Micropulse cyclophotocoagulation compared to continuous wave cyclophotocoagulation for the management of refractory pediatric glaucoma

• Published in: PloS one 2024-01, Vol.19 (1), p.e0291247-e0291247
• Main Authors: Wang, Bo, Wallace, Ryan T, Musser, John A, Chaya, Craig J, Kraus, Courtney L
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Anesthesia; Biology and Life Sciences; Child; Ciliary Body - surgery; Comparative analysis; Continuous radiation; Diagnosis; Dosage and administration; Drug therapy; Engineering and Technology; Eye; Glaucoma; Glaucoma - surgery; Glaucoma in children; Health aspects; Humans; Inflammation; Intraocular Pressure; Laser Coagulation - methods; Lasers; Light coagulation; Medical research; Medicine and Health Sciences; Medicine, Experimental; Ophthalmic drugs; Patient outcomes; Patients; Pediatrics; Performance evaluation; Retrospective Studies; Sclera - surgery; Statistical analysis; Surgeons; Surgery; Surgical outcomes; Survival analysis; Treatment Outcome; Vision disorders in children; Visual Acuity
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0291247

Micropulse cyclophotocoagulation (MPCPC) has been shown in adults to offer a favorable post-operative safety profile compared to continuous wave transscleral cyclophotocoagulation (CWCPC) in the management of glaucoma. The purpose of this study is to evaluate the long term efficacy, safety, and effectiveness of MPCPC in the management of pediatric glaucoma when compared to CWCPC. IRB approved retrospective chart review of patients with pediatric glaucoma that underwent MPCPC and CWCPC at 2 separate institutions. Success was defined as intraocular pressure (IOP) between 5 and 21mmHg on any number of topical glaucoma medication without requiring additional surgical intervention or oral IOP lowering medication. Of the 48 patients in the study, 22 (26 eyes) underwent MPCPC and 26 (30 eyes) underwent CWCPC. At 1 year, 7 out of 26 eyes (26.9%) achieved success in the MPCPC group compared to 13 out of 30 eyes (43.3%) in the CWCPC group. Survival analysis unveiled a statistically significant difference in success between the two groups (p = 0.03). In pediatric glaucoma patients undergoing cyclophotocoagulation procedures, CWCPC outperformed MPCPC using default settings in terms of achieving long-term IOP control. Additional studies are required to evaluated augmented MPCPC settings in pediatric glaucoma patients.