Laser-assisted subepithelial keratectomy provided significantly quicker visual recovery, eliminated post-PRK pain, and reduced the haze level in eyes with low to moderate myopia compared with conventional PRK. It provided good visual and refractive outcomes. There were no serious complications.

We evaluated efficacy and complications of diode laser cyclophotocoagulation in pediatric patients with refractory glaucomas. The retrospective study comprised 69 eyes of 53 pediatric patients with uncontrolled refractory glaucoma treated by transscleral diode laser cyclophotocoagulation. The mean age was 6.1 ± 4.29 (range 0.9–15) years. The main parameters evaluated were: intraocular pressure (IOP), visual acuity, and complications. The mean follow-up period was 5.6 ± 2.8 (range 2.2–9.5) years. Treatment success was defined as a postoperative IOP of ≤21 mm Hg, with or without adjunctive glaucoma medications. The baseline mean pretreatment IOP was 34.08 ± 7.13 (range 24–47) mm Hg. The final mean postoperative IOP was 20.81 ± 6.38 (range12–33) mm Hg after a mean of 2.13 ± 1.47 (range 1–6) laser procedures. After one treatment session, 66% of the eyes had a successful reduction in IOP (≤21 mm Hg), but this had fallen to 41% by 1 year. With repeat cyclophotocoagulation, 79% of the eyes had a clinically effective reduction in IOP(≤21 mm Hg) for 1 year (mean 7.1-month interval between treatments). Postoperative complications included choroidal detachment in 4 eyes and retinal detachment in 2 eyes with progression of vision loss. All these complications occurred in aphakic patients. Cyclophotocoagulation by diode laser is a useful therapy for the treatment of refractory pediatric glaucomas with uncontrolled IOP. Cyclodiode repeated treatment can provide effective control of IOP with a low risk of severe complications. Aphakic patients may have an increased risk of postoperative complications.

Purpose: The optimal role of intraocular lenses (IOLs) in infants remains a controversial topic. Some ophthalmologists advocate correction with a contact lens (CL), whereas others recommend an IOL correction. Our study compared visual acuity, ocular alignment, retreatment rate and binocular vision outcomes in children treated with these two methods at our clinic. Methods: This study included 41 children with unilateral congenital cataract who underwent cataract surgery with posterior capsulorhexis and anterior vitrectomy, coupled with (IOL group, n = 18) or without (CL group, n = 23) primary IOL implantation. All infants underwent the first surgery during the first 12 months of their life and they were operated on in the period from 1994 to 1999. The mean age at surgery was 3.11 ± 2.65 months (range: 28 days to 11 months). All patients were prescribed the same half-time reduced occlusion therapy. Good cooperation of the parents and good compliance with patching were the necessary conditions to include a patient in the study. Between January and February 2003, the final visual acuity and binocular vision outcomes were examined. Results: The mean final visual acuity (logarithm of the minimum angle of resolution) of the operated eye was 0.43 ± 0.33 for the IOL group and 0.58 ± 0.39 for the CL group (p = 0.14). The mean interocular difference in visual acuity was 0.22 ± 0.29 for the IOL group and 0.56 ± 0.31 for the CL group (p = 0.042). The reoperation rate was 78% in the IOL group compared with 35% in the CL group (p = 0.017). Esotropia or exotropia of more than 8 prism diopters were present in 55% of children (10/18) in the IOL group compared with 83% of children (19/23) in the CL group (p = 0.039). Conclusions: We suggest that correction of aphakia after unilateral congenital cataract surgery with primary IOL implantation results in improved visual acuity, improved binocular vision outcome and less occurrence of strabismus, but a higher rate of complications requiring reoperation. Further studies with a larger pediatric patient group are necessary to confirm the optimal treatment of aphakia after unilateral congenital cataract extraction.