Endoscopic diode laser cyclophotocoagulation in the management of aphakic and pseudophakic glaucoma in children

Long-term results after transscleral diode laser cyclophotocoagulation in refractory posttraumatic glaucoma and glaucoma in aphakia

“…It can be concluded that: (1) the use of TDLC in patient 50 years or younger with glaucoma in aphakia and posttraumatic glaucoma should be combined with a more aggressive treatment protocol, or (2) TDLC should be avoided and other glaucoma surgery preferred. Even under the use of endoscopic cyclophotocoagulation, a relatively low success rate (53% in the cited study) was demonstrated in aphakic and pseudophakic glaucoma in childhood [3]. Another recently published study by Iliev and Gerber found a higher re-treatment rate for cyclophotocoagulation in younger patients and patients with posttraumatic glaucoma [10].…”

Outcome of angle surgery in children with aphakic glaucoma

“…[19][20][21][22] However, none of these procedures are free of complications. The potential complications of trabeculectomy with an antifibrotic agent include increased incidence of bleb leakage and infection.…”

“…Success criteria was selected on the basis of the definition of treatment failure in previous study of aphakic glaucoma. 19 We recognize that certain aphakic eyes have fluctuations in IOP into the low 20s without progressive optic neuropathy. This finding may be attributable in part to greater than normal corneal thickness in aphakic eyes.…”

“…Such procedures include angle surgery, trabeculectomy, aqueous shunt implantation, cyclophotocoagulation with a trans-scleral diode laser or endoscopy, cyclocryotherapy, and peripheral iridectomy with anterior vitrectomy. 3,4,14,19 Although angle surgery, including trabeculotomy and goniotomy, has been used to treat aphakic glaucoma in children, data documenting these treatment modalities in this setting are limited. Chen and colleagues 3 reported a success rate of glaucoma control after angle surgery of only 16% in 24 eyes.…”

Childhood glaucoma surgery in the 21st Century

“…127,128 Endoscopic diode achieves similar results with a lower re-treatment rate. 124,129,130 Our preference is to use transscleral diode laser with transillumination of the eye to improve the accuracy of laser placement, and we avoid areas of pigmentation, haemorrhage, and scleral thinning. If future GDD surgery is planned, we do not treat the superotemporal quadrant to avoid scleromalacia.…”