. Transscleral diode laser contact cyclophotocoagulation in the treatment of different glaucomas, also as primary surgery. Graefes Arch Clin Exp Ophthalmol. 2002;240(9):698–703. doi: 10.1007/s00417-002-0508-5
  3. Boyko EV, Kulikov AN, Skvortsov VY. Comparative evaluation of diode-laser thermotherapy and laser coagulation as methods of cyclodestruction (experimental study). Prakticheskaya medicina. Ophthalmologiya. 2012;(1):175–179. (In Russ).
  4. Souissi S, Le Mer Y, Metge F, et al. An update on continuous-wave cyclophotocoagulation (CW-CPC) and micropulse transscleral laser treatment (MP-TLT) for adult and paediatric refractory glaucoma. Acta Ophthalmol. 2021;99(5):e621–e653. doi: 10.1111/aos.14661
  5. Tan AM, Chockalingam M, Aquino MC, et al. Micropulse transscleral diode laser cyclophotocoagulation in the treatment of refractory glaucoma. Clin Exp Ophthalmol. 2010;38(3):266–272. doi: 10.1111/j.1442-9071.2010.02238.x
  6. Radcliffe N, Vold S, Kammer J, et al. MicroPulse trans-scleral cyclophotocoagulation (mTSCPC) for the treatment of glaucoma using the MicroPulse P3 device. Poster presented at the American Glaucoma Society annual Meeting. April 2015.
  7. Souissi S, Baudouin C, Labbe A, Hamard P. Micropulse transscleral cyclophotocoagulation using a standard protocol in patients with refractory glaucoma naive of cyclodestruction. Eur J Ophthalmol. 2021;31(1):112–119. doi: 10.1177/1120672119877586
  8. Aquino MC, Barton K, Tan AM, et al. Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study. Clin Exp Ophthalmol. 2015;43(1):40–46. doi: 10.1111/ceo.12360
  9. Sarrafpour S, Saleh D, Ayoub S, Radcliffe NM. Micropulse Transscleral Cyclophotocoagulation: A Look at Long-Term Effectiveness and Outcomes. Ophthalmol Glaucoma. 2019;2(3):167–171. doi: 10.1016/j.ogla.2019.02.002
  10. Radhakrishnan S, Wan J, Tran B, et al. Micropulse Cyclophotocoagulation: A Multicenter Study of Efficacy, Safety, and Factors Associated With Increased Risk of Complications. J Glaucoma. 2020;29(12):1126–1131. doi: 10.1097/IJG.0000000000001644
  11. Noecker RJ. The benefits of micropulse TSCPC for early-stageglaucoma. Ophtalmol. Times Eur. 2017: 30–2.
  12. Magacho L, Lima FE, Avila MP. Double-session micropulse transscleral laser (CYCLO G6) for the treatment of glaucoma. Lasers Med Sci. 2020;35(7):1469–1475. doi: 10.1007/s10103-019-02922-1
  13. Elhefney EM, Mokbel TH, Hagras SM, et al. Micropulsed diode laser cyclophotocoagulation in recurrent pediatric glaucoma. Eur J Ophthalmol. 2020;30(5):1149–1155. doi: 10.1177/1120672119858226
  14. Abdelrahman AM, El Sayed YM. Micropulse Versus Continuous Wave Transscleral Cyclophotocoagulation in Refractory Pediatric Glaucoma. J Glaucoma. 2018;27(10):900–905. doi: 10.1097/IJG.0000000000001053
  15. Lee JH, Shi Y, Amoozgar B, et al. Outcome of Micropulse Laser Transscleral Cyclophotocoagulation on Pediatric Versus Adult Glaucoma Patients. J Glaucoma. 2017;26(10):936–939. doi: 10.1097/IJG.0000000000000757
  16. Katargina LA Denisova EV, Ibeid BNA, et al. Transskleral’naya diodlazernaya tsiklokoagulyatsiya v kompleksnom lechenii postuveal’noi glaukomy u detei. In: Materialy Sbornik Rossiiskogo obshchenatsional’nogo oftal’mologicheskogo foruma. Moscow; 2020. P:183–187. (In Russ).
  17. Kraus CL, Tychsen L, Lueder GT, Culican SM. Comparison of the effectiveness and safety of transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation in pediatric glaucoma. J Pediatr Ophthalmol Strabismus. 2014;51(2):120–127. doi: 10.3928/01913913-20140211-01
  18. Autrata R, Rehurek J. Long-term results of transscleral cyclophotocoagulation in refractory pediatric glaucoma patients. Ophthalmologica. 2003;217(6):393–400. doi: 10.1159/000073068
  19. Prager AJ, Anchala AR. Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy. Am J Ophthalmol Case Rep. 2020;18:100659. doi: 10.1016/j.ajoc.2020.100659
  20. Alqaseer B, Abunajma M. Intraocular Lens Subluxation following Micropulse Transscleral Cyclophotocoagulation. Saudi J Ophthalmol. 2020;34(3):233–235. doi: 10.4103/1319-4534.310401
  21. Dhanireddy S, Yin HY, Dosakayala N, et al. Severe Inflammation and Hyphema After Micropulse Diode Transscleral Cyclophotocoagulation. J Glaucoma. 2020;29(6):e50–e52. doi: 10.1097/IJG.0000000000001508

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Copyright (c) 2022 Panova A.Y., Katargina L.A., Denisova E.V., Sorokin A.A.

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