Transscleral Diode Laser Cyclophotocoagulation for Refractory Pediatric Glaucomas

Bock, Charles J.; Freedman, Sharon F.; Buckley, Edward G.; Shields, M. Bruce

doi:10.3928/0191-3913-19970701-11

Cited by 84 publications

(33 citation statements)

References 7 publications

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“…Notably, the retinal detachment complications present in both studies were isolated to aphakic patients. Finally, Bock et al18 reported one patient out of 26 eyes developed a total retinal detachment following 113.4 J of total energy (2100 mW × 2000 ms × 27 shots × 360 deg, mean age 12.1 y). These results may indicate a dose-response relationship between delivered cyclodiode energy and complication rates, and utilizing a lower power or number of treatment spots may avoid the retinal complications reported in our patient.…”

Section: Discussionmentioning

confidence: 99%

“…These results may indicate a dose-response relationship between delivered cyclodiode energy and complication rates, and utilizing a lower power or number of treatment spots may avoid the retinal complications reported in our patient. All 3 studies [16][17][18] similarly found the retinal detachment complications to occur in the months following cyclodiode treatment and, apart from 2 eyes that underwent YAG cycloablation prior, were presumed to be unrelated to previous procedures. In addition, PVR complications have not been reported following glaucoma filtration surgery and are unlikely to be the cause of PVR development in our case.…”

Section: Discussionmentioning

confidence: 99%

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Proliferative Vitreoretinopathy Following Transscleral Diode Cyclophotocoagulation

Bai

Sharma

Chiang

2023

Journal of Glaucoma

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Précis: Transscleral diode laser cyclophotocoagulation may trigger the development of proliferative vitreoretinopathy. Our article demonstrates one such case leading to tractional macula-off retinal detachment in a child with aphakic glaucoma.Purpose: The purpose of this article is to describe a case of proliferative vitreoretinopathy (PVR) developing subsequent to transscleral diode laser cyclophotocoagulation (cyclodiode) in a pediatric patient with aphakic glaucoma. PVR most commonly occurs following rhegmatogenous retinal detachment repair; however, to the best of our knowledge, it has never been reported to appear after cyclodiode.Methods: Retrospective evaluation of case presentation and intraoperative findings.Results: A 13-year-old girl with aphakic glaucoma presented 4 months after cyclodiode of the right eye with a retrolental fibrovascular membrane and anterior PVR. The PVR extended posteriorly over the next month, after which the patient developed a tractional macula-off retinal detachment. Pars Plana vitrectomy was performed, confirming dense anterior and posterior PVR. A review of the literature suggests that an inflammatory cascade, similar to that seen in PVR development following rhegmatogenous retinal detachment, may occur from the destruction of the ciliary body by cyclodiode. As a result, fibrous transformation may occur, likely accounting for the cause of PVR development in this case. Conclusion:The pathophysiology of PVR development remains unclear. This case demonstrates that PVR may occur following cyclodiode and should be considered during postoperative monitoring after this procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Proliferative Vitreoretinopathy Following Transscleral Diode Cyclophotocoagulation

Bai

Sharma

Chiang

2023

Journal of Glaucoma

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“…Complications associated with continuous wave TSCPC (CW-TSCPC) include conjunctival burns, hypotony, phyhisis, uveitis, cataracts, retinal detachment, scleromalacia, and vision loss. These are reported to be up to 18%, and more common in eyes with successive treatments or in eyes with already low vision (61,(63)(64)(65)(66).…”

Section: Cyclodestructionmentioning

confidence: 99%

Current surgical techniques for the management of pediatric glaucoma: A literature review

Aktaş¹,

Ikiz²

2023

Front. Ophthalmol.

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Pediatric glaucoma surgery is challenging due to its diverse and complex pathophysiology, altered anterior segment anatomy, greater potential for failure, and complications compared to adult patients. Moreover, numerous challenges are associated with long-term postoperative management. Thus, when dealing with childhood glaucoma, it is important to consider the potential complications in addition to the benefits of each intervention. The purpose of this article is to review recently published literature to shed light on the most recent surgical techniques for the safe and effective treatment of childhood glaucoma. Current literature shows that goniotomy and trabeculotomy are the first choices for the management of primary congenital glaucoma. Although older children with phakic eyes seem to benefit from trabeculectomy with adjunctive mitomycin C, it carries a long-term risk of bleb-related endophthalmitis. Glaucoma drainage devices may be preferred for patients with secondary or refractory glaucoma. However, hypotony or tube-related complications are common and encountered more often in children than in adults. Cyclodestructive procedures are also an option for cases in which filtering surgery has failed, but they can also be used as a temporizing measure to reduce the rate of complications in high-risk patients. However, their outcomes can be unpredictable, in terms of efficiency and complications. Finally, minimally invasive glaucoma surgery (MIGS) as the sole alternative treatment or as an adjunctive surgical procedure is a relatively new path for pediatric patients.

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“…With transscleral application, the success rate ranges from 30% to 79% with retreatment in about 70% of patients. [54][55][56][57] Using endoscopic application, the success rate has been reported 64% at 1 year and 16% by 5 years. Endoscopic retreatment brings the success rate up to 81% at 1 year and 34% at 5 years.…”

Section: Surgical Therapymentioning

confidence: 99%

“…Success has been unpredictable. With transscleral application, the success rate ranges from 30% to 79% with retreatment in about 70% of patients 54–57. Using endoscopic application, the success rate has been reported 64% at 1 year and 16% by 5 years.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Glaucoma: Diagnosis, Management, Treatment

Barke¹,

Dhoot²,

Feldman³

2021

International Ophthalmology Clinics

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According to the World Glaucoma Association (WGA), pediatric glaucoma comprises all disorders with elevated intraocular pressure (IOP)-related damage to the eye in childhood. Unlike adult glaucoma, this definition is not solely based on optic nerve appearance or visual field defects which can be difficult to ascertain in children. Many classification schemes have been used to organize pediatric glaucomas but consensus in the 2013 WGA meeting organizes pediatric glaucomas as primary or secondary. The primary forms, as previously mentioned, include PCG and JOAG. Secondary forms can be acquired from trauma, uveitis, steroid use, tumor, retinopathy of prematurity, or after cataract surgery. Secondary nonacquired forms can include those associated with systemic conditions such as chromosomal disorders, phakomatoses, or those associated with ocular abnormalities such as Axenfeld-Rieger, aniridia, peters anomaly, and iridotrabecular dysgenesis 14 (Table 1).While the WGA discourages the use of words with inconsistent definitions such as developmental, congenital, or infantile, PCG is frequently broken down by age of presentation to: (1) newborn onset (0 to 1 mo), (2) infantile onset (1 to 24 mo), (3) late onset or late recognized ( > 24 mo), and (4) spontaneously arrested cases. Spontaneously arrested cases are rare but represent cases with normal IOP and optic discs but with other typical signs of PCG that are not progressive. Timing of diagnosis may be different in areas with variable health care access and is influenced by severity of disease. While PCG will commonly present between 3 and 9 months of age, newborn onset is the most severe. 15 Etiology and PathogenesisPCG is most often sporadic, however, there are autosomal recessive cases with penetrance ranging from 40% to 100%. 16 Linkage analysis have thus far identified 5 loci that are involved with the development of PCG: GLC3A (located on chromosome 2p22-p21), GLC3B (1p36.2-p36.1), GLC3C (14q24.3), GLC3D (14q24.2-q24.3, not overlapping with GLC3C), and GLC3E (9p21) (16,18). Genes have been identified with 3 of the 5 loci. The GLC3a loci contains the CYP1B1 gene, the GLC3D locus contains latent transforming growth factor beta binding protein 2 (LTBP2) and the GLC3E loci contains tunica internal endothelial cell kinase gene (TEK/TIE2). 15 CYP1B1 mutations are associated with 15% to 20% of PCG cases in Japan and the United States and LTBP2 mutations have been reported in consanguineous Iranian, Pakistani, and Slovakian Roma families. 4,[17][18][19] Genetic testing can identify a cause in 40% of cases of PCG; in cases of parental consanguinity, it is essential to screen current and future siblings. 4

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Transscleral Diode Laser Cyclophotocoagulation for Refractory Pediatric Glaucomas

Cited by 84 publications

References 7 publications

Proliferative Vitreoretinopathy Following Transscleral Diode Cyclophotocoagulation

Proliferative Vitreoretinopathy Following Transscleral Diode Cyclophotocoagulation

Current surgical techniques for the management of pediatric glaucoma: A literature review

Pediatric Glaucoma: Diagnosis, Management, Treatment

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